Q1 2025 Carrier Update Overview

• Rate Change: 2.6%
• Quoting Availability: Available now
• Plan/Portfolio Updates: Plans have minor benefit changes to remain compliant. New value-add programs for all members include Aetna Health Your Way-Core, 12-months Contraceptives, and $0 diabetic benefit.

• Rate Change: HMO 3.0%-4.0% / HMO HSA 2.9%-3.8% / PPO 2.6%-3.3% / PPO HSA 3.0%-4.0%
• Quoting Availability: Available now
• Plan/Portfolio Updates: Plans have minor benefit changes to remain compliant. All members will receive the Price Edge program to reduce costs of prescriptions. 
• Network Updates: Prosano is expanding to Tucson.
• Broker Incentives: Two new bonus programs for new groups.

• A broker bonus program is available.

• Quarterly Rate Change: HMO 2.6%-2.9% / PPO 4.1%-4.3% / PPO HSA 6.3%
• Quoting Availability: Available now
• Plan/Portfolio Updates: Plans updated to meet AV, 5 discontinued plans (see the California Toolkit for a list and map)
• Network Updates: AWH Northern California HMO network discontinued. Members will be mapped to an alternate plan at renewal.

• Quarterly Rate Change: HMO 0.9%-1.3% / PPO 1.1%-2.5%
• Annual Rate Change: HMO 7.4%-8.5% / PPO 7.7%-9.0%
• Quoting Availability: Available now
• Plan/Portfolio Updates: Chiropractic copay is $15 on all copay PPO plans; Rx benefit improvements in Vivity HMO; RxD plans have been discontinued; Silver Priority Select and Silver Vivity HMO plans removed.
• Underwriting Guidelines: DE-9C no longer required with 3+ enrolling; relaxed participation; carrier exit simplified underwriting extended through 1/1; network flexibility continues through 3/1

• Quarterly Rate Change: 1.3% average
• Quoting Availability: Available now
• Plan/Portfolio Updates: Minimal changes are expected, but include improved deductibles and out-of-pocket maximums, added benefits, easier HMO pairing, and expanding access to care. There are also pharmacy updates and updates to small business dental.

• Rate Change: Varies from -2.4% for UHC to 13.3% for WHA
• Quoting Availability: Available now
• Plan/Portfolio Updates: Anthem Platinum HMO B became available on 9/1/2024. Several plans have benefits changes. Cigna+Oscar plans have been terminated.
• Network Updates: Cigna+Oscar is no longer available.
• Underwriting Guidelines: Groups leaving Cigna+Oscar can take advantage of relaxed underwriting and submit a bill rather than the DE-9C.

• Quoting is available.

• No plan or rate changes.
• Quoting is available.

• The 2024 portfolio remains in effect through 03/01/2025.
• Quoting is available.

• Contributory plans: 8.5% increase
• Voluntary plans: 15% increase
• Calculator is available.

• Rate Changes: Decreased rates for some PPO bundles; no other changes otherwise
• Quoting Availability: Available now
• Plan/Portfolio Updates: Dual choice plans now have rate bands based on total number of employees; voluntary PPO bundle expands child ortho option

• No plan or rate changes.
• Quoting is available.

• No plan or rate changes.
• Quoting is available.

• Quarterly Rate Change: HMO varies from 2.2% to 8.5% / PPO 1.0%
• Quoting Availability: Available now
• Plan/Portfolio Updates: Several plans have updated names to reflect benefit changes.
• Broker Incentives: Partnership that Pays continues through January 1, 2025 effective dates.

• Quarterly Rate Change: HMO Full 1.9% / HMO Limited 1.8% / PPO 2.3% / PPO HSA 3.0%
• Annual Rate Change: HMO Full 9.3% / HMO Limited 7.6% / PPO 6.7% / PPO HSA 9.4%
• Quoting Availability: Available now
• Plan/Portfolio Updates: 61 plans for 2025; CommunityCare products have been discontinued.
• Network Updates: PPO network covers all California counties; out-of-state members have access to Cigna Healthcare PPO. Salud HMO y Más is adding one county.
• Broker Incentives: 6% for 6 is ongoing through January; top eight producers earn exclusive getaway.

• Quarterly Rate Change: HMO 5.1% SoCal, 8.2% NorCal / PPO 7.0% SoCal and NorCal
• Quoting Availability: Available now
• Plan/Portfolio Updates: One plan will be discontinued and members mapped onto a similar, new, plan. Primary plan changes have occurred across all metal tiers.
• Underwriting Changes: Slice group participation requirements have been updated.
• Broker Incentives: Small Group Bonus and Total Replacement Reward are available.

• Quoting is available.

