Friends

OK - we've finally had a chance to review the individual health insurance rates for 2018...

Forewarning, they are not great...

We wanted to give you a heads up on this so we can set expectations going into the 2018 Open Enrollment Period (OEP).  While we (i.e. the health insurance industry) are not surprised with this, we understand that you (our valued clients) deserve some explanation on why we are in this situation.  Consider the following...

What is the average rate increase for 2018 in the state of Michigan?

The average rate increase in MI for 2018 is 27.6% - almost double the average rate increase from 2017.  The increases fluctuate from 16.5% up to 59.4% between the 10 carriers who are still providing individual health insurance options in Michigan.  We have put together a simple breakdown of what rates will look like from our preferred carrier partners (i.e. Priority Health, BCBSM, and BCN).

Here are the rate increases, by carrier, for 2018

Why are rates going up so much?

The main reason why rates are going up so much is because our lovely Federal Government has yet to decide whether they are funding a critical component of the PPACA for 2018 - the Cost Sharing Reimbursements (CSR's).  Because of this, health insurance carriers across the nation were forced to submit two sets of rates back in May of 2017.  One rate assuming they would fund CSR's and another set assuming they would not fund CSR's.  The Federal Government was supposed to have a decision on 9/21/2017 - as of today, they have not made a decision.

That being said, health insurance carriers have been forced to move forward with the assumption that they are not going to fund this component of the PPACA.  As a result, we are now looking at much higher rates than originally expected for 2018.  

What are your alternatives?

If you are planning on enrolling in a fully insured plan during the 2018 OEP we would suggest the following to keep your rates as low as possible:

 

Look into a "narrow" network HMO plan

 

A "narrow" network HMO simply means you agree to stay within a specific hospital system - i.e. Beaumont, St John's, St Joseph's, etc.  This restricts your access but allows the health insurance carrier to have more control over their costs.  This translates into having the exact same coverage as a full blown HMO network at a much lower rate.

 

Consider changing your doctor

 

I know this does not sound ideal, but we are no longer in an ideal situation - and likely will not be for the foreseeable future.  Many of you have a doctor you do not want to part with - and we are sympathetic to that position.  That being said, we would encourage you to consider how much medical care you consume through your Primary Care Physician (PCP) in relation to the savings of taking a less expensive plan.  It is entirely possible to get as good, if not better, coverage at a lower price if you are flexible with respect to the doctors you see.

 

MOVE TO A MEDICAL SHARING MINISTRY (MSM) PLAN!!!

 

We have send numerous communications on the benefits of Medical Sharing Ministry (MSM) plans.  Here are just a few highlights:

• You can enroll at anytime throughout the year
• You are protected from the PPACA penalty if you move to an MSM plan
• You are rated based on "Age Bracket" which means your rate will not go up until you hit 40, 50, 60, or 64 (right before Medicare)
• Example:  You are a 45 year old male with a 45 year old wife and two teenage children.  Your rate will not go up until you or your wife turn 50
• Benefits of an MSM plan are typically much better than fully insured, PPACA plans
• You have access to a nationwide network of providers
• The plans are "Guaranteed Issue"
• For the ideal client profile, we are seeing savings of between 40% and 60%

Consider the illustration below - we are comparing a $13,300 deductible H.S.A. plan against a MSM plan with first dollar copays for PCP, Specialist, Urgent Care, Emergency Room, and Labs/X-Rays. 

 

www.altruisbenefit.com | 877.442.5878 | @altruishealth | [email protected]