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 of Washington.
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.
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. The only company that we are aware of that is still offering Short Term Medical plans is Lifemap of WA.
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.
Our Supplemental Plan lineup has 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 – 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 – We offer plans from companies such as Surebridge, LifeSecure, Medico, and Washington National.
- 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 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 (National General, Allied National and Trustmark), we have a new agency called National Insurance Partners (NIPC) with whom we have recently partnered. NIPC has five different companies offering Level Funded plans.
All eight of these 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 2021 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.
The 2021 Open enrollment period has been extended 30 days to January 15, 2021. Enrollment on or before December 15th will start January 1, 2021. Enrollment from 12/16 to 1/15/21 will start 2/1/2021.
The biggest change is the addition of Standardized “Cascade Care” plans offered by all companies participating ON the Health Plan Finder exchange.
IMPORTANT NOTE: As noted in the link above, there are both Standard and Public Option 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 2021:
Bridgespan Health –
Bridgespan is significantly expanding the counties in which it will offer plans from 5 in 2021 to 20 in 2021. Here are the counties (Bold are 2020 counties):
On-Exchange: Adams, Benton, Clark, Columbia, Franklin, Garfield, King, Kitsap, Kittitas, Klickitat, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Yakima
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Off-Exchange: Benton, Clark, Columbia, Franklin, King, Kitsap, Klickitat, Pierce,
Skagit, Snohomish, Spokane, Thurston, Walla Walla, Yakima
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It looks like they are also focusing on their larger, statewide “Real Value” provider network for all plans and removing their limited networks like the UW Medicine network.
Coordinated Care (Ambetter) –
Is expanding and adding 7 more counties compared to 2020. Here are the counties (Bold are new 2021 counties):
Adams, Asotin, Benton, Chelan, Columbia, Douglas, Ferry, Franklin, Garfield, Grant, Jefferson, King, Kitsap, Kittitas, Lewis, Lincoln, Mason, Okanogan, Pend Oreille, Pierce, Snohomish, Spokane, Stevens, Thurston, Walla Walla, Whitman, Yakima
Unfortunately Ambetter has dropped their HSA qualified plans in all counties for 2021!
Kaiser Permanente of WA HMO plans –
Kaiser is adding new plans called “Virtual Plus.” For most of your care, including care from a specialist, you’ll start with a virtual visit. Virtual visits are covered at no charge.
These plans are available in Washington to individuals and families residing in King, Kitsap, Pierce, Snohomish, Spokane, and Thurston counties.
Lifewise –
LifeWise will again offer on-exchange medical and dental plans in 33 counties. They will also continue to sell off-exchange medical plans in Pierce, Snohomish, and Spokane counties.
All current LifeWise plans will renew in 2021, except the Essential Catastrophic plan.
They are adding a new Essential Bronze plan to provide another option in the market for an affordable plan with competitive benefits.
Members on all plans (except HSA) will also now have access to telehealth services for just a $5 copay, including virtual behavioral health services.
Molina Healthcare –
Molina will offer their plans in the same counties as they did in 2020.
Their hospital network has improved in the Puget Sound region to now include Swedish hospitals in King County. They still do not have Evergreen Hospitals in King County. They have Providence Hospital in Everett in Snohomish, and six hospitals in Pierce County.
Their only plan change is modifying their Silver plan.
Molina Highlights for 2021
- FREE 24/7 virtual care visits through Teladoc
- No referral required for specialist office visits
- Mail Order Pharmacy benefit is available to all members
Premera Blue Cross –
Premera be in the same 6 counties in 2021: Franklin, Grays Harbor, King, Kitsap, Pacific, Skamania, and Wahkiakum.
Premera individual members will continue to use the Individual Signature Network. This broader network includes UW Medicine, Swedish, Virginia Mason, and Providence. Plus, no referrals are needed to see a specialist.
All current Premera plans will renew in 2021, except the Preferred Gold 1000.
Regence BlueShield –
Regence is significantly expanding the counties in which it will offer plans from 5 in 2021 to 20 in 2021. Here are the counties:
Clallam, Cowlitz, Grays Harbor, Island, Jefferson, King, Kitsap, Klickitat, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum, Whatcom, Yakima
Regence will be providing their larger, statewide “Individual and Family Network” for all plans and removing their limited networks like the UW Medicine network. The Individual and Family Network looks to have most of the hospitals in the Puget Sound Region. The hospitals and provider groups that they do not have are Swedish and CHI Franciscan.
Small Group Plans
As with many states there is not much “new” to report with ACA/Obamacare small group plans in Washington.
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.
As noted in our Federal Market Update and in the rates changes below, ACA/Obamacare small group plans had mostly small rate increases or decreases.
2021 Rate ACA/Obamacare review:
Washington individual plan approved rate filings are as follows:
- Asuris - Received an average decrease of 4% varying by plan type
- Bridgespan Health Received an average decrease of 0.09% varying by plan type
- Community Health Network of Washington - NEW
- Coordinated Care (Ambetter) - Received an average increase of 1.4% varying by plan type
- Kaiser Permanente of WA HMO plans - Received an average decrease range of 2.56% to 4.94% varying by plan type and location
- Lifewise - Received an average decrease of 2.1% varying by plan type
- Molina Healthcare HMO (ON Exchange only) - Received an average decrease of 5.8% varying by plan type
- PacificSource Health Plans - Received an average increase of 7.68% varying by plan type (not finalized yet)
- Premera Blue Cross – Received an average decrease of 8.56% varying by plan type
- Providence Health Plan - Received an average increase of 3.18% varying by plan type
- Regence BlueShield - Received an average decrease of 7.78% varying by plan type
- Regence BlueCross BlueShield of Oregon - Received an average decrease of 2.31% varying by plan type
Washington small group market approved rate filings look like this:
- Aetna - Received an average increase of 5.34% varying by plan type
- Asuris - Received an average increase of 4.23% varying by plan type
- Health Alliance NW Health Plan - Received an average increase of 1.87% varying by plan type
- Kaiser Permanente of WA HMO plans - Received an average increase of 2.07% varying by plan type and location
- Kaiser Permanente of WA Options PPO plans - Received an average increase of 3.25% varying by plan type
- Premera Blue Cross – Received an average increase of 1.46% varying by plan type (not finalized yet).
- Regence BlueShield – Received an average increase of 5.89% varying by plan type
- Regence BlueCross BlueShield of Oregon - Received an average increase of 5.19% varying by plan type
- United Healthcare - Received an average range of a decrease of 0.04% to a 2.81% 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.