Arizona insurance law and regulation
News that affects your health insurance and planning
October 25, 2021 – More than 60,000 Arizona residents enrolled for health insurance in the first half of 2021 through the plans established by the Affordable Care Act. The increase is attributed to a federal government that is not hostile to the benefits commonly known as ‘Obamacare’.
May 24, 2019 – Status of alternative non-ACA health plans: Arizona does not require individuals to maintain adequate health coverage and permits non-ACA compliant plans. The state provides no premium or cost-sharing subsidies for individual market coverage, permits insurers to sell non-compliant transitional policies in the individual market and does not limit the sale of short-term coverage more strictly than the federal government. Arizona allows medically underwritten alternate insurance plans and allows them to be issued for longer periods of time. (Source: Commonwealth Fund).
March 19, 2019 – Access to a primary provider is the first benchmark of quality health care. Arizona ranks 44th out of 50 states when it comes to physician shortages, according to a recent study by the UA’s Mel and Enid Zuckerman College of Public Health’s Center for Rural Health. Some Arizona residents live in areas where they have to travel 30 or 40 miles to get basic health care, he said.
The history of health care planning in Arizona (Information is outdated and links may be expired)
12/30/2015 Arizona’s Governor signed a new law bars women from buying any health care plan through the federal marketplace that includes abortion coverage. This state law is in direct opposition to the federal health insurance law that requires abortion coverage.
2/20/2015 The state senate has voted to approve a bill that would bar health insurance from covering abortions. The federal government required health insurance to provide this coverage in order to meet minimum coverage requirements. It is unclear what effect the senate’s move would have on the availability of insurance or the impact on federal tax penalties on the residents of the state who might be unable to purchase qualifying coverage under federal law.
2/11/2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
7/26/2013 Affordable Smart Term Life Insurance is now available to most Arizona residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
2/22/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 Aetna Life Insurance Company, UnitedHealthcare Insurance Company, and Health Net Life Insurance Company are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
10/17/2011 State law S1619 enacted April 2011 that offered a guaranteed issuance insurance to all small employers allows insurers to base rates on age, sex, health status-related condition, group size, geographic area and community rating. As a result, rates are typically higher than individual insurance policies not governed by these liberal provisions so that group health insurance is not affordable to many small businesses.
7/27/2011 Bridgeway Health Solutions announced it was awarded a contract to deliver Long-term Care services in three geographic service areas in Arizona effective October 1, 2011. This contract award represents an estimated 50% increase in Bridgeway’s Long-term Care at-risk membership. Bridgeway is a subsidiary of Centene Corporation that also owns Celtic Insurance Company whose individual insurance products are also supported by OnlineAdviser services at Celticenrollment.com.
7/10/2011 The U.S. Center for Consumer Information and Insurance Oversight announced that Arizona lacks proper resources or authority in the individual or small-group health insurance market to effectively review large rate increases as required by federal law. The federal government will temporarily take over the task of reviewing both individual and small business health insurance rate increases that are greater than 10%.
5/4/2011 Arizona state legislature voted to became the first state to authorize its residents to enroll in lower priced health insurance offered by other states. Hope for savings was dashed this week when Governor Brewer vetoed the bill. She reportedly believes that it is important for the state to have legal authority over the health plans of its residents. We anticipate that the proposal will eventually be reconsidered and become law after other states adopt the same measures. For now, Arizona residents must choose from the plans listed on the Arizona exchange that are registered with the state.
2/12/2011 With dozens of health plans choices available online offering a wide range of pricing and benefits, how do you find the best combination of price and benefits? Celtic Insurance realizes that the choices can be overwhelming; the company offers more than 40 possible health plan designs in many parts of the United States. A new feature called “Help Me Choose” lets users easily and quickly select the benefits they value most and narrows the list down to a few of the best choices. No personal information is required other than zip code and date of birth.
2/7/2011 The state’s pre-existing condition insurance plan monthly premium rates (per person):
PCIP will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, beginning on your coverage effective date, even if it’s to treat a pre-existing condition – there are no waiting periods. PCIP applicants who are approved to participate in PCIP can choose from three plan options, with different levels of premiums, calendar year deductibles, prescription deductibles and prescription copays. The HSA Option provides an opportunity to open a Health Savings Account, a tax-exempt account where you can deposit funds for eligible medical expenses. Each of the three PCIP plan options provides preventive care (paid at 100%, with no deductible) when you see an in-network doctor and the doctor indicates preventive diagnosis. Included are annual physicals, flu shots, routine mammograms and cancer screenings. For other care, you will pay a deductible before PCIP pays for your health care and prescriptions. After you pay the deductible, you will pay 20% of medical costs in-network. The maximum you will pay out-of-pocket for covered services in a calendar year is $5,950 in-network/$7,000 out-of-network. There is no lifetime maximum or cap on the amount the plan pays for your care. If you apply for PCIP coverage, you will be billed for the premium once your application is approved. You will need to send in your payment in order for your coverage to be effective. Please do not send in the premium before you are billed. Note that your premium may increase if you age into a higher rate tier, or if PCIP adjusts its premiums to any changes in the commercial market.
2/3/2011 Arizona is named as one of the states most likely to cut back on Medicaid spending and coverage. The Universal Health Insuranceblog discusses the impact on the state’s commercial insurance consumers.
12/28/2010 The state’s pre-existing condition insurance plan attracted only 33 Arizona residents this year despite the government-subsidized premium. This plan provides a health coverage option for consumers who have been uninsured for at least six months, have a pre-existing condition or have been denied health coverage because of their health condition, and are a U.S. citizen or are residing here legally. The federal government pays most of the premium cost. The plan was initially criticized for excessive taxpayer costs but the overall lack of public interest in this insurance was not anticipated.
12/16/2010 Arizona Department of Insurance officials met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, Arizona said that it would: 1) Develop a comprehensive plan for Exchange implementation that ensures a strong competitive marketplace, improves quality and continuity of care so that consumers can seamlessly move from one product to another and ensures that any implementing entity has sufficient flexibility to meet challenging timeframes while maintaining accountability, 2) Contract with the Medicaid Division, the Department of Insurance, and the Arizona State University Department of Biomedical Informatics to help plan for an Exchange, and 3) Convene stakeholders to gather input and leverage existing resources.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
5/10/2010 Diabetes Coverage: A new resource to help with health insurance for diabetics in Arizona is available.
3/23/2010 A proposed constitutional amendment that prevents citizens from being forced to purchase health care insurance is scheduled to appear on the November ballot. If this ballot initiative is passed and the Arizona residents removed from the state’s SCHIP program do not voluntarily purchase health insurance in the commercial market, then Arizona could easily have the highest percentage of uninsured residents in the U.S.
1/28/2010 More than 5 percent of Arizona’s residents will lose their state provided health insurance this year if the Governor’s budget proposal is adapted. If these cutbacks are enacted, Freedom Benefits will focus on making a minimal coverage available to the 47,000 kids and 310,000 adults who could be dropped from the state’s insurance plan. These individuals are unlikely to be able to afford the price of major medical insurance but may want to buy a basic health insurance or accident coverage at a lower price as a temporary measure.