Director's Message Regarding Health Insurance Premiums for 2018

NEW ADDRESS


Arizona Department of Insurance
100 North 15th Avenue, Suite 261

Phoenix, AZ  85007-2630


Starting July 1, 2020, we will be the
Department of Insurance and Financial Institutions (DIFI).

Open enrollment will be available from November 1, 2017 through December 15, 2017 for health insurance coverage commencing January 1, 2018.  Here are a few things you can expect when purchasing or renewing health insurance this year.

In Arizona, the overall average Marketplace (“on-exchange”) Plan Year 2018 rates have stabilized with only slight changes from last year’s premium rates.  This is significant for our market after sustaining large premium increases in 2017.  This premium rate stabilization gives us hope that more insurers may consider entering our market for Plan Year 2019. Unfortunately, like last year, Arizonan’s health insurance plan choices are limited.  Only two insurance carriers will be issuing tax subsidized major medical policies on the exchange in 2018.  One insurer will be offering health plans in Maricopa and Pima counties, and the other insurer will be offering plans in the other 13 counties.  Additionally, we are down to a total of 4 health insurers offering individual plans off-exchange for 2018. Visit our Health insurance rate page to see a list of plans and premium averages by county. 

Additionally, you can view detailed information, compare plans, and complete the enrollment process at the federal Marketplace website at https://www.healthcare.gov.

As you may have read, the federal government announced that it will stop reimbursing insurers for Cost Share Reductions (CSR) associated with major medical policies issued to Marketplace customers that meet the federal poverty level criteria.  This announcement did not result in any changes to the 2018 Arizona Marketplace plan rates for Open Enrollment.

Families with children should be aware that the federal government made some changes to the “child” premium rate calculations which will result in higher premiums for children.  This will have the greatest impact on families that do not qualify for the premium tax credit.  For an explanation of how rates for children will be changing, please read our Frequently Asked Questions document.

Under Arizona state law, the Department of Insurance is not given the legal authority to approve or disapprove the major medical health insurance rates filed with us.  Instead, the Department’s role is to review the rate filings and confirm that valid, detailed financial and actuarial justification (as required by federal and state law) is provided and any change in the rate is found reasonable by these standards.  In order to perform that review, the Department engages independent actuaries to scrutinize the rate filings in depth to confirm compliance with the laws and regulations.  You can read the insurers’ justification of their rate increases and a narrative describing the data and assumptions that the insurer used to develop its rate (a consumer justification) by visiting https://filingaccess.serff.com/sfa/home/AZ.   Visitors can also see a list of all rate change filings (On and Off Marketplace, Individual and Small Group) on the Department’s Health Insurance Rate Information webpage.

Insurers Offering Individual Health Insurance in Arizona

Lists insurance companies that are offering health insurance to individuals and families in Arizona in 2020.  Open enrollment starts November 1st and now runs through December 17th, 2019.  Individuals can start shopping for coverage now at healthcare.gov or cuidadodesalud.gov (Spanish)

Notice of Proposed Rulemaking - Corporate Governance Annual Disclosure Model Regulation In 2019, the Arizona Legislature adopted the NAIC Corporate Governance Annual Disclosure Model Act at Arizona Revised Statutes (“ARS”) by enacting the Corporate Governance Act at Title 20, Chapter 2, Article 16 (Laws 2019, 1st Reg. Sess., Ch. 180, § 1).   The Department of Insurance (“Department”) seeks to adopt the correlate Corporate Governance Annual Disclosure Model Regulation.  ARS § 20-492.02 allows the Department to adopt rules to carry out the Act upon notice and an opportunity to be heard.  The Legislature has exempted the Department from Title 41, Chapter 6 for one year after the effective date of the Act.  (Laws 2019, 1st Reg. Sess., Ch. 180, § 2.)
Arizona's Surprise Bill Resolution Report for 2019

As shown in the attached report prepared pursuant to A.R.S. § 20-3118(A), the Department of Insurance received 91 requests for dispute resolution in Calendar Year 2019.  Of those, 53 have been resolved or closed, and health plan enrollees saved $41,538 by submitting their surprise bills for resolution.  

Not all health care bills qualify for the surprise bill resolution process.  The Department's Suprise Out-of-network Billing Dispute Resolution website (https://insurance.az.gov/soonbdr, and especially the section entitled, "I got a surprise bill. Can I submit a request for arbitration?") lists conditions when a health care bill may not qualify under Arizona law for the dispute resolution process.  But for those that do, the enrollee will only be responsible for paying the enrollee's cost-sharing amounts (copay, coinsurance and deductible) if the enrollee provides information the Department needs, and participates in an informal settlement teleconference with the health care insurer and the health care provider.

Regulatory Bulletin 2020-02

Implementation of Executive Order 2020‐07 Proactive Measures to Protect Against COVID‐19 and Executive Order 2020‐15 Expansion of Telemedicine.

Regulatory Bulletin 2020-03

Complying with Regulatory Requirements during the Public Health Emergency

Regulatory Bulletin 2020-04

COVID-19 and Insurance Customer Relief; Flexibility

Regulatory Bulletin 2020-01

Uninsured and Underinsured Motorist Coverage Offer Form; SB1087