Pennsylvania already switched to having a state-based exchange on the federal platform (SBM-FP) as of the fall of 2019. Nearly 300,000 Pennsylvanians have insurance through or Obamacare. But that’s changing in the fall of 2020, with the debut of Pennsylvania’s new state-run exchange, called Pennie . Independence Blue Cross told Pennsylvania brokers in October that they would no longer be paying commissions for new business enrolled through the exchange for 2017, and that commissions would only apply to some HMO plans sold off-exchange. The Health Insurance Marketplace in Pennsylvania Here are a few ways residents have benefited from Pennsylvania’s health insurance marketplace: 347,024 Pennsylvanians enrolled in a plan off the healthcare exchange in 2018. In the Philadelphia area, the average premium was decreasing by 10.7 percent in 2015. The website debuted in August, and Pennsylvania residents will use Pennie (instead of to enroll in coverage for 2021. Get up-to-the-minute news sent straight to your device. Actuarial modeling in the state’s proposed waiver indicated that with the reinsurance program in place, unsubsidized premiums in the individual market would be 4.9 to 7.5 percent lower in 2021 than they would otherwise have been. In February, Wolf began the process of moving away from Healthy Pennsylvania. Producers serve an important role in the marketplace and we are committed to continuing to ensure customers have access to the services of licensed health producers. Wolf had long been an advocate of fully expanding Medicaid under the ACA, without any state-specific waiver or modifications. There was an error processing your request. This was a much shorter open enrollment period than was used in previous years. Pennsylvania residents use to shop for and buy health insurance. It was set at 3.5 percent of premiums in 2019, and although that dropped to 3 percent in 2020 (actually 2.5 percent for Pennsylvania, since the state has transitioned to a state-based exchange using the federal platform, as described below), it was still going to be $88 million (now $73 million) that Pennsylvania insurers — and thus, Pennsylvania insureds — have to send to the federal government to use the federally-run exchange. The website debuted in August, and Pennsylvania residents will use Pennie (instead of to enroll in coverage for 2021. It was unclear initially how the transition would play out, but Wolf said he would abandon Healthy Pennsylvania in favor of straight Medicaid expansion, and Democratic state lawmakers urged him to move quickly in doing so. The system has been undergoing the various testing procedures that are necessary in order to ensure a seamless transition in November. GetInsured is the exchange vendor for several other state-run exchanges, including Nevada’s recent transition away from in the fall of 2019 and New Jersey’s transition to a fully state-run exchange in the fall of 2020. As noted above, the enrollment window will continue through January 15, 2021, giving Pennsylvania residents an additional month to sign up for coverage. If you look at the second column in that list, the four-letter codes at the start of each plan’s tracking number indicate their parent company: CABC = Capital Blue Cross; HGHM = Highmark; GSHP = Geisinger; INAC = Independence Blue Cross; UPMC = UPMC.]. And the process of creating the state-run exchange — which will be known as Pennie — has been underway since the legislation was enacted, and the exchange will be up and running for the open enrollment period that begins November 1, 2020. Prior to the President’s announcement, a quarter of a million Pennsylvania residents — about one-third of the individual market in the state — had received cancellation notices. As of November 2014, across 13 carriers, PricewaterhouseCooper was reporting an average premium increase of 10.4 percent in Pennsylvania for 2015. Governor Tom Wolf announced in September 2017 that the uninsured rate in Pennsylvania had fallen to 5.6 percent as of 2016 — the lowest it had ever been, and down from nearly 10 percent before the ACA was implemented. United’s total exchange enrollment in Pennsylvania was 65,159 in 2015. Most of the states that use did end up with lower enrollment for 2018 than they had in 2017, due to the shorter enrollment period as well as sharp reductions in federal funding for exchange marketing, outreach, and enrollment assistance. The Pennsylvania Insurance Department addressed those issues in its letter, asking the federal government to vigorously enforce the individual mandate and to confirm that CSR money would continue to flow to insurers. Pennsylvania exchange applicants are enrolled in Medicaid if their income is up to 138 percent of the poverty level, and 685,809 people were enrolled in the state’s expanded Medicaid program as of December 2019. As a basis for comparison, we encourage you to get quotes direct from other insurance companies to view a better range of plans … Enrollment in expanded Medicaid had grown to 684,297 people as of July 2019. The Pennsylvania Insurance Department’s website has a page that shows rate filings for transitional plans, but the only recent individual market transitional plan filing shown on that page is for Geisinger, for a plan that had 1,791 enrollees as of 2018. In August 2019, Governor Wolf announced the appointees for the Pennsylvania Health Insurance Exchange Authority’s board of directors. But Pennsylvania enacted legislation (H.B.3/Act 42) in 2019 that calls for the state to transition to running its own exchange platform and also create a reinsurance program that will help to make coverage more affordable. But it’s true that adding the cost of CSR only