Annual Virginia 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 Virginia.
Virginia 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 Virginia. 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
Virginia is one of our states that has seen a BIG reversal of available options in the alternative health plans that are available in the state going into 2023. As noted below, Short Term Medical plans are no longer available for extended coverage terms.
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.
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. 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 are limited by state law to duration's of no more than 90 days per policy. Because of this we aren’t recommending that they be used in our alternative plan packages at this time. However, we do offer the following STM plan companies for up to 3-month terms as needed:
National General – As of 10/19/2021 National General will not be offering plans during the open enrollment period.
United Healthcare – Offers their standard STM plans for up to 92 days.
Pivot Health – Includes their Classic STM plans that have unique “No Network” plans.
Our Supplemental Plan lineup includes the following options:
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 – We offer the 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.
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.
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 (Allstate Benefits, Allied National and Trustmark), we have added two new companies. One is called Sana Benefits. The other is a 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.
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.
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 ourGroup Census spreadsheet and email it to: robtavis@ushealthinsurancesolutions.com.
Virginia 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 Virginia.
There are 12 insurers that offer health plans in Virginia’s exchange in 2022. Bright Health Group will no longer offer individual and family plans in Virginia after 2022. So, there will be 11 insurers in 2024.
The participating insurance companies are proposing average rate decreases from about 10.5 percent to over 24 percent for plans in 2024.
In Virginia, 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 Virginia.
Virginia 2024 ACA/Obamacare Rate review:
Virginia 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.
Virginia preliminary 2024 individual plan rate filing requests are as follows:
Aetna - requested an average increase range of 21.27% to 24.52% varying by plan type (not finalized yet)
Anthem PPO -Group Hospitalization and Medical Services, Inc. - requested an average increase of 99.94% varying by plan type (not finalized yet)
Anthem HMO - HealthKeepers, Inc. - requested an average increase of 15.86% varying by plan type (not finalized yet)
CareFirst BlueChoice, - requested an average increase of 34.23% varying by plan type (not finalized yet)
Cigna Health and Life Insurance Company - requested an average increase of 26.12% varying by plan type (not finalized yet)
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - requested an average increase of 16.31% varying by plan type (not finalized yet)
Optima Health Plan – requested an average increase of 21.05% varying by plan/network type (not finalized yet)
Oscar Insurance Co – requested an average increase of 11.09% varying by plan/network type (not finalized yet)
Piedmont Community HMO – requested an average increase of 26.77% varying by plan type (not finalized yet)
Virginia small group market rate filing requests look like this
Aetna - requested an average range of a 13.75% decrease to a 6.22% increase varying by plan and network (not finalized yet)
Aetna Innovation Health - requested an average increase range of 5.97% to 6.49% varying by plan type and network (not finalized yet)
Anthem PPO plans - requested an average increase of 0.66% varying by plan type and network (not finalized yet)
Anthem HealthKeepers, Inc. POS plans - requested an average increase of 6.77% varying by plan type (not finalized yet)
CareFirst BlueChoice, - requested an average increase of ?% varying by plan type (not finalized yet)
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - requested an average increase of 9.24% varying by plan type (not finalized yet)
Optima Health Plan – requested an average increase range of 2.14% to 3.6% varying by plan type and network (not finalized yet)
Piedmont Community HMO – requested an average increase range of 6.31% to 6.34% varying by plan type (not finalized yet)
United Healthcare - requested an average increase range of 3.64% to 8.57% varying by plan type and network (not finalized yet)
Virginia 2023 ACA/Obamacare Approved Rates:
Virginia individual plan approved rate filings are as follows:
CareFirst BlueChoice, - Received an average increase of % varying by plan type
Cigna Health and Life Insurance Company - Received an average increase of % varying by plan type
Anthem PPO -Group Hospitalization and Medical Services, Inc. - Received an average increase of % varying by plan type
Anthem HMO - HealthKeepers, Inc. - Received an average decrease of % varying by plan type
Innovation Health Plan (Aetna) - Received an average decrease of % varying by plan type
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Received an average decrease of % varying by plan type
Optima Health Plan – Received an increase of % varying by plan/network type
Oscar Insurance Co – Received an increase of % varying by plan/network type
Piedmont Community HMO – Received an average decrease of % varying by plan type
Virginia small group market approved rate filings look like this:
Aetna - Received an average range of a decrease of % to 5% increase varying by plan and network
Aetna Innovation Health - Received an average decrease of % varying by plan and network
Anthem PPO plans - Received an average increase range of % to % varying by plan type and network
Anthem HealthKeepers, Inc. POS plans - Received an average increase of % varying by plan type
CareFirst BlueChoice, - Received an average increase of % varying by plan type
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Received an average increase of % varying by plan type
Optima Health Plan – Received an average increase range of % to % varying by plan type and network
Optimum Choice - Received an average increase of % varying by plan
Piedmont Community HMO – Received an average increase of % varying by plan type
United Healthcare - 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.