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Posted by on Aug 26, 2013 in Florida | 0 comments

Florida Health Insurance Exchange

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Doesn’t Florida already have an online health insurance marketplace?

While the state of Florida has actively fought the PPACA, the state actually began the process of setting up an online health insurance marketplace for small businesses and some individuals, such as state retires, in 2008. The online marketplace, Florida Health Choices, is not yet operational and there is no set launch date. Come October 1, 2013, consumers in Florida will be able to use the federally-facility exchange at healthcare.gov to compare plans, apply for financial aid, and purchase health insurance coverage.

Will coverage and health insurance premiums be the same statewide?

Some carriers will be offering health insurance plans statewide, however, there are many companies that will only offer coverage in specific areas of the state.

While residents of some high population counties will have a variety of  health insurance options, like Broward with 9 insurance companies seeking to offer 90 plans; Miami-Dade with 9 companies seeking to offer 97 plans; and Palm Beach, with 8 companies seeking to offer 86 total plans; consumers in counties like Calhoun, Franklin, Gadsden, Glades, Hamilton, Hardee, and Jackson will have fewer options; in each of these counties, consumers will only be able to choose among six plans being offered by one company.

Insurers can charge different premiums depending on the geographic area in which a person resides. Many states are divided into multiple geographic rating areas, which are used to help determine health insurance premiums. Each of Florida’s 67 counties is its own rating area; because health insurance costs vary across the state, the same person might have a different insurance premium in area 1 than they would have in area 67.

Which insurance companies have been approved to offer health insurance plans on the exchange?

While Florida’s form and rate review process is ongoing, (as of July 31, 2013) the Florida Office of Insurance Regulation or FLOIR has released information on products that have been approved and comply with the PPACA for sale in the individual marketplace. Here is what we know about the companies that plan to offer plans on the federally-facilitated exchange in Florida.

Aetna Life Insurance Company has been approved to offer their Open Access Gatekeeper PPO product through the Florida exchange. Aetna has recently withdrawn from several state exchanges; so, assuming Aetna stays in the Florida exchange market, the company will be offering 10 individual plans: 1 gold, 3 silver, 4 bronze, and 2 Catastrophic plans.

Florida Blue (formerly Blue Cross & Blue Shield of Florida) is an independent licensee of the Blue Cross and Blue Shield Association. Exchange plans are filed under Blue Cross & Blue Shield of Florida. BCBSF/Florida Blue recently received approval from FLOIR to reorganize its corporate structure and move subsidiary companies within the group. Subsidiary/affiliate companies include Health Options Inc. and Florida Health Care Plan Inc.

BCBS of Florida/Florida Blue: has been approved to offer 53 individual plans: 10 platinum, 14 gold, 16 silver, 12 bronze, and 1 catastrophic plan. BCBS of Florida will also be offering 4 small group plans: 2 gold and 2 silver plans. The small group plans will be BlueOptions and BlueSelect PPO products; these are also current products with BCBSF. BlueOptions PPO has a large network and BlueSelect EPO/PPO is a low cost plan.

Health Options Inc. (an affiliate/subsidiary of Florida Blue) was approved to offer their BlueCare HMO product on the exchange. The company will be offering 24 individual plans: 4 platinum, 6 gold, 8 silver, and 6 bronze. Health Options will also offer 4 small group plans: 2 gold and 2 silver.

Florida Health Care Plan Inc. (an Independent Licensee of the Blue Cross and Blue Shield Association) was approved to offer 80 individual plans: 8 platinum, 20 gold, 20 silver, 20 bronze, and 12 catastrophic. The company will also offer 36 small group plans: 8 platinum, 12 gold, 8 silver, and 8 bronze.

Cigna Health & Life Insurance Co. was approved to offer 11 individual PPO plans: 3 gold, 5 silver, and 3 bronze.

Coventry Health Care of Florida Inc. was approved to offer 32 individual plans: 6 gold, 12 silver, 12 bronze, and 2 catastrophic. In Florida, Coventry only offers products in the Tampa and South Florida regions.

Health First (Health First Insurance Inc. and Health First Health Plans, Inc.): Health First Insurance Inc. was approved to offer 10 individual plans: 4 gold, 3 silver, 2 bronze, and 1 catastrophic. The company will also be offering 7 small group plans: 5 gold and 2 silver. The company’s PPO products will only be offered through the exchange. Health First Health Plans was approved to offer 16 small group plans: 1 platinum, 9 gold, 5 silver, and 1 bronze.

Humana Medical Plan Inc. was approved to offer 18 individual plans: 3 platinum, 3 gold, 3 silver, 6 bronze, and 3 catastrophic. The exchange HumanaOne products will utilize the NPOS, HMO, and Gated HMO networks.

Molina Healthcare of Florida Inc. was approved to offer their individual HMO Molina Marketplace products. The companies 3 individual plans include: 1 gold, 1 silver, and 1 bronze option.

Preferred Medical Plan Inc. was approved to offer individual HMO products through the exchange. Options will include gold premier, silver choice, silver deluxe, silver elite, bronze select, and catastrophic value products. Preferred Medical plans will only be available in Miami-Dade and Broward counties.

Sunshine State Health Plan Inc., a wholly-owned subsidiary of Centene Corporation, will be offering individual HMO products. The company currently offers a Medicaid health plan.

 

New information is being released every day. Follow this blog to receive updates as new information is released in Florida.

Jillian Carlile

Research Analyst & Health Exchange know-it-all

Strenuus

jcarlile@strenuus.com

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Strenuus® is the industry leader in delivering network competitive intelligence services. We are the largest collector of managed care data in the country. With a singular focus on the managed care industry, we provide services to support payors, brokers, consultants and healthcare IT companies. Whether you represent employer-based coverage, Medicare, Medicaid, dental, work comp or specialty networks, we have the data and insights you need.

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