to on-exchange silver plans is the option that protects the greatest number of consumers. In December 2012, then-Governor Corbett announced Pennsylvania would use the federal health insurance exchange rather than implementing a state-run exchange. Compare Health Plans & Providers Now Enter your ZIP code to get started. amounted to $98 million in 2019. By the 2021 plan year, however, Pennsylvania is planning to have its own exchange platform. This was the fifth straight year of enrollment declines in Pennsylvania’s exchange. (717) 705-6938 / Toll-free: 1-877-888-4877 (only in Pennsylvania), Pennsylvania Consumer Assistance Program However, consumer groups and legislators did not support the concept. Email notifications are only sent once a day, and only if there are new matching items. Statewide, the average benchmark premium (second-lowest-cost Silver plan) was 10.9 percent more expensive in 2016 than it was in 2015. The state’s final waiver proposal projects total funding of about $139 million in 2021, with the federal government paying about $95 million of that via pass-through funding (when a reinsurance program results in lower premiums, the necessary premium subsidies are also lower, resulting in savings for the federal government; pass-through funding refers to the process of using a 1332 waiver to allow the state to use the savings, instead of having the federal government keep the money). Pennie stems from legislation that Pennsylvania enacted in 2019, calling for the state to establish its own health insurance exchange that would be operational in time for the 2021 plan year. By the end of the 2014 open enrollment period, private plan Obamacare enrollment in Pennsylvania was the fourth highest out of the 36 states where HHS was running the exchange (trailing Texas, Florida, and North Carolina). Pennsylvania was one of 37 states that used in 2015, and subsidies hung in the balance for millions of enrollees in those states, including 382,000 people in Pennsylvania. UPMC Health Plan has cut broker commissions by one-third, to $10 PMPM, for premium network individual plans, noting that “commissions and pricing are determined by competition and market dynamics.”. Highmark told brokers that they would reinstate commissions for 2017, although their broker commissions were still $0 as of 2018. Earlier in 2012, Corbett had repeatedly indicated his administration preferred a state-run exchange, and feedback gathered by a consultant showed broad-based public agreement. People wanting to … Across the entire individual market in Pennsylvania, which includes five additional insurers that only offer plans outside the exchange, the overall proposed rate change is a decrease of about 2.6 percent. The two […] Pennsylvania has made progress in stabilizing its individual insurance marketplace, with premiums decreasing an average of 2.3 percent in 2019, and shifting to a state-based exchange will "continue to make health care more accessible and more affordable for those who buy health insurance for themselves and their families,” Pennsylvania Insurance Commissioner Jessica Altman said during … Kentucky, New … Final approved rates for some insurers were slightly higher than the insurers had proposed, but the overall impact of the rate review process was a somewhat smaller overall average rate changes across the whole market. You may submit your information through this form, or call Pennsylvania is among the states that have allowed pre-2014 plans to continue to renew and remain in force until the end of 2020, at the discretion of health insurance carriers. Pennie’s goals include: (1) providing a seamless transition from those using, (2) improving access to healthcare for all Pennsylvanians, (3) lowering healthcare costs and premiums, (4) and ensuring excellent customer assistance … Aetna then exited the off-exchange market at the end of 2017. All of the insurers that offered plans in Pennsylvania’s exchange in 2018 continued to do so for 2019 — and several expanded their coverage areas — and Ambetter (Centene) joined the exchange. In the first two days alone, 41,500 people enrolled (30,000 of them did so through In a press release earlier in 2019, Governor Wolf’s office noted that the user fee that was currently being collected by the federal government (for the use of, the federal call center, etc.) But states that run their own exchange enrollment platforms have more flexibility on this, and most of them have opted to extend open enrollment most years. Eleven insurers plan to offer 2021 individual market plans through Pennsylvania’s health insurance exchange (Pennie). Jessica Altman, Pennsylvania’s Insurance Commissioner, testified before the PA House Insurance Committee in May 2019 and outlined the myriad benefits of switching to a state-run exchange. Pennsylvania initially opted not to establish its own exchange (although the state seriously considered establishing its own exchange in 2015, when the King v. Burwell lawsuit threatened premium subsidy access in states that didn’t run their own exchanges). On June 15, Pennsylvania was one of three states that got conditional approval from the Obama Administration to operate a state-run exchange. If you have questions or comments on this service, please She has written dozens of opinions and educational pieces about the Affordable Care Act for Read about Insurers in Pennsylvania added the cost of CSR to the premiums for on-exchange silver plans. See health coverage choices, ways to save today, how law affects you. All told, there are nearly a million people in Pennsylvania who are receiving either expanded Medicaid or premium subsidies in the exchange to make private coverage more