Ohio Small Business Health Insurance Market Guide  

# Insurance Plans Offered Cost & Availability Network Strength Carrier EPO/PPO Cost HMO Cost Available Statewide National Doctor Network Network Tiers # Ohio Hospitals Covered # Ohio Doctors Covered $ n/a Yes 3 190 34,000 No 1 186 35,000 $$$ 175 26,500 $$ 180 33,000 Ohio Small Business Health Insurance Market Guide   Market Overview The Ohio small business health insurance market is comprises primarily of 4 major national carriers and one local carrier. Compared to some of the other states, carriers in Ohio offer fewer tiers of networks, with most carriers electing to only offer a full network to small businesses. This makes selecting a health insurance plan much easier for small businesses, with the primary decision coming down to which health insurance carrier to choose. Ohio’s market is pretty competitive, with competitive rates offered by most of the carriers. Ohio Market at a Glance # Insurance Carriers # of Doctor Networks # Insurance Plans Offered 5 9 200+ Ohio Market Recommendations We’ve summarized the different options into a high level set of recommendations. Aetna and Anthem are currently the two most cost competitive carriers in the market, and both offer access to broad PPO networks. Carrier Network Strength PPO Cost HMO Cost Large, national network $ n/a $$$ Smaller regional network $$

Ohio Health Insurance Carriers At-A-Glance Available Statewide National Doctor Network Offers SHOP Exchange Plans Network Tiers Small Business Plans # Ohio Hospitals Covered # Doctors Covered Yes No 3 67 190 34,000 1 43 186 35,000 34 175 26,500 15 180 33,000 53 http://kff.org/other/state-indicator/total-hospitals/ 182 hospitals in Ohio http://kff.org/other/state-indicator/total-active-physicians/ 17649 PCPs 20440 Specialists 38089 total doctors 2.158 ratio

Insurance Carrier Overview: Columbus 100M 43201 Toledo 25M 43608 Youngstown 44511 Cleveland 35M 44103 Open Choice - Hospitals 182 16 26 72 Scrubbed Open Choice Hospitals 121 13 12 44 Open Choice – PCPs 7686 823 844 3663 Open Choice – All Medical Professionals 30592 3165 2310 14800 Scrubbed PCP + Specialists 21312 9723 HNOption - Hospitals 169 15 73 HNOption – All Medical Professionals 27627 2588 2130 13921 Savings Plus- Hospitals n/a 11 57 Savings Plus – All Medical Professionals 2119 1408 7807 Insurance Carrier Overview: Aetna is a national carrier offering medical, dental, and vision coverage. Aetna several networks including PPO and HMO networks options, and allows companies can mix and match up to 5 different plans to offer employees. Aetna’s full PPO and HMO networks are very broad and includes a large number of hospitals and doctors. Aetna plans are currently among the most competitive for small businesses, and are a very good value for companies looking for cost savings and access to broad networks. Network Overview Open Choice PPO: Aetna’s largest network in Ohio, with access to expansive network of doctors and hospitals. Offers nationwide coverage through Aetna’s national network. HealthNetwork Option (HNOption): HNOption is a point-of-service plan that encourages but does not require the use of a primary care physician. While a very broad network, it is smaller compared to the full PPO and only represents a small cost savings. Savings Plus of Ohio: Savings Plus is a narrow network comprised of medical providers with lower negotiated costs to Aetna, and only available to companies in the greater Cleveland and Cincinnati region. Plans are ~16% less expensive than the full network. Network Type # Ohio Doctors # Ohio Hospitals Cost Savings vs Full Network Open Choice PPO Full PPO 34,000 190 HealthNetwork Option (HNOption) POS 31,000 181 3% Savings Plus of Ohio 8,000 50 16% Aetna OHNetworks Open Choice PPO HNOption Open Access Savings Plus Regions Fairfax 22030 / Region 10 (25M radius) Ohio Beach 23450 (25-50M Radius) Bedford 24523 (100M radius) Chesterfield 23224 (100M radius)

Insurance Carrier Overview: Columbus 100M 43201 Toledo 30M 43608 Youngstown 44511 Cleveland 44103 Blue Access - Hospitals 118 10 12 30 30M 46 50M Blue Access – PCPs 9401 755 1003 3746 (30M) 5070 (50M) Open Choice - Hospitals 182 16 26 72 Scrubbed Open Choice Hospitals 121 13 44 Insurance Carrier Overview: Anthem Blue Cross Blue Cross is a part of Wellpoint and offers medical, dental, and vision coverage. Anthem plans offer access to a very strong statewide network, and national coverage through the BCBS BlueCard network. Anthem only offers a single PPO network in Ohio. Anthem plans are currently among the most competitive for small businesses, and are a very good value for companies looking for cost savings and access to broad networks. Network Overview Blue Access: Blue Access is Anthem’s PPO network for small businesses, and is a very broad Ohio network. Plans on Blue Access includes access to the national BlueCard network. Network Type # Ohio Doctors # Ohio Hospitals Blue Access Full PPO 35,000 186

