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Health Insurance Through the State Bar of Texas
By: John Jansonius

If you are like me, you cringe and scramble for the nearest exit when you hear the words “health insurance.” It’s a subject particularly hard to avoid as the 2017 health insurance open enrollment begins November 1 and runs through January 31.  To help guide us through open enrollment, the Texas Bar Private Insurance Exchange (PIE) will be doing presentations in Austin, Dallas, and Houston on October 31, November 2, and November 3, respectively. The Austin presentation will be recorded and posted on the State Bar’s website.

Grappling with rising costs in federal exchange plans, insurers are either abandoning the federal exchange or significantly raising rates. While solid information is difficult to acquire from the insurance carriers, here’s what we know now and will be keeping an eye on as we near open enrollment. The average proposed rate increase for the 13 carriers offering plans in Texas is 35 percent. BlueCross BlueShield of Texas has proposed an average 58 percent rate increase, which is pending approval by the Texas Department of Insurance.

Between 2016 and 2017 the number of non-HMO networks available went from 10 to four. The carriers continuing to offer these networks in 2017 are Aetna, Cigna, Oscar, and Scott & White. Aetna and Scott & White will be available through the PIE and not available on the federal exchange. Other significant market changes for 2017 include:

1.  Oscar has indicated it will be leaving the Dallas market and will only offer plans in the San Antonio area. Oscar will be available on the Texas Bar PIE and not on the federal exchange.

2.  Humana has not filed any PPO/POS plans in any Texas counties, indicating it will only offer HMO-style plans in limited Texas counties. It appears Humana will offer plans both on the federal exchange and through the Texas Bar PIE.

3.  Currently, Cigna has indicated it will limit Exclusive Provider Organization (EPO) offerings to one plan that will be available only in the Houston and Austin areas. Cigna is in discussions with the Texas Department of Insurance to pull out of the 2017 federal exchange, which would mean Cigna may be available only through the private market, like the Texas Bar PIE.

Those who normally purchase individual major medical policies may find traditional small group policies are becoming more advantageous. Small group health plans may not always offer lower premiums, but they do provide access to more quality plan options and robust provider networks no longer available through individual policies.

The Texas Bar PIE is working to educate State Bar of Texas members about the benefits of small group plans. It now offers online quoting for small groups, where members can instantly evaluate plans and rates from multiple group health carriers. For these plans, State Bar members need to have at least one other full-time employee to potentially qualify as an eligible group.

As mentioned, starting October 31, the Texas Bar PIE will conduct open enrollment presentations in Austin, Dallas, and Houston to discuss the above and much more. A recording of the Austin presentation will also be made available on the State Bar’s website.

Information on 2017 open enrollment will continue to evolve up to the start of open enrollment. Learn more by clicking here.

To speak with someone at the State Bar about the private insurance exchange, please contact Cory Squires at 800-204-2222, ext. 1724 or by email.

Views and opinions expressed in eNews are those of their authors and not necessarily those of the Texas Young Lawyers Association or the State Bar of Texas.

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