affordable. The expansion of short-term health plans also created an alternative for some healthy enrollees (Pennsylvania defaults to the federal rules for short-term plans, so longer short-term policies have been available in the state since the fall of 2018). Cutting commissions has an immediate effect on sales, as brokers are less likely to work with carriers that aren’t paying them, or that are paying far less than other carriers. Short-term health plans can be sold in Pennsylvania, November 1, 2020, through January 15, 2021, New Jersey’s transition to a fully state-run exchange, already switched to having a state-based exchange on the federal platform (SBM-FP) as of the fall of 2019, five other states have the same exchange model, fund the state’s portion of the cost of the reinsurance program, 60 percent of the cost of claims that fall between $60,000 and $100,000, The following average rate change proposals, average proposed rate increase of 4.6 percent, published final 2016 rates for the individual and small group markets, available on the Pennsylvania Insurance Department’s website, list of entities offering coverage in the exchange in 2017, HHS finalized risk adjustment data in July 2017, would have been in the range of 7.6 percent, is the option that protects the greatest number of consumers, if the individual mandate penalty hadn’t been eliminated, not offering silver plans at all in the individual market in 2017, likely because of people switching from private health plans to Medicaid, insurer exits from the exchanges/individual market, penalty repeal didn’t take effect until 2019, Pennsylvania defaults to the federal rules for short-term plans, just 12.6 percent of what they were supposed to be, reduced or eliminated broker commissions for 2016, page that shows rate filings for transitional plans, used by Arkansas, Kentucky, Oregon, Nevada, and New Mexico, Health Care Matters, Pennsylvania Office of the Attorney General, Health insurance & health reform authority, Nearly a million people in Pennsylvania have. What is Obamacare? The Insurance Department’s summaries of the proposed and approved rates made it very clear that the federal government’s actions with regards to the ACA had been destabilizing, and highlighted the “Wolf Administration efforts to combat the effects of sabotage on health insurance markets by the federal government and specifically the Trump Administration to dismantle the Affordable Care Act (ACA).”. This was slightly lower than the enrollment total in late 2018, so enrollment in Pennsylvania’s expanded Medicaid, which took effect in 2015, appears to have stabilized. Highmark also expanded into 14 additional counties for 2020. With the reinsurance program in place, Pennsylvania estimates that the number of subsidized enrollees in the state’s individual market will remain roughly level from 2020 to 2021, but that the number of unsubsidized enrollees will grow by about 4,000 people. The state had indicated that they would likely keep the fee at 3 percent of premiums and use the excess for “any unexpected transition costs” that arise as the state switches from to its own enrollment platform. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Ambetter from PA Health & Wellness joined the exchange for 2019, offering plans in the Philadelphia area, and Oscar joined the exchange for 2020, also offering plans in the Philadelphia area. Pennsylvania’s plan is to also implement a reinsurance program, and to fund the state’s portion of the cost of the reinsurance program with the savings (roughly $42-66 million) that come from switching to a state-based exchange. Harrisburg, PA – September 22, 2020 – Today, Pennsylvania announced, Pennie™, the new state-based health insurance marketplace for 2021 coverage. The new system, HealthChoices, is the managed care system that Pennsylvania has used for years, although the benefits have been modified. Pennie — the new Pennsylvania Insurance Exchange — will be in use when open enrollment begins on November 1, 2020. Many Pennsylvania consumers now pay less for their coverage than before the Affordable Care Act (ACA) was created. Corbett’s administration proposed establishing several, regional exchanges. The following average rate change proposals are being considered by regulators in Pennsylvania: In Pennsylvania, Highmark’s individual market plans are available through several affiliates. There were three plan options under Healthy PA: One for healthy enrollees, one for sick enrollees, and the third for the newly-eligible population with incomes up to 138 percent of poverty (as opposed to the single Medicaid program for all enrollees that the ACA’s straight Medicaid expansion uses). Winds W at 5 to 10 mph. Open enrollment through Pennie will run Nov. 1 through Jan. 15. And a Commonwealth Fund analysis found an average rate increase of 12 percent in the Pennsylvania exchange, across all plans and metal levels, for a 40-year-old non-smoker. to speak directly with licensed enrollers who will provide advice specific to your situation. But then in November 2014, Democrat Tom Wolf defeated Corbett in the election, and took over as Governor in January 2015. Pennie is available to all Pennsylvanians and aims to improve the accessibility and affordability of individual market health coverage. Stay up-to-date on breaking news, weather and entertainment with "Desktop Alert Notifications" Ambetter from PA Health & Wellness is offering plans in the Philadelphia area (Bucks, Montgomery, and Philadelphia counties). About Pennsylvania’s Health Insurance Marketplace Nearly 332,000 residents enrolled in health insurance for the 2020 open enrollment , which ended on December 18, 2019. