WA Small Group plans - here's the scuttlebutt on the 2018 programs!

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​Check out our compilation of what’s happening in the WA small group health insurance market this year:  what’s in, what’s out, common trends, enhancements, take-aways, and more.

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We are all burning the midnight oil at this point in Q4. Hang in there….  Here’s a quick run-down of some benefit trends that we are seeing as carriers and Trusts come out with their new plans.
 
Plans going away
Plans are going into the “round file”.  The leaders of the pack are Aetna and United, who seem to be deleting plans throughout low, medium, and high deductible levels. 

• Aetna – ridding of $250, $1350, $1750 and $7150 PPO plans; $4000 copay plan; $6350 Saver plan; $1500, $4900 and $5500 (60/70/50) HSA plans
• AWB – ridding of $250 PPO and $1300 HSA
• Omni/CleanTech – ridding of $0 PPO plan
• Premera – ridding of Balance $500 PPO Employee only plan, Balance $750 PPO and Balance $4000 HSA
  
• Regence – ridding of $7150 PPO and $6000 HSA
  
• United– ridding of $0 PPO and $2700 HSA; FlexFree plans; Consumer plans

Some plans with smaller networks and/or PCP-required referrals are going the way of the dinosaur.

• Aetna – ridding of their Aetna Whole Health programs

• Premera – ridding of their PersonalCare plans

 
New plans added
Although more than 20 plans are going away, we are seeing a number of new plans being added. As would be expected, most of them have deductibles on the higher end of the spectrum.

• Aetna – adding $6500 Copay plan
• AIMS – adding $2750 PPO
• AWB – adding $6000 PPO and $3500 HSA
• BHT – adding $4000 PPO
• Omni/CleanTech – adding $3500 PPO and $6000 PPO
• Premera – adding $1500 PPO, $3000 HSA and $6000 HSA under the larger network; $1500 HSA under the smaller network
• Regence – adding $2500 PPO and $5500 PPO
• United – adding Choice $100, $500 and $2500 PPO plans

 
Trust changes
A few more Trust plans are splitting into separate business segmentations, where the plan offerings, plan names, or renewal dates are diverging.

• AET – a couple years ago we saw them split into AIMS and ALLtech with different plan names and some differences in plans offered. They’ve added another plan to just the AIMS lineup this year.
• BHT – they have broken out five “sub-trusts” (aerospace, healthcare, media, tourism, transportation) that will next renew on 7/1/2019 rather than 1/1/2019. For now all the plans remain the same between the “regular” and the “fab-5” segments.
• OMNI – their CleanTech and Life Science programs will now move further apart with different plan names and a few different plan offerings under the CleanTech segment.

 
Plan enhancements
Some nice enhancements are appearing. I especially like to see that more services are being covered before having to meet pretty high annual deductible limits.

• AIMS – their Ascent $3000 and $5000 PPO plans will now cover chiropractic and acupuncture before the deductible, with just a copay
• ALLtech – their Balance $3000 and $5000 PPO plans will now cover chiropractic and acupuncture before the deductible, with just a copay
• BHT – their Titanium $200, $350, and $500 plans will now cover diagnostic lab & x-ray before the deductible, still subject to the coinsurance
• Kaiser – adding nonpreferred drug coverage to their HMO plans
• Kaiser – removing the emergency room copay from all plans that currently have one
• Premera – on their HSA plans, will no longer require a specific employer contribution, or no employer contribution, into employee HSA accounts
• Regence – nonHSA plans will now cover outpatient rehabilitation and massage before deductible, with just a copay
• Trust plans using Premera – plans with the smaller Heritage Prime network will now include the PrimePlus Care Program.  This will allow members to receive enhanced coverage when they seek certain services at Seattle Cancer Care Alliance, NW Medical Specialties, and Proliance Surgeons (even though they are out of network under the Heritage Prime network normally).

Telehealth is being added by more and more carriers/trusts, through various external vendors.  

• Asuris NW and Regence -  adding Doctor on Demand
• AIMS and ALLtech – adding MD Live
• BHT and OMNI – adding Teladoc
• WTIA - adding Teladoc, but only on their nonHSA plans

There were already a number of programs that included Telehealth, and will continue to do so.  These include AWB, Aetna, Kaiser, Premera, and United.  Member cost for accessing Telehealth continues to have a wide range depending on the carrier/trust and in some cases the plan elected under that carrier/trust.  NonHSA plans range anywhere from a copay of $0 to $50, with the most common being a $10 copay.  Most HSA plans require the member meet their deductible first, then cover at the plan’s coinsurance level.  

Plan take aways
A number of plans are increasing deductibles, out of pocket maximums, copays, etc.  We noticed two sweeping reductions in benefits that are occurring on the Aetna plans this year.

• Aetna – all out of network services will have an unlimited out of pocket maximum
• Aetna – all nonHSA plans will increase emergency room copay to $500

 
Trusts on the move
On a final note, some Trusts (and even one direct carrier) are moving their non-medical programs to new insurance carrier partners.

• AWB – moving dental from Premera to Delta Dental
• Regence – moving vision from Regence to Vision Service Plan
• WTIA – moving dental from Premera to Delta Dental
• WTIA – moving life and disability from Aetna to MetLife

 
Phew! I am sure I have not captured all the changes going on out there, since there seem to be so many moving pieces this year….