Blue Cross of Arizona
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Arizona Family Health Insurance
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Affordable Health Insurance in Arizona
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Blue Cross® Blue Shield® of Arizona/CIGNA/AETNA
ALERT: Current BCBSAZ Grandfathered and Grandmothered individual plans are not affected by the dramatic 2017 changes discussed below.
The death spiral of the individual health insurance market in Arizona has begun, and is in full-force in Maricopa County. Across the country the situation is the same, or worse. In Maricopa County, AZ., there will be one health insurance company offering individual ACA coverage in 2017, Centene. Centene HMO is awaiting approval from the Arizona Department of Insurance to sell in Maricopa and Pinal counties.
Effective 01/01/2017, Blue Cross and Blue Shield of Arizona, Aetna, United Healthcare, HealthNet, Cigna, and Humana will no longer offer Affordable Care Act (ACA) individual and family policies in Maricopa County, though BCBSAZ will continue offering individual plans in many rural counties throughout the state. Current BCBSAZ ACA individual/family policyholders in Maricopa County will lose coverage effective 01/01/2017, affecting 44,000 members. The most populous cities in Arizona such as Phoenix, Tempe, Mesa, Scottsdale, and Gilbert are located in Maricopa County.
Centene, a Missouri insurance company that owns HealthNet, is awaiting approval to sell individual plans in Maricopa County in 2017. If approved, they will be the only insurer available for those seeking individual and family coverage in Maricopa County in 2017. Expect rates to be approximately 65% higher than 2016 rates, and with much smaller provider networks. Centene has contracted with Cigna to allow Centene members access to approximately 100 Cigna doctors and 50 specialists, in addition to HealthNet’s narrow HMO network. NO PPO networks will be available. With the combination of one insurer, few in-network doctors, no coverage for out of network doctors, and tens of thousands of individuals and families seeking care, delays in receiving medical attention should be expected. Like all HMO’s, there will be no coverage available out of network unless it is an emergency, and specialist care must be approved by the insurer beforehand.
If you are one of the tens of thousands of individuals and families losing coverage in 2017, it is recommended that you consider purchasing a short term health insurance policy for 364 days. BCBSAZ offers such policies, and can be purchased on this website. Short term policies are much less expensive than ACA policies, offer very good protection, but do not count as ACA creditable coverage. As non-creditable coverage policies, exposure to an IRS tax penalty at the end of the year is possible. The average tax penalty last year was approximately $1000.00. Even with a tax penalty, short term plans will likely be much less expensive than purchasing an ACA policy. Short term policies are medically underwritten, meaning that the applicant must answer around seven general medical questions to see if they qualify for coverage. Though the policies are renewable, you must go through medical underwriting during each renewal. This is why it is important to purchase a 364 day policy. If a medical condition arises during the 364 days that would typically exclude you from buying another short term plan, cancer or heart condition as examples, you can switch to an ACA plan during the next ACA open enrollment at the end of the year. It is highly recommended that you purchase a short term policy for the full 364 days as opposed to month to month. It will be less expense purchasing for the year. By purchasing for the year, this will also hopefully give the new president and his or her administration the time necessary to come up with a fix to this very serious situation.
Senator McCain has introduced legislation to waive the tax penalty for those living in counties with only one, or no, insurers offering coverage, but the likelihood of such legislation passing with the current administration is questionable at best. Depending on the outcome of the elections, the ACA will either be modified or replaced, but in any case the health insurance markets will likely continue to implode for the foreseeable future.
Not Affected/BCBSAZ: Those currently insured with a BCBSAZ Grandfathered or Grandmothered individual or family plan will NOT lose coverage in 2017, and it is highly recommended that such policies be kept in force. Policyholders with individual ACA plans residing outside of Maricopa County will not be affected, though a rate increase in the 65% range is expected. The federal government will now allow those with Grandmothered plans to keep such plans through 2017, as opposed to the previous 04/30/2017 expiration date. Grandfathered individual policies are those purchased on or before the implementation of the Affordable Care Act (ACA) on March, 23, 2010. Grandmothered individual plans are those purchased after March, 23rd, 2010, but before January 1st, 2014. ACA individual plans are those purchased on or after January, 1st, 2014, and these are the policies being discontinued in Maricopa County. Medicare supplement and group health plans will NOT be affected.
