As the annual Open Enrollment Period approaches this fall, there are some major changes to be aware of for your health insurance renewal. In 2022, Covered California ( Covered CA) premium rates will have a modest weighted average premium increase of 1.8% across California. Some insurance carriers are seeing premiums drop such as LA Care while Oscar Health is showing the largest premium increase for 2022. While there is a slight increase overall, the American Rescue Plan will continue to provide financial relief for Covered CA policyholders through the end of 2022 (legislation has been proposed to extend the American Rescue Plan premium assistance past 2022). We are also seeing benefit improvement to the Silver plan benefits, the introduction of Bright Health into California, and other changes for the 2022 year.

The American Rescue Plan Act will still provide additional premium assistance in 2022. The act will cap the cost of the 2nd most affordable silver plan to no more than 8.5% of household income; however, the unemployment premium assistance generously provided in 2021 will expire on December 31st, 2021. The unemployment premium assistance provided the maximum premium assistance available ( Silver 94 benefits) , regardless of household income, calculating federal tax credits at just above the cutoff for Medi-Cal. This will mean many Covered CA members who reported unemployment as a source of income in 2021 will likely see less premium assistance in 2022. If they do not actively renew will be moved from their Silver 94 plan to the regular Silver 70 plan with less generous benefits and higher premiums.

With the introduction of the American Rescue Plan in 2021 all Covered California policyholders received a prorated premium deduction from May to December 2021. The prorated deduction was calculated out of the difference of the higher premiums from January to April of 2021. to the premiums from May to December of 2021. So although you will see a 1.8 % average increase, you will also see a higher premium in January due to the end of the pro-rated premiums in 2021. For example, your premium was $ 300 monthly from January to April, and then due to the American Rescue Plan, the rate dropped to monthly $ 200 in May. They took the difference of January to April ( 4 x $100) = $400 and deducted this for the remaining 8 months, so your rate was not only lowered to $ 200 in May but it was $ 200- $50 = $ 150 prorated . So the January 2022 rate will show an increase of 1.8 % then 2021 rate will be $ 203.60 – and this might be confusing as you paid in December the prorated rate of $ 150 and you feel that this is a steep increase.

Starting in January 2022 , Covered California will pay $ 1.00 per month per member on any Covered CA health plan , regardless if they get a subsidy or not. ( Assembly Bill133)

Bright Health Expansion into California

In 2022, Bright HealthCare will start offering individual and family plans in Contra Costa as a small initial entry into the California individual and family health insurance market. You could say Bright HealthCare is “testing the waters” before a possible expansion into more regions of California in the future. We look forward to a total of 12 health insurance carriers participating in the individual and family health insurance market in 2022.

Blue Shield Trio HMO Expansion & rate drops

Blue Shield of California’s Trio HMO is expanding into Santa Barbara & Monterey in 2022. Not only that, the Trio HMO is seeing major premium drops, Gold 80 Trio HMO plans are dropping 35% in West Los Angeles (price region 16) and 30% in Orange County (price region 18) while Blue Shield’s PPO rates are seeing a modest 3% rate increase statewide.

Silver Plan Changes

In 2022, the Silver 70 plans will have some big changes. The most notable change is the drug deductible is dropping from $300 to just $10, a $290 decrease. In addition, the medical deductible is decreasing $300 from $4,000 to $3,700 while doctor copays are dropping from $40 to $35 for primary care, urgent care, and therapists while specialist copays are dropping from $80 to $70.

As we approach the Open Enrollment Period from November 1st, 2021 to January 31st, 2022, please review your income, preferred doctors, and of course your budget for the next year’s health insurance. At Solid Health Insurance, we strive to find the right health, dental, vision, life, and long-term care insurance which best fits your budget and medical needs. Please contact us at info@solidhealthinsurance or at 310-909-6135 to go over your 2022 renewal options.