Washington State Health Insurance Market Annual Update
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
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 Washington. 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 $1,850 per year LESS than the maximum out of pocket for 2025 non-HSA qualified ACA/Obamacare plans. For HSA qualified plans the maximum out of pocket limit will be $1,500 per year LESS than the maximum out of pocket for 2025 HSA qualified 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.
These plans are health underwritten. The final rates can be rated up or down based on health, or one can be declined. If approved, both programs cover all pre-existing conditions with no limitations.
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
In Washington the state continues to take a very pro-ACA/Obamacare position.
The new options above are really the only alternatives to the plans on the ACA/Obamacare Health Plan Finder exchange in the state.
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.
- 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.
- 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.
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. 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.
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 US Insurance Solutions Group Census form-WA spreadsheet and email it to: [email protected].
Washington State 2024 ACA/Obamacare Health Insurance Market Updates
Individual Plans
Please see the following for updates in Washington in the ACA/Obamacare individual market.
There are 12 insurers that offer health plans in Washington’s exchange in 2024. However, Pacific Source will stop selling plans in the state, so there will be 11 insurers in 2025.
The participating insurance companies are proposing average rate changes from under a 0.5 percent decrease to over 15 percent increases for plans in 2025.
In Washington, the 2025 Open enrollment begins on November 1, 2024 and ends on January 15, 2025. A health plan must be purchased by December 15, 2024 to have coverage effective January 1, 2025. Plan purchases from December 16, 2024 to January 15, 2025 will start on February 1, 2025.
Small Group Plans
The biggest change in Washington small group market is that Aetna will be exiting the market in 2025. The administrator that offered their plans has found a replacement through a Chamber of Commerce that will offer both Kaiser Core HMO and Access PPO plans statewide.
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.
2025 Rate ACA/Obamacare review:
2025 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.
Washington preliminary 2025 individual plan rate filing requests are as follows:
(Using state insurance dept website not FFM)
Asuris – requested an average increase of 15.54% varying by plan type (not finalized yet)
Bridgespan Health requested an average increase of 14.66% varying by plan type (not finalized yet)
Community Health Network of Washington – requested an average increase of 9.3% varying by plan type (not finalized yet)
Coordinated Care (Ambetter) – requested an average increase of 9.28% varying by plan type (not finalized yet)
Kaiser Permanente of WA HMO plans – requested an average increase range of 8.44% to 9.5% varying by plan type and location (not finalized yet).
Lifewise – requested an average increase of 8.1% varying by plan type and depending on filing date? (not finalized yet)
Molina Healthcare HMO (ON Exchange only) – requested an average increase of 6.36% varying by plan type (not finalized yet)
Premera Blue Cross – requested an average increase of 15.25% varying by plan type (not finalized yet)
Providence Health Plan – requested an average increase of 9.38% varying by plan type (not finalized yet)
Regence BlueShield – requested an average increase of 22.65% varying by plan type (not finalized yet)
Regence BlueCross BlueShield of Oregon – requested an average increase of 16.97% varying by plan type (not finalized yet)
United Healthcare of Oregon – requested an average increase of 23.45% varying by plan type (not finalized yet)
Washington small group market rate filing requests look like this
Kaiser Permanente of WA HMO plans – requested an average increase range of 5.96% to 6.58% 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 7.88% varying by plan type (not finalized yet).
Premera Blue Cross HMO – requested an average increase of 7.97% varying by plan type (not finalized yet).
Premera Blue Cross PPO – requested an average increase of 9.3% varying by plan type (not finalized yet).
Regence BlueShield – requested an average increase of 15.27% varying by plan type (not finalized yet).
Regence BlueCross BlueShield of Oregon – requested an average increase of 21.86% varying by plan type (not finalized yet)
United Healthcare – requested an average range of increase of 5.76% to 8.96% varying by plan type and network (not finalized yet)
2025 Rate ACA/Obamacare Approved Rates:
Washington individual plan approved rate filings are as follows:
Asuris – Received an average decrease of % varying by plan type
Bridgespan Health Received an average increase of % varying by plan type
Community Health Network of Washington – Received an average decrease of % varying by plan type
Coordinated Care (Ambetter) – 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
Lifewise – Received an average increase of % varying by plan type
Molina Healthcare HMO (ON Exchange only) – Received an average increase of % varying by plan type
PacificSource Health Plans – Received an average increase of % varying by plan type
Premera Blue Cross – Received an average increase of % varying by plan type
Providence Health Plan – Received an average increase of % varying by plan type type
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 of Oregon – Received an average decrease of % 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.