While the majority of the US population has health coverage through their employer, there are still many people who look to the private insurance market or the Affordable Care Act exchanges for their individual health insurance. Unfortunately, those people are facing premium rate increases of over 20%, with most of our clients falling into the 25-28% range. The affordability that was meant to follow the ACA is under question and predictions from the recent election tell of changes to come. In the meantime, the ACA is still law and individuals are still required to have health care in 2017. With renewal dates coming up quickly, the Wharton Insurance Team is working diligently to find more affordable options for our clients.

2017 Individual Health Insurance Options:

1) Change Your Provider – If you are currently covered under an ACA health insurance exchange plan, it may be worthwhile to check out your options with an off-exchange insurance provider such as Anthem, IU or United Healthcare. On the other hand, if you already have a private plan, taking a look at ACA exchange plans may be worthwhile. Your insurance broker will be able to help you compare the benefits and premiums of all of your options to get you the best coverage for the price.

2) Reduce your Benefits – Regardless of whether you have an on- or off-exchange plan, another way to reduce your premiums is to reduce your benefits. Raising your deductible, out of pocket fees or co-insurance percentages can help you save on monthly premiums. You will want to consider the overall costs when making this assessment, as reducing your benefits may end up costing you more in the long run if you end up fully using your health insurance due to an unexpected illness.

3) Consider Short-term Major Medical Plans – Commonly referred to as catastrophic coverage, short-term major medical plans are a good stopgap option between your COBRA running out and signing up for a group health plan with an employer. The catch is that under the ACA, these plans are set to be banned beginning in 2017. However, it is unclear if that portion of the law will be enforced. Short-term major medical does not count as insurance coverage under the ACA, so you will be required to pay a fine at tax time. However, the total cost of the plan plus the fine may still be less than supporting a full insurance plan.

4) Decline Coverage – An available option we do not like to see anyone take is to go without health insurance. Under the ACA, you will be required to pay the fine for lack of coverage; however, it could be less costly than plan premiums—as long as you do not get sick!

5) Move to a Group Plan – If you are a business owner, as long as you have two FTE employees working a minimum of 30 hours per week, you are eligible for group health insurance plans. Historically, the premiums have been much more stable in this market, with an average of 10-11% increases year over year for a healthy group. Your insurance broker can help you find the best fit for your business.

Another recent change in the health insurance market is the fee structure for brokering individual health insurance services. Previously, the cost of tapping into the expertise of a knowledgeable broker was folded into the monthly premiums. However, the insurance providers have changed their structure, placing the cost onto the consumer. This means that you should expect to pay service fees to your broker for managing your health insurance needs, or some, but, not all insurance companies. Having a knowledgeable partner by your side will help you avoid the headaches of researching and signing up for your best insurance coverage option.

The Wharton Insurance Team has over 25 years of experience in assisting our clients in finding cost-effective health insurance plans. Send us an email, or give us a call at 317-663-4138 for more information on how we can help you.