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.
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 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 for 2021.
California has adopted the same, permanent open enrollment period each year. This year it will be from November 1, 2020 through January 31, 2021.
Oscar and Anthem Blue Cross will expand their coverage areas in 2021. Oscar is expanding to cover San Mateo County. Anthem is expanding to cover Imperial, Inyo, Kern, Mono, and Orange counties.
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 smaller overall increases or small decreases for 2021.
California 2021 ACA/Obamacare Rate review:
California individual plan approved rate filings are as follows:
- Anthem Blue Cross - Received an average increase of 5.94% varying by plan
- Blue Shield of CA - Received an average decrease of 2.4% varying by plan
- Chinese Community Health Plans - Received an average decrease of 1.23% varying by plan
- Health Net of CA/Ambetter – Received an average range of an increase of 2.76% to 6.57% varying by plan
- Kaiser – Received an average increase of 0.59% varying by plan
- Molina Healthcare – Received an average decrease of 3.89% varying by plan
- Oscar Health Plans – Received an average increase of 6.61% varying by plan
- Sharp Health Plan - Received an average decrease of 0.23% varying by plan
- Sutter Health Plan - Received an average increase of 3.39%
- Valley Health Plan - Received an average increase of 9%
- Western Health Advantage - Received an average decrease of 2.85% varying by plan
California small group market approved rate filings look like this:
- Aetna – Received an increase range of a 4.07% to 8% varying by plan and network
- Anthem Blue Cross - Received an overall average decrease of 0.15% varying by plan
- Blue Shield of CA - Received an overall average decrease of 0.33% varying by plan
- Chinese Community Health Plans - Received an average decrease of 3.86% varying by plan
- Health Net - Received a range of a 1.13% decrease to a 1.02% increase varying by plan and network
- Kaiser – Received an increase range of a 2.58% to 7% varying by plan and network.
- Oscar Health Plans – Received an average increase of 3.66% varying by plan
- Sharp Health Plan - Received an average increase of 3.88% varying by plan
- Sutter Health Plan - Received an average increase of 3.53%
- United Healthcare - Received an overall average increase range of 0.46 to 0.7% varying by plan
- Western Health Advantage - Received an average decrease of 4% 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.