Health Insurance Companies and Plan Rates for

Transcription

1 Health Insurance Companies and Plan Rates for September 6, 2013

2 What is Washington Healthplanfinder? Washington Healthplanfinder is a new online health insurance marketplace. Individuals and families can find, compare and enroll in quality health insurance plans. Washington Healthplanfinder was created to provide all Washington residents with a brand new way to find health insurance based on their needs and their budget. This booklet is a brief summary of information about individual health insurance plans for the Washington Healthplanfinder. For more information on the Washington Healthplanfinder, please visit

3 Table of Contents About the Washington Healthplanfinder Health Insurance Plans... 1 Washington State Rating Area... 4 Rating Area Rating Area Rating Area Rating Area Rating Area

4 About the Washington Healthplanfinder Health Insurance Plans About Washington Healthplanfinder Insurance Plans All health plans offered through Washington Healthplanfinder meet strict benefit and quality standards. And all the essentials are covered, including visits to the doctor and emergency room, prescriptions, maternity care and preventive care like cancer screenings and immunizations. If an accident or illness strikes, a quality health plan can help protect you from huge medical bills. In addition, no one will be denied coverage because they are sick or have a pre-existing condition. Washington Healthplanfinder will offer a range of health plans so you can choose the one that best meets your financial and health needs. This document will provide you with an overview of the health plans and costs that are available in your local area. Qualified s Selected The following insurance carriers were approved to sell health and pediatric dental plans through Washington Healthplanfinder: u BridgeSpan King, Kitsap, Pierce, Skagit, Snohomish, Thurston, and Spokane u u u Adams, Benton, Chelan, Clark, Cowlitz, Douglas, Ferry, Franklin, Grant, Grays Harbor, King, Kitsap, Lewis, Okanogan, Pacific, Pend Oreille, Pierce, Skagit, Snohomish, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Yakima Adams, Benton, Chelan, Douglas, Franklin, Grant, Grays Harbor, Jefferson, King, Kitsap, Mason, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Yakima Benton, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason, Pierce, San Juan, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, and Yakima u u u Washington All 39 counties Molina Health Care King, Pierce and Spokane All counties except Clark u u Clark and Cowlitz (Small Business and Individual Market) Delta Dental,, LifeWise, All 39 counties ( Dental Only) These health plans have been certified to meet state and federal requirements for health plans as well as standards developed by Washington Healthplanfinder. 1

5 About the Washington Healthplanfinder Health Insurance Plans Standard Plan Benefits Starting in 2014, all health insurance plans are required to provide a certain level of standard benefits known as Essential Health Benefits. The federal Affordable Care requires that all health plans offered in the individual and small group markets must provide these items and services. These benefits fit into the following 10 categories: u Ambulatory patient services u Emergency services u Hospitalization u Maternity and newborn care u Mental health and substance use disorder services, including behavioral health treatment u Prescription drugs u Rehabilitative and habilitative services and devices u Laboratory services u Preventive and wellness services and chronic disease management u services, including dental and vision care Levels of Coverage Washington Healthplanfinder will allow shoppers to find a plan that fits their needs and their budget by offering side-by-side comparisons of health plans based on a variety of factors such as cost, quality and physician networks. Plan options will be broken down into metal tiers including Gold, Silver and Bronze based on the level of coverage they provide: u u u Gold Plans: Gold plans cover 80 percent of the cost of essential health benefits, while the patient pays 20 percent. Silver Plans: Silver plans cover 70 percent of the cost of essential health benefits, while the patient pays 30 percent. Bronze Plans: Bronze plans cover 60 percent of the cost of essential health benefits, while the patient pay 40 percent. A "catastrophic" plan will also be offered. This is a type of health care plan only available through Washington Healthplanfinder for individuals under age 30. This type of plan generally offers the least coverage with the lowest monthly premiums. 2

