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Reply to On-Exchange Child Only Policiy Issue- Pima County     
Old 11-21-2016, 04:47 PM   #1
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State: monty1988 is an Insurance Agent from
On-Exchange Child Only Policiy Issue- Pima County On-Exchange Child Only Policiy Issue- Pima County
So I am having a heck a time trying to figure this out, and as usual, the Marketplace Navigators are of no help!

As you know, Pima County essentially has 3 ACA options, all On-Exchange.

I had two clients who wanted to enroll only their children. They did not qualify for a subsidy so they wanted to go with the BCBS SimpleHealth Cat plan. When I got to the plan selection, only the Ambetter options showed up (Gold and Silver). I even tried placing the children in different groups and received the same results.

On the flip side, I had a couple of families qualify for subsidy and cost-share, but when I went to the plan selection, only the Ambetter Gold and BCBS Cat plans showed up- no Silver. Now, if I put each child in their own group, then yes, the Silver plan would show up. However, this would raise the overall deductible for the family since each of the four children would need to meet their individual deductible since they'd be on their own plan.

It seems to me like in each case, the system is eliminating the lowest cost option. In talking to both Blue Cross and Ambetter, it's apparent that this is most definitely a Healthcare.gov issue.

Has anyone else run into this issue? If so, is there is workaround?
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