Individual Health Insurance Marketplace Exchange Information for 2016_Post 2

This week we would like to paint the landscape of Individual Health Insurance Carriers for plan year 2016, as we prepare for the open enrollment commencing in a couple of weeks.

Anthem, is the largest carrier offered through the Marketplace Exchange measured by membership. Their plans use the Pathway Network, which include all but 5 of the 26 NH hospitals. They do not have Concord Hospital, Frisbee Memorial, Portsmouth Hospital, Monadnock Community Hospital or Parkland Hospital

Harvard Pilgrim Health Care, is a non-profit insurance company previously only selling group plans in NH, until 2015, when they joined the individual market in NH. They are offering two different plan networks. The HMO Hospital Network includes all 26 NH hospitals. The Elevate Health Hospital Network is a partnership Harvard Pilgrim has with Dartmouth-Hitchcock and the Elliot. This is a lower cost plan geared to individuals living in the southern NH counties and includes 17 of 26 NH hospitals.

Community Health Options, is a co-op of out Maine. The co-op includes all 26 NH hospitals and includes a nationwide First Health network (PPO). This co-op likes to be known for its Chronic Illness Support Program, which they believe are keeping their members healthy and reducing costs. They are the only individual company in NH featuring a national network.

Minuteman Health, is a co-op out of Massachusetts. They are available in all NH counties except Cheshire. Minuteman’s HMO network includes 13 of 26 NH hospitals. They will also allow the individual market access to the Lahey systems & St. Elizabeth’s Medical Center in Brighton, MA.  There is NO CONCORD, PARKLAND, or SOUTHERN NH HOSPITAL, to name a few. This is a very limited network, but it is very attractively priced.

Under ACA plans, you could possibly qualify for a subsidy to assist you with paying your premiums. Subsidies are based off of estimated adjusted gross income for 2015.  To see if you are subsidy eligible, visit:  http://kff.org/interactive/subsidy-calculator/. If you are eligible for a subsidy, the amount you will pay will likely be lower than the quoted rate.