Important Changes to Medical Mutual’s 2017 Individual Products

Special Broker Update

08-16-2016

While Medical Mutual is firmly committed to Ohio and the Individual ACA market both on and off exchange, it is necessary for them to make changes to their 2017 individual health insurance products. These changes will allow them to remain viable as some of the protections for health insurance companies put in place by the Affordable Care Act (ACA) go away.
CLEVELAND AND AKRON

  • Medical Mutual will continue to offer a broad network ACA product in the Cleveland and Akron region.
  • For regulatory reasons, they are transitioning these products from Preferred Provider Organization (PPO) to Point of Service (POS) products.
  • For all intents and purposes, the POS products and network will function exactly like the current PPO with the vast majority of providers remaining in network.
TOLEDO, YOUNGSTOWN, CINCINNATI, COLUMBUS, LIMA, AND SPRINGFIELD

For the balance of the most populated regions of the state MMO will eliminate their PPO products and instead offer highly competitive, single-hospital system, HMO products. As a result, most existing members who are moved to HMO products will see rate decreases.

UPDATE: Members residing in Franklin, Delaware, Fairfield, Licking, Union, Morrow, Richland, Marion, Hardin, Athens, & Pickaway will be receiving a letter advising that MMO will not have an OFF exchange product. Members OFF exchange will have to purchase an ON Exchange plan if they wish to maintain MMO coverage.


REGIONCOUNTIESNETWORK
CincinnatiButler, Clermont and HamiltonMercy HMO
ColumbusAthens, Delaware, Fairfield, Franklin, Hardin, Licking, Marion, Morrow, Richland and UnionOhioHealth HMO
LimaAllen and PutnamMercy HMO
SpringfieldChampaign and ClarkMercy HMO
ToledoLucas and WoodProMedica HMO and Mercy HMO
YoungstownColumbiana, Mahoning and TrumbullMercy HMO

COUNTIES WITH DISCONTINUED PRODUCTS

Unfortunately, the product changes necessitate Medical Mutual to stop offering products in the 57 of Ohio’s 88 counties listed below. MMO will be notifying members in these counties in mid –August, and again closer to the start of open enrollment when they may begin purchasing new plans. View a sample letter here.

AdamsFultonJeffersonNobleStark
AuglaizeGalliaKnoxOttawaTuscarawas
BelmontGreeneLawrencePauldingVan Wert
BrownGuernseyLoganPerryVinton
CarrollHancockMadisonPickawayWarren
ClintonHarrisonMeigsPikeWashington
CoshoctonHenryMercerPrebleWayne
CrawfordHighlandMiamiRossWilliams
DarkeHockingMonroeSanduskyWyandot
DefianceHolmesMontgomerySciotoErie
HuronMorganSenecaFayetteJackson
MuskingumShelby   

FOR MORE INFORMATION
The product changes outlined above are for individual ACA business only and do not affect transitional or grandfathered individual business nor group business. Changes for 2017 plans do not affect policies in place through December 31, 2016. Throughout 2017, MMO will continue to explore options that will allow them to once again serve all 88 of Ohio’s counties with high quality, yet affordable health insurance plans.




AgentSuite

Contact

Jim LaFleur
Vice President
Phone: 330.576.1131
Toll Free: 1.800.792.6795
JimL@buaweb.com