Sharp Health Plan Updates Rates and Portfolio for Q1 2019

Nov 02, 2018

Category

Sharp has updated rates for 2019. HMO plans will increase 1.1% across all networks. PPO plans will increase 6.6% in region 19 and 16.5% in region 17. Non-Mirrored plans and rates are pending approval by the Department of Managed Health Care (DMHC). HMO rates are valid for Q1 2019 while PPO rates are valid for all of 2019. Many plans are experiencing minor benefit changes, with most changes happening to deductible and out-of-pocket maximums.

Plan name	Benefit	2018	2019
Bronze HDHP NG 1	Deductible	Individual $3,100 Family $6,200	Individual $5,650 Family $11,300
	Out-Of-Pocket Max	Individual $6,500 Family $13,000	Individual $6,650 Family $13,300
Gold HMO NG 1	Generic Rx	$19 copay	$20 copay
Gold HMO NG 3	Out-Of-Pocket Max	Individual $4,300 Family $8,600	Individual $7,000 Family $14,000
Gold HMO NG 4	Out-Of-Pocket Max	Individual $4,500 Family $9,000	Individual $7,900 Family $15,800
Silver HMO NG 1	Deductible	Individual $2,100 Family $4,200	Individual $2,150 Family $4,300
	Out-Of-Pocket Max	Individual $7,300 Family $14,600	Individual $7,900 Family $15,800
	PCP copay	$40	$60
Silver 70 HDHP HMO 2500/20%/20% + Child Dental (PeVC)	Deductible	Individual $2,000 Family $4,000	Individual $2,500 Family $5,000
	Out-Of-Pocket Max	Individual $6,550 Family $13,100	Individual $6,650 Family $13,300
Silver 70 HDHP HMO 2500/20% + Child Dental Premier	Deductible	Individual $2,000 Family $4000	Individual $2,500 Family $5000
	Out-Of-Pocket Max	Individual $6,550 Family $13,100	Individual $6,650 Family $13,300
Silver 70 HMO 2000/45/20% + Child Dental (PrVC-20%)*	Out-Of-Pocket Max	Individual $7,000 Family $14,000	Individual $7,550 Family $15,100
	Radiology	$70 copay	$75 copay
	Pharmacy deductible	$125	$200
Silver 70 HMO 2000/45/20% + Child Dental (PeVC-300)*	Out-Of-Pocket Max	Individual $7,000 Family $14,000	Individual $7,550 Family $15,100
	Radiology	$70 copay	$75 copay
	Pharmacy deductible	$125	$200
Silver 70 HMO 2000/45 + Child Dental Premier	Out-Of-Pocket Max	Individual $7,000 Family $14,000	Individual $7,550 Family $15,100
	Radiology	$70 copay	$75 copay
	Pharmacy deductible	$125	$200
Silver 70 HMO 2000/45 + Child Dental Performance	Out-Of-Pocket Max	Individual $7,000 Family $14,000	Individual $7,550 Family $15,100
	Radiology	$70 copay	$75 copay
	Pharmacy deductible	$125	$200
Gold 80 HMO 0/30/600 + Child Dental (PeVC)	Out-Of-Pocket Max	Individual $6,000 Family $12,000	Individual $7,200 Family $14,400
	PCP copay	$25	$30
Gold 80 HMO 0/30/20% + Child Dental (PrVC)	Out-Of-Pocket Max	Individual $6,000 Family $12,000	Individual $7,200 Family $14,400
	PCP copay	$25	$30
Bronze 60 HMO 6300/75/100% + Child Dental (PrVC)	Out-Of-Pocket Max	Individual $7,000 Family $14,000	Individual $7,550 Family $15,100
Bronze 60 HDHP HMO 6000/40%/40% + Child Dental (PeVC)	Deductible	Individual $4,800 Family $9,600	Individual $6,000 Family $12,000
	Out-Of-Pocket Max	Individual $6,550 Family $13,100	Individual $6,650 Family $13,300
Premier Bronze 60 HDHP HMO 6000/40% + Child Dental	Deductible	Individual $4800 Family $9,600	Individual $6,000 Family $12,000
	Out-Of-Pocket Max	Individual $6550 Family $13,100	Individual $6650 Family $13,300
Performance Bronze 60 HMO 6300/75 + Child Dental	Out-Of-Pocket Max	Individual $7,000 Family $14,000	Individual $7,550 Family $15,100
Gold 80 HMO 0/30 + Child Dental	PCP copay	$25	$30
	Out-Of-Pocket Max	Individual $6,000 Family $12,000	Individual $7,200 Family $14,400

Three Pseudo-mirror plans are also additional changes to ensure plans are in compliance with Mental Health Party

Sharp Platinum 90 HMO 0/15/10% + Child Dental (Pr/V/C)
Sharp Silver 70 HMO 2000/45/20% + Child Dental (Pr/V/C-20%)
Sharp Silver 70 HMO 2000/45/20% + Child Dental (Pe/V/C-300)

Quoting will be available soon. Contact your LISI Regional Sales Manager for more information.