Insurance Carrier Overview: Columbus 100M 43201 Toledo 30M 43608 Youngstown 44511 Cleveland 40M 44103 Hospitals 111 11 18 35 All PCPs 6814 705 839 3836 Insurance Carrier Overview: Humana is a national carrier and offers medical, dental, and vision coverage in Ohio. Humana only offers a single PPO network in Ohio. While expansive, Humana’s PPO network is smaller compared to the PPO networks on other carriers. Humana is very small business friendly, and covers many classes of small businesses that other insurance carriers do not, such owner-only companies and husband/wife-only companies. However, Humana plans are among the most expensive options for small businesses in Ohio. Network Overview ChoiceCare PPO: Full PPO network with access to a large doctor network and nationwide coverage on Humana’s national network. Network Type # Ohio Doctors # Ohio Hospitals ChoiceCare PPO Full PPO 26,500 175

Insurance Carrier Overview: Columbus 100M 43201 Toledo 30M 43608 Youngstown 44511 Cleveland 40M 44103 Hospitals All Doctors 19755 5421 1895 6308 Insurance Carrier Overview: Medical Mutual is a regional carrier that offers medical coverage primarily in Ohio. Medical Mutual small business plans utilize the SuperMed PPO network. The SuperMed PPO network is an expansive Ohio network, and includes access to a large population of doctors and hospitals. Medical Mutual plans are pretty competitive in Ohio, though are more expensive than comparable plans offered by national carriers. Network Overview SuperMed PPO: Small business PPO network with access to large number of doctors and hospitals. Plans on SuperMed PPO have access to a national doctor network through a partner network (MultiPlan). Network Type # Ohio Doctors # Ohio Hospitals SuperMed PPO PPO 33,000 180 https://account.kp.org/broker-employer/resources/!ut/p/a0/FcpBDsIgEADAt_QBZEOkuOuttZL04Fnhhs2mIQFqgOr3rcdJBhw8wWX_CatvYcs-HrYL58blUpOPUbz2GjLXCg9w4AqvRwN7n6c_fWlhiQzW9Hg2REpomqSQ8qbEgFIL6o3Gk7qOOBK8U8Lv0HU_waIiWQ!!/ Select Signature

Insurance Carrier Overview: Columbus 100M 43201 Toledo 30M 43608 Youngstown 44511 Cleveland 44103 Choice Plus - Hospitals 141 23 16 35 Choice Plus – Hospitals, scrubbed 117 13 20 29 (+12) Choice Plus - PCPs 6279 1918 794 2172 Navigate - Hospitals 21 PCPs 6287 710 795 2179 Navigate Plus - Hospitals 6285 700 Insurance Carrier Overview: United Healthcare is the largest carrier in the country, and offers medical, dental, and vision coverage in Ohio. United Healthcare PPO plans provide access to the nationwide United Healthcare network. United Healthcare offers several tiers of coverage including PPO. EPO, and HMO networks, thought focuses primarily on the PPO network. United plans are competitive, but more expensive than the comparable plans offered by the other national carriers. Network Overview Choice Plus PPO: Full PPO network with access to one of the largest network of doctors and hospitals in Ohio and nationwide coverage through United Healthcare’s national network. Navigate Plus EPO: The Navigate Plus EPO network utilizes the same network as the Navgiate HMO, with the primary advantage of not requiring a primary care physician referral for specialisit visits. Navigate Plus EPO plans are 8% less expensive than the full PPO, though only silver and gold plans are available. Navigate HMO: Large HMO network with 5088of the doctors and 87% of the hospitals of the PPO network. One of the only HMO networks available to small businesses in Ohio, and plans are ~15% less expensive than the full PPO. Network Type # Ohio Doctors # Ohio Hospitals Cost Savings vs Full Network Choice Plus Full PPO 34,000 190 Navigate Plus EPO 30,000 165 8% Navigate HMO 15% https://smallbusiness.uhc.com/va/resources/our-networks#plan-navigate 100M of Columbus 25M of Toledo 25M of Youngstown 30-40M of Cleveland

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100M of Columbus 25M of Toledo 25M of Youngstown 30-40M of Cleveland