• Quarterly Rate Change: HMO 1.1% / HMO HSA 2.9% / POS 1.6%
• Quoting Availability: Available now
• Plan/Portfolio Updates: Four plans are being mapped to new plan names; all plans have experienced minor benefit changes.
• Broker Incentives: Tiered bonus program runs through January 2025 effective dates.

Note that Q2 2025 Rates are also now available.

• Quarterly Rate Change: HMO 3.9% / HMO HSA 4.9%
• Quoting Availability: Available now
• Plan/Portfolio Updates: Medical plan guide is available now.

• Quarterly Rate Change: PPO 0.4% / HMO -2.4%
• Annual Rate Change: PPO 5.3% / HMO 0.0% / Navigate 7.0%
  Rates are pending completion of regulatory review.
• Quoting Availability: On or before October 1, 2024
• Plan/Portfolio Updates: Care Cash removed from two plans. PCP selection will no longer be required on Select Plus PPO plans.
• Network Updates: Harmony HMO no longer available in Northern California.
• Underwriting Guidelines: uBundle is being added for level funded plans.
• Broker Incentives: Producers can qualify for one of four trip prizes based on the number of new members sold.

• Quarterly Rate Change: HMO 12.8% / HMO HSA 13.7%
• Quoting Availability: Available now
• Plan/Portfolio Updates: Three plans have been mapped to new versions. A new nurse advice line is coming. Expanded disease management and wellness offerings will be available.

• Quoting Availability: Available now
• Network Updates: Pathway CT PPO network transitioning to an in-state Connecticut network; these plans will no longer include national BlueCard access. Century Preferred Network has been added.

• Rate Changes: 4.5% average rate increase for fully insured business
• Quoting Availability: Available now
• Plan/Portfolio Updates: Portfolio has been streamlined and simplified. PCP/Specialist tiering has been removed.
• Network Updates: Freedom Network has non-gated PPO plans; Liberty Network has gated HMO plans (except Platinum tier).
• Broker Updates: Commission on fully insured small groups will change to $37 per employee per month.

• Quoting is available.

• Quoting Availability: Quoting will now only be available on Producer World.
• Plan/Portfolio Updates: Portfolio reduced to 14 plans (7 base; 7 dependent 30). Note that the renewal process will vary by group, depending on whether the plan(s) are included in the new portfolio. Some groups may not receive a full renewal proposal.
• Broker Updates: Aetna will no longer pay broker commissions on new sales of NY SG ACA medical plans with effective dates on or after January 1. For existing business, this change will take place on the group's 2025 renewal date.

• Quoting is available.

• Quoting Availability: Available now
• Plan/Portfolio Updates: HSA plans have changed to deductible, then coinsurance. Gate-keepers removed from all plans except Healthy NY. Mental health/substance abuse outpatient visits covered at $0 copay ($0 after deductible on HSA plans). Blue Access plans have been moved to the Select Rx formulary.
• Network Updates: New tiered PCP benefit (Diamond Provider).

• Rate Changes: decreased rates for all bundles; group size-based rating
• Quoting Availability: Available now
• Plan/Portfolio Updates: PPO bundle availability expansion; dual choice plans now have rate bands based on total number of employees; child ortho availability expansion

• Quarterly Rate Change: HMO and HMO HSA -2.4% / PPO -2.6%
• Quoting Availability: Available now

• Quarterly Rate Change: HMO -2.4% / HMO HSA -2.2% / PPO -5.2% / EPO Full 2.8% / EPO HSA Full -3.9% / EPO Limited 0.4% / EPO HSA Limited 1.5%
• Quoting Availability: Available now

• Annual Rate Change: 5.3% average statewide
• Quoting Availability: Available now
• Plan/Portfolio Updates: Care Cash now embedded into most non-HSA medical plans; premium designation (tiered) plans discontinued; Place-of-Service Tiering discontinued; vision benefits now embedded into most plans.
• Network Updates: Platinum plans are only available on the Freedom Network. PPO plans are only available on the Freedom network. Liberty Network consists only of non-gated EPO plans. All HSA plans in the Metro Network are gated.

• Annual Rate Change: 1.0% average statewide
• Quoting Availability: Available now
• Plan/Portfolio Updates: Plans are designed to be more affordable and simpler.
• Network Updates: Expansion to the Syracuse and mid-Hudson areas with UHC Choice and UHC Choice Plus.
• Underwriting Guidelines: No participation requirements or waivers in the mid-Hudson area.
• Broker Incentives: compensation on mid-Hudson area new sales increased to 4%.