6 About the Washington Healthplanfinder Health Insurance Plans Help Paying for Coverage More people than ever before will qualify for financial help to pay for coverage. Depending on how much you earn, you can qualify for a free or low-cost health plan, or be eligible for financial help that can lower the cost of your premiums and copays. Qualified s file rates through the Washington State Office of the Insurance Commissioner and only upon approval are offered on Washington Healthplanfinder. Financial help will be available in several ways: 1. Tax credits: Tax credits can be used to lower the health insurance premium costs of Washington Healthplanfinder Qualified s. This tax credit provides you the option to either reduce the amount of your monthly health insurance premium or have a lump sum deduction when you file your annual income tax return. To see if you may qualify, use our cost-estimate calculator wahealthplanfinder.org. 2. Cost-sharing subsidies: Cost-sharing subsidies reduce the out-of-pocket amount of expenses you have to pay when you receive health care services at the hospital or doctor s office. 3. Medicaid or Washington Apple Health: Starting in 2014 under the Affordable Care Act, Washington State is expanding the Medicaid program/washington Apple Health. The coverage is free for those who qualify. Choosing a Washington Healthplanfinder will have a network of customer support across Washington State to help you get the information you need to enroll in health coverage that best meets your needs and your budget. Whether you prefer to receive assistance online, over the phone or in person, trained representatives will be there to help educate you about your options and walk you through the enrollment process: u Customer Support Center: Our Toll-Free Customer Support Center opens Sept. 3, Help will be available in up to 175 different languages. Call WAFINDER ( ) or TTY/TTD u Find a Broker: Washington Healthplanfinder will offer assistance through registered Insurance Brokers who often live in and support their local communities. Brokers are uniquely educated and licensed professionals that can help you find a health insurance plan. Brokers are the only individuals who are able to recommend an appropriate health care coverage plan for you. u Find a Navigator: A Navigator/In-Person Assister is a trained, certified representative who can help you enroll in health care coverage through Washington Healthplanfinder. Representatives from community-based organizations will be available throughout the state. 3

7 Rating Areas Whatcom San Juan Skagit Ferry Pend Oreille Island Stevens Clallam Snohomish Jefferson Chelan Grays Harbor Mason Kitsap Thurston Pierce King Kittitas Douglas Grant Lincoln Adams Spokane Whitman Pacific Wahkiakum Lewis Cowlitz Clark Skamania Klickitat Yakima Benton Franklin Garfield Columbia Asotin Walla Walla Rating Area 1... King Rating Area 2... Clallam...Cowlitz... Grays Harbor...Island... Jefferson... Kitsap...Lewis... Mason...Pacific... Pierce... San Juan...Skagit... Snohomish...Thurston... Wahkiakum... Whatcom Rating Area 3... Clark...Klickitat... Skamania Rating Area 4... Ferry...Lincoln... Pend Oreille...Spokane... Stevens Rating Area 5... Adams...Asotin... Benton...Chelan... Columbia... Douglas...Franklin... Garfield...Grant... Kittitas... Okanogan...Walla Walla... Whitman...Yakima 4

8 RATING AREA 1 Counties Covered King Toll-Free Customer Support Center WAFINDER ( ) TTY/TTD Gold Plans Gold Gold Ambetter Gold Core Gold Plan Gold 1000/20 Gold 1000 Gold 1500 Molina Health Care of Washington Gold Preferred Gold 1000 Preferred Gold 1500 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

9 Silver Plans Silver Silver Ambetter Silver Core Silver Plan Silver 1500/30 Silver 2500/30 Silver 1750/0/HSA Silver 2000 Silver 2500 HSA Silver 3000 Molina Health Care of Washington Silver Preferred Silver 2000 Preferred Silver 2500 HSA Preferred Silver 3000 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 1 Continued 6

