Tennessee Health Insurance in 2016 - American Exchange

Tennessee Health Insurance in 2016

Health insurance providers in the state of TN, like Blue Cross Blue Shield of Tennessee, Community Health Alliance, CIGNA, and United Healthcare have filed their proposed rates for 2016 and there are some interesting points to learn from the filings, even if the State does not approve them (which they rarely do).

The most shocking filing is that of Blue Cross and Blue Shield of Tennessee’s, as they have requested an increase of 36.30%. The memo that has been filed with the State states “The majority of the rate increase being requested is due to higher than expected morbidity in 2014 for the BCBST Marketplace and Non-Marketplace plans increases in underlying medical cost due to inflation in the cost of medical services as well as increased utilization of medical services and a reduction in anticipated payments from the Federal Transitional Reinsurance Program.”

The filing also states that the increase would affect 209,639 members that were enrolled in active plans as of May 5th of this year. But wait! Before you light the torches and grab your pitchforks, please consider a few things.

First, anyone that is currently eligible for Advanced Premium Tax Credits (APTCs) will have protection from annual rate increases. APTCs work to offset the full cost of health insurance down to the federally mandated maximum percentage of household income that you have to pay for health insurance. In other words, the APTC will adjust to keep your 2016 premium close to your current 2015 rate.

For example, a single individual at 200% of the Federal Poverty Level will only spend 6.5% or less of the gross income on health insurance. That being said, if you are an individual tax filer with no dependents making $22,980, the most you will spend on health insurance for 2015 and 2016 is going to be $124.48 per month (Based off of the second lowest cost Silver Level Plan; Gold and Platinum Coverage would cost you more), the tax credits will adjust to meet the 6.5% max.

Secondly, there are other carriers out there! United Healthcare, which is an option that has been on the Marketplace in other states, will be in all areas of Tennessee beginning January 1st, 2016 and their rates will be competitive.

Community Health Alliance will also be offering affordable, competitive options and have told us that they will not be freezing enrollment during the 2016 Annual Enrollment Period, which has caused some enrollment problems for member’s who enrolled with CHA before the freeze on January 14th, 2015.

The big question mark with Community Health Alliance and United Healthcare is going to be the Network options. Will UHC or CHA have your doctors in network?

The other options in Tennessee will include CIGNA and Humana (in some areas of TN). Humana is a popular option in the Nashville and Memphis metropolitan areas for 2015, and should continue to be a good option in those areas of the State. CIGNA was overpriced in 2015, and only saw a small group of enrollees, who were mainly enrolled directly with CIGNA, outside of the Marketplace.

If you’re really interested in the methodology and details of the requested rates for 2016, links for each are below. Otherwise, you can start going over your options beginning on November 1st, 2015 during the Annual Open Enrollment Period.


United Healthcare



Community Health Alliance

Andrew Hetzler is the Chief Operating Officer of American Exchange. For a free consultation with a licensed agent call 1-888-995-1674 or email info@americanexchange.com. To contact Andrew directly, you can email him at andrew.hetzler@americanexchange.com.