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Our office is offering No Fee Benefit Reviews this year. Please use the top right menu link to schedule.

The Individual Health Insurance Market is improving in 2020:

  • Smaller rate increases and two new insurance companies, CareSource & Oscar Health

What is a Gatekeeper Plan and why is it so important?

Gatekeeper – a form of managed care; it requires the member to get a referral approved from their Primary Care doctor (PCP) to see a Specialist, frequently this requires an office visit to the PCP first.
A plan with a Gatekeeper is intended to reduce frequent/excessive visits to the higher cost Specialist.

No Gatekeeper – allows the member to make appointments directly with Specialist, no referral required.


  • No Gatekeeper
  • Largest Provider network of all companies includes Piedmont, Emory and WellStar
  • Customer service has been steadily improving
  • Lowest rates of all companies for Silver and Gold plans


  • Gatekeeper required for members in nine metro Atlanta counties
  • Small Provider network in Atlanta
  • Competitive rates on Bronze high deductible plans
  • Left a bad taste after non-renewing the WellStar contract right after open enrollment last year


  • No Gatekeeper
  • New to Georgia, well respected non-profit company based in Ohio
  • Solid network in metro Atlanta and Savannah, includes Piedmont, WellStar and Northside
  • Lowest rates on Bronze high deductible plans with copays for doctor office visits – will be popular


  • Gatekeeper staff model – the strictest type of managed care
  • Network is Kaiser doctors and facilities only, unless referred out
  • Rates are higher than all above companies

Oscar Health

  • No Gatekeeper
  • Small Provider network, WellStar only
  • Highest rates of all plans
  • New to Georgia, financial backing from Warren Buffet and Google… not bad
  • Oscar will be a non-event in Georgia this year, stay tuned for next year

Clients without pre-existing conditions may want to consider the lower cost UnitedHealthcare Short Term PPO Plans. Rates are approximately 50% less than ACA plans.

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