Why 4 major Arizona insurance carriers are dropping PPO plans in favor of HMO plans car insurance salem or. Cigna Health and Life Insurance Company and Cigna HealthCare of Arizona, Inc cheap health insurance phx az. Four major health insurance companies will discontinue preferred-provider plans for tens of thousands of Arizonans next year on the federal marketplace. Instead, they’ll sell pared-down, health maintenance organization plans that limit the doctors and hospitals that consumers can visit at lower, in-network rates.
However, Health Net and UnitedHealthcare's All Savers Insurance have filed paperwork to sell PPO plans in 2016, pending federal approval, Klug said. HMOs dominated Arizona’s insurance market in the 1990s, before consumer backlash over these more restrictive plans fueled the popularity of PPO plans. PPOs gave consumers a broader choice of doctors, hospitals and specialists but also coincided with an era of inflated medical spending. As Arizona insurers seek to trim losses on Affordable Care Act marketplace plans but still keep plans affordable for consumers, they increasingly are dropping PPOs in favor of HMOs that are often paired with smaller networks of doctors and hospitals. Blue Cross Blue Shield of Arizona already has mailed out notices to the first wave of about 37,000 PPO customers explaining that they'll be assigned to new HMO plans beginning next year.
Those losses were offset by plans sold to businesses, federal employees and seniors. Even though the insurer had an underwriting loss, it made a profit of $4 million due to returns on investments. Other Arizona insurers had larger losses in 2014. Health Net reported a net loss of nearly $79 million in Arizona, Cigna lost $16.9 million and the startup, non-profit health insurance cooperative Meritus lost more than $16 million, according to the NAIC report. The report did not provide separate financial figures for different areas of an insurer's business, such as individual marketplace plans or larger group plans sold to businesses.
Some health insurers will get lucrative payments from these programs designed to counter the extra cost from taking on high-risk patients. The federal Centers for Medicare and Medicaid Services announced in June it would pay $7.9 billion to 437 insurers nationwide under the reinsurance program, which collects funds from all insurers and distributes money to insurers to offset the medical costs of patients whose claims exceed $45,000. Insurers that signed up more high-risk patients in 2014 expected to get tens of millions of dollars in reinsurance payments, CMS records show.
“Insurers are recognizing that in order to be competitive, they have to offer lower-cost plans,” said Cynthia Cox, associate director of health reform and private insurance for Kaiser Family Foundation. “It’s much easier for insurers to contain cost when there is an HMO plan.” That is one reason why health insurers may be scaling back networks by shifting from PPOs to HMOs and increasing rates for 2016. The Arizona Department of Insurance already has reviewed and approved plans and rates for next year, but the details on these won't be known until the federal government signs off on all marketplace plans, likely before mid-October. The three-month enrollment period begins Nov.
Health insurers say that because the marketplace did not start until Jan. 1, 2014, there has been an element of guesswork in establishing plans and setting rates. Arizona had some of the lowest-priced plans among states that use the federal marketplace. "It's really hard to price," said Tom Zumtobel, CEO of the Meritus, which launched with the financial backing of federal loans. "You have to assume what your risk is going to be.
" Meritus is an example of the frenzied nature of marketplace pricing over the first two years, and the market changes that consumer will see next year. The non-profit's plans were priced higher than many other insurers' in 2014 and it signed up fewer than 3,600 people that year. Meritus slashed its rates this year, and enrollment soared to nearly 58,000 as of mid-September, according to Zumtobel. Meritus initially decided to keep rate increases for 2016 to less than 10 percent for all of its plans, assuming it would receive financial relief from the federal government's "risk corridor" program.
6 percent for 26 HMO offerings, Zumtobel said. Health insurance cooperatives such as Meritus were established by the federal health-care law and backed by federal loans to provide competition to private health plans. But the vast majority have struggled to meet enrollment and profit projections, according to a Health and Human Services Inspector General report issued in July. Zumtobel said Meritus' biggest challenge has been managing a startup that had relatively little enrollment during the first year and explosive growth during the second year.
