The Norman Transcript

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September 14, 2013

Three insurance companies to offer individual coverage under the Affordable Care Act

(Continued)

NORMAN —

The marketplace will begin accepting applications on Oct. 1 for coverage that begins on Jan. 1, 2014. The federal government already is pre-registering applicants through its marketplace website, healthcare.gov. The toll-free help line is 1-800-318-2596.

The federal government is operating the marketplace in Oklahoma. Private insurance companies will issue the policies. Because the marketplace will offer a wide range of plans with different rates and tax credit calculations, it is expected that many people will need one-on-one guidance. Individual counseling will be provided by the federal government, by health clinics and other nonprofit organizations, and by licensed health insurance agents.

Five companies are planning to offer insurance policies to Oklahomans through the health care marketplace. Three of them — Aetna, Blue Cross Blue Shield and Coventry — are offering preferred provider plans that allow policy holders to pay less if they use “network” doctors and services, but let them to go outside the network if they choose and still receive some insurance reimbursement.

The other two companies — GlobalHealth Inc. and Community Care — operate health maintenance organizations that require policy holders to use only network doctors and health facilities. If they go outside the network, they pay the entire cost themselves.

All five companies have posted their rates with the Oklahoma Department of Insurance. But the department released the information only for the three PPO companies. It said state law does not allow it to release rate information for HMOs.

Aetna acquired Coventry earlier this year. But the two companies made separate rate filings listing different plans and rates for the policies they plan to issue n Oklahoma.

The three companies’ rate schedules are voluminous. Blue Cross Blue Shield filed a 207-page document containing hundreds of rates; Aetna’s filing listed 35 plan types and filled 151 pages.

The companies did not provide information in their filings on how rates for plans being offered under the Affordable Care Act compare to plans on existing policies. Advocates of the law caution that such comparisons are misleading because existing plans often don’t contain the full range of benefits required under the act, and companies can no longer exclude people with pre-existing medical conditions.

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