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Posted by on Sep 5, 2013 in Nebraska | 0 comments

Nebraska releases preliminary exchange information

NE_Title

 

What information is available regarding the health insurance exchange in Nebraska?

On August 29, 2013, the Nebraska Department of Insurance released Preliminary ACA Plan Rates. The document released has a chart showing proposed medical and dental carriers, plans, plan types, and rates for the various rating areas for non-smokers and smokers. Products shown are subject to review by the U.S. Department of Health and Human Services.

While the Nebraska Department of Insurance has information available regarding the Federal Health Care Law on their website, consumers will use the federal website, HealthCare.gov, to compare coverage options, apply for subsidies, and enroll in health insurance.

Will coverage and premiums be the same statewide?

In Nebraska, the geographic rating areas, which are used to help determine health insurance premiums, were developed by grouping regions of the state together by using the first three numbers of the area’s zip code. There are four rating areas in Nebraska; so insurance companies may charge different premiums in each of the areas. This means the same person may have a different premium in area one than they would have in area four. Furthermore, insurance carriers are not required to offer coverage in all regions of the state. Here is a breakdown of the rating areas:

AREA ZIP CODE
1 680, 681
2 683, 684, 685
3 686, 687, 688, 689
4 690, 691, 692, 693

Which carriers will be offering plans on the exchange?

Four medical carriers and four dental carriers have submitted plans to be offered through the Nebraska health insurance exchange.

MEDICAL CARRIERS DENTAL CARRIERS
Blue Cross Blue Shield of Nebraska BEST
CoOportunity Health Delta Dental
Coventry Health Dentegra
Health Alliance of Urbana, Illinois Guardian

Medical Carriers

Blue Cross Blue Shield of Nebraska will be offering plans through the exchange statewide. BlueEssentialsPlus and SelectBluePlus individual plans will be offered at the catastrophic, bronze, silver, and gold metal levels. BluePridePlus and SelectBluePlus small group plans will be offered at the bronze, silver, and gold metal levels.

SelectBlue, introduced in 2012, is a select-tier health insurance plan. It is only available in the Omaha metro area; which includes Douglas, Sarpy, Cass, Saunders, Dodge, Washington, Burt and Otoe counties. This three-tier plan uses two in-network tiers and one out-of-network tier.

CoOportunity Health is a marketplace brand for Midwest Members Health. It is a new Consumer Operated and Oriented Plan, or CO-OP. The nonprofit is the only CO-OP operating in two states: Iowa and Nebraska. CoOportunity received a certificate of authority to provide health insurance from the Nebraska Department of Insurance on April 1, 2013. CoOportunity Health has strategic business alliances with HealthPartners Administrators, Inc. to support health plan administrative services, and Midlands Choice, a multistate Preferred Provider (PPO) network. The company will be offering products statewide both on the Exchange and off the Exchange to individuals, small businesses, and other employers.

Individual plans will be offered at the catastrophic, bronze, silver, gold, and platinum levels. CoOporunity is offering the only platinum individual exchange plan. Small group plans will be offered at the bronze, silver, gold, and platinum levels. CoOportunity is offering the only platinum small group exchange plan.

Coventry Health will have health insurance plan options available statewide, but not all plans will be available in all regions of Nebraska. Individual HMO and POS plans will be offered at the catastrophic, bronze, silver, and gold levels. Small group HMO plans will be offered at the bronze, silver, and gold levels.

Health Alliance of Urbana, Ill. is a managed care organization headquartered in Urbana, Illinois. The company will have plans available only in regions 1 and 2; Health Alliance currently offers coverage in 74 of 102 Nebraska counties. Guide HMO and Pathway POS products will be offered to individuals at the catastrophic, bronze, silver, and gold levels and to small business at the bronze, silver, and gold metal levels.

Dental Carriers

BEST has applied to offer both individual and small group low level and high level plans statewide.

Delta Dental has submitted both individual and small group low level and high level plans to be offered in rating area one.

Dentegra has applied to offer both individual and small group plans at the low and high levels in rating area one.

Guardian has submitted only small group plans to be offered statewide at the low and high levels.

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

Jillian Carlile
Research Analyst & Health Exchange know-it-all
Strenuus
jcarlile@strenuus.com

About Strenuus

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.

Learn more at www.strenuus.com.

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