PHOENIX — California-based Health Net sold the lowest-cost insurance plans to Arizona residents under the Affordable Care Act, but the insurer has also netted the most complaints.
The Arizona Republic reports (http://bit.ly/1oc2J2c) Health Net has been named in 89 of the 110 complaints filed with the Arizona Department of Insurance since marketplace coverage began Jan. 1
Most consumers complained about Health Net's inadequate network of providers, lack of access to care, payments not properly credited and policy cancellations.
Some doctors have also voiced frustrations, saying they were listed in Health Net's directory of providers but had not yet signed contracts for the insurer's marketplace plans. They turned away patients as a result.
Health Net says it has added six hospitals and more than 1,300 primary care doctors and specialists to its network since January. It has also hired more customer service representatives.
"We are looking systematically at our own processes. We are seeing these issues decrease. We do expect great improvement as time goes on," said Brad Kieffer, a spokesman for Health Net.
Health-care analysts say some confusion among insurers, doctors, hospitals and consumers should be expected during the first year of the health insurance marketplace.
Experts also say consumers may not be familiar with how to use insurers' networks of doctors, hospitals, pharmacies and labs. If consumers go outside the network, plans pay little or nothing of their overall bills.
Health Net credits these narrow networks with allowing the company to rein in expenses and charge consumers lower monthly premiums, although it will seek to raise rates nearly 14 percent in 2015.
This year, the insurer's lowest-cost HMO plans in Pima, Maricopa and Pinal counties were among the lowest-priced plans across the federal marketplace's 36-state territory.
Consumer watchdogs say that complaints about health-network issues are a sign that insurers, providers and consumers are all adjusting to the new marketplaces and that people will be able to draw on their experience this year to find plans next year that work for them.
"Some will choose (plans) based on cost. Some will base (decisions) on network adequacy or other factors," said Diane Brown, executive director of Arizona Public Interest Research Group. "Insurance companies should work hard to lower cost and improve services in order to remain competitive and grow their customer base."
Information from: The Arizona Republic, http://www.azcentral.com