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Posted by on Sep 13, 2013 in Michigan, Uncategorized | 0 comments

Michigan’s Exchange Will See Few Statewide Options

Michigan’s Health Insurance Exchange

Michigan Governor Rick Snyder supported the development of a Michigan-based health insurance exchange and asked the Legislature to adopt legislation to create the MI Health Marketplace. However, the state began moving in the direction of a partnership exchange in August 2012 due to legislative opposition that left the state unable to meet the federal timetable for implementation. On November 16, 2012, Governor Snyder filed a grant application to the U.S. Department of Health and Human Services (HHS) to develop a state-federal partnership exchange. Michigan will perform plan management and consumer assistance functions and defer other exchange management functionality to the federal government. The Michigan Department of Insurance and Financial Services (DIFS) will review all plans to ensure compliance with state and federal laws before submitting the plans to the federal government. Come October 1, 2013, Michigan consumers can use the federal website, HealthCare.gov, to compare plan options, apply for subsidized coverage, and enroll in health insurance.

Will coverage and premiums be the same statewide?

Health insurance options will vary across the state of Michigan. Many of the companies that have applied to offer coverage through the new health insurance exchange have only applied to offer products in select counties.

Premiums can vary across the state by geographic rating area. The 83 counties in Michigan have been divided into 16 geographic rating areas.  The rating areas are used to help determine insurance premiums and the same person may have a different premium in one rating area than they would have in another rating area.

AREA COUNTIES
1 Monroe, Wayne
2 Macomb, Oakland
3 St. Clair
4 Lenawee, Washtenaw, Livingston
5 Lapeer, Genesee, Shiawassee
6 Huron, Sanilac, Tuscola
7 Clinton, Eaton, Hillsdale, Ingham, Jackson
8 Arenac, Gratiot, Saginaw, Bay
9 Berrien, St. Joseph, Cass, Van Buren
10 Branch, Calhoun, Kalamazoo
11 Allegan, Barry
12 Ionia, Kent, Lake, Mason, Mecosta, Montcalm, Muskegon, Newaygo, Oceana, Osceola, Ottawa
13 Gladwin, Clare, Isabella, Midland
14 Antrim, Benzie, Charlevoix, Emmet, Grand Traverse, Manistee, Kalkaska, Missaukee, Wexford, Leelanau
15 Alcona, Alpena, Cheboygan, Chippewa, Crawford, Iosco, Mackinac, Montmorency, Ogemaw, Oscoda, Otsego, Presque Isle, Roscommon
16 Alger, Baraga, Delta, Dickinson, Gogebic, Houghton, Iron, Keweenaw, Luce, Marquette, Menominee, Ontonagon, Schoolcraft

MI_Counties_Map

Which companies are seeking to participate in the new health insurance marketplace in Michigan?

On June 6, 2013 the Michigan Department of Insurance and Financial Services (DIFS) announced that it had received filing information from 14 health insurance companies seeking to participate in the health insurance exchange.

Blue Cross Blue Shield of Michigan and its subsidiary, Blue Care Network of Michigan applied to offer both individual and small group plans through the exchange. Blue Cross Blue Shield of Michigan submitted a multi-state plan for review as well. Blue Cross Blue Shield of Michigan offers PPO products. Blue Care Network offers HMO products utilizing a smaller network than available to members with access to the PPO network.

Consumers Mutual Insurance of Michigan (CO-OP) is a new nonprofit insurer in Michigan. The company submitted individual and small group plans. On May 13, 2013, Consumers Mutual announced that the company received their official license from the DIFS. The company submitted four different individual PPO options: Premier, for comprehensive, low deductible, higher premium plans; Choice, for comprehensive, low to medium deductible, moderate premium plans; Basic, for comprehensive, high deductible, lower premium plans; and Generation Y Plan, for individuals under 30 years of age. The company also submitted three different small group PPO options that include all of the individual options except the Generation Y Plan. Consumers Mutual is developing a provider network with healthcare professionals all across the state of Michigan; here is a look at the network service area as of August 5, 2013:

Consumers_Mutual-Service_Area

Health Alliance Plan of Michigan and its wholly owned subsidiary Alliance Health and Life Insurance Company, submitted individual and small group plans to be available in central and south east Michigan. HAP HMO products are currently available in nine counties and Alliance Health and Life and HAP Preferred Products can be found in the same nine counties plus an additional 14 counties.

HAP-Service_Area

Priority Health/ Priority Health Insurance Company submitted new individual and small group products. Priority Health serves members across 65 counties of Michigan’s Lower Peninsula; the Priority PPO plan covers employees living outside Michigan as well. Here is a look at the Michigan service area:

Priorty-Service_Area

Humana Medical Plan of Michigan, Inc., Meridian Health Plan of Michigan, Inc., Molina Healthcare of Michigan all submitted individual plans to be offered through the online health insurance marketplace.

McLaren Health Plan, Physicians Health Plan, and Total Health Care USA all submitted individual and small group plans. Each of the company’s products are only available in select counties.

United Healthcare Life Insurance Company submitted small group plans to be offered through the Michigan online health insurance exchange.

From the BEST Life and Health Insurance Company website, it appears the company intends to offer dental products on the Michigan health insurance exchange, but nothing has been publically announced regarding exchange dental plans.

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

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.

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