From 15th October 2018 till 15th January 2019, open enrollment in California will be operating for plans in 2019. These new plans that will be covered in 2019 include a new health startup, and will provide the best health insurance for Californians.
California will lose the double-digit premium increases, as an addition of return (for 2019) of the 11 carriers that participated in individual market in 2018. Let us tell you more about what is different on the marketplace for 2019 and what will remain the same.
What is different?
Short-term plans banned.
California’s government wanted to protect the state’s robust individual marketplace, so they have abolished short term plans that ACA rollback allowed to be renewed for a year.
Premiums have stabilized.
The state marketplace said that the average weighted premium increase across the state would be close to 5% rather than 8.7% for 2019, in case the Individual Mandate penalty had not been recalled.
Individual mandate disappearing.
The Individual Mandate which fines Americans who skip out on health coverage will no longer be in effect in 2019. 10% of policyholders are expected to drop their coverage because of it. Make sure you purchase a health plan that meets Minimum Essential Coverage (MEC) to participate in the tax-free reimbursements, in case your health reimbursement plan such as QSEHRA was sponsored by your employer.
QSEHRAs are on the rise.
Since there are many small companies and startups that cannot afford traditional group plans, there is a new plan on the rise. Qualified Small Employer Health Reimbursement Arrangements, or QSEHRAs for short, offer reimbursement for medical expenses tax-free to this kind of companies. Another good thing here is that the employers will be able to choose what works best for them individually, without trying to fit into the same group plan.
What is the same?
Doctor networks staying small.
The Affordable Care Act, known as Obamacare, will stay the same. Many plans cover a much smaller percentage of doctors in a given area. This helps carriers to keep costs down but makes consumers financially vulnerable with fewer choices and in potential need to go out of doctor network to get the care they need. Another thing is that the network changes every year, making you do your research whether your preferred doctors are in-network for the following year.
Subsidies.
In order to get federal subsidies, you will have to pass the qualification.
Options for the best health insurance in California 2019
California offers different pricing and health insurance options. Consumers are able to choose from at least three health insurance companies, and in some regions that number goes up to seven, while there are 19 pricing regions.
By 1st November 2018, plans including your favorite doctors in a network were loaded in the system. Consumers are provided with take Command Health’s plan search tool, which helps them search the plan options in their zip code.
Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, Yuba, Santa Clara, San Joaquin, Stanislaus, Merced, Mariposa and Tulare counties are all covered by Anthem. It offers EPOs to individuals. Covered California plans cover around 108,000 Californians.
PPO plans is offered by Blue Shield CA throughout California, while some parts of the state are offered HMO plans too. Blue Shield Covered California plans make 29% of Covered CA customers.
People in San Francisco and northern San Mateo counties are offered HMO plans by Chinese Community Health Plan.
HMO, PPO, EPO and HSP are offered by Health Net, which covers 13% of the CA state insurance exchange registered customers.
Over 24% of Covered California enrollees choose one of the top three insurance options, which is Kaiser Permanente, and they offer HMO plans.
The Northeast and Southwest Los Angeles regions have HMO plans via L.A. Care Health Plan.
Eastern region, L.A. county – northeast and southwest, the Inland Empire and San Diego County are also offered HMO plans by Molina. Molina is a desirable option because of their competitive pricing.
EPO plans are offered to San Francisco county, L.A. county and Orange county by Oscar.
HMO plans with two options: Premier Network and Performance Network – Network 2, is offered by Sharp. Sharp covers San Diego and the Southern Riverside areas.
Santa Clara County is covered by Valley Health Plan, which offers HMO plans.
Sacramento, Yolo, Solano, El Dorado, Placer, Marin, Napa, and Sonoma counties are covered by Western Health Plan and it offers HMO and Health Savings HMO plans.
Faith-based sharing plans
Alternatives to traditional insurance that can save you lots of money depending on your expected needs, are something many consumers are opting for nowdays.
Private Healthcare Systems, PHSC for short, owned by Multiplan, are managing a state-wide PPO network. Medi-Share has it. It provides flexibility, and it is not for everyone, but you might check it out to see if you are interested in Medi-Share’s faith-based guidelines.
Shopping for plans will be much easier this year!
During the 2019 Open Enrollment Season, California will be covered by Take Command Health for the first time. They made their online tool free and easy to use, because they want to make consumers to shop smarter. On-exchange and off-exchange plans are offered to consumers, and they have been available since 1th November 2018. It is even possible to chat with licensed insurance professionals via their site.
This is what CEO and Founder of Take Control Health, Jack Hooper, had to say about being in California in 2019: „Shopping is going to be important for Californians this year.
Even if your plan is not increasing much, often the underlying doctor networks and prescription formularies are – it’s important to make sure your needs are still being met by your health plan. We are excited to bring our doctor and prescription search features to Californians shopping for plans.
A new alternative for small employers in California is to look at the new QSEHRA. This allows California businesses to reimburse employees tax-free for individual insurance plans and medical expenses. We find this leads to a much more optimized solution than trying to fit a one-size-fits-all group plan onto a small group.“