Annual Ohio 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 Ohio.
Ohio 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 Ohio. 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
Ohio is one of our states that had the biggest increases in options available for alternative health plans going into 2023. 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 24 months. Also includes your choice of the Aetna or Cigna nationwide PPO networks.
United Healthcare – Also offers multiple STM plans for up to 12 months.
Pivot Health – Includes two of their three updated STM plans that include the choice of traditional PPO and unique “No Network” plans for up to 24 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.
MedMutual of Ohio Short Term Medical plans – MedMutual offers 3 Short Term Medical plans with 364-day durations. There is are $1,000, $2,500 and $5,000 deductible plans. All plans use the SuperMed Plus network.
IMPORTANT TIP: In Ohio, 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 three companies we already have (Allstate Benefits, Allied National and Trustmark), we have added three new companies. One is called Sana Benefits. The other two are companies that have previously provided only fully insured plans to small businesses. They are United Healthcare and Med Mutual.
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.
Ohio 2024 ACA/Obamacare Health Insurance Market Updates
Individual Plans
Eleven insurers are offering plans in Ohio’s exchange for 2024.
The participating insurance companies are proposing average rate increases of about 4% to over 12% for plans in 2024.
In Ohio, 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 Ohio.
Ohio 2024 ACA/Obamacare Rate review:
Ohio 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.
Ohio preliminary 2024 individual plan rate filing requests are as follows:
Ault Care - requested an average increase of 8.84% varying by plan type and network (not finalized yet)
Ambetter - Buckeye Community Health Plan - requested an average increase of 6.61% varying by plan type and network (not finalized yet)
Anthem Blue Cross Blue Shield of OH - requested an average increase of 12.44% varying by plan type and network (not finalized yet)
CareSource - requested an average increase of 5.96% varying by plan (not finalized yet)
MedMutual – requested an average increase of 6.33% varying by plan type and network (not finalized yet)
Molina Healthcare – requested an average increase of 5.46% varying by plan (not finalized yet)
Oscar Insurance – requested an average increase range of 4.05% to 8.83% varying by plan type (not finalized yet)
Paramount Insurance - requested an average increase of 11.37% varying by plan type (not finalized yet)
Summa Insurance Company - requested an average increase of 4.41% varying by plan type (not finalized yet)
United Healthcare - requested an average increase of 6.87% varying by plan type (not finalized yet)
Ohio small group market rate filing requests look like this
Aetna - requested an average increase range of 2.35% to 6.34% varying by plan and network (not finalized yet)
Ault Care - requested an average increase of 5.02% varying by plan type and network (not finalized yet)
Anthem Blue Cross Blue Shield of OH - requested an average increase of 18.74% varying by plan type and network (not finalized yet)
MedMutual – requested an average increase of 16.31% varying by plan type and network (not finalized yet)
Paramount Insurance - requested an average increase of 15.71% varying by plan type (not finalized yet)
The Health Plan of West VA - requested an average increase of 1.02% varying by plan type (not finalized yet)
Summa Insurance Company - requested an average increase of 6.28% varying by plan type (not finalized yet)
THP Insurance Company - requested an average increase of 6.4% varying by plan type (not finalized yet)
United Healthcare - requested an average increase range of 11.74% to 14.73% varying by plan and network (not finalized yet)
Ohio 2023 ACA/Obamacare Approved Rates:
Ohio individual plan approved rate filings are as follows:
Ault Care - Received an average decrease of % varying by plan type and network
Ambetter - Buckeye Community Health Plan - Received an average increase of % varying by plan type and network
Anthem Blue Cross Blue Shield of OH - Received an average decrease of % varying by plan type and network
CareSource - Received an average increase of % varying by plan
MedMutual – Received an average increase of % varying by plan type and network
Molina Healthcare – Received an average decrease of % varying by plan
Oscar Insurance – Received an average range of a decrease of 0% to an increase of % varying by plan type
Paramount Insurance - Received an average increase of % varying by plan type
Summa Insurance Company - Received an average increase of % varying by plan type
Ohio small group market approved rate filings look like this:
Aetna - Received an average increase range of % to % varying by plan and network
Ault Care - Received an average increase of % varying by plan type and network
Anthem Blue Cross Blue Shield of OH - Received an average decrease of % varying by plan type and network
Humana - Received an average increase range of % to % varying by plan and network
MedMutual – Received an average increase of % varying by plan type and network
Paramount Insurance - Received an average increase of % varying by plan type
Summa Insurance Company - Received an average increase of % varying by plan type
The Health Plan of West VA - Received an average increase of % varying by plan type
THP Insurance Company - Received an average increase of % varying by plan type
United Healthcare - Received an average increase range of % to % varying by plan and network
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 Solutionsis 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.