Annual Texas 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 Texas.
Texas 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
Texas is one of our states that has seen BIG improvements in the alternative health plans that are available in the state going into 2021. 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.
Our Primary Plan lineup has expanded and improved:
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.
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 36 months! We now offer plans from four great companies:
National General – Includes their best, updated STM plans with multiple deductible/coinsurance options for up to 36 months. Also includes your choice of the Aetna or Cigna nationwide PPO networks.
IHC Group - Includes their best, updated STM plans with multiple deductible/coinsurance options for up to 36 months.
United Healthcare – Also offers multiple STM plans for up to 36 months.
Pivot Health – Includes their Classic STM plans that have unique “No Network” plans for up to 24 months.
NEW! North American Health Plans STM – NAHP has partnered with US Fire Insurance CO to offer the new Aspen/Choice Advantage STM plans for up to 36 months.
IMPORTANT TIP: In Texas, 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. 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. 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. NEW! We have a new plan from the IHC Group called Independence Hospital Insurance. This plan is a little more expensive than the Manhattan Life base plan, but includes outpatient surgery coverage in addition to inpatient hospital coverage.
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 three companies we already have (National General, Allied National 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: firstname.lastname@example.org.
Texas 2021 ACA/Obamacare Health Insurance Market Updates
The following are some of the biggest updates/changes in the ACA/Obamacare individual market in Texas.
Decent Health plans – Are offering a new, fully insured alternative to ACA/Obamacare plans. They are in Central Texas now and looking to expand.
Friday Health plans is offering health plans in Texas in 2021.
Centene Corporation, which also brands itself as Ambetter, and which offers plans under the name Celtic, will be offering plans in Texas under the name "Superior Health Plan" next year.
Ambetter will also begin offering an off-exchange product portfolio specifically designed for those who do not qualify for a tax credit subsidy.
NOTE: For the first time in 2021 we are now appointed to write Ambetter plans in ALL states where we are licensed and they offer plans!
Scott & White Health Plan will also join the exchange for 2021, with plans expected to be available in the northern part of the state. Scott & White purchased FirstCare/SHA in 2019, and those plans are available on-exchange in western Texas. In addition, the Scott & White Health Plan HMOs will also be available on-exchange in some areas in 2021.
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in Texas.
NOTE: It should be noted that Texas is a state that will allow a business where a husband and wife are the only employees to qualify for a small group health insurance plan as another alternative to an individual ACA/Obamacare plan.
Texas 2021 ACA/Obamacare Rate review:
Texas individual plan approved rate filings are as follows:
- Blue Cross Blue Shield of TX - Received an average increase of 2.97% varying by plan type
- CHRISTUS Health Plan - Received an average increase of 3.16% varying by plan type
- Community Health Choice - Received an average increase of 8.65% varying by plan type
- Molina Healthcare - Received an average increase of 5.39% varying by plan type
- Oscar Insurance Co – Received an increase of 9.91% varying by plan/network type
- Scott & White - Received an average range of a decrease range of 33.41% to 53.95% varying by plan type and network
- Sendero Health Plans - Received an average increase of 7.07% varying by plan type
- Superior Health Plans (Ambetter) - Received an average increase of 11.69% varying by plan type
- SHA/FirstCare Health Plans - Received an average increase of 1.25% varying by plan type (not finalized yet)
Texas small group market approved rate filings look like this:
- Aetna - Received an average decrease range of 26.47% to 26.8% varying by plan and network
- Blue Cross Blue Shield of TX - Received an average increase of 5.35% varying by plan type
- FirstCare Health Plans - Received an average increase of 11.57% varying by plan type (not finalized yet)
- Humana - Received an average increase of 5.63% varying by plan type and network
- Memorial Hermann Health - Received an average increase range of 5.29% to 7.81% varying by plan type
- Prominence Health First of TX - Received an average increase of 6.61% varying by plan type
- Scott & White - Received an average decrease range of 3.07% to 8.63% varying by plan type and network
- Texas Health + Aetna Health - Received an average decrease of 21.9% varying by plan type
- United Healthcare - Received an average range of a 3.2% decrease to a 1.34% increase 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.