Texas health insurers seek 24% ACA premium hike

When a health insurance company refuses to pay for treatment, most people begrudgingly accept the decision. Few patients appeal; some don’t trust the insurer to reverse its own decision. But a little-known process that requires insurers and plans to seek an independent opinion outside their walls can force insurers to pay for what can be lifesaving treatment. External reviews are one of the industry’s best-kept secrets, and only a tiny fraction of those eligible actually use them #Healthcare #insurance https://lnkd.in/entRCf98

The prior authorization system for health insurance can lead to people paying extreme amounts of money for necessary and life-saving treatment. While it can take years, it is possible to appeal a prior authorization denial and win against insurers, but the process has been reported to be very difficult and overwhelming, and it is that way by design. Insurers want you to give up, but the Las Vegas Review-Journal has published an article on what to do in the face of prior authorization denial. Read more: https://lnkd.in/enhnDwVS

🚨 Health Insurance Premiums Are Surging Nationwide — Including Right Here in Michigan For the past year, I have been sounding the alarm on LinkedIn about the unsustainable trajectory of health insurance costs. The latest filings for 2026 confirm what many of us have been anticipating: double-digit premium increases across the board for fully insured groups. According to recent reports: - ACA premiums are projected to rise by an average of 20% nationally which is the biggest jump since 2018. - In Michigan, increases are ranging from 20-30% on average with many companies seeing 40%+ Other states are seeing similar spikes: - Illinois: +27% - Texas: +21% - Washington, Georgia, Rhode Island: 20%+ - Arkansas: Over 50% in some filings These increases are being driven by: - Rising hospital, physician, and pharmacy costs (especially GLP-1s and specialty drugs) - Expiration of enhanced federal subsidies - Increased utilization post-pandemic - Labor shortages and higher reimbursement demands from providers What does this mean for employers and employees? - Employers will face steep renewal challenges and must prepare for tough decisions. - Employees may see higher deductibles, co-pays, and out-of-pocket costs, even if premiums are partially subsidized. - Without strategic planning, affordability and access will be at risk. This is not just a pricing issue, it is a business continuity issue. If you are not already reviewing your benefits strategy for 2026 and 2027, now is the time. #EmployeeBenefits #HealthInsurance #ACA #MichiganBusiness #BenefitsStrategy #HealthcareCosts #Hylant #LinkedInVoice https://lnkd.in/eZ_kaNNj

Choosing individual or family health insurance can be complex—premium vs. total cost, in-network care, prescription coverage, HSA options, disability protection, and more. We’ve compiled the 10 most common mistakes we see and how to avoid them, so you can choose confidently and control long-term costs. A licensed broker can walk you through options at no extra cost. Read the guide: https://lnkd.in/gU23kcst #HealthInsurance #EmployeeBenefits #OpenEnrollment #DallasBusiness #InsuranceBroker

The Illinois Department of Insurance finalized rates for 2026 health insurance premiums this month, exercising a new right to modify premium adjustments proposed by companies issuing small group or individual insurance plans through the Affordable Care Act.

The Illinois Department of Insurance finalized rates for 2026 health insurance premiums this month, exercising a new right to modify premium adjustments proposed by companies issuing small group or individual insurance plans through the Affordable Care Act.

NEWS FLASH: Employer-Sponsored health insurance costs are rising at an unsustainable clip. The attached WSJ article's take on employers' options to manage these increases: pass on more of the cost to the employee. Much like these premium increases, that is not a sustainable model. Bottom line is that if you have more than 50 employees, your insurance premiums are at least partially driven by your claims. You cannot hide from that no matter what model you move to: fully-insured, level-funded, self-insured, or even a PEO. So what's the answer? The answer is found in transparency and consumerism. How is your plan design making it easier to understand where the increases are coming from and are you able to do anything about it? If it's not, and you can't, then it might be time to change something. It's renewal season, don't take the easy way out. Even if there's not a change to be made this year, look at funding models that give you more control. You'll be glade you did, and be more prepared when we see the same headlines again next year..

https://lnkd.in/gpjp9j3h Health Insurance Costs Rise This WSJ article underlines what many of us are already feeling: premiums, deductibles, and out-of-pocket costs are climbing. As coverage gets more expensive, people are looking for smarter ways to protect their health and their wallet. That’s where something like an Apex-Benefit Solutions MEC (Minimum Essential Coverage) plan can be a game changer: How a MEC plan from Apex helps Lower Premiums: MEC plans are designed to meet the essential coverage requirements under the ACA without the full cost of a comprehensive policy. That often means significantly lower monthly premiums compared to full major medical plans. Basic Yet Critical Coverage: While MEC plans aren’t intended to cover everything, they do cover the core services required by law (think preventive care, emergency services, etc.). It’s not “insurance for everything,” but it can protect against the worst financial surprises. Compliance & Peace of Mind: Having MEC coverage means you meet the ACA’s minimum coverage requirement, which avoids penalties (where still applicable) and helps ensure you’re not unprotected in case something unexpected happens. Bridge Solution: For people between jobs, waiting for employer benefits to kick in, or with budget constraints, a MEC plan can serve as a cost-effective bridge so you’re not totally exposed during the high-cost health risk years. Predictability: When full health insurance costs are unpredictable (deductibles, coinsurance, network issues, surprise bills), MEC plans offer a more predictable cost structure with lower fixed costs for coverage of essential risks.

AIA New Zealand has rolled out a new health insurance benefit, AIA Living Specialist and Testing Support (STS), designed to provide access to specialist consultations and diagnostic procedures without requiring a full health insurance policy. #NewZealand #Lifeinsurance #Healthinsurance #Agents #Advisors https://lnkd.in/gQNMAWqh

There are storm clouds on the horizon for the health insurance market. Our CEO Jack Hooper shares his thoughts with Employee Benefit News on how to navigate a costly year and leverage off-exchange plans with #ICHRA to control your budget. #healthcarecosts #healthinsurance #aca #obamacare #employeebenefits https://lnkd.in/gfkGY5VH