Annual California Health Insurance Market Update
The following contains information for our NAHP Alternative Health Plan Solutions and ACA/Obamacare plans for individuals and small businesses in the state of California.
California Alternative Health Plan Solutions Updates
IMPORTANT NOTE: All non-ACA/Obamacare alternative plans are available year-round. For both individuals and small groups. There is NO limited (open enrollment) period for these options.
Individual Alternative Plans
For those who don’t qualify for a federal tax credit subsidy or the new California state tax credit to help pay for an ACA/Obamacare plan, we offer the following “health insurance buffet” of alternative plans.
For our Primary Fixed Benefit plans we now offer the following:
Philadelphia American - Health Choice Select fixed benefit plans.
Manhattan Life – Their newest and best fixed benefit plan - Affordable Choice Enhanced Fixed Benefit Plan. NOTE: The Affordable Choice plans have the BEST inpatient hospital coverage of any fixed benefit plan available today. They have also significantly upgraded their overall coverage.
Our Supplemental Plan lineup to pair with a Philadelphia American Fixed Benefit plan has expanded and improved:
REMINDER NOTE: All these supplemental plans pay in addition to ANY other coverage you have. So, they are NOT just for our alternative “buffet” plans. They can reduce/eliminate out of pocket costs (plus provide additional cash for bills and other costs) of ANY primary health plan (group, individual, Medicare, etc.)
- Accident Plans – In addition to accident supplemental plans from all our Primary plan companies (above), we offer separate LifeSecure Accident plans.
- Critical Illness Plans – Again, along with plans from all our Primary plan companies, we offer separate LifeSecure Critical Illness plans. NEW! From Manhattan Life we have a unique critical illness plan called Manhattan Life Critical Protection & Recovery Plans
- Cancer and Dread Disease Treatment – This is my favorite addition to our supplemental plans. Manhattan Life Cancer Care Plus Cancer and Dread Disease treatment plans.
- First Day Hospital Stay Protection – Along with plans from most of our Primary plan companies, Manhattan Life Out of Pocket Protection Plan is my favorite to include with whatever primary health plan YOU have to cover out of pocket costs from an inpatient hospital stay. That includes employer group plans, Medicare, etc.
- Hospitalization Buy-Up - NEW! We have a new plan from Enrollment First. When paired with their SelectMed Pro or Max plans (see below), this plan provides an extra $50,000 or $100,000 of inpatient hospital coverage. This can be a great addition to a Fixed Benefit plan as your primary coverage to provide extra protection for hospitalization.
- Preventive Care Plus Plans^^^ – For those who want the MOST comprehensive coverage for preventive care plus other outpatient services, we offer the Enrollment First SelectMed plans. There are 3 options Base, Pro and Max.
- Prescription Drug Plans – For anyone who needs extra coverage for high cost prescriptions, we offer the SHA SCRIPTS program that includes their SHARx prescription drug plan. This plan works with our alternative plans and any employer plan with a high deductible for non-preferred brand and specialty prescriptions.
^^^NOTE: To avoid the California state tax penalty for not having ACA/Obamacare compliant health insurance, one of the preventive care plans must be added to any alternative plan package.
More information on all plans above can be found on each company’s page on our website and on our US Supplemental Coverage page.
IMPORTANT TIP: In most cases, you can combine one of the above Fixed Benefit plans and/or STM plans together with an Accident, Critical Illness, Cancer Treatment AND First Day Hospital plans, and still be at least 15-20% LESS than a high deductible ACA/Obamacare plan! That is a package with first dollar, NO deductible coverage versus paying a high deductible up front before getting benefits on most services.
Small Group Alternative Plans
In California the state regulations regarding level funded health plans make it extremely difficult to offer these plans to small businesses with less than 50 employees. As a result we do not have the ability to offer these plans at this time. We are continuing to monitor the market for opportunities to offer level funded plans to small businesses in CA.
California 2023 ACA/Obamacare Health Insurance Market Updates
Individual Plans
There are 12 insurers that offer health coverage through Covered California as of 2022. Aetna will expand into 4 new states for the 2023 open enrollment. That will include California. That brings the total to 13 insurers offering coverage through Covered California in 2023.
The participating insurance companies are proposing average rate increases of just under 2% to about 13.5% for plans in 2023.
In California, the 2023 Open enrollment begins on November 1, 2022 and ends on January 31, 2023. A health plan must be purchased by December 31, 2022 to have coverage effective January 1, 2023. Plan purchases from 1/1/2023 to 1/31/2023 will start on February 1, 2023. There is also an early enrollment period starting 10/1/2022 for existing Covered CA customers to renew their coverage.
