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
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 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:
Manhattan Life – Their fixed benefit plan with upgraded doctor office visit benefits - Affordable Choice 20 Fixed Benefit Plan. NOTE: The Affordable Choice plans have the BEST inpatient hospital coverage of any fixed benefit plan available today.
Philadelphia American – Their newest and best fixed benefit plan – Health Saver Plus Gold. NOTE: The HSP Gold plan offers the BEST overall coverage of any fixed benefit plan in the market.
Our other Primary plan option - Short Term Medical (STM) plans are now available for duration's of 30 days up to as long as 12 months! We now offer plans from two great companies:
IHC Group - Includes their STM plans with multiple deductible/coinsurance options for up to 6 months.
United Healthcare – Also offers multiple STM plans for up to 12 months.
IMPORTANT TIP: In Pennsylvania, whenever possible we recommend combining one of the Fixed Benefit plans together with a United Healthcare 360-day Short Term Medical plan above. The Fixed Benefit plan pays “first dollar” benefits for charges that are applied to your 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. NEW! From Manhattan Life we have a unique critical illness plan called Manhattan Life Critical Protection & Recovery Plans
Accident + Critical Illness Plans - NEW! We have a new plan from the IHC Group called Metal Gap 2. This is a guaranteed issue product that offers $2,500 to $10,000 of both Accident and Critical Illness coverage.
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. 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.
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.
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 (National General and Trustmark), we have added three new companies that offer as many as seven different plan administrators 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, 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 2021 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.
In 2021 Pennsylvania will be moving away from the federal marketplace and switching to their own state-based exchange. They are calling it “Pennie.”
This year, Pennie extended the 2021 Open Enrollment Period from November 1, 2020 through January 15, 2021
As you can see below, the individual market rates mostly went down with some company’s rates dropping 10-15%!
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in Pennsylvania.
Pennsylvania 2021 ACA/Obamacare Rate review:
- Pennsylvania 2021 individual plan approved rate filings are as follows:
- Capital Blue Cross – Received an average decrease range of 14.3% to 15.5% varying by plan type and network
- First Priority Health HMO - Received an average increase of 19.2% varying by plan type
- Geisinger – Received an average decrease range of 11.28% to 13.57% varying by plan type and network
- Highmark – Received an average decrease range of a 15.6% decrease to an increase of 3.1% varying by plan type
- Independence Blue Cross (PPO) – Received an average decrease of 3.88% varying by plan type and network
- Keystone Health Plan (IBC HMO) – Received an average decrease of 3.9% varying by plan type
- Oscar Health Plan of PA - – Received an average increase of 6.86% varying by plan type and network
- PA Health & Wellness (Ambetter) - Received an average decrease of 6.6% varying by plan type
- UPMC – Received an average increase of 1.3% varying by plan type and network
small group market approved rate filings look like this:
- Aetna - Received an average increase range of 6.2% to 7.3% varying by plan and network
- Capital Blue Cross – Received an average decrease range of 6% to 6.9% varying by plan type and network
- First Priority Life - Received an average increase of 12.4% varying by plan type
- Geisinger – Received an average increase range of 16.48% to 17.87% varying by plan type and network
- Highmark – Received an average range of a 1.1% decrease to an increase of 2.37% varying by plan type and network
- Independence Blue Cross – Received an average increase of 0.9% varying by plan type and network
- Keystone Health Plan (IBC HMO) – Received an average range of a 8.7% decrease to an increase of 0.9% varying by plan type and network
- United Healthcare - Received an average increase range of 5.3% to 7.2% varying by plan and network
- UPMC – Received an average range of a 3% decrease to an increase of 4% varying by plan type 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 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.