Ohioans who do not have health insurance through their employer, Medicare or Medicaid may be eligible to purchase coverage through Ohio's exchange.
The Affordable Care Act (ACA) requires that every state have an exchange where consumers can buy individual health insurance policies. In Ohio, the federal government runs the health insurance exchange. Ohioans who do not have health insurance through their employer, Medicare or Medicaid may be eligible to purchase coverage through the exchange.
Open enrollment for coverage next year (2018) begins November 1, 2017 and there continues to be a significant amount of change on the federal exchange in terms of which insurers are selling policies. Health insurers continue to struggle with market changes and uncertainty and as a result, consumers in many parts of Ohio will see a difference this fall as they shop for coverage. In addition, as consumers start using their plans in 2018, the policies may not cover certain providers and may not offer the same co-pays, co-insurance and deductibles as plans they have today.
Ohio's Health Insurance Market (2016 – 2018)
- In 2016, 17 companies sold health insurance products on the federal exchange in Ohio and all 88 counties had at least four insurers selling exchange products.
- In 2017, 11 companies sold health insurance products on the exchange in Ohio, but there were 20 counties with just one insurer selling and 27 counties with just two insurers.
- In 2018, 8 companies will sell health insurance products on the exchange in Ohio.
- In 2018, 42 counties will have just one insurer and 20 counties will have just two.
Premium Information for 2018
Following implementation of the ACA, plan options and the premiums associated with those plans underwent significant changes. Since 2013, the Department has provided information prior to open enrollment each year as plans and premiums change. In 2013, the weighted average premium for an individual market plan was $2,650.17 and in 2018, it will be $5,798.83. That is an increase of 119 percent.
In addition, the average cost of coverage for individual plans sold on the federal exchange in 2018 will be 34 percent higher than the average cost of coverage in 2017. Approximately 11 percent of that increase is attributable to the assumption that insurers will not receive Cost Sharing Reduction (CSR) payments in 2018.
The average cost of insurance in the small group market has stayed level from 2017 to 2018 – with only an increase of one-half of one percent. Overall, the weighted average premium has increase 84% from 2013 to 2018, from $4,041.66 to $7,444.34.
Insurance Carriers Approved to Sell Individual Exchange Products in 2018
- AultCare Insurance Company
- Buckeye Community Health Plan
- Medical Health Insuring Corp. of Ohio
- Molina Healthcare of Ohio, Inc.
- Paramount Insurance Company
- Summa Insurance Company
Questions and Answers
When do I begin shopping for my new coverage?
All Ohioans who purchased health insurance through the federal exchange in 2017 will need to select a plan for 2018 during open enrollment, which begins November 1. Ohioans who bought health insurance from Anthem or Premier on the exchange will need to find another insurer for 2018, but they have coverage until December 31, 2017. Those currently using Anthem or Premier exchange plans will receive notices about the change in the fall.
When will I be impacted by these changes if I buy on the exchange?
As early as January 1, 2018. Open enrollment begins on November 1, 2017 and runs through December 15, 2017. You will need to choose a plan during this time if you want your coverage effective January 1, 2018.
What types of coverage will be available in previously “bare” counties where insurers have agreed to offer coverage?
Coverage will be very similar to options in previous years. As the result of insurers stepping into counties with no insurer, some counties may have only silver level plans available. Consumers will also want to look closely at in network providers for the plan that is offered, as the options likely have changed. Some in network providers may be outside of the county.
What is causing these changes to Ohio's health insurance market?
Ohio's insurance market is different than many others around the country. Because Ohio had so many insurance carriers selling in Ohio and because Ohio didn't require a lot of mandated coverage before the ACA, there was more choice for consumers and a wider range of prices. The ACA has narrowed the market in Ohio resulting in less choice for many consumers.
I need assistance to understand my situation and my options. Who should I contact?
During exchange open enrollment, the best first step is to contact an agent or broker. Additionally, consumers looking to obtain coverage may contact the federal exchange in Ohio directly by visiting www.healthcare.gov or by calling 1-800-318-2596. However, if consumers are having problems with their coverage, claims disputes, or other concerns with their policy they can contact the Ohio Department of Insurance at 1-800-686-1526.