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in California.
California 2023 ACA/Obamacare Rate review:
California 2023 ACA/Obamacare Preliminary Rate review:
NOTE: Final approved rates are not readily available at the time of this writing. We will do our best to update this page with the approved rates as soon as we can.
California preliminary 2023 individual plan rate filing requests are as follows:
Anthem Blue Cross - requested an average increase of 5.98% varying by plan (not finalized yet)
Blue Shield of CA - requested an average increase of 10.4% varying by plan (not finalized yet)
Bright Health - requested an average increase of 5% varying by plan (not finalized yet)
Chinese Community Health Plans - requested an average increase of 3.34% varying by plan (not finalized yet)
Health Net of CA/Ambetter – an average increase of 2.41% varying by plan (not finalized yet)
Kaiser – requested an average increase of 4% varying by plan (not finalized yet)
Molina Healthcare – requested an average increase of 10.69% varying by plan (not finalized yet)
Oscar Health Plans – requested an average increase of 13.54% varying by plan (not finalized yet)
Sharp Health Plan - requested an average increase of 6.7% varying by plan (not finalized yet)
Sutter Health Plan - requested an average increase of 3.25% (not finalized yet)
Western Health Advantage - requested an average increase of 1.88% varying by plan (not finalized yet)
California small group market rate filing requests look like this
Aetna – filed for an increase range of 11.01% to 13.5% varying by plan and network
Anthem Blue Cross - requested an overall average increase of 5.92% varying by plan
Blue Shield of CA - requested an overall average increase of 8.24% varying by plan
Chinese Community Health Plans - requested an average increase of 6.3% varying by plan (not finalized yet)
Cigna - requested an average increase of 7.92% varying by plan (not finalized yet)
Health Net - filed for an decrease of 2.85% varying by plan and network (not finalized yet)
Kaiser – filed for an increase range of a 6.7% to 7% varying by plan and network. (not finalized yet)
Oscar Health Plans – requested an average increase of ?% varying by plan (not finalized yet)
Sharp Health Plan - requested an average increase of 3.04% varying by plan (not finalized yet)
Sutter Health Plan - requested an average increase of 3.95% (not finalized yet)
United Healthcare - requested an average increase range of 4.21% to 7.42% varying by plan
Western Health Advantage - requested an average increase of 4.12% varying by plan (not finalized yet)
California 2023 ACA/Obamacare Approved Rates:
California individual plan approved rate filings are as follows:
Anthem Blue Cross - Received an average increase of % varying by plan
Blue Shield of CA - Received an average decrease of % varying by plan
Chinese Community Health Plans - Received an average decrease of % varying by plan
Health Net of CA/Ambetter – Received an average range of an increase of % to % varying by plan
Kaiser – Received an average increase of % varying by plan
Molina Healthcare – Received an average decrease of % varying by plan
Oscar Health Plans – Received an average increase of % varying by plan
Sharp Health Plan - Received an average decrease of % varying by plan
Sutter Health Plan - Received an average increase of %
Valley Health Plan - Received an average increase of %
Western Health Advantage - Received an average decrease of % varying by plan
California small group market approved rate filings look like this:
Aetna – Received an increase range of a % to % varying by plan and network
Anthem Blue Cross - Received an overall average decrease of % varying by plan
Blue Shield of CA - Received an overall average decrease of % varying by plan
Chinese Community Health Plans - Received an average decrease of % varying by plan
Health Net - Received a range of a % decrease to a % increase varying by plan and network
Kaiser – Received an increase range of a % to % varying by plan and network.
Oscar Health Plans – Received an average increase of % varying by plan
Sharp Health Plan - Received an average increase of % varying by plan
Sutter Health Plan - Received an average increase of %
United Healthcare - Received an overall average increase range of % to % varying by plan
Western Health Advantage - Received an average decrease of % varying by plan
US Healthcare Resources and Shopping Services
I invite you to go to my US Healthcare Resources page and spend some time going through all of the different tools, services and providers that are available to help you become a better health care consumer. I believe these resources can help you lower your overall health care costs no matter what primary health insurance you have.
U.S. Insurance Solutions is here to help
Remember, you are NOT in this alone…I am here to help! As your Personal Health Insurance Advisor, my goal is to make your life easier by taking the hassle out of finding the right health plan for your situation and needs.
To discuss your health insurance options and make sure you have the best possible health plan for your situation, please go to the link above with the image that says CALL ME and schedule a call with me on a day and time that works for you, and I will call you to review your options.