Was your health plan canceled, again?
"It's Deja Vu all over again" - Yogi Berra
It's starting to become routine. You scramble to find a health plan that you think will work for you and your family and then get a letter a few months later that the plan will no longer be continued. Even if your plan's sticking around, you were probably notified that the rates are through the roof! Back to the drawing board. Your friends that work for big companies complain about insurance, but they don't really know what it's like to have to hunt for their own policy like you do.
If it's starting to feel like a lonely hamster wheel, you're not alone. We estimate over 100K fellow Georgians will be looking for new coverage this year because their plan is going away (#pro-tip: we recommend shopping your plan each year no matter what, but that's another article). The last two years in Georgia we have seen major changes in the individual health market, and 2017 is bringing with it the most changes we've seen yet.
In this post, we want to lay out our insider perspective of what's going on in the overall market and for each insurance company to help prepare you to navigate this upcoming Open Enrollment.
Important health insurance trends in Georgia for 2017
At Take Command Health, we're busy serving our customers during Open Enrollment (the deadline is 12/15 for 1/1/17 start dates, by the way). Since receiving plan information for Open Enrollment, we've run our own analysis on the plan structures, doctor networks, and prescription formularies that we use to help our clients on our website, TakeCommandHealth.com. Now that we have a clear picture on what the 2017 market looks like, we wanted to share 3 things that you need to know:
- More "off exchange" only plans - For the last few years, with only a few exceptions, there has been very little difference between on-exchange and off-exchange plans. (BTW, "on-exchange" refers to health plans you can find on Healthcare.gov that are eligible for tax credits. Off-exchange refers to plans not on Healthcare.gov and therefore are not tax-credit or subsidy eligible. Both are still ACA compliant). This year however, many plans will only be available off-exchange. All of Aetna's plans and all of Cigna's plans. In fact, Aetna and Cigna won't even have their plans on their websites. At TakeCommandHealth.com, we pride ourselves on helping you see all your options, including plans on-exchange, off-exchange, and even faith-based plans.
- Premiums up, but some more than others - On average, monthly premiums in Georgia have increased by 28% across the state. Of the big name brands, Blue Cross increased by 21%, Kaiser and Alliant by 18%, and Humana has by far the largest increase at a whopping 67%. It's a tough market this year, which makes it even more important for you to ensure that the plan you choose will best serve your needs and include your doctors. We can help you estimate your total cost of care and recommend the plan that best utilizes your health plan dollars.
- Narrower doctor networks - This year the number of PPO options has decreased. Alliant has an on-exchange PPO in north Georgia, while Cigna has an off-exchange plan in the Atlanta area. All other carriers, including the market-leader Blue Cross, continue to move towards narrower HMO networks. The good news, however, is that doctor's still have to take some insurance to be able to have a patient base, it just makes it harder for your family to find everyone they need on one plan. Our tip here is to consider placing your family on different plans. You can also try out our brand-new, first-of-its-kind doctor search tool to quickly search all of the doctor networks in your area.
What to expect from each major insurance company in Georgia
Now that you've got the overall picture on what's happening in the market, we wanted to share some of our insider knowledge and perspective on what's happening with each insurance company. We'll continue to update this if there are any late-breaking announcements from the carriers.
So long United. Sayonara. Don't let the door hit you on the way out.
United makes headlines because they are the largest insurer in the US. However, most people don't realize last year was their first time to offer individual plans on-exchange. Their entrance made clients, brokers, and everyone excited. Their plans had large doctor networks and were paying brokers top commissions. But the wheels came off before Open Enrollment was even over last year. United had severely miscalculated and was terrible at serving individuals. Although they couldn't pull their plans off the market (companies are committed for the whole year), they slashed commissions to 0% and cut back on customer service and retention efforts. They were the worst-rated company among our clients for customer service. Even if they didn't pull out, we were likely going to cut them from our line-up anyway.
Anthem Blue Cross
Status: State-wide coverage
Athem Blue Cross remains committed to the individual insurance market in Georgia, and is the clear market leader. Anthem will serve the whole state on Healthcare.gov this year with HMO plans. The catch, however, is premiums will be up across the board by an average of 21%. If you receive a tax-credit on-exchange, your credit will likely scale with the increase, meaning you'll have negligible impact. However, if you don't qualify for a tax-credit, your plan will be more expensive for you this year.
