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Illinois Health Insurance Market Annual Update

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Annual Illinois 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 Illinois.

Illinois Alternative Health Plan Solutions Updates

ACA Compliant Off Exchange Options: As I mentioned in my Federal market update, I now have two programs that offer multiple health plans that will work well for certain people in Arkansas. These plans are comprehensive coverage and compliant with ACA/Obamacare mandates. They each utilize a nationwide PPO network, so they offer a much better choice of providers than most ACA/Obamacare plans.

One of the programs is available to self-employed people, independent contractors and small business owners. That program also offers plans with much lower maximum out of pocket limits than ACA/Obamacare plans. The other program is available to anyone with a unique approach of offering research projects for compensation to people that apply, which makes them contract employees eligible for the insurance.

The standard rates for these plans are competitive with the full price without a subsidy on current, similar ACA/Obamacare plans for people in the 45-64 age range who do not qualify for a tax credit subsidy to purchase ACA/Obamacare plans.

Both programs are health underwritten and applicants can be approved or declined.

If you fit this criterion, please reach out to me to see if one of these plans might be a better option for you.

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.

Health Insurance Buffet – Individual Alternative Plans

Beginning in 2025, the state of Illinois will ban the writing of Short Term Medical plans. They have previously been available for up to 6 month terms.

For those who don’t qualify for a tax credit subsidy to help pay for an ACA/Obamacare plan, we have a solid “health insurance buffet” of alternative plans in Illinois. In addition to the new options mentioned above, we have the following:

Manhattan Life – Their newest and best fixed benefit plan – Affordable Choice Enhanced Fixed Benefit Plan. 

Philadelphia American – Their newest and best fixed benefit plan – Optimum Health Saver offers the BEST overall coverage for the money of any fixed benefit plan in the market.

Our Supplemental Plan lineup has also 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.)

NEW: FlexBenefits (Underwritten by Companion Life Insurance Company) is a new option available to help consumers reduce the burden of medical bills by filling coverage gaps left by major medical and other types of plans. FlexBenefits plans include coverage for Accident Medical Expense – first-dollar benefits up to $30,000, no deductible. Lump-Sum Protection for sickness, hospital stays, urgent care, and surgeries. Critical illness insurance for cancer, heart attack and stroke up to $30,000. Accidental Death Benefit – $25,000 paid to a beneficiary or estate. Disability Income – weekly benefit of $500–$1,500 for up to 13 weeks (if unable to work due to accidental injury). Guaranteed issue with access to Clever Health Smart Virtual Care.

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. For those who choose one of Philadelphia American’s Fixed Benefit plans, their Specified Disease plan is the preferred option for getting maximum coverage for Cancer and other Dread Diseases.

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. That includes employer group plans, Medicare, etc. Manhattan Life also has a second hospital benefit plan that offers a higher maximum of up to $10,000 per year for a first day hospital stay. It is called Hospital Indenmity Select.

Preventive Care Plus Plans – For those who want the MOST comprehensive coverage for preventive care plus other outpatient services, we offer the USA Health Plans SBA MEC plans. There are 3 options with Preventive care only and options that add 100% coverage for outpatient diagnostic tests (X-Ray, Blood Work) and coverage for Primary Care office visits and urgent care with a small copay.

More information on all plans above can be found on each company’s page on our website and on our US Supplemental Coverage page.

Small Group Alternative Plans

In addition to the companies we already have (Allstate Benefits, Allied National, andTrustmark), we have added several new companies. One is called Sana Benefits. Plus two other companies that has previously provided only fully insured plans to small businesses…United Healthcare .and Aetna. 

All the above options provide cost-saving, level funded alternative group health plans. Level funded plans can be a BETTER option for many businesses than the “one size fits all” ACA/Obamacare small group health insurance plans. Level Funded plans can provide upfront savings of 10-20%, the same fixed monthly premium as fully insured and the potential for a refund at the end of the plan year. All while providing the same or better coverage as you are used to with a fully insured plan.

If you own, or work for a business with 5 to 50 employees covered on a “traditional,” fully insured group health plan, and believe the covered group members to be reasonably healthy overall, then it might be time for your company to explore a level funded plan.
To get quotes on a level funded group health plan, please schedule a call with us to review your situation. We will also need you to fill out our US Insurance Solutions Group Census form non-WA spreadsheet and email it to: [email protected].

Illinois 2027 ACA/Obamacare Health Insurance Market Updates

Individual Plans

The following are some of the biggest updates/changes in the ACA/Obamacare individual market in Illinois.

Seven insurance companies will offer Marketplace coverage in Illinois for 2027. Molina and Cigna will both be leaving the state in 2027.

The participating insurance companies are proposing average rate increases of +1.8% to +14.9% and a weighted average of +10.5%.

In Illinois, the 2027 Open enrollment begins on November 1, 2026 and ends on January 15, 2027. A health plan must be purchased by December 15, 2026 to have coverage effective January 1, 2027. Plan purchases from December 16, 2026 to January 15, 2027 will start on February 1, 2027.

Small Group Plans

As with many states there is not much “new” to report with ACA/Obamacare small group plans in Illinois. Small group rates are trending at +10.3%

Illinois 2027 ACA/Obamacare Rate review:

Illinois 2027 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.

I

Illinois preliminary 2027 individual plan rate filing requests are as follows:

Ambetter (Celtic) – requested an average increase of 9.24% varying by plan and network (not finalized yet)

Blue Cross Blue Shield of IL – requested an average increase of 14.88% varying by plan and network (not finalized yet)

MercyCare HMO – requested an average increase of 12.15% varying by plan (not finalized yet)

Molina Healthcare – requested an average increase of 1.83% varying by plan (not finalized yet)

Oscar – requested an average increase of 12.68% varying by plan (not finalized yet)

United Healthcare – requested an average increase of 12.35% varying by plan (not finalized yet)

Illinois small group market rate filing requests look like this

Blue Cross Blue Shield of IL – requested an average increase of 17.82% varying by plan and network (not finalized yet)

Medical Associates Health Plans – requested an average increase of 8.69% varying by plan and network (not finalized yet)

MercyCare HMO – requested an average increase of 6.66% varying by plan (not finalized yet)

United Healthcare – requested an average increase range of 9.5% to 12.92% varying by plan and network (not finalized yet)

Illinois 2027 ACA/Obamacare Approved Rates:

Illinois individual plan approved rate filings are as follows: 

Ambetter (Celtic) – Received an average increase of % varying by plan and network

Blue Cross Blue Shield of IL – Received an average decrease of % varying by plan and network

Cigna – Received an average increase of % varying by plan

Health Alliance Medical – – Received an average increase of %varying by plan and network

Quartz Health Plans – Received an average decrease of % varying by plan

Illinois small group market approved rate filings look like this:

Aetna – Received an average increase increase range of % to %  varying by plan and network

Blue Cross Blue Shield of IL – Received an average increase of % varying by plan and network

Health Alliance Medical – – Received an average increase of % varying by plan and network

Humana – Received an average increase range of % to % varying by plan and network

Medical Associates Health Plans – Received an average increase of % varying by plan and network

MercyCare HMO – Received an average increase of % varying by plan and network
United Healthcare – Received an average increase range of % to % varying by plan and network
Quartz Health Plans –
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.
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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 my online calendar and schedule a call with me on a day and time that works for you, and I will call you to review your options.

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