Buying OFF the ACA Marketplace in Arizona….

There is only 1 OFF Marketplace ACA plan in 2018 for Maricopa County with a Cigna HMO plan.  

Cigna’s rates are going up 61% next year, and are approximately 34% higher than the Ambetter Health Net HMO alternative.  

This Cigna HMO plan is not recommended for most situations.

1)  Bronze Connect HMO Plan

HMO using Cigna Medical Group Centers Only

20 citywide centers act as your PCP doctor

Banner only specialists and hospitals

Referrals are Required to Banner specialists

Paper application only

Increasing 61% in 2018

$0 Commission to Agents / Brokers

Cigna Medical Center Connect HMO Network

Cigna Rx Formulary List

2018 Update:  The AZ OFF Marketplace choices in Maricopa and Pima Counties have imploded, and is no longer a valid option.  In all other AZ counties, BCBS of AZ still offers mirrored ACA plans.

WHO should buy a health plan OFF the Marketplace?

Many consumers believe the only way to buy health insurance in today’s market, is “ON the Marketplace” through the ACA / “Obamacare” website at healthcare.gov.  That is simply not true.  What is true, is that it is the only platform to receive financial assistance or tax credits if you’re eligible.

Many consumers bypass the government website altogether, and buy directly from their insurance carrier of choice for one reason or another. Examples of consumers who seek coverage OFF the Marketplace are:

  • Higher Income: Your Modified Adjusted Gross Income (MAGI) is too high (Above 400% FPL) to qualify for any financial assistance with Advanced Premium Tax Credits (APTC).
  • Cheaper Alternatives:  Many compare full priced ACA plans to what’s being offered by their employer, especially when comparing child only plans and premiums. In 2017, there are cheaper non subsidized plans OFF the Marketplace.
  • Nationwide PPO Networks:  Snowbirds or college students MAY need a plan with a PPO network that covers them in both places.   Larger PPO networks are only available OFF the Marketplace.

If any of this describes your situation, you have the option to buy an ACA compliant health insurance plan directly from a carrier with or without an agent during the Open Enrollment Period (OEP), or if you have a Special Enrollment Period (SEP).  Of course, it’s always best to call me to assess your situation and suitability for an OFF Marketplace plan.