• Quarterly Rate Change: HMO 1.2% / HMO HSA -0.1% / POS 1.7% / POS HSA 0.2% / PPO -4.3% / PPO HSA -6.3%
• Quoting Availability: Available now

• Rate Change: HMO 3.7% / HMO HSA 4.1% / POS 4.3%
• Quoting Availability: Available now
• Network Updates: Four new locations are available. Members can receive high quality care at locations outside of Kaiser Permanente states with access to Cigna's PPO network.
• Broker Incentives: Effective from October 1, 2024, through January 31, 2025, brokers can increase their rewards. 

• Quarterly Rate Change: HMO -2.0% to -0.4% / HMO HSA 3.7% / POS 0.2% / POS HSA 2.5%
• Quoting Availability: available now
• Plan/Portfolio Updates: 13 new plans have been added. All plans include UHC Core Rewards. Non-HSA plans include Care Cash, $0 virtual visits, $0 children PCP visits. HSA plans virtual visits are $0 after deductible.
• Network Updates: The Choice EPO has been discontinued. Participants will be mapped to a new plan at renewal.

• Quarterly Rate Change: EPO 9.3% / EPO HSA 8.4% / HMO 6.2% / HMO HSA 3.8% / PPO 5.7% / PPO HSA 8.3%
• Quoting Availability: Available now
• Plan/Portfolio Updates: The portfolio is updated with minor changes, some new HSA plans available.
• Network Updates: No changes.
• Underwriting Guidelines: No changes.

• Quarterly Rate Change: HMO 0.0% / HMO HSA -0.6% / POS 0.2% / POS HSA -0.5% / PPO 2.4% / PPO HSA 1.7%
• Quoting Availability: Available now

• Rate Change: HMO 3.4% / HMO HSA 4.2% / POS 3.7% / POS HSA 3.5%
• Quoting Availability: Available now
• Network Updates: Four new locations are available. Members can receive high quality care at locations outside of Kaiser Permanente states with access to Cigna's PPO network.
• Broker Incentives: Effective from October 1, 2024, through January 31, 2025, brokers can increase their rewards. 

• Quarterly Rate Change: EPO 1.9%-2.5% decrease / HMO 1.0% decrease to 1.5% increase / POS 1.2%-1.9% decrease
• Quoting Availability: Available now
• Plan/Portfolio Updates: The Plan portfolio has been streamlined and simplified.
• Network Updates: The last remaining plan on the OCI Preferred POS has been discontinued. Plan participants will be mapped to the OCI HMO.
• Underwriting Guidelines: No changes.

• Quoting Availability: Available now
• Broker Incentives: January 2025 Sales Bonus Program is now available; earn up $50 for each qualifying member.

• Quoting is available.

• Rate Change: HMO 4.6% / HMO HSA 5.2% / POS 4.7%
• Quoting Availability: Available now
• Network Updates: Four new locations are available. Members can receive high quality care at locations outside of Kaiser Permanente states with access to Cigna's PPO network.
• Broker Incentives: Effective from October 1, 2024, through January 31, 2025, brokers can increase their rewards. 

• Annual Rate Change: Rate hold.
• Quoting Availability: Available now
• Plan/Portfolio Updates: Product portfolio has been expanded.
• Network Updates: No changes.
• Underwriting Guidelines: No changes.
• Broker Incentives: The Northern Virginia Broker Bonus is being extended into 2025. Brokers are also reminded about the 2025 Broker Rewards Program.

• Quarterly Rate Change: HMO 0.5% / HMO HSA 0.9% / POS -0.6% to 1.4% / POS HSA -0.7% to 1.5%
• Quoting Availability: Available now
• Plan/Portfolio Updates: All plans include UHC Core Rewards. Non-HSA plans include Care Cash, $0 children copay for primary care, and $0 copay for virtual visits. HSA plans virtual visits are $0 after deductible.
• Network Update: The Choice EPO has been discontinued and the OCI Preferred portfolio has been reduced to a single plan. Plan participants will be mapped to new plans at renewal.

• Quarterly Rate Change: Full HMO 3.2% / Limited HMO -0.4% / Full HMO HSA 4.0% / Full PPO & PPO HSA 2.6% 
• Quoting Availability: Available now
• Plan/Portfolio Updates: Five low-enrollment plans have been discontinued. Members on these plans will be mapped to other plans. In addition, other plans have been adjusted to meet actuarial value.
  Final plan designs are pending regulatory approval.
• Network Updates: BlueSelect has added 3 counties. SimplyBlue has added 2 counties.

• Fully insured quoting is available.
• Chamber SMART and GA FARM plans are expanding into four more counties with four new plans, and have updates to networks and pharmacy benefits.
• Anthem Balanced Funding (level funded) is being introduced for small groups 20-50. Quoting begins November 1, 2025.