Annual US Health Insurance Market Update
As we approach the ACA/Obamacare open enrollment period for 2022 individual health insurance and the annual renewal for most small business group health plans, I am providing information regarding changes that are happening in the market in 2022 to elp you get prepared to find the BEST possible health plan for your situation and needs.
I also know that if you are on an ACA/Obamacare individual plan you may have already received your current plan’s renewal information for next year, so I hope this also provides some context to the planned rate increases or decreases, plan changes and cancellations, etc. that you are seeing.
Below you will find changes that are happening at the federal level as well as links to more information in the states where US Insurance Solutions is currently licensed. Click the link for your home state to get more information about what is happening where you live.
Please review this information and then, if you haven’t already done so, go to my online calendar (and at the bottom of this page) and set an appointment for us to talk about your options for 2021.
General Update
In 2021 the focus of the new presidential administration has been on expanding the ACA/Obamacare markets. That expansion has centered around passage of one law and at least two presidential executive orders.
The new law that was passed in March 2021 as part of the broader “COVID Relief” is called the American Rescue Plan Act (ARPA).
(ARPA) Information:
Under the American Rescue Plan of 2021 (ARP), Subsidies were expanded for all. These expanded subsidies are set to continue in 2022. Here is how it works:
· All previously subsidy eligible people with incomes above the federal poverty level (FPL) and below 400% of the FPL will receive higher subsidies than before.
· Removal of 400% of federal poverty level (FPL) maximum cap.
· Family incomes up to 700% of FPL could be eligible for subsidies depending on ages, family makeup, location, and plan choice.
· Nobody will pay more than 8.5% of their annual adjusted gross income (AGI) for their ACA/Obamacare health insurance coverage.
Congress and the President are currently trying to pass a $3.5 Trillion dollar package of legislation via reconciliation that would include making the above expansion permanent beyond 2022.
The two primary executive orders will add the following:
Expanded Open Enrollment - Open Enrollment for 2022 will be extended by one month. The period runs from Monday, November 1, 2021–Saturday, January 15, 2022. Enroll by December 15, 2021 for coverage that starts January 1, 2022. Enrollment after January 15th will result in coverage starting February 1, 2022. While some of the state-based exchanges already have longer open enrollment periods, this change applies to ALL states using the Federal Marketplace (www.healthcare.gov).
New Special Enrollment Period (SEP: A new monthly SEP will allow consumers with a projected annual household income no greater than 150% of the federal poverty level to enroll in Marketplace coverage with low or no premiums after tax credits are applied.
I remain cautiously optimistic that the administration will not go beyond the above regarding the health insurance markets. However, as I noted in last year’s update, it is still possible that the President could try to reverse some of the expansion of options in the non-ACA alternative health insurance market. So, we will be watching closely for any efforts in this area.
Alternative Health Plan Solutions Updates
In many states we are continuing to see expansion of CHOICES for U.S. individuals and small businesses than the one-size-fits-all ACA/Obamacare plans. There are MORE and BETTER affordable alternative plan options than there have been in years.
As I mentioned last year, here are some notable changes that have led to this expansion of alternative plan options (and how they have helped):
- The elimination of the federal tax penalty for not having an ACA/Obamacare “qualified” health plan. (Alternative plans are even more affordable, and people can buy more comprehensive coverage with the tax penalty money they don’t have to pay).
- Extending the duration of Short Term Medical plans up to 12 months with the ability to renew for up to a total of 36 months. (Provides a minimum of a full year of coverage. Extending up to 36 months provides longer term rate stability and coverage for pre-existing conditions after the first year).
- Health Reimbursement Arrangements (HRAs) as an alternative to a group health insurance plan. (Specifically, the Individual Coverage HRA (ICHRA) can be a more affordable way to offer benefits for businesses that can’t afford to offer a group health plan).
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 - Alternative Individual Plans
Primary (Main Course) plans - In addition to more and longer Short Term Medical*** plans, our two main Fixed Benefit plan companies, Philadelphia American and Manhattan Life have each made significant upgrades to their plans in many states.
***Article: Short-Term Health Beats Individual Major Medical
Supplemental (Side Dish) plans - We also have expanded plan offerings and enhancements to available accident, critical illness and hospital indemnity plans. You can see many of these on our US Supplemental Coverage page.
Your Health Insurance "Plate" - We always work to provide you with the most comprehensive coverage we can offer to fit in your budget. We do that by combining the available Primary and Supplemental plans in your state into the best available package.
NOTE: All plans in our health insurance buffet require some level of health underwriting to be approved for coverage. For those who are approved, they do not cover pre-existing conditions for a minimum of 12 months after the enrollment date. Therefore, these plans are best suited for people without serious, ongoing health issues. We always evaluate each person’s situation to ensure we are recommending the best possible coverage.
As noted on our US Insurance Solutions home page, if you are looking for a better, more affordable individual/family health plan and make too much money to get a tax credit subsidy from the government, one of our NAHP alternative individual health plan solutions may be just what you need!
OR…
Alternative Small Group Health Plans
If you own (or work for) a small business with under 50 employees, and meet certain criteria, one of our NAHP alternative group health plans could be a better option than an ACA/Obamacare, fully insured group health plan.
Again, click on the link for your home state (below) to learn more about the alternative health plan changes and updates where you live.
