Annual Missouri 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 Missouri.
Missouri Alternative Health Plan Solutions Updates
NEW OPTION: As I mentioned in my Federal market update, I have recently come across a set of health plans that will work well for certain people in Missouri. These plans are comprehensive coverage and compliant with ACA/Obamacare mandates. They also utilize a nationwide PPO network, so they offer a much better choice of providers than most ACA/Obamacare plans. All plans have a maximum out of pocket limit that will be $2,100 per year LESS than the maximum out of pocket for 2024 ACA/Obamacare plans. 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. 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
For those who do not qualify for a tax credit subsidy to help pay for an ACA/Obamacare plan, we have a STRONG “health insurance buffet” of alternative plans.
NOTE: As discussed in my 2024 Federal Market Update, the Biden administration has proposed a new rule that states that plans that claim to be “short-term” health insurance would be limited to just three months, or a maximum of four months, if extended – instead of the current three-year maximum. When that rule takes effect around January 1, 2024, the Short Term Medical plans we work with below will no longer be a viable option in our Health Insurance Buffet program. Because of this, we recommend that you consider locking in a longer term Short Term Medical plan before the rule changes.
With our Primary Fixed Benefit plans we now offer the following:
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.
Philadelphia American – Their newest and best fixed benefit plan – Health Saver Plus Gold.
Our other Primary plan option - Short Term Medical (STM) plans are now available for duration's of 30 days up to as long as 36 months! We now offer plans from five great companies:
National General – Includes their best, updated STM plans with multiple deductible/coinsurance options for up to 36 months. Also includes your choice of the Aetna or Cigna nationwide PPO networks.
United Healthcare – Also offers multiple STM plans for up to 36 months.
Pivot Health – Includes their three best, updated STM plans that include the choice of traditional PPO and unique “No Network” plans for 24 to 36 months.
Anthem Enhanced Choice can offer a budget-friendly solution for those who don’t qualify for ACA/Obamacare subsidies. There are six plans. It is a medically underwritten Individual health plan that provides coverage for doctor visits, prescriptions, and more. Individuals only need to apply once to obtain benefits for nearly 36 months over three terms.
IMPORTANT TIP: In Missouri, whenever possible we recommend combining one of the Fixed Benefit plans together with a Short Term Medical plan above. The Fixed Benefit plan pays “first dollar” benefits for charges that are applied to your annual deductible on the Short Term Medical plan, which lowers or eliminates your out of pocket costs. This is a “best of both worlds” package with a much larger choice of providers that can still be LESS than a high deductible ACA/Obamacare plan!
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.)
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 new 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.
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.
More information on all plans above can be found on each company’s page on our website and on our US Supplemental Coverage page.
NOTE: You can also combine one of the above Fixed Benefit plans OR STM plans together with Accident, Critical Illness, Cancer Treatment, Hospital Indemnity and Preventive Care (Plus) plans and create a comprehensive plan that will still be at least 15-20% LESS than a high deductible ACA/Obamacare plan!
Small Group Alternative Plans
In addition to the companies we already have (Allstate Benefits, Allied National, and Trustmark), we have added several new companies. 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 Group Census spreadsheet and email it to: robtavis@ushealthinsurancesolutions.com.
Missouri 2024 ACA/Obamacare Health Insurance Market Updates
Individual Plans
The following are some of the biggest updates/changes in the ACA/Obamacare individual market in Missouri.
For 2023 coverage, Missouri’s exchange has 10 participating insurers. In 2024, that should remain the same.
Aetna is expanding their footprint in existing markets, including more counties in Missouri.
The participating insurance companies are proposing average rate changes ranging from a 4% decrease to a nearly 19% increase for plans in 2024.
In Missouri, the 2024 Open enrollment begins on November 1, 2023 and ends on January 15, 2024. A health plan must be purchased by December 15, 2023 to have coverage effective January 1, 2024. Plan purchases from December 16, 2023 to January 15, 2024 will start on February 1, 2024.
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in Missouri.
As noted below the market is split with half relatively small increases or decreases and the other half with increases over 10%.
Missouri 2024 ACA/Obamacare Rate review:
Missouri 2024 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.
Missouri preliminary 2024 individual plan rate filing requests are as follows:
Anthem BCBS – requested an average increase of 4.4% varying by plan (not finalized yet)
Blue Cross Blue Shield of KC – requested an average decrease of 4.3% varying by plan (not finalized yet)
Celtic/Ambetter - requested an average increase of 4.36% varying by plan (not finalized yet)
Cigna - requested an average increase of 18.7% varying by plan (not finalized yet)
Cox Health Systems – requested an average decrease of 4.15% varying by plan (not finalized yet)
Medica - requested an average decrease of 0.19% varying by plan (not finalized yet)
Oscar Health Plan - requested an average increase of 1.4% varying by plan (not finalized yet)
SSM Health Insurance Company - requested an average increase of 18.71% varying by plan (not finalized yet)
United Healthcare - requested an average increase of 5.79% varying by plan (not finalized yet)
Missouri small group market rate filing requests look like this
Aetna - filed for an decrease range of a 2.15% to 8.7% varying by plan and network
Anthem Blue Cross Blue Shield of MO - requested an average increase of 6.82% varying by plan (not finalized yet)
Blue Cross Blue Shield of KC – requested an average decrease of 6.89% varying by plan (not finalized yet)
Cigna - requested an average increase of 16.69% varying by plan (not finalized yet)
Cox Health Systems – requested an average increase of 4.33% varying by plan (not finalized yet)
United Healthcare - requested an average increase of 11.86% varying by plan (not finalized yet)
Missouri 2023 ACA/Obamacare Approved Rates:
Missouri individual plan approved rate filings are as follows:
Anthem BCBS – Received an average decrease of % varying by plan
Blue Cross Blue Shield of KC – Received an average increase of 15.4% varying by plan
Celtic/Ambetter - Received an average increase of % varying by plan
Cigna - Received an average increase of % varying by plan
Cox Health Systems – Received an average increase of % varying by
Medica - Received an average decrease of % varying by plan
Oscar Health Plan - Received an average increase of % varying by plan
SSM Health Insurance Company - Received an average decrease of % varying by plan
Missouri 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 Blue Shield of MO - Received an average increase of % varying by plan
Blue Cross Blue Shield of KC – Received an average increase of 9% varying by plan
Cox Health Systems – Received an average decrease of % varying by plan
Humana - Received an average increase of % varying by plan
United Healthcare - Received an average increase 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.