To receive critical updates from us regarding 2019 open enrollment
Health Insurance Enrollment – Virginia
Lay of the Land in Virginia in 2019
If you don’t get health insurance through your employer, then you may know first-hand what it’s like to buy your own health insurance in Virginia:
- High premiums
- Hyper-local, narrow provider networks
- Limited plan options
If you’re like many of our clients, the reason you don’t have health insurance through your employer is that you ARE your employer — you’re self-employed or you own a small business.
In 2018, we helped hundreds of self-employed and small business owners get out of the individual market and into the more stable small group market. This opened the door to more options and less restrictive networks.
But for most of 2018, there was only one insurance company who would write a one-person group.
Starting July 1, 2018, this changed, and we’re very excited about it.
Insurance for Self-Employed Individuals
The most important health insurance development in Virginia for 2019 is the passage of a new law – SB 672. Effective July 1, 2018 self-employed individuals must be allowed to establish a group health plan. (Note, you must meet certain criteria.)
SB 672 is a game-changer for Virginia!
Please visit our page on Self-Employed Health Insurance to see if you may qualify, and for more details.
Note, if you are eligible for a subsidy in 2019 based on your income, then a group plan may not be the best option. There are no subsidies for group plans.
Insurance for Small Business Owners/ Partners in a Business
If you own a small business — by yourself or with a partner(s) — you also may be able to set up a small group health plan. If you think this may be an option, visit our page for small business group health insurance to learn more and request a free quote.
Individual/Family Health Insurance in Virginia
Once again, with the exception of the CareFirst service area in northern Virginia (see below), there are no PPO plans available for individuals in the state.
All 2019 plans — from all carriers except Carefirst — are HMO plans. HMOs offer limited provider networks and no out-of-network coverage except in the event of a true emergency.
Details by Carrier in Virginia
Visit each section below for more detailed enrollment information.
- Cigna (Medical and Dental)
- Kaiser Permanente
- Optima Health
- Piedmont Community Healthcare
- Virginia Premier
Virginia Service Areas by Carrier
Anthem counties and cities in Virginia: Accomack, Albemarle, Alleghany, Amherst, Appomattox, Augusta, Bath, Bedford, Bedford City, Bland, Botetourt, Bristol City, Brunswick, Buchanan, Buckingham, Buena Vista City, Campbell, Caroline, Carroll, Charlotte, Charlottesville City, Chesapeake City, Covington City, Craig, Culpeper, Cumberland, Danville City, Dickenson, Emporia City, Essex, Fauquier, Floyd, Fluvanna, Franklin, Franklin City, Frederick, Fredericksburg City, Galax City, Giles, Gloucester, Goochland, Grayson, Greene, Greensville, Halifax, Hampton City, Harrisonburg City, Henry, Highland, Isle of Wight, James City, King and Queen, King George, King William, Lancaster, Lexington City, Lee, Louisa, Lunenburg, Lynchburg City, Madison, Martinsville City, Mathews, Mecklenburg, Middlesex, Montgomery, Nelson, New Kent, Newport News City, Norfolk City, Northampton, Northumberland, Norton City, Nottoway, Orange, Page, Patrick, Pittsylvania, Poquoson City, Portsmouth City, Powhatan, Prince Edward, Pulaski, Radford City, Rappahannock, Richmond, Roanoke, Roanoke City, Rockbridge, Rockingham, Russell, Salem City, Scott, Shenandoah, Smyth, Southampton, Spotsylvania, Staunton City, Suffolk City, Surry, Tazewell, Virginia Beach City, Washington, Waynesboro City, Westmoreland, Williamsburg City, Winchester City, Wise, Wythe, York
CareFirst service area in Virginia: Cities of Alexandria and Fairfax; Town of Vienna; Arlington County; Areas of Fairfax and Prince William Counties lying east of Route 123.
Cigna counties in the Northern Virginia area: Alexandria City, Arlington, Clarke, Fairfax City, Fairfax, Falls Church City, Loudoun, Manassas City, Manassas Park City, Prince William, Stafford and Warren.
Cigna counties in the Richmond area: Amelia, Charles City, Chesterfield, Dinwiddie, Hanover, Henrico, Prince George, Sussex, Colonial Heights City, Hopewell City, Petersburg City and Richmond City.
Kaiser Permanente has facilities in the Northern Virginia and Fredericksburg areas.
Optima service area: Charlottesville, Harrisonburg, Hampton Roads / Virginia Beach / Norfolk, Halifax & Mecklenburg
Piedmont service area: cities of Lynchburg, Bedford, and Danville; and the counties of Amherst, Appomattox, Bedford, Buckingham, Campbell, Charlotte, Cumberland, Halifax, Lunenburg, Mecklenburg, Nelson, Nottoway, Pittsylvania, and Prince Edward.
Virginia Premier: Richmond area
Health Insurance Enrollment – Maryland
Lay of the Land in Maryland in 2019
There are two carriers offering individual plans in 2019 — CareFirst and Kaiser. Premiums are actually going down in Maryland in 2019 due to the newly approved reinsurance program in the state.
Note, we do not sell subsidized plans on the Maryland Health Connection.
- are self-employed or own a small business;
- live in the greater Baltimore area; and
- will not be eligible for a subsidy in 2019
…we may be able to set up a group health plan. Please be in touch right away if this may apply to you.
Details by Carrier in Maryland
Visit the sections below for more details about enrollment.
Health Insurance Enrollment – District of Columbia
Lay of the Land in DC in 2019
Open enrollment in DC runs from November 1, 2018 – January 31, 2019. The individual mandate remains in place in DC for 2019. This means you are subject to a penalty if you do not have health insurance in 2019.
There are two carriers offering individual plans in 2019 — CareFirst and Kaiser.
All individual health plans in DC continue to be sold via DC Healthlink. The first step in having our assistance with a DC plan is to establish your account on DC Healthlink, and then designate us as your broker. Click here for detailed instructions.
Details by Carrier in DC
Visit the sections below for more details about enrollment.