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at Pennsylvania’s new reinsurance program, described above, is playing a role in keeping premiums down for 2021; the expectation is that insurers would have proposed a small overall average rate increase if the reinsurance program had not been created. Ten Tips for Selecting a Health Insurance Provider; is not an insurance company and is not affiliated with any State or Government entity. And the risk corridor payments that were supposed to make up some of the 2014 losses ended up being just 12.6 percent of what they were supposed to be. This change reduced Pennsylvania’s exchange user fee to 2.5 percent of premiums for 2020, instead of 3 percent. But the Kaiser Family Foundation looked at the average cost of the benchmark plan for a 40-year-old enrollee in a major metropolitan area in each state. For perspective, here’s a look at how average premiums have changed in Pennsylvania’s exchange over the years: 2015: In 2014, rates for coverage in the Pennsylvania exchange were lower than the national average. Thank you for participating in Pennsylvania’s new health insurance marketplace launching for the 2021 plan year! In addition to financial savings, states that run their own exchanges also have flexibility regarding their open enrollment schedules (Pennie’s first enrollment window will continue until January 15, 2021, which is an extra month beyond what it would be if the state had continued to use, call center operations, and navigator grants. Highmark insured nearly 60 percent of the people who enrolled in coverage through the Pennsylvania exchange in 2015. The Pennsylvania Insurance Department and the CEOs of the five individual market insurers had sent a letter in April 2017 to HHS, asking the federal government to take swift action to ensure stability in the individual insurance markets. If a customer enrolls in coverage between December 16 and January 15, the coverage will begin on February 1, 2021. Success! People wanting to enroll in coverage that begins on January 1, 2021 need to apply by Dec. 15. Open Enrollment and Obamacare in Pennsylvania The Open Enrollment period for Obamacare started November 1st 2021 and ends on December 15th 2020. And HHS announced in October 2016 that the average cost of a benchmark plan (second-lowest-cost silver plan) in Pennsylvania for a 27-year-old would be 53 percent higher in 2017 than it was in 2016 (significantly more of an increase than the 22 percent average across all the states that use Health Care Matters, Pennsylvania Office of the Attorney General Chance of rain 50%.. Showers early, then partly cloudy overnight. No denials or cancellations. Explore health coverage plans and find the right one for your needs. But this tactic allows the carriers to remain on the exchange (albeit with reduced sales) and keep their options open for sales the following year. 619-367-6947 But several insurer entities are part of the same parent group. Residents in nearly half of Pennsylvania’s counties had additional plan options for 2019. Showers early, then partly cloudy overnight. Official site of Affordable Care Act. Pennsylvania on Tuesday debuted its state-based insurance marketplace,, which will give residents who buy individual health plans an extra four weeks to shop for 2021 coverage. The Insurance Department credits the state’s decision to have insurers add the cost of cost-sharing reductions (CSR) only to on-exchange silver plans for 2018 with helping to stabilize the market and resulting in “only a small decline [in exchange enrollment] from the previous year.” Pennsylvania’s exchange market shrank by 9 percent in 2018, while the average across all states that use was about 5 percent. And Zachary Sherman, who previously served as the director of Rhode Island’s health insurance exchange, is leading Pennsylvania’s exchange. As of June 2020, the exchange had a full-time staff of 19 people and was beginning a second hiring wave, which brought the staffing level up to about 25 as of late September. 2019: Initially, in June 2018, Pennsylvania insurers filed plans with an overall rate increase of 4.9 percent. Although overall average rates in Pennsylvania’s exchange declined slightly for 2019, they would have declined even more if the individual mandate penalty hadn’t been eliminated and if the Trump Administration hadn’t expanded access to short-term plans and association health plans (AHPs). Average premiums in Pennsylvania’s individual market decreased slightly for 2019, and although they increased by an average of almost 4 percent for 2020, a rate decrease is expected again for 2021, thanks to the transition to a state-run exchange and the implementation of a reinsurance program. Across all states that use, enrollment was about 5 percent lower in 2017, so Pennsylvania’s decline (about 3 percent) wasn’t quite as significant as the average. Freedom Life/National Foundation Life also exited the off-exchange market at the end of 2017, but the Pennsylvania Insurance Department confirmed that Freedom Life/National Foundation Life never marketed their plans and didn’t have any enrollees in 2017. Assuming the state’s waiver proposal is approved, the federal government would provide a substantial amount of pass-through funding. On May 1, 2015, Pennsylvania Governor Tom Wolf announced that Pennsylvania had a contingency plan to create a state-run exchange if the Supreme Court ruled that subsidies could not be provided via the federally facilitated marketplace ( Lowest monthly SHOP health insurance premiums in Pennsylvania . A few flurries or snow showers possible. 2019: 365,888 people enrolled during the sixth open enrollment period, for 2019 coverage.