Other insurers, too, are taking a close look at the types of health insurance plans that resonate with customers. Cigna won't sell PPO plans on the federal marketplace in 2016, but those plans will be sold to customers who buy plans outside the marketplace. Consumers must use the marketplace if they want to collect federal subsidies to offset monthly premiums. Those subsidies are based on a person's income, with more generous subsidies for lower-income earners. People who earn more than four times the federal poverty level are not eligible for subsidies.
Blue Cross Blue Shield will route its customers to HMO plans that have distinct networks of doctors, hospitals and other health providers. One HMO network includes doctors and hospitals from two health systems, Banner Health and HonorHealth. The other network includes a network of providers from Abrazo Health, Dignity Health and IASIS Healthcare. Those two networks represent about 90 percent of all doctors, hospitals and other providers in Maricopa County, and the insurer will attempt to pair customers with plans that include their doctors, Stelnik said.
Find Health Plans in Thorne, Bay, AK 99919 – Buy Health Insurance Plan in Alaska cheap health insurance mesa az. Paperwork filed by five major health insurers gives Arizona its first glimpse of how much the Affordable Care Act will cost consumers when they begin shopping for mandatory coverage next month auto insurance pontiac michigan. Plans submitted to the Arizona Department of Insurance signal that average monthly rates will range from $225 to $334 when insurance marketplaces launch Oct.1. Filing rate plans were Aetna, Blue Cross Blue Shield of Arizona, Cigna, Health Net and Meritus, formerly called Compass Health Cooperative. The documents suggest Arizona consumers will be able to choose from a variety of plans and rates during the six-month enrollment period, with monthly premiums that will range from less than $100 to more than $1,700.
Sayen said that he is confident the rates — when offset by federal subsidies — will be affordable for Arizona consumers and that enrollment will start Oct. 1, citing favorable results last week from a key test of the marketplaces’ data backbone. “What I see is something that is attractive, and it’s going to work,” Sayen said. “I am very confident that people in the insurance industry will put out products that work at a competitive price.
But he cited information released by states such as California that will run their own marketplaces as evidence that “the picture looks better for consumers.” Consumers will shop for plans across four tiers that will include bronze, silver, gold and platinum coverage. The bronze plans will be the least expensive and will cover about 60 percent of a person’s health costs. Platinum plans will be the most expensive and robust, covering about 90 percent of costs. Avalere Health, a private firm that analyzes health information, studied 12 states and found the average premium for a bronze plan is $274 and the average silver plan cost $336. Arizona was not included in the study.
“You will have shoppers looking for a plan, and they will generally gravitate toward lower prices,” Mendelson said. Blue Cross Blue Shield of Arizona, the state’s largest insurer for the individual market, will offer more than a dozen plans across all tiers with individual monthly premiums that range from $71 to $1,489. The average plans will cost Blue Cross consumers $264 before subsidies are calculated. Blue Cross Vice President Jeff Stelnik said the company tailored its plans to appeal to a wide selection of residents, from cost-conscious consumers to those accustomed to a richer selection of benefits. Stelnik said it is difficult to compare new rates with existing plans because the health-care law requires a basic set of benefits that do not exist in all current plans, such as maternity coverage. Also, the law prevents insurers from denying coverage based on existing conditions and limits how much rates can vary based on age.“It’s so hard to compare apples to apples,” Stelnik said. “It is so specific to the individual.” Health Net spokesman Brad Kieffer said the insurer anticipates “most of the consumers shopping for coverage on the exchange will be value-conscious.” Health Net’s individual plans will range from $82 to $897 per month. “We are looking at the silver and bronze tiers as where we will see most of our enrollment,” Kieffer said. Diane Brown, executive director of Arizona Public Interest Research Group, said consumers should be careful not to rush into a plan. Arizona PIRG will encourage consumers to evaluate how deductibles and copayments may impact how much they spend on health care.
One way that insurers in Arizona will seek to limit costs is by narrowing a consumer’s choice among doctors and hospitals in exchange for lower monthly rates. People will not be able to check how robust a health insurer’s network is on the federal government’s website. Rather, consumers will be referred to the insurer’s website and informational brochures to learn which doctors and hospitals a consumer could use. The enrollment deadline is March 31. Once consumers make a selection, they will be locked in until the next enrollment period in fall 2014.