Our one Primary plan is the Philadelphia American Health Choice Select Fixed Benefit plan.

Our Supplemental Plan lineup has also expanded and improved:

• 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.
• Cancer and Dread Disease Treatment – BIG ADDITION - 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 – To provide extra protection for an inpatient hospital stay, we offer plans from companies such as Surebridge, LifeSecure, Medico, and Washington National.
• Preventive Care Plus Plans – For those who want the MOST comprehensive coverage for preventive care plus other outpatient services, we have two options: Enrollment First SelectMed plans and SHA Preventive and Prescription Drug Plans.
• Prescription Drug Plans – For anyone who needs extra coverage for high cost prescriptions, the SHA link above 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.

IMPORTANT TIP: In most cases, you can combine one of the above Fixed Benefit plans and/or STM plans together with an Accident, Critical Illness, Cancer Treatment AND First Day Hospital plans, and still be 15-20% LESS than a high deductible ACA/Obamacare plan! That is a package with first dollar, NO deductible coverage versus paying a high deductible up front before getting benefits on most services.

There is one last NEW addition I want to mention. I worked on it most of the past year. While I think it will be especially beneficial to people with one of the alternative plan packages (above), I believe it can help you lower your overall health care costs no matter what primary health insurance you have. Please 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.

Small Group Plans

In Washington, we have two companies (National General and Trustmark) 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: robtavis@ushealthinsurancesolutions.com.

Washington State 2020 ACA/Obamacare Health Insurance Market Updates

Individual Plans

In Washington there is a LOT of activity in the ACA/Obamacare individual market. Please see the following for updates.

Thirteen health insurers request record-low increase of less than 1%. As I said in the Federal Market Update, while lower increases (and decreases) are better than the BIG increases we have had for the last 6 years, to me this just means that all insurance companies have finally raised rates high enough and made all other adjustments to be able to make money in the individual market under current law.

Two new insurers join individual market in 2020 - PacificSource Health Plans and Providence Health Plan — are joining Washington’s market next year. See below for more information on each company.

The following are specific updates for each of the companies that will be offering individual plans in 2020.

Premera –

Premera Blue Cross individual plans will be in seven counties next year: Franklin, Grays Harbor, King, Kitsap, Pacific, Skamania, and Wahkiakum. 

Premera is exiting Benton, Cowlitz, Grant, Stevens, Whatcom, Snohomish and Pierce counties

Premera will offer individual plans exclusively on the exchange in 2020. All plans will be exclusive provider organization (EPO) plans, which means no referrals are needed to see a specialist. Next year all current PersonalCare plans will be discontinued.

In addition to the 10 essential benefits, most plans feature:

• First two visits with a designated primary care provider covered in full
• $15 copay for telehealth services
• Low copay and no deductible for preferred generic drugs on gold and silver plans

Premera has filed for an average rate decrease. Please see the preliminary rate review information below.

Lifewise –

LifeWise will be in 33 counties next year, compared to 12 this year.

Residents in all 33 counties can purchase LifeWise medical and dental plans on the exchange. Lifewise will essentially replace Premera in the counties that Premera is exiting  (see above).

Check out the 2020 county map to see where LifeWise plans will be available. The only counties where they are not going to offer plans are Grays Harbor, Pacific, Wahkiakum, Skamania, Franklin and Kitsap.

All Lifewise plans will be exclusive provider organization (EPO) plans, which means no referrals are needed to see a specialist.

LifeWise Primary Network – Lifewise will have a provider network with access to major hospital systems, including Swedish Medical Center, Providence Health, and CHI Franciscan.

The Lifewise Essential plan portfolio includes a new catastrophic plan for individuals under age 30 or who otherwise meet Affordable Care Act (ACA) eligibility requirements. They are also introducing a low deductible silver plan and a bronze health savings account (HSA) plan.

Also new for next year are two off-exchange plans for people who live in Snohomish, Pierce, or Spokane counties – LifeWise Primary gold and silver plans.

In addition to the 10 essential health benefits, most LifeWise plans will offer:

• Lower copay for visits to a designated primary care provider
• Unlimited primary care and specialist visits
• $15 copay for telehealth video or phone consultations
• Low copay and no deductible for preferred generic drugs

Lifewise has filed for an average rate decrease. Please see the preliminary rate review information below. 

Kaiser –

Kaiser will continue to offer the same HMO plans ON and OFF the Health Plan Finder exchange in 2020 that they did this year. A few plans are receiving proposed deductible and/or out-of-pocket maximum adjustments, but no benefit changes are being proposed for 2020.

Delta Dental of Washington has filed a proposed 2.77% rate increase for its Individual and Family Dental Pediatric and Basic plans offered through Kaiser.

Small group plans

Later this fall, we’ll announce a few modifications and enhancements to plan designs, and a new plan in select counties.

Delta Dental of Washington has filed a proposed 8.77% rate increase for Small Group Pediatric and Adult Family plans (Basic and Standard).

NOTE: As of July 1, 2019, they have extended in-network coverage to all members (HMO, POS, and PPO) seeking care at any Kaiser Permanente medical facility. Beyond Washington state, we have facilities in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington, D.C.

In 2020 Kaiser is exiting San Juan County and will no longer offer individual/family or group plans in that county.

Please see the preliminary rate review information below for Kaiser’s proposed rate adjustments.

Ambetter (from Coordinated Care) –

In addition to their current plan options, Ambetter will offer two new plans in select counties. In King, Pierce and Thurston counties they will add a Bronze plan that we believe will be an HSA qualified plan. They will also add a second Gold plan in all 20 counties where they offer plans.

Ambetter from Coordinated Care has filed for the largest average rate increase of any company. Please see the preliminary rate review information below.

Bridgespan –

In Washington Bridgespan will offer plans in the following counties in 2020:

On-Exchange: King, Pierce, Klickitat, and Clark Counties
Off-Exchange: Benton, Franklin, Klickitat, Walla Walla, and Yakima Counties

They will offer five plans each with four different networks varying by county.

Bridgespan has filed for a small average rate decrease. Please see the preliminary rate review information below.

Molina –

Molina will add a Bronze plan to their existing plans. Giving them 3 total plans.

Molina has filed for an average rate decrease. Please see the preliminary rate review information below.

PacificSource Health Plans –

PacificSource Health Plans will offer five plans in 3 Counties: Clark, Pierce, Spokane

Providence Health Plan –

Providence Health Plan will offer three plans in 6 Counties: Clark, Benton, Franklin, Spokane Thurston, Walla Walla.

Small Group Plans

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

As noted in our Federal Market Update ACA/Obamacare small group plans generally reported higher overall increases than the individual market.