Director's Message Regarding Health Insurance Premiums for 2018

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.

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Arson Suspect Indicted in $120,050 Insurance Fraud Scheme

Phoenix, AZ The Arizona Department of Insurance (ADOI) Fraud Unit, in conjunction with the Phoenix Fire Department Investigations Unit, arrested Mohamed Abdulrahman on multiple felony charges, including arson of a structure, fraudulent insurance claim, and forgery. 

The fire occurred in a commercial storage building in the early hours of November 1st, 2017.  When Mr. Abdelrahman was interviewed by insurance adjusters, he misrepresented details and facts during the claim process, which is a violation of Arizona statutes.  During the claim process, Mr. Abdelrahman pushed for a fast settlement, and even filed complaints with the Arizona Department of Insurance Consumer Affairs Division, requesting assistance because the insurance companies were not paying him for his losses.

During the four-month investigation that would ensue, investigators learned that Mr. Abdelrahman had increased his insurance coverage on the unit a few days prior to the fire.  Mr. Abdelrahman was in the area of the storage facility when the fire was discovered and used his vehicle to block first responders from entering the location, alleging his vehicle broke down in-front of the facility entrance. The building security cameras were sabotaged hours before the fire was reported.

The claims Abdelrahman filed with insurance companies totaled $120,050.00.  The case is being prosecuted by the Arizona Attorney General’s Office for criminal charges.  If found guilty, Mr. Abdelrahman could receive up to 12 1/2 years in prison.

For a copy of the indictment, CLICK HERE.

FY 2019 INSURER ANNUAL ASSESSMENT INVOICES ARE AVAILABLE

Click here to view invoices for annual assessments to insurance companies and service companies. Invoices will also be sent by mail July 10, 2018. Payments are due August 7, 2018. 

Please consider using the OPTins Assessment account to pay your assessment invoice.