10 Bronze Plans Bronze HSA Bronze Ambetter Bronze Core Bronze Plan Bronze 4500/50 Bronze 5000/30%/HSA Bronze 5250 HSA Bronze 5500 Bronze 6350 Preferred Bronze 5250 HSA Preferred Bronze 5500 Preferred Bronze 6350 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 1 Continued 7

11 Catastrophic Plans Core Basics Plus of the Catastrophic 6350/0 Dental Plans $ $ $ Plan Marketing Name Delta Dental Individual - Washington Kids KP WA Dental 80 LifeWise Individual Dental Plan Premera Blue Cross Individual Dental Plan Level of Coverage Annual Out- Of-Pocket Maximum Annual Deductible Counties Covered Rate $1, $50.00 Statewide $33.13 N/A N/A $2, $65.00 Statewide $26.50 $2, $65.00 All counties except Clark $26.50 Rating Area 1 Continued 8

12 RATING AREA 2 Counties Covered Clallam, Cowlitz, Grays Harbor, Island, Jefferson, Kitsap, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Snohomish, Thurston, Wahkiakum, Whatcom Toll-Free Customer Support Center WAFINDER ( ) TTY/TTD Gold Plans Gold Gold Ambetter Gold Core Gold Plan Gold 1000/20 Gold 1000 Gold 1500 Molina Health Care of Washington Gold Preferred Gold 1000 Preferred Gold 1500 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

13 Silver Plans Silver Silver Ambetter Silver Core Silver Plan Silver 1500/30 Silver 2500/30 Silver 1750/0/HSA Silver 2000 Silver 2500 HSA Silver 3000 Molina Health Care of Washington Silver Preferred Silver 2000 Preferred Silver 2500 HSA Preferred Silver 3000 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 2 Continued 10

14 Bronze Plans Bronze HSA Bronze Ambetter Bronze Core Bronze Plan Bronze 4500/50 Bronze 5000/30%/HSA Bronze 5250 HSA Bronze 5500 Bronze 6350 Preferred Bronze 5250 HSA Preferred Bronze 5500 Preferred Bronze 6350 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 2 Continued 11

15 Catastrophic Plans Core Basics Plus of the Catastrophic 6350/0 Dental Plans $ $ $ $ $ $ Plan Marketing Name Delta Dental Individual - Washington Kids KP WA Dental 80 LifeWise Individual Dental Plan Premera Blue Cross Individual Dental Plan Level of Coverage Annual Out- Of-Pocket Maximum Annual Deductible Counties Covered Rate $1, $50.00 Statewide $33.13 $1, N/A Clark and Cowlitz $23.81 $2, $65.00 Statewide $26.50 $2, $65.00 All counties except Clark $26.50 Rating Area 2 Continued 12

16 RATING AREA 3 Counties Covered Clark, Klickitat, Skamania Toll-Free Customer Support Center WAFINDER ( ) TTY/TTD Gold Plans Gold Gold Ambetter Gold Core Gold Plan Gold 1000/20 Gold 1000 Gold 1500 Molina Health Care of Washington Gold Preferred Gold 1000 Preferred Gold 1500 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

17 Silver Plans Silver Silver Ambetter Silver Core Silver Plan Silver 1500/30 Silver 2500/30 Silver 1750/0/HSA Silver 2000 Silver 2500 HSA Silver 3000 Molina Health Care of Washington Silver Preferred Silver 2000 Preferred Silver 2500 HSA Preferred Silver 3000 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 3 Continued 14

18 Bronze Plans Bronze HSA Bronze Ambetter Bronze Core Bronze Plan Bronze 4500/50 Bronze 5000/30%/HSA Bronze 5250 HSA Bronze 5500 Bronze 6350 Preferred Bronze 5250 HSA Preferred Bronze 5500 Preferred Bronze 6350 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 3 Continued 15

