Annual Washington State 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 ofWashington.
Washington State 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
In Washington the state continues to take a very pro-ACA/Obamacare position.
For individuals, Short Term Medical plans continue to be limited to just ONE 3-month policy per person per year. However we do not find any companies offering plans at this time.
With that said, we still have the same alternative “health plan buffet” package available for those who do not qualify for a tax credit subsidy to help pay for an ACA/Obamacare plan. We have a few additions to the supplemental plans that I will discuss below.
Our one Primary plan is the Philadelphia American Health Choice Select Fixed Benefit plan.
NEW! As noted below the newest supplemental plan addition is my favorite hospital indemnity plan that I have been offering in other states for several years. The Manhattan Life Out of Pocket Protection plan is the MOST affordable plan available to provide extra coverage for an inpatient hospital stay of at least one day.
Our Supplemental Plan lineup is as follows:
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.
· 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 – BEST VALUE - The new addition to our alternative “buffet“ package is the Manhattan Life Cancer Care Plus plans. These plans give a HUGE boost by paying for actual treatment costs for Cancer and many other Dread Diseases.
- Hospital Stay Protection – NEW! The newest addition is my favorite Manhattan Life Out of Pocket Protection Plan! We offer plans from companies such as Surebridge, LifeSecure, Medico, and Washington National.
- 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 have the Enrollment First SelectMed. There are 3 options Base, Pro and Max.
· 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.
Small Group Alternative Plans
In addition to the three companies we already have (Allstate Benefits, Allied National and Trustmark), 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.
Washington State 2023 ACA/Obamacare Health Insurance Market Updates
Individual Plans
Please see the following for updates in Washington in the ACA/Obamacare individual market.
In general, it looks like the focus for most companies will be away from offering their own designed plans and toward the State standardized plans (Cascade and Cascade Select). We have learned that this is because the State is limiting the number of non-standardized plans that each company can offer to: one Silver, two Bronze and two Gold plans.
IMPORTANT NOTE: For the Washington State standardized plans offered on the Health Plan Finder exchange, there are both Standard (Cascade) and Public Option (Cascade Select) plans available. The Public Option plans have “Select” in their name. Public Option plans are sold by the private insurance companies, but they are fully controlled, administered and claims paid by the State of WA. In general, any insurance market with a “public option” is the first step toward a “single payer” system that eliminates private insurance options over time. I just want you to be aware of this as you make your coverage choices.
The following lists company specific updates for 2023:
Providence Health Plan, which joined Washington’s exchange as of 2020, plans to only offer coverage outside the exchange as of 2023.
Community Health Network’s coverage currently covers 18 counties.
Coordinated Care’s (Ambetter) coverage area will go from 29 to 31 counties (Skamania and Wahkiakum are being added). They are expanding their public plan option (Cascade Select) into 8 new counties. They are also expanding their provider network to include Virginia Mason Medical Center in Seattle and Overlake Hospital in Bellevue in King County. They are adding all Multicare doctors and hospitals in Pierce County and Multicare Capital Medical Center in Olympia.
Kaiser - As of 10/2/2022 we are awaiting details of their 2023 plan offerings.
Lifewise’s coverage area will continue to be 35 counties. They are expanding their Cascade Select (public option) plans to 15 counties in 2023, and their Cascade Care (standard) plans to 20 counties. In 2023 they will move current Cascade Care plan members to the Cascade Select plans in the counties with both options. Their non-standardized Lifewise Essential plans are available in all 35 counties where they offer coverage.
Molina’s coverage area currently covers 18 counties. In 2023 Molina will focus the majority of their plans on the standardized Cascade plans. They will eliminate their non-standardized Core Care Bronze plan and their Choice Gold plan. They will keep their Constant Care Silver plan.
Premera will continue to offer plans in the exchange in 5 counties: Franklin, Grays Harbor, King, Kitsap, Pacific. Premera’s Individual Signature network is once again the largest of any Individual insurer in WA. You will have access to providers at UW Medicine, Providence, Swedish, Virginia Mason, Seattle Cancer Care Alliance, and more.
Regence is offering plans in 23 counties in 2023. They will split their offering between direct plans and the Health Plan Finder exchange. Their plans on the exchange will no longer include their HSA plans. Their HSA plans will only be sold direct by them. They will have one broad Individual and Family provider network and one other regional network: Eastside Health network.
United Healthcare will offer 3 non-standardized plans and the Cascade Care (standardized) plans in 2023. UnitedHealthcare's 2023 Footprint includes the following counties:
Clallam, Jefferson, King, Mason, Pierce, Lincoln, Kittitas, Yakima, Adams and Whitman.
