Annual Pennsylvania 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 Pennsylvania.

Pennsylvania Alternative Health Plan Solutions Updates

Individual Plans

For those who don’t qualify for a tax credit subsidy to help pay for an ACA/Obamacare plan, we have a strong “health insurance buffet” of alternative plans in Pennsylvania.

On our Primary Fixed Benefit plans we now offer the following:

Philadelphia American - Health Saver Plus (HSP) Gold and Health Choice Select fixed benefit plans. NOTE: The HSP Gold plan offers the BEST overall coverage of any fixed benefit plan in the market. Combine this plan with Philadelphia American’s new Specified Diseaseplan (see below) for VERY strong protection against the most serious diseases.

Manhattan Life - Manhattan Life Affordable Choice 18 fixed benefit plan. NOTE: The Affordable Choice 18 plan has the BEST inpatient hospital coverage of any fixed benefit plan available today.

As noted on our Pennslvania state page, our other Primary plan option - Short Term Medical (STM) plans are limited by state law to duration's of no more than 90 days per policy. Because of this we aren’t recommending that they be used in our alternative plan packages at this time.

Our Supplemental Plan lineup has also 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 – We have two great options here. Manhattan Life Cancer Care Plus is my favorite plan to pair with ANY of our Primary alternative plans (above).
• 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.

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 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 Pennsylvania, we have two companies (National General and Trustmark) that 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.

If you own, or work for a business with 5 to 50 employees covered on a “traditional,” fully insured group health plan from one of the companies below requesting a BIG increase, 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.

Pennsylvania 2020 ACA/Obamacare Health Insurance Market Updates

Individual Plans

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

Pennsylvania to shift from the federal marketplace to it’s own state-based insurance exchange in 2021. The state also plans to have a reinsurance program in place by then.

Oscar will offer individual plans for the first time in Pennsylvania (Philadelphia), 

Small Group Plans

As with many states there is not much “new” to report with ACA/Obamacare small group plans in Pennsylvania.

As noted in our Federal Market Update ACA/Obamacare small group plans generally reported higher overall increases than the individual market. The one exception is a small decrease from Highmark on some of their plans.

Pennsylvania 2020 Preliminary Rate review:

Pennsylvania preliminary 2020 individual plan rate filing requests are as follows: 

• Ambetter - requested an average decrease of 1.5% varying by plan type (not finalized yet)
• Capital Blue Cross – requested an average range of a 2.33% decrease to an increase of 3.31% varying by plan type (not finalized yet)
• Blue Cross of NE PA - requested an average decrease of 1.76% varying by plan type (not finalized yet)
• Geisinger – requested an average increase range of 7.12% to 8.44% varying by plan type and network (not finalized yet)
• Highmark – requested an average decrease range of 1.25% to 2.21% varying by plan type and network (not finalized yet)
• Independence Blue Cross – requested an average increase of 9.68% varying by plan type and network (not finalized yet)
• Keystone Health Plan – requested an average increase range of 2.84% to 9.91% varying by plan type and network (not finalized yet)
• UPMC – requested an average range of a 1.76% decrease to an increase of 1.71% varying by plan type and network (not finalized yet)

Pennsylvania small group market rate filing requests look like this

• Aetna - requested an average increase range of 10.65% to 11.59% varying by plan and network (not finalized yet)
• Capital Blue Cross – requested an average increase range of 13.19% to 14.45% varying by plan type and network (not finalized yet)
• Blue Cross of NE PA - requested an average increase of 0.24% varying by plan type (not finalized yet)
• Geisinger – requested an average increase range of 15.75% to 17.84% varying by plan type and network (not finalized yet)
• Highmark – requested an average range of a 1.5% decrease to an increase of 6.49% varying by plan type and network (not finalized yet)
• Independence Blue Cross – requested an average increase of 11.88% varying by plan type and network (not finalized yet)
• Keystone Health Plan – requested an average increase range of 9.23% to 9.97% varying by plan type and network (not finalized yet)
• United Healthcare - requested an average increase of 7.14% varying by plan type (not finalized yet)
• UPMC – requested an average increase range of 10.58% to 12.01% varying by plan type and network (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.