On the other hand, for individuals who are eligible for a tax credit subsidy to help pay their premium and/or have significant health issues I can help find the best ACA/Obamacare individual plan. Also, for small businesses who don't have enough people for an alternative plan and/or have people with significant health issues in their group, I can help find the best fully insured ACA/Obamacare small group plan. Please review the following…
Federal ACA/Obamacare Changes
The following are some of the main changes happening with ACA/Obamacare plans.
Individual Plans
Insurance companies entering or expanding in ACA/Obamacare individual markets:
As I have mentioned in previous annual updates, ACA/Obamacare markets are continuing to expand. Some of the main reasons you are seeing this expansion is that premiums and deductibles are now HIGH enough and provider networks are now SMALL enough for insurance companies to make money on individual ACA/Obamacare plans.
There are at least nine health insurance companies entering new Obamacare markets or re-entering the market again in 2022. The two companies re-entering the market after a several year absence are Aetna and United Healthcare. United Healthcare did re-enter some markets with limited options in 2021, but in 2022 they are offering a full portfolio of plans in around 15 states.
Aetna - ACA expansion states** include NV, MO, TX, GA, FL, NC, VA and AZ.
Ambetter – In 2022 Ambetter is expanding into four new states**. They are Louisiana, North Carolina, Nebraska and Oklahoma. In total they will now be in 24 states.
Bright Health - Bright Health is expanding in 2022 to five new states**. They are California, Georgia, Texas, Utah and Virginia. In total they are adding 42 new markets that include expansion in states where it already does business, including Florida, California, Colorado and North Carolina.
CareSource – In 2022 CareSource will add coverage in Indiana to their existing states of GA, KY, OH and WV.
Cigna – In 2022 Cigna is expanding into three additional states**. They are Georgia, Mississippi and Pennsylvania. In addition, they will expand coverage in existing states for a total of 93 new counties added. They will now be in 14 states.
Friday Health Plans – Friday will be expanding into GA, NC and TX for the first time in 2022. Friday Health offers competitive plans with unlimited $0 copay Telemedicine, $0 Primary Care visits and $0 mental health visits.
Molina Healthcare - Molina will add plans in ID, IL and KY. They will also expand into more counties in the existing states of MI, SC, OH, WA.
Oscar Insurance Corp – As a part of their 2022 expansion, Oscar will offer Individual and Family Plans for the first time in Arkansas, Illinois, and Nebraska. Oscar also will expand its existing state footprints in Colorado, Florida, Georgia, Iowa, Missouri, Oklahoma, Pennsylvania, and Texas. Their individual ACA plans will be available in the following states**: AR, AZ, CA, CO, FL, GA, KS, IA, IL, MI, MO, NJ, NC, NE, OH, OK (OKC), TN, TX, and VA.
United Healthcare – In 2022 the company will have plans in AL, AZ, CO, FL, GA, IL, LA, MD, MI, NC, OK, TN, TX, VA and WA.
**Not all markets in all states
Changes to out of pocket limits and deductibles:
For the NINTH year in a row, the maximum deductible and out of pocket limits for ACA/Obamacare compliant plans are on the rise! The government sets a limit on how much these maximums can be. Family maximums can be twice as high as the maximum amount in a plan covering just one person (a “self-only plan”).
For 2022, the self-only maximum deductible and out of pocket limit can be up to $8,700 and the family maximum, up to $17,400.
For high-deductible plans that are compatible with Health Savings Accounts (HSAs) they are lower with limits up to $7,050 for individuals and $14,100 for families.
The maximum contribution limits to an HSA are $3,650 for an individual and $7,300 for a family. As always, there is an additional $1,000 “catch up” contribution amount for each individual age 55 and above.
Lower but varied rate increase percentages on individual plans around the country:
Continuing a trend over that past few years, average increases on individual ACA/Obamacare plans continue to be lower than in the first 4 to 5 years of the law in many states. However, there are some states with higher average increases. Including a few states with near double digit (9%+) and higher average increases.
Personal Note: While I would much rather see rate decreases or NO to very low increases in ACA/Obamacare plans, I believe we have reached a point where any positive news is (as the old saying goes), "like putting lipstick on a pig." No matter what you do to try to make it look pretty, it's still a PIG!
Small Group Plans – Not Much Different than Last Year
While it looks like there are more companies having small increases or small decreases in rates in the ACA/Obamacare small group market there are still many companies with rate increases near or over 10%. With a few targeted exceptions, you are also NOT seeing expansion of companies offering small group ACA/Obamacare plans.
The reason you are not seeing expansion is that while fully insured, small group health plans must comply with ALL the same ACA/Obamacare rules and coverage mandates as the individual plans, group plans typically still offer larger PPO networks, which are more costly to insurance companies.
The limited new entries in the small group market are including more limited EPO and/or HMO network plans, which are like the individual market. If/when we see the elimination of larger PPO network availability with small group plans, then we might start seeing more companies entering or re-entering the small group ACA/Obamacare markets.
In the State Changes section below I have outlined all the proposed rate changes I could find in your state for both individual and small group health insurers.
State by State Changes and Updates
As noted above, please click on the link for your state for more details on what is happening with both the Alternative Health Plans market and ACA/Obamacare plans where you live.
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.