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in Washington. However, we have expanded our available options for fully insured small group plans by partnering to offer the AWB HealthChoice plans through the Association of Washington Business.
While not a lot has changed (other than rates), the one thing that is the same is that to the best of my knowledge Premera Blue Cross is still the only company that will a “group of one” small group plan for business owners without any other “common law” employees. They must meet specific criteria to qualify.
2023 Rate ACA/Obamacare review:
2023 Preliminary Rate review:
Washington preliminary 2023 individual plan rate filing requests are as follows:
Asuris - requested an average increase of 10.93% varying by plan type (not finalized yet)
Bridgespan Health requested an average increase of 16.1% varying by plan type (not finalized yet)
Community Health Network of Washington - requested an average increase of ?% varying by plan type (not finalized yet)
Coordinated Care (Ambetter) - requested an average decrease of 1.23% varying by plan type (not finalized yet)
Kaiser Permanente of WA HMO plans - requested an average increase range of 3.7% to 4.5% varying by plan type and location (not finalized yet).
Lifewise - requested an average increase of 12.51% varying by plan type and depending on filing date? (not finalized yet)
Molina Healthcare HMO (ON Exchange only) - requested an average increase of 8.69% varying by plan type (not finalized yet)
PacificSource Health Plans - requested an average increase of 15.41% varying by plan type (not finalized yet)
Premera Blue Cross – requested an average increase of 9.66% varying by plan type (not finalized yet)
Providence Health Plan - requested an average increase of 9.09% varying by plan type (not finalized yet)
Regence BlueShield - requested an average increase of 13.71% varying by plan type (not finalized yet)
Regence BlueCross BlueShield of Oregon - requested an average increase of 4.52% varying by plan type (not finalized yet)
United Healthcare of Oregon - requested an average increase of 15.26% varying by plan type (not finalized yet)
Washington small group market rate filing requests look like this
Aetna - requested an average decrease of 11.07% varying by plan type (not finalized yet).
Asuris - requested an average increase of 8.91% varying by plan type (not finalized yet).
Health Alliance NW Health Plan - requested an average increase of 8.34% varying by plan type (not finalized yet).
Kaiser Permanente of WA HMO plans - requested an average increase of 3.91% or 10.21% varying by plan type and location and depending on filing date? (not finalized yet).
Kaiser Permanente of WA Options PPO plans - requested an average increase of 2.57% varying by plan type (not finalized yet).
Premera Blue Cross – requested an average increase of 8.5% varying by plan type (not finalized yet).
Regence BlueShield – requested an average increase of 6.21% varying by plan type (not finalized yet).
Regence BlueCross BlueShield of Oregon - requested an average increase of 6.73% varying by plan type (not finalized yet)
United Healthcare - requested an average range of increase of 3.87% to 6.75% varying by plan type and network (not finalized yet)
2023 Rate ACA/Obamacare Approved Rates:
Washington individual plan approved rate filings are as follows:
Asuris - Received an average increase of 9.1% varying by plan type
Bridgespan Health Received an average increase of 15.68% varying by plan type
Community Health Network of Washington - Received an average decrease of 5.98% varying by plan type
Coordinated Care (Ambetter) - Received an average decrease of 3.5% varying by plan type
Kaiser Permanente of WA HMO plans - Received an average increase range of 5.22% to 6.99% varying by plan type and location
Lifewise - Received an average increase of 16.05% varying by plan type
Molina Healthcare HMO (ON Exchange only) - Received an average increase of 10.02% varying by plan type
PacificSource Health Plans - Received an average increase of 15.48% varying by plan type
Premera Blue Cross – Received an average increase of 10.08% varying by plan type
Regence BlueShield - Received an average increase of 12.83% varying by plan type
Regence BlueCross BlueShield of Oregon - Received an average increase of 0.42% varying by plan type
United Healthcare of Oregon - Received an average increase of 15.28% varying by plan type
Washington small group market approved rate filings look like this:
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.
Aetna - Received an average increase of % varying by plan type
Asuris - Received an average increase of % varying by plan type
Health Alliance NW Health Plan - Received an average increase of % varying by plan type
Kaiser Permanente of WA HMO plans - Received an average increase of % varying by plan type and location
Kaiser Permanente of WA Options PPO plans - Received an average increase of % varying by plan type
Premera Blue Cross – Received an average increase of % varying by plan type (not finalized yet).
Regence BlueShield – Received an average increase of % varying by plan type
Regence BlueCross BlueShield of Oregon - Received an average increase of % varying by plan type
United Healthcare - Received an average range of a decrease of % to a % 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.