DISCLAIMER

The lists below are companies who notified the State of Florida they would be selling Health Maintenance Organization (HMO) plans Off the Marketplace starting 2015.  As of  April, 2015 this list was current, but it may no longer be current  To get the current list of available health insurance plans for the companies listed, your are encouraged to visit the website of each company or visit

https://www.healthcare.gov/see-plans/.

 

 

Not all plans are available in all states and zip codes. You may visit the federal Marketplace website at https://www.healthcare.gov/see-plans/ to determine what plans are available in your zip code. 

 

Both on-Exchange and Off-Exchange plans are private insurance.  In fact, some companies offer plans that are both On-Exchange and Off-Exchange plans.  All private insurance have the standard cost-sharing components in that they have Deductibles, Co-insurance, Co-pays and Out-of-Pocket limits.   If the Off-Exchange plan is Affordable Care Act (ACA) compliant, it covers the ten (10) Essential Benefits required by law and is mandatory for all On-Exchange plans.  These ten categories are, as outlined by Healthcare.gov:

 

· Ambulatory patient services (a.k.a. outpatient care that you can receive without being admitted to a hospital)

· Emergency services

· Hospitalization for surgery, overnight stays, and other conditions

· Pregnancy, maternity, and newborn care

· Mental health and substance use disorder services

· Prescription drugs

· Rehabilitative and habilitative services and devices (a.k.a. treatment and devices that that help people gain or recover mental or physical skills after an injury, disability or onset of a chronic condition)

· Laboratory services

· Preventive and wellness services, as well as chronic disease management

· Pediatric services, including dental and vision coverage for children

 

Additionally, ACA compliant plans are required to cover birth control and breast feeding equipment and counseling.

 

Insurers and Health Maintenance Organizations (HMOs) have more freedom in structuring Off-Exchange plans because they choose the level of benefits they want to offer (within state-mandated parameters) they want to offer. Insurers and HMOs can choose to make their plans ACA or non-ACA compliant, or offer more or less benefits than their On-Exchange plans.  Some Insurers and HMO’s have chosen to only offer their plans Off-Exchange or have chosen to offer more plans Off-Exchange than those offered On-Exchange.  Some have even chosen to retain their largest or most popular Networks for their Off-Exchange consumers.  And some offer more comprehensive drug coverage in their Off-Exchange plans than their On-Exchange plans.

 

For more information about the ACA, please review our Health Care Reform webpage or contact the Department of Financial Services, Consumer Services Division at 1-877-MY-FL-CFO (1-877-693-5236) within Florida or directly at 850-413-3089.  Additional information may be obtained at: https://www.healthcare.gov/choose-a-plan/plan-types/

* www.healthcare.gov.

 

 

 

 

Off-Exchange Health Insurance

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DISCLAIMER

The lists below are companies who notified the State of Florida they would be selling plans Off the Marketplace starting 2015.  As of  April, 2015 this list was current, but it may no longer be current  To get the current list of available health insurance plans for the companies listed, your are encouraged to visit the website of each company or visit https://www.healthcare.gov/see-plans/.

 

 

Plans that are available outside of the public exchange environment or in the open market and may or may not be in compliance with the Affordable Care Act (ACA) which began January 1, 2015. Off-Exchange offer greater plan choices than On Exchange and may be better suited for the shopper who does not qualify for a subsidy.  Off-Exchange Plans do not qualify for the Advanced Premium Tax Credits (APTC) commonly called a subsidy. However, these plans can also fall into the four metal  categories: Bronze, Silver, Gold and Platinum.  Plan premium vary by state and zip code. The chart below shows the average monthly premiums for each category  in zip code 33330, Broward County, Florida.

COMPANY

NAME

PHONE NUMBER

WEBSITE

CATASTROPHIC

PLAN?

Aetna Life Insurance Company

1-800-694-3258

Get A Quote

Yes

Blue Cross and Blue Shield of Florida dba Florida Blue

1-800-955-2227 or visit a Florida Blue Center

Get A Quote

Yes

Celtic Insurance Company

1-800-779-7989

Get A Quote

No

CIGNA Health and Life Insurance Company

1-866-438-2446

Get A Quote

No

Freedom Life Insurance Company of America

1-800-387-9027

Get A Quote

No

Health First Insurance

1-800-716-7737

Get A Quote

Yes

Humana Health Insurance Company of Florida

1-877-229-6285

Get A Quote

Yes

Time Insurance Company

1-800-647-9094

Get A Quote

No

UnitedHealthcare Life Insurance Company

Contact insurance agent.  List of agents is on website. 

Get A Quote

No

COMPANY

NAME

PHONE NUMBER

WEBSITE

CATASTROPHIC

PLAN?

Aetna Health, Inc.

1-800-694-3258

Get A Quote

No

Av-Med, Inc.

1-800-477-8768

Get A Quote

Yes

Coventry Health Care of Florida

1-800-862-1901

Get A Quote

Yes

Coventry Health Plan of Florida

1-800-862-1901

Get A Quote

Yes

Florida Health Care Plan, Inc.

1-800-352-9824

Ask for Marketing

Get A Quote

Yes

Health First Health Plans, Inc

1-855-443-4735

Get A Quote

Yes

Health Options, Inc. dba Florida Blue

1-800-633-6808 or visit a Florida Blue Center

Get A Quote

 

No

Humana Medical Plan

1-877-229-6285

Get A Quote

Yes

Molina Healthcare of Florida

1-888-560-5716

Get A Quote

No

Sunshine State Health Plan

1-877-687-1169

Get A Quote

No

UnitedHealthcare of Florida, Inc.

1-800-474-4467

Get A Quote

Yes

Bronze

Silver

Gold

Platinum

$331 Average Monthly premium. 

 

Usually has a lower monthly premium than a Silver plan, but also has higher deductibles and higher costs when you get care.*

$358 Average Monthly premium. 

 

Has higher monthly premium than  Bronze, but the plan starts to pay its share sooner and you will  pay less each time you get care.*

$528 Average Monthly premium.

 

Has higher monthly premium than Silver, but the plan starts to pay its share sooner and you will  pay less each time you get care.*

$742 Average Monthly premium.

 

Has higher monthly premium than Gold, but the plan starts to pay its share sooner and you will  pay less each time you get care.*