Pennsylvania Health Insurance Market Annual Update
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
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 Pennsylvania. 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 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 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. 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
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 – 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.
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. 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 Group Census spreadsheet and email it to: robtavis@ushealthinsurancesolutions.com.
Pennsylvania 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 Pennsylvania.
Thirteen insurers are offering 2024 individual market plans through Pennsylvania’s health insurance exchange (Pennie).
The participating insurance companies are proposing average rate changes from a 3% decrease to 13% increase for plans in 2024.
In Pennsylvania, 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 2024.
Pennsylvania 2024 ACA/Obamacare Rate review:
Pennsylvania 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.
Pennsylvania 2024 individual plan rate filing requests are as follows.
Capital Blue Cross – requested an average increase of 7.04% varying by plan type and network
Cigna – requested an average increase of 13.21% varying by plan type and network
Geisinger – requested an average increase range of 7.07% to 7.3% varying by plan type and network
Highmark – requested an average increase range of 9.88% to 13.21% varying by plan type
Independence Blue Cross (PPO) – requested an average decrease of 2.68% varying by plan type and network
Keystone Health Plan (IBC HMO) – requested an average decrease range of 0.79% to 3.45% varying by plan type
Oscar Health Plan of PA – – requested an average increase of 8.23% varying by plan type and network
PA Health & Wellness (Ambetter) – requested an average increase of 7.52% varying by plan type
UPMC – requested an average increase range of 6.37% to 7.8% varying by plan type and network
Pennsylvania small group market rate filing requests look like the following. These are the approved rates as of 10/16/2020:
Aetna – requested an average increase range of 0.62% to 4.53% varying by plan and network
Capital Blue Cross – requested an average increase of 4.93% varying by plan type and network
Cigna – requested an average increase of 1.38% varying by plan type and network
First Priority Life – requested an average increase of 3.0.3% varying by plan type
Geisinger – requested an average decrease range of 1.18% to 3.44% varying by plan type and network
Highmark – requested an average increase range of 1.2% to 3.8% varying by plan type and network
Independence Blue Cross – requested an average increase of 2.41% varying by plan type and network
Keystone Health Plan (IBC HMO) – requested an average increase range of 1.47% to 5.11% varying by plan type and network
United Healthcare – requested an average increase range of 9.86% to 10.3% varying by plan type and network
UPMC – requested an average increase range of 6.44% to 6.75% varying by plan type and network
Pennsylvania 2023 ACA/Obamacare Approved Rates:
Pennsylvania 2023 individual plan approved rate filings are as follows:
Capital Blue Cross – Received an average range of a % decrease to a % increase varying by plan type and network
First Priority Health HMO – Received an average increase of % varying by plan type
Geisinger – Received an average increase of % varying by plan type and network
Highmark – Received an average decrease range of a % decrease to an increase of % varying by plan type
Independence Blue Cross (PPO) – Received an average decrease of % varying by plan type and network
Keystone Health Plan (IBC HMO) – Received an average range of a decrease of % to a % increase varying by plan type
Oscar Health Plan of PA – – Received an average decrease of % varying by plan type and network
PA Health & Wellness (Ambetter) – Received an average decrease of % varying by plan type
UPMC – Received an average range of a % decrease to an increase of % varying by plan type and network
small group market approved rate filings look like this:
Aetna – Received an average decrease range of % to % varying by plan and network
Capital Blue Cross – Received an average increase range of % to % varying by plan type and network
First Priority Life – Received an average decrease of % varying by plan type
Geisinger – Received an average decrease range of % to % varying by plan type and network
Highmark – Received an average range of a % decrease to an increase of % varying by plan type and network
Independence Blue Cross – Received an average increase of % varying by plan type and network
Keystone Health Plan (IBC HMO) – Received an average increase range of % to % varying by plan type and network
United Healthcare – Received an average range of a % decrease to an increase of % varying by plan and network
UPMC – Received an average increase range of % to % 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.