2020 Seattle-area ACA plans: an early look

Next year will be our family’s first experience buying health insurance on the individual market through our state’s ACA exchange. In 2019 there are four companies offering insurance in King County (home to Seattle, many of its suburbs, and nearly a third of Washington’s population): Ambetter, Kaiser Permanente, Molina, and Premera. Premera offers EPO plans, while the other three insurers are HMOs.

That’s this year. What about next year?

While the insurers aren’t actively selling their plans yet, they have all submitted proposals to the state insurance commissioner for the plans they would like to offer and rates they would like to charge. The commissioner has to review and approve these rates before the plans go on sale during open enrollment later this year.

I spent a little time looking through these proposals to see what’s in store for next year. All four of the companies currently offering individual insurance in King County plan to continue doing so next year. We’ll also see the addition of two more companies to the local exchange: BridgeSpan and LifeWise.

Keep reading for a company-by-company summary of the proposals for next year.

Ambetter

Ambetter is the low-priced leader for silver plans in 2019. They offer seven silver plans on the ACA marketplace, including the cheapest six across all companies. This is perhaps not a profitable price point for them, as they requested the largest price increases in King County.

This company intends to continue offering all eight of their current plans (seven silver and one gold) in 2020. They also will add a bronze plan and a second gold plan to their lineup.

Monthly premiums for a 34-year-old non-smoker

Metal Level20192020 (proposed)Percent change
Bronzen/a$333n/a
Silver$350-$393$397-$43210%-13%
Gold$414$46612%

Kaiser Permanente

As far as I can tell, Kaiser Permanente is the only health insurance company on the King County ACA exchange in 2019 that covers out-of-network urgent care for people traveling around the US. This seems like a pretty important differentiating factor for me, and if this continues to be the case in 2020 I will likely buy insurance from them.

They offer six plans on the exchange: a catastrophic plan (the only one available in the county), two bronze plans (including one HSA-eligible plan), two silver plans, and a gold plan.

They also offers two silver plans outside of the exchange, with lower premiums than any silver plan offered on the exchange. One of them is even HSA-eligible! While these plans don’t qualify for premium tax credits, they’re worth a look for anyone with incomes too high for subsidies.

Kaiser intends to continue offering the exact same selection of plans in 2020, with very minor changes in premiums.

Monthly premiums for a 34-year-old non-smoker

Metal Level20192020 (proposed)Percent change
Catastrophic$245$2481.2%
Bronze$303-$304$304-$3090.3%-1.8%
Silver$417-$427$398-$416decrease of 2.6%-4.5%
Silver (off-exchange)$319-$349$323-$3520.8%-1.1%
Gold$451$4540.8%

Molina

Molina has a very simple plan lineup. In 2019 they have one silver plan and one gold plan. In 2020 they will continue offering these (with slightly different names), and will be adding a bronze plan as well. Their two continuing plans will see pretty substantial premium decreases.

Monthly premiums for a 34-year-old non-smoker

Metal Level20192020 (proposed)Percent change
Bronzen/a$297n/a
Silver$391$358decrease of 8.6%
Gold$485$443decrease of 8.7%

Premera

Premera currently offers four plans in King County through the state exchange: a bronze HSA-eligible plan, a bronze non-HSA-eligible plan, a silver plan, and a gold plan. This will continue to be the case in 2020, though the plans will be named differently than before. Will this mean a major change in physician networks or general coverage levels? It’s hard to tell from my reading of the rate request documentation.

What is apparent is that the company has requested lower premiums for the 2020 plans than what they’re charging in 2019. Premera was the most expensive for its metal level in 2019, and looks to remain so in 2020, though they intend to narrow the gap a bit.

Monthly premiums for a 34-year-old non-smoker

Metal Level20192020 (proposed)Percent change
Bronze$397-$434$370-$375decrease of 6.8%-13.7%
Silver$494$474decrease of 4.0%
Gold$582$541decrease of 7.0%

LifeWise

LifeWise currently offers ACA insurance in several Washington counties, but not King County. They plan to expand into King County in 2020, with six plans at a variety of price points.

Monthly premiums for a 34-year-old non-smoker

Metal Level2020 premiums (proposed)
Catastrophic$239
Bronze$286-$289
Silver$383-$385
Gold$414

BridgeSpan

BridgeSpan is another new entrant to the King County marketplace. They will be offering a selection of plans affiliated with the University of Washington medical system, including a silver high-deductible plan that should be HSA-eligible.

Monthly premiums for a 34-year-old non-smoker

Metal Level2020 premiums (proposed)
Bronze$263-$282
Silver$398
Gold$464

Regence

Regence will also be offering a new selection of plans affiliated with UW Medicine, but their plans will only be sold outside of the state exchange and therefore ineligible for premium tax credits for households below 400% of the poverty line.

Monthly premiums for a 34-year-old non-smoker

Metal Level2020 premiums (proposed)
Bronze (off-exchange)$271-$298
Silver (off-exchange)$343-$382
Gold (off-exchange)$483

Summary

All in all, the state of the ACA marketplace in King County seems pretty strong heading into 2020. The number of insurers offering individual policies will be increasing, and the price of many of these policies will be decreasing if the insurance commissioner approves the proposed rates.

Most interestingly for those of us who anticipate receiving tax credits toward our premiums, the second-cheapest proposed silver plan (offered by Ambetter) will be more expensive than this year, while most of the competition will be cheaper by comparison.

This is important because the ACA is designed to set the net price of the second-cheapest silver plan at a fixed percentage of income. If the second-cheapest silver plan goes up in cost, everyone’s tax credit goes up by that same amount. Meanwhile with many other plans actually going down in price, this could lead to a pretty noticeable cost reduction for anyone who chose a plan with one of these insurers than is lowering their rates.

The insurance commissioner should be issuing their final decisions in the near future, and I’ll make an updated post when that happens.

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