Health Insurance Carriers 101
Health insurance is a major purchase that can be stressful to navigate, but it doesn’t have to be. Here we review 2024 carrier options in Illinois for both the individual and group markets, along with tips for understanding and picking the best carrier for your needs.
Understanding the Difference Between Health Insurance Carriers in the Individual Market
When picking a health insurance plan, there are generally a handful of carriers to select from. When picking a carrier, the goal is to choose the best-priced plan that includes doctors and hospitals you prefer and medication coverage along with the plan components that work best for you. Make sure you choose a plan that creates stability for your life. Folks are encouraged to make selections based on cost, network and plan features. Sometimes cheapest is not best; the middle of the road and/or cheaper plans can work for you.
2024 Individual Qualified carriers include:
BlueCross BlueShield
Oscar
United Healthcare
Ambetter
Cigna
The individual market is pretty bleak with few options, most of which are HMOs with a handful of PPOs from BCBS that offer their smaller choice network. The individual market is sometimes the only direction for folks and when one can access a subsidy - a tax credit used like a coupon - it makes these inferior options much better.
Ambetter offers the least expensive plan in the market. BCBS offers an inferior product called FocusCare that is also inexpensive. Cigna has some options that are middle priced and not competitive. The goal for health insurance purchasing is to get the best possible plan that meets your network needs for the least possible price.
Sometimes a few plans will apprise themselves as viable options and this is the juncture where you need to decide if you are a name brand buyer or willing to go with a carrier that is newer to the market or not as popular. To put this into perspective, if BCBS has a plan for $150 and Ambetter has a plan for $50 then you need to decide if you are willing to go with a newer, less seasoned carrier. Is saving $1200 per year on health insurance the right place to save? If you are super healthy and rarely use your insurance, then this could be the right place to save. If you are a regular or heavy user of insurance then taking the leading carrier that pays their claims quickly and is extremely well-staffed and organized is likely the best route.
How to Choose the Best Health Insurance Carrier For Your Needs in the Group Market
The group market offers larger networks and more options than the individual market, but no access to subsidies. Rates in the fully insured market are pre-filed and as-is with no ability to alter them. They are based on age and zip code. Rates in the level funded market are underwritten and take into consideration age, zip code, and also health and sex.
2024 Small Group fully funded carriers include:
BlueCross BlueShield (BCBS)
United Healthcare (UHC)
Oscar
Aetna
Cigna
2024 Small Group level funded carriers include:
United Healthcare
Aetna
National General
Nationwide
Depending on the size of your group there will be different carriers available and, again, choosing the best priced plans that meet your network and usage needs is key.
In the fully funded insurance market, when choosing between BCBS and other plans, it is important to understand network and important coverage components like medication or mental health needs. United Healthcare is better at covering formulary medications, whereas BCBS is better at covering mental health. You can change fully insured products in the group market at any time.
In the level funded insurance market, it is very important to pick a carrier that is using a large, high-quality network and has the ability to pay claims. No matter which carrier is selected, the rates provided will be later underwritten and confirmed. Often, you are committed to at minimum a year of holding the policy.
We are happy to help navigate choosing the best carrier for your needs. Contact us today to get started.
