BCBSAZ is OUT of the Market in Phoenix

Jun 29, 2016

  1. Ann H
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    Ann H Guru

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    This affects Phoenix (the major city in AZ). BCBSAZ is out of the IFP market here.

    Recent email:

    After months of reviewing options for our 2017 individual and family product line, we have reached a decision. We will continue selling individual under 65 health plans through the Health Insurance Marketplace. However, we are limiting where plans will be available.

    Our focus is on the underserved and rural parts of our state. As a local company with deep community roots, we could not overlook that some areas would have no options or very limited access. That is why we will offer up to five different individual and family plans—pending approval—in 13 of Arizona’s 15 counties. ACA individual plans will no longer be available in Maricopa and Pinal counties. Keep in mind these changes do not affect grandfathered and transitional (grandmothered) plans. We will support those plans no matter where the member resides.

    We believe we have found a mix of plan types and benefits changes that will make these ACA plans sustainable for at least another year. Once we receive approval from CMS, we will send you information about the plans and rates.

    We know this is not ideal, but in order to make plans available at a lower cost, we could not continue with statewide coverage. The decision to only serve the rural areas means approximately 44,000 members in Maricopa and Pinal will need to find another source of health insurance. For some that may mean choosing a different carrier. For others, they may consider a BCBSAZ short-term medical plan.

    Your clients and our members can expect to receive information about their coverage and how to re-enroll or how to select a different plan starting in September.

    We will share plan details and pricing once we receive regulatory approval. In the meantime, you can expect to receive support materials and FAQs in the coming days. If you have immediate questions please feel free to contact me.

    Sincerely,

    Mike Tilton, Vice President of Sales
    Blue Cross Blue Shield of Arizona​
     
    Ann H, Jun 29, 2016
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  2. Yagents
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    Yagents Guru

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    The disgusting collapse continues.
    Brilliant move. Avoid 80% of the losses, and still be the hero that saves rural AZ.
    Plus, being the only carrier in rural AZ, they can control how much the gov't pays (umm...taxpayer)
    And, those folks in Scottsdale may have no close hospitals in network without Honor Health participating in any marketplace plan.
    Ooops.

    Sidenote: Health Net AZ also just pulled their PPO from off marketplace. The last remaining PPO holdout in AZ is now gone.
     
    Yagents, Jun 29, 2016
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  3. AllenChicago
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    "Stung by financial losses on marketplace plans in 2014 and 2015, Blue Cross Blue Shield of Arizona has filed documents with the Arizona Department of Insurance to discontinue such plans in Maricopa and Pinal counties. About 44,000 Blue Cross Blue Shield customers will need to find new sources of health coverage for 2017.

    Similarly, state filings show Health Net will drop Affordable Care Act plans in Maricopa and Pinal counties next year."

    Source: Blue Cross, Health Net drop Affordable Care Act marketplace plans

    What is it about the residents of Maricopa and Pinal counties that frighten health insurers so?
     
  4. Yagents
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    Yagents Guru

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    With Health Net also leaving, this completely eliminates the OFF exchange market in Phoenix, AZ.

    All 4 of the remaining carriers require you to purchase off HC.gov platform.
     
    Yagents, Jun 30, 2016
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  5. Ann H
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    Ann H Guru

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    Allen, Maricopa County is the population center (Phoenix metro area of 4+ million people). Pinal County is our neighbor and contains some of our suburbs.

    With the exception of Tucson (500,000) and Flagstaff (65,000), the rest is called "rural", but don't think of it like the midwest where it's dotted with all those farms and towns! In Arizona, rural population means anywhere you can get to water. We have lots of empty desert dotted by a few communities.

    So, BCBSAZ is going to serve anything except the Phoenix area. Phoenix, with its major hospital chains and doctors had the highest claims in AZ. Rural, where water and doctors are few, wasn't as bad. And if you can give them a local HMO network, with those small hospitals, but without access to Phoenix hospitals, then claims may be containable. However, it may be a great place to sell life insurance and cemetery plots. Sorry, sick joke.

    ----------

    Also, a lot more people in the rural areas are subsidized. Since they are the only carrier in those areas, they set the SLCSP, and rates can be high while the govt pays the majority of it.
     
    Ann H, Jun 30, 2016
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  6. tonyisme
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    The foreigners (no ssn) can still buy international IMG or Cigna Global insurance if healthy. The voting citizen has to wait till open enrollment then bend over 2 get the "new rates" https://youtu.be/qdFLPn30dvQ

    rates likely to be 45% or more higher. Blue is saving that news 4 later
     
    tonyisme, Jun 30, 2016
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  7. sam816
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    sam816 Super Genius

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    "ACA individual plans will no longer be available in Maricopa and Pinal counties."

    I am not familiar with BCBS's group products but aren't they just combinations of individual plans that are offered to various businesses?

    So does this mean that they will stop offering group products also? isn't that market still profitable?

    It's hard to believe that ACA's designers/supporters could have made such a mistake by allowing an insurer to offer group plans while avoiding individual market entirely.
     
    sam816, Jul 2, 2016
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  8. Yagents
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    Yagents Guru

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    Yes, they will offer group p.p.o.

    Group plans not sold thru government dictated(or) exchange.

    Even the liberals didn't want to destroy group, only 3% of population is on a.c.a.

    destroying I.f. p was easier to pass Congress and to deceive voters. Most will lose doctor(s) in Phoenix this upcoming year

    Tail wag dog
     
    Yagents, Jul 2, 2016
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  9. sam816
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    sam816 Super Genius

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    Wow, didn't know ACA has such a big loophole that allows insurers to pick group over individual.

    What is the min number to qualify as a group? maybe the right advice is to start a family business.
     
    Last edited: Jul 3, 2016
    sam816, Jul 2, 2016
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  10. Yagents
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    No loophole. Designed by idiots. It only took 4 yrs to implement, and 3 years to be left hanging by a thread.

    In AZ, in just 3 years we've lost 6 major carriers, most of them here for years: Assurant, Humana, UHC, Health Net, BIG Blue Cross, & the Meritus Co-Op.
    We're down to 2 medicaid HMO players, and 2 carriers that are merging and are just playing nicey nice to get approval from the feds. (Aet/Hum & Cigna/Anthem).

    &

    Now Doctors are starting to wake up that their business will be impacted, when they start losing a lot of patients they gained recently due to not being in network. There needs to be more press on this type of stuff.

    Providers cut plans for Pinal - trivalleycentral.com: Area News
     
    Yagents, Jul 3, 2016
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