How safe are health insurance companies in Pennsylvania? Perhaps the most respected and authoritative resource is A.M. Best Company, which has been rating financial safety and strength of insurers since 1899. Not only do they provide an unbiased snapshot and opinion of major companies, but they also report the latest changes in financial status and alert consumers if a carrier may be under distress.
The three major ratings are financial strength, debt and credit. All three could possibly impact the current and future rates that may be charged to individuals or businesses in the Keystone state. A++ and A are considered “superior” and A and A- are considered “excellent.” B++ and B+ are considered “good” while B and B- are considered “fair.” Additional classifications are “marginal,” “weak” and “poor.”
These classifications are especially important when considering a Medigap plan in Pennsylvania. Seniors often utilize (and they should) this type of information when deciding which Supplement plan to purchase. There are many national and local carriers to consider.
Listed below are the most recent A.M. Best Company ratings for major Pa health insurance companies: (“NR” denotes not rated)
We Research And Compare Pa Health Insurers
Aetna A
AmeriHealth NR
Avalon NR
Capital Blue Cross NR
Coventry A-
First Priority NR
Geisinger NR
HealthAmerica A-
HealthAssurance A-
Highmark A-
HMO Of Northeastern Pennsylvania NR
Independence Blue Cross NR
Inter County NR
Keystone Health Plan East NR
Keystone Health Plan West A-
Sterling Life B++
UnitedHealthcare A-
UPMC A-
So what does this mean? Is Aetna safer than Highmark? Is UPMC better than Sterling Life? Not necessarily. There are man other factors to consider when comparing two companies. For example, there are other financial rating instruments such as Standard and Poors and Moodys. You can also check the Pa Dept. of Insurance to research the history of complaints and how effectively they are handled.
A.M. Best Co. is simply one of many available tools that allow you to research and analyze an insurer. But perhaps a simpler and easier way is to utilize our website and all of the in-depth information that is available, including current free online quotes. We will always consider a company’s safety and security when discussing plan choices. But affordability and reliability are also important.
Pa adultBasic, the state funded healthcare plan for low income adults may be making a triumphant return. Earlier this month, with the help of former policyholders through a class-action lawsuit, Judge Dan Pellegrini declared that it was unconstitutional for the state’s tobacco settlement funds to be diverted away from the program. Although the ruling does not make any retroactive changes, it still is a big win for lower wage-earners
Thus, adultBasic must be reinstated or another program must be created that closely mirrors the benefits. And 30% of the tobacco funds are to be used for the fiscal year of 2013-2014. Currently, those funds are earmarked for other programs. However, there should be ample time to make the appropriate changes to those specific affected programs.
The Return Of adultBasic
The Pennsylvania Health Investment Insurance Act 77 was enacted in 2001 and created the program for the needy. Some of the money awarded from tobacco litigation in 1998 was expected to total approximately $375 million and $425 million dollars each year. However, in February of 2011, the program came to an abrupt halt when funding stopped and money ran out.
More than 40,000 Pennsylvania residents were left without medical coverage and another 500,000 were on a waiting list. At that time premiums were less than $40 per month, making it a lifesaver for many of the poorer Pa residents that had no coverage through work or made too much money to be Medicaid-eligible. Special Care was the replacement, but the Blue Cross plan has been much more expensive and offers fewer benefits. Less than half of eligible participants switched to Special Care.
So should adultBasic be resurrected and started up again? It may make sense since it appears that it would not cost the taxpayers any of their own money. Or creating a program that offers similar benefits at a reasonable price could accomplish the same goals. We are confident the Governor will make the most prudent (and popular decision.
Pennsylvania health insurance plans raised premiums for 32% of all applicants that bought medical coverage according to “HealthPocket,” a resource that ranks individual and family plans. The data was obtained by the HHS (Department Of Health And Human Services). More than 10,000 policies were used in the nationwide study that did not include persons that were eligible for Medicare or over age 65.
There are many reasons why prices were often higher than the original quote provided to the consumer. Of course, any discrepancies in the submitted application could impact the final premium. Some common examples would be missing medical information, conditions or medications that were not disclosed, and inaccurate statements regarding current or past treatment.
Although more than two out of three policies were issued at the quoted rate, Pennsylvania had the highest percentage of issued contracts that cost more than the original estimate. Other states closely behind were Indiana, Ohio, Virginia, Kentucky and South Carolina. Oddly four of the top six states are in very close proximity to each other. Senior Pa Medicare options were not included since there is no underwriting during Open Enrollment periods.
Your Pa Health Insurance Quote Should Be Accurate
The top five companies that had the highest increased premiums were Anthem Health Plans Of Virginia, PacificSource, Blue Cross of Idaho, Blue Cross and Blue Shield of Florida and Rocky Mountain Hospital and Medical Service (Anthem BCBS). Premiums in these areas can vary depending on underwriting criteria for the specific carrier. Most insurers that have “Community rating,” (health conditions not taken into account) saw no variance in the quoted premium and the actual premium.
OK…So what does this mean? Are Pennsylvania insurers gouging the public? Absolutely not! With any underwritten product (life, auto, home, disability, long-term care ect…) your medical conditions, zip code, age and a few other factors determine the rate you pay. And it should. For persons with severe medical issues that can not qualify for a policy, there are options (Open Enrollments, State Risk Pool) that can be quite affordable. Although, ironically, enrollment in the State Risk Pools will be stopping next month.
And all of these statistics will merely be a forgotten moot point in 2014 when the Pennsylvania State Health Insurance Exchange opens for business. Don’t worry. You can still use this website to compare the most affordable quotes and apply for coverage. But since there will be no medical underwriting and all plans will be “guarantee issue,” presumably 100% of all quotes will be accurate. Smoking will still cause an increase in prices.
The variable will be the amount of the subsidy applicants qualify for. For example, a young family of four living in the Pittsburgh area (parents both age 35) with an annual income of $40,000 will receive a subsidy of about $9,000 per year towards their premiums, which will result in an approximate monthly premium of about $165 per month. That’s very affordable.
However, if their household income increases to $60,000, the subsidy reduces to about $11,000 resulting in a monthly premium of about $490. An $80,000 income would increase their premium to $634.
The biggest injustice incurs at higher income levels. For example, A family of four (parents age 55) with a household income of $93,000 receive a subsidy of $10,915. A bump in income to $94,000 eliminates all subsidies! It appears there we would be little incentive to work, once a specific income level is reached. In fairness, these figures are estimates (although quite accurate) courtesy of the Kaiser Foundation. And different ages and sizes of the family will show different results.
How can you reduce or eliminate the possibility of an inaccurate quote on your Pa health insurance plan? During the application process, correspond with the broker (phone or email is fine) and allow them to review the application before submission. You will greatly improve your chances of the policy getting issued.
