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
Individual 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 have a strong “health insurance buffet” of alternative plans in California.
For our Primary Fixed Benefit plans we now offer the following:
Philadelphia American - Health Choice Select fixed benefit plans.
Our Supplemental Plan lineup to pair with a Philadelphia American Fixed Benefit plan has expanded and improved:
- 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.
- 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.
- Preventive Care Plus Plans^^^ – For those who want the MOST comprehensive coverage for preventive care plus other outpatient services, we have two options: Enrollment First SelectMed plans and SHA Preventive and Prescription Drug Plans.
- Prescription Drug Plans – For anyone who needs extra coverage for high cost prescriptions, the SHA link above 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 new 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.
There is one last NEW addition I want to mention. I worked on it most of the past year. While I think it will be especially beneficial to people with one of the alternative plan packages (above), I believe it can help you lower your overall health care costs no matter what primary health insurance you have. Please 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.
Small Group 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 2020 ACA/Obamacare Health Insurance Market Updates
Individual Plans
California has been one of the most “active” states in the ACA/Obamacare individual market. The following are some of the biggest updates/changes in California.
In 2020, California has a new state mandate for health insurance. Under California Senate Bill 78, residents who fail to maintain qualifying health insurance coverage would be subject to a tax penalty of $695 or more, unless they qualify for an exemption. California residents will be required to have qualifying health insurance (MEC) each month beginning on January 1, 2020.
NOTE: As discussed above under our individual alternative plans update, those who wish to go with our alternative health plan packages, can avoid the CA tax penalty by including one of the Enrollment First SelectMed plans under the Preventive Care Plus Plans listed above.
Also starting Jan. 1, 2020, Californians will get new financial help from the state of California in addition to the financial help they may be eligible to receive from the federal government to help them obtain health insurance. The biggest change will be for those who previously did not qualify for financial help because they exceeded federal income requirements. Now, consumers who earn between 400 and 600 percent of the federal poverty level (FPL), may be eligible to receive a state subsidy even though they make too much to get a federal tax credit subsidy.
IMPORTANT REMINDER: Open enrollment in California begins October 15th and runs through January 31,2020. As of October 1st, you can shop and compare 2020 plans and prices. Please go to our health insurance quote page and scroll down to the link to the Covered CA Shop and Compare tool.
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in California.
As noted in our Federal Market Update ACA/Obamacare small group plans generally reported higher overall increases than the individual market. As noted below, the only company to request a small decrease in group plan rates was Sharp Health Plan.
California 2020 Preliminary Rate review:
California preliminary 2020 individual plan rate filing requests are as follows:
- Anthem Blue Cross - requested an average decrease of 7.99% varying by plan (not finalized yet)
- Blue Shield of CA - requested an average increase of 3.58% varying by plan (not finalized yet)
- Chinese Community Health Plans - requested an average increase of 19.54% varying by plan (not finalized yet)
- Health Net of CA/Ambetter – requesting a range of a 5.75% decrease to a 4.14% increase varying by plan and network type (not finalized yet)
- Kaiser – requested an average increase of 0.62% varying by plan (not finalized yet)
- Molina Healthcare – requested an average increase of 1.34% (not finalized yet)
- Oscar Health Plans – requested an average decrease of 9.91% varying by plan (not finalized yet)
- Sharp Health Plan - requested an average decrease of 6.68% varying by plan (not finalized yet)
- Sutter Health Plan - requested an average increase of 4.9% (not finalized yet)
- Western Health Advantage - requested an average increase of 2.31% varying by plan (not finalized yet)
California small group market rate filing requests look like this
- Aetna – filed for an increase range of a 0.1% to 10.6% varying by plan and network
- Anthem Blue Cross - requested an overall average increase of 3.99% varying by plan
- Blue Shield of CA - requested an overall average increase of 7.08% varying by plan
- Chinese Community Health Plans - requested an average increase of 17% varying by plan (not finalized yet)
- Health Net - filed for an increase range of a 4.21% to 8..35% varying by plan and network (not finalized yet)
- Kaiser – filed for an increase range of a 3.36% to 5% varying by plan and network. (not finalized yet)
- Oscar Health Plans – requested an average increase of 5.99% varying by plan (not finalized yet)
- Sharp Health Plan - requested an average decrease of 2.63% varying by plan (not finalized yet)
- Sutter Health Plan - requested an average increase of 1.77% (not finalized yet)
- United Healthcare - requested an overall average increase of 12.65% varying by plan
- Western Health Advantage - requested an average increase of 3.191% varying by plan (not finalized yet)
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.