“Blue Cross and Blue Shield of Illinois will be the only insurer offering PPO health insurance plans on the state’s Obamacare exchange next year, according to information released Friday by the state Department of Insurance.
That’s down from five insurers that offered individual PPO plans on the exchange this year. Many consumers prefer PPO health plans because, unlike HMO plans, they allow patients to see specialist doctors without a referral and see physicians who are out-of-network, albeit at higher costs.
The reduced choices were not unexpected, following the exit of several insurers from Illinois’ exchange. Aetna, its Coventry brand, UnitedHealthcare, UnitedHealthcare subsidiary Harken Health and Land of Lincoln all announced this year they wouldn’t offer individual plans on the exchange next year. Many insurers have cited financial struggles as their reason for abandoning the exchange.
The information was released Friday along with final rates for insurance plans on the exchange, which on average, are largely the same as rates submitted to the federal government in August. Rates will increase by an average of 44 percent for the lowest-priced bronze plans, 45 percent for the lowest-priced silver plans and 55 percent for the lowest-priced gold plans.
The information released Friday, however, also shows for the first time which insurers will offer what types of plans in each county on the exchange next year:
• In Cook County, insurer Celtic will offer an HMO plan, Cigna will offer an HMO and Blue Cross and Blue Shield will offer an HMO and a PPO.
• In Lake and McHenry counties, Blue Cross and Blue Shield will be the only on-exchange insurer offering HMO and PPO plans.
• In Kane and DuPage counties, Cigna will offer an HMO, Celtic will offer an HMO to part of the area and Blue Cross and Blue Shield will offer an HMO and PPO.
The federal government will release specific premiums, deductibles and information about networks by Nov. 1, when consumers can begin shopping for insurance on the exchange.
This year, Blue Cross and Blue Shield of Illinois stopped offering its broadest PPO plan for individuals on the exchange, instead offering a smaller PPO network that didn’t include popular academic medical centers at Northwestern University and the University of Chicago or hospital chain NorthShore University HealthSystem.
“We will continue to work with state and federal regulators and legislators to ensure a stable and sustainable insurance marketplace and to improve the quality and cost of care for all of our members,” Blue Cross and Blue Shield of Illinois said in a statement Friday.
Illinois is not unique in how few insurers will offer on-exchange PPOs next year, said Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation.
Options will be more plentiful for Illinois residents who buy individual insurance off the exchange, but people who buy off-exchange plans aren’t eligible for federal subsidies that offset insurance costs. About 75 percent of Illinois residents who buy insurance on the exchange now get those subsidies, which will allow those consumers to pay less than $75 a month next year, even with the rate increase, Jonathan Gold, a spokesman for U.S. Department of Health and Human Services, said in a statement.
Five insurers will offer off-exchange PPO plans next year in different parts of the state. In all, 14 insurers will offer plans off the exchange. Consumers typically can buy off-exchange insurance through brokers or through insurance companies directly.
Oftentimes, insurers are more inclined to offer plans off the exchange because they may believe they’ll get healthier customers, said Larry Levitt, a senior vice president for special initiatives at the Henry J. Kaiser Family Foundation.
Most consumers, he said, are most concerned about making sure insurance plans’ networks include their doctors and that their monthly premiums aren’t too high. “It means consumers have to shop around carefully, as options are changing,” he said.