An interesting note is that Anthem will also offer a POS networks plan off-exchange through the vast majority of the state. If you aren't familiar with a Point of Service (POS) network, it provides a little more flexibility than an HMO including out-of-network benefits. Learn more about doctor networks.
If you're an Anthem customer and not eligible for tax credits, this may be a good year to look at your other off-exchange options available at TakeCommandHealth.com.
Status: Northern Georgia PPO option
Alliant offers one of the only PPO plans, but is only available in 31 of Georgia's northern counties. Like Blue Cross, Alliant will be increasing plans on average by 21% this year. If you're in their service area and really want a PPO, this may be a great option to consider. You can use our brand-new doctor search tool to look for your doctors on the Alliant network.
Status: Off-exchange only, but a PPO!
Cigna will offer one plan in Georgia this year, and it will only be available off-exchange. This means you won't find them on Healthcare.gov and you can't get a subsidy or tax-credit to help you pay for your premiums. The good news is that it's an HSA-eligible PPO, the Bronze LocalPlus 6400. It will be available at TakeCommandHealth.com for clients in Atlanta, Macon, Dublin, and other parts of Northwest Georgia.
Status: Off-exchange only, but a state-wide POS network option
Like Cigna, Aetna will offer plans in Georgia this year, but only off-exchange. The good news is that their plans will be available state-wide, so it's an option that everyone will have. The plan is a POS network, which as we mentioned in the Blue Cross commentary is like a HMO but a little more flexible. If you need tax credits this isn't for you, but for those of you that don't qualify for tax credits it's another option that you can take a look at.
Our sense is that Cigna and Aetna have figured out there are actuarial differences between their clients that purchase on the exchange and those that don't. This isn't surprising as we've found it's too easy to "cheat" on Healthcare.gov and sign up for coverage only when you're sick - an insurance company's worst nightmare. We think Aetna and Cigna are essentially "hiding" this year: they want to stay in the market but they won't be actively promoting plans. We have great relationships with both carriers and have their full line-up available at TakeCommandHealth.com.
Humana is offering their HMO plans in parts of Central Georgia, primarily around Atlanta, Macon, Columbus, and Savannah. Unfortunately, Humana will have the highest rate increases of any carrier in the state at 67%. They've cut back the total number of plans they're offering compared to last year across most of the country. We think is evidence that Humana has struggled to make ends meet on the individual market, but is still hopeful they can right the ship.
Similarly, Kaiser is offering HMO plans in the Atlanta area and several surrounding counties. The better news with Kaiser is that rates increased about 17% - below the state average. Kaiser is definitely worth a look if you're trying to avoid major rate increases.
Status: State-wide, off-exchange (faith-based)
Faith-based Medi-Share has a state-wide PPO network available in 2017 managed by PHCS (Private Healthcare Systems, now owned my Multiplan). It’s smaller than some of the PPO networks in the past, but it does provide flexibility to see your doctors and will cover out-of-network expenses as long as it meets Medi-Share’s faith-based guidelines. Medi-Share won’t be for everyone, but is a worthy option to consider if it fits your personal convictions and lifestyle. Make sure to check out our Medi-Share review and compare it to other major medical plans on our website before you enroll.
Next Steps: What's my best option?
Well, you probably already figured out the bad news - your rates have increased. The good news here in Georgia is we will still have a lot more choice than residents in other states if you know where to look.
We don't want you to feel alone though. Take Command Health is here to be your advocate and empower you to find a plan that works for you and your family. In addition to our award-winning tools that'll help you make a confident plan choice, we've added some new features we want to let you know about:
- We're expanding the capabilities of our doctor search tool to search doctor networks no matter where the plan is - on exchange, off exchange, and even faith-based plan types.
- We've negotiated some pretty awesome deals for our members--Call a doctor 24/7 for $0, medical bill negotiation support, dental, vision, and pharmacy discounts, etc.
- We're pretty confident we have the biggest, most complete line-up of plans in Georgia this year.
- We've put together a new support team ready to help you tackle any issue. You can get started by chatting with us on our website or emailing us at firstname.lastname@example.org.
Now that Open Enrollment has started, you can visit our website and we'll walk you through your options. Our goal is to help you get the most out of your money and find the plan that really works for you and your family. Remember you have until Dec 15th to select a plan that starts Jan 1st, 2017.