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 ofPennsylvania.

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.

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

Accident + Critical Illness Plans - 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 - 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 Pennsylvania, in addition to the two companies we already work with (Allstate Benefits, Trustmark and IHC Specialty Benefits), we have another company that has previously provided only fully insured plans to small businesses…United Healthcare .

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.

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 2023 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 2023 individual market plans through Pennsylvania’s health insurance exchange (Pennie).

The participating insurance companies are proposing average rate increases from just over 2 percent to over 27 percent for plans in 2023.

Small Group Plans

As with many states there is not much “new” to report with ACA/Obamacare small group plans in 2023.

Pennsylvania 2023 ACA/Obamacare Rate review:

Pennsylvania 2023 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 2023 individual plan rate filing requests are as follows.

Capital Blue Cross – requested an average increase of 12.07% varying by plan type and network

Cigna - requested an average increase of 6% varying by plan type and network

Geisinger – requested an average increase range of 26.26% to 27.48% varying by plan type and network

Highmark – requested an average increase range of 5.71% to 14.42% varying by plan type

Independence Blue Cross (PPO) – requested an average increase of 2.07% varying by plan type and network

Keystone Health Plan (IBC HMO) – requested an average range of a 7.62% decrease to a 2.42% increase varying by plan type

Oscar Health Plan of PA - – requested an average increase of 10.4% varying by plan type and network

PA Health & Wellness (Ambetter) - requested an average increase of 3.74% varying by plan type

UPMC – requested an average increase range of 5.2% to 5.5% 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 decrease range of 12.25% to 32.19% varying by plan and network

Capital Blue Cross – requested an average increase range of 3.78% to 11.2% varying by plan type and network

First Priority Life - requested an average increase of 0.5% varying by plan type

Geisinger – requested an average decrease range of 5.51% to 7.58% 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 0.34% varying by plan type and network

Keystone Health Plan (IBC HMO) – requested an average increase range of 0.29% to 8.44% varying by plan type and network

United Healthcare - requested an average increase range of 6.7% to 7.59% varying by plan type and network

UPMC – requested an average increase range of 10.83 to 12.57% 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.