Mike Higgins is federally certified to assist those that qualify for individual/family plans on the 2017 Marketplace Exchange. Please feel free to call Mike any day or time at 602-405-8769 if you have any questions. Subsidies are not available for off-Exchange policies. Blue Cross of Arizona and most other insurers will no longer offer individual plans on or off the Exchange in Maricopa County in 2017.
In those counties where individual policies will be sold, most will face rate increases in the 65% range in 2017. As mentioned, 44,000 policyholders currently insured with BCBSAZ ACA plans in Maricopa County will lose coverage effective 01/01/2017, along with tens of thousands of other individuals and families that are currently insured with carriers such as Aetna, Humana, United Healthcare and HealthNet leaving the market in 2017. Again, Grandfathered and Grandmothered BCBSAZ individual plans will not be affected, though an average rate increase of 17% for these plans is expected.
BCBSAZ will continue to offer group policies to small and large groups. Small group policies require a minimum of two enrolled, cannot be husband and wife if the only two enrolling, and must include at least one W-2 employee. Premium assistance for up to three years from the Arizona Department of Revenue may be available for groups with less than 25 employees. To qualify for AZDOR funds, the company must be based in Arizona, and in existence at least one year. Please call Mike Higgins at 602.405.8769 for further details. Tax credits/premium assistance may also be available to certain small groups through the federal SHOP program, of which Mike Higgins is also a certified broker.
If you are a current Blue Cross and Blue Shield of Arizona member living in Maricopa County, and are insured with an ACA individual/family policy purchased on or after January 1st, 2014, you will need to find other coverage from another insurer by 01/01/2017.
The open enrollment period for 2017 is Nov. 1, 2016, through Jan. 31, 2017. You may enroll anytime during the year if you have a qualifying event such as loss of group coverage, divorce, death in the family, etc. Please call Mike Higgins at 602.405.8769 to discuss all options available outside of open enrollment.
THANK YOU: Michael Higgins has been ranked as a Top 10 broker in 2016, according to Ranking Arizona magazine. Ranking Arizona, now in its 19th year, is the largest business opinion poll in Arizona. 1.5 million participants vote each year, with recommendations based on quality of service, and with whom they would recommend doing business. To vote, please click on the, “Top 10 Ranking Arizona,” link on the upper-right of this webpage.
For those living outside of Maricopa County….. To generate an instant quote for a Blue Cross Blue Shield of Arizona individual or family plan during open enrollment simply click on the, “Free Online Quote,” link. No personal information is required. Blue Cross Blue Shield of Arizona online application and submission for individuals and families is also available at no cost to the applicant. Please call 602.405.8769 for an employer group quote. Small group quotes are available over the phone.
As of 01/01/2014, no Arizona health insurance company may deny coverage during open enrollment, (or during the year if an applicant has a Special Enrollment Period qualifying event.) Insurers may no longer apply a rate-up due to pre-existing conditions, or base premium rates on the sex of an applicant. Insurers may base premiums on age, zip-code, and whether one uses tobacco or not, (the PPACA, “Obamacare,” allows up to a 50% rate increase for tobacco use.)
Michael Higgins Insurance, LLC., an independent Arizona health insurance agency, specializes in individual and group health insurance. With decades of experience in the Arizona health insurance market, obtaining the right policy for you is most important to Mike. He will take the time necessary to solve your Arizona health insurance needs, suggesting different approaches or programs that may be beneficial. Along with Blue Cross and Blue Shield of Arizona, Mike also offers Aetna, United Healthcare, and Cigna individual and group plans where available.
Term-Life policies are available from many A+ rated life insurance carriers. Please call Mike for a quote, 602.405.8769.
Child-Only policies are now offered by Blue Cross Blue Shield of Arizona in select counties.
Short-term policies are an alternative to child-only policies, and for those seeking coverage for up to 364 days. Here are the Arizona short term plans, and you may apply online if you would like. Please keep in mind that short-term health insurance policies DO NOT qualify as essential coverage under the Patient Protection and Affordable Care Act, (Obamacare.) Being uninsured for more than 90 continuous days triggers an IRS penalty of $695.00, or 2.5% of MAGI, whichever is greater. Under certain conditions the IRS may waive the penalty.
CIGNA/Blue Cross Blue Shield of Arizona
There is a lot of confusion in the individual and family market, which Arizona health insurance plans are available in 2017, and in which counties. Instead of searching high and low for answers on the Internet, you may find it easiest to simply call Mike Higgins, 602.405.8769, any time, any day.
For further information, 24/7, please call 602.405.8769 and speak with Mike.