UPDATED: Nov 30, 2018
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PreferredOne was founded in Golden Valley, Minnesota in 1984. Made up of three companies (PreferredOne Administrative Services, PreferredOne Insurance Company, and PreferredOne Community Health Plan), they are wholly owned by Fairview Health Services.
PreferredOne serves about 327,000 members and contracts with 99% of Minnesota hospitals, offering a wide network of care. One of the most affordable and largest insurers in Minnesota, the company made waves by pulling out of MNSure, the state health insurance exchange, in 2014. The move caused a large number of individual members to leave PreferredOne; the company now appears to focus more on group insurance plans.
The plans offered by PreferredOne are varied, including small group, large group, accountable care, self-insurance, and standard individual health plans. The vast majority of the plans are only available through employers.
Most of the listed PreferredOne health plans on the website are only available as employee benefits. In fact, although a wide array of plans are offered, there is only one individual plan for 2018.
PreferredOne Individual Plan
The PreferredOne Balance Plus plan is a PCP/Specialist Copay plan with a PPO network that includes coverage for out-of-network providers.
This plan has deductibles of $3,000 individual and $6,000 family. The first three office visits have a $25 copay for primary care and a $45 copay for specialists. After the first three combined visits, the deductible applies, and visits are covered at 80% after the deductible is met. Most other services are subject to the deductible and then covered at 80%.
Prescription drugs at Tiers 1 and 2 have copays of $10 and $30 respectively. Other Tiers are subject to the deductible before coverage is available. Coinsurance amounts apply after the deductible.
This plan includes both pediatric vision and dental coverage, but neither of those is included for adults.
Group plans offered through employers appear to be the largest part of PerferredOne’s products.
They offer small and large group plans both on a traditional insurance policy basis and as self-insured plans. They also have PreferredOne Simplicity, a plan that is designed to refund unused health care dollars, and Accountable Care plans referred to as “value plans”.
Accountable Care plans have several options for a more limited network and are administered by partners, one of which (PreferredHealth) is parent company Fairview. These are meant to bring down healthcare costs for employees as well as employers.
We ran a quote for PreferredOne’s only individual plan option, using a 30-year-old non-tobacco user as our sample. The monthly rate returned is $364.60, which we find to be high for a young, single person as well as for a plan with a relatively high deductible.
While our research indicates that PreferredOne was once considered an affordable health care option, it appears rate changes in the wake of the company’s departure from the state marketplace may have changed that.
By comparison, another local insurer, HealthPartners, offers their $1,000 deductible Gold plan with a rate of $365.63 for the same search parameters. That means better coverage can be had for a similar monthly rate; plans with higher deductibles can be had for much less.
According to the PreferredOne site, they have processed 2.2 million electronic claims. The company website does not offer much in the way of claims information, which isn’t unusual for a health insurance only company.
Claims questions appear to be handled through the main customer service line.
Ratings and Consumer Reviews
PreferredOne has an A+ rating with the Better Business Bureau (BBB), and there are eight complaints on file in the past three years. Of those, two were closed in the past 12 months.
Google reviews are mixed, with several complaints about customer service and some stating that there is a large volume of paperwork involved in even basic services. There are also some positive reviews mixed in, for an overall 2.4-star rating. One review came from an employee at a provider, stating difficulty getting policy and contact information from a patient’s PreferredOne insurance card.
We found only one negative review on Yelp, again stating that there is a lot of red tape involved in getting coverage.
The Bottom Line
If you are in the market for individual coverage, there are many different health insurance companies that will have more options for you. PreferredOne has made moves in recent years to reduce its share of the individual plan market and is far more focused on employer coverage. With only one individual plan option available that is more costly than options offered with better coverage elsewhere, Minnesota residents seeking their own insurance plan aren’t likely to find this company high on the list. Employers, however, seeking to provide group benefits, may well find some good options at PreferredOne.
For a list of companies that we recommend, visit our Best Insurance Companies page.