19 Catastrophic Plans Core Basics Plus of the Catastrophic 6350/0 Dental Plans $ $ $ Plan Marketing Name Delta Dental Individual - Washington Kids KP WA Dental 80 LifeWise Individual Dental Plan Premera Blue Cross Individual Dental Plan Level of Coverage Annual Out- Of-Pocket Maximum Annual Deductible Counties Covered Rate $1, $50.00 Statewide $33.13 $1, N/A Clark and Cowlitz $23.81 $2, $65.00 Statewide $26.50 $2, $65.00 All counties except Clark $26.50 Rating Area 3 Continued 16

20 RATING AREA 4 Counties Covered Ferry, Lincoln, Pend Oreille, Spokane, Stevens Toll-Free Customer Support Center WAFINDER ( ) TTY/TTD Gold Plans Gold Gold Ambetter Gold Core Gold Plan Gold 1000/20 Gold 1000 Gold 1500 Molina Health Care of Washington Gold Preferred Gold 1000 Preferred Gold 1500 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

21 Silver Plans Silver Silver Ambetter Silver Core Silver Plan Silver 1500/30 Silver 2500/30 Silver 1750/0/HSA Silver 2000 Silver 2500 HSA Silver 3000 Molina Health Care of Washington Silver Preferred Silver 2000 Preferred Silver 2500 HSA Preferred Silver 3000 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 4 Continued 18

22 Bronze Plans Bronze HSA Bronze Ambetter Bronze Core Bronze Plan Bronze 4500/50 Bronze 5000/30%/HSA Bronze 5250 HSA Bronze 5500 Bronze 6350 Preferred Bronze 5250 HSA Preferred Bronze 5500 Preferred Bronze 6350 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 4 Continued 19

23 Catastrophic Plans Core Basics Plus of the Catastrophic 6350/0 Dental Plans $ $ $ Plan Marketing Name Delta Dental Individual - Washington Kids KP WA Dental 80 LifeWise Individual Dental Plan Premera Blue Cross Individual Dental Plan Level of Coverage Annual Out- Of-Pocket Maximum Annual Deductible Counties Covered Rate $1, $50.00 Statewide $33.13 N/A N/A $2, $65.00 Statewide $26.50 $2, $65.00 All counties except Clark $26.50 Rating Area 4 Continued 20

24 RATING AREA 5 Counties Covered Adams, Asotin, Benton, Chelan, Columbia, Douglas, Franklin, Garfield, Grant, Kittitas, Okanogan, Walla Walla, Whitman, Yakima Toll-Free Customer Support Center WAFINDER ( ) TTY/TTD Gold Plans Gold Gold Ambetter Gold Core Gold Plan Gold 1000/20 Gold 1000 Gold 1500 Molina Health Care of Washington Gold Preferred Gold 1000 Preferred Gold 1500 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

25 Silver Plans Silver Silver Ambetter Silver Core Silver Plan Silver 1500/30 Silver 2500/30 Silver 1750/0/HSA Silver 2000 Silver 2500 HSA Silver 3000 Molina Health Care of Washington Silver Preferred Silver 2000 Preferred Silver 2500 HSA Preferred Silver 3000 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 5 Continued 22

26 Bronze Plans Bronze HSA Bronze Ambetter Bronze Core Bronze Plan Bronze 4500/50 Bronze 5000/30%/HSA Bronze 5250 HSA Bronze 5500 Bronze 6350 Preferred Bronze 5250 HSA Preferred Bronze 5500 Preferred Bronze 6350 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rating Area 5 Continued 23

27 Catastrophic Plans Core Basics Plus of the Catastrophic 5000/30%/HSA Dental Plans $ $ $ Plan Marketing Name Delta Dental Individual - Washington Kids KP WA Dental 80 LifeWise Individual Dental Plan Premera Blue Cross Individual Dental Plan Level of Coverage Annual Out- Of-Pocket Maximum Annual Deductible Counties Covered Rate $1, $50.00 Statewide $33.13 N/A N/A $2, $65.00 Statewide $26.50 $2, $65.00 All counties except Clark $26.50 Rating Area 5 Continued 24

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