PreferredOne Insurance Review & Complaints: Health Insurance (2023)

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PreferredOne is a Minnesota-based health insurance company offering both group and individual plans to residents. They have a wide range of health plan options available within a large network of health care providers including some of the largest health systems in the state.

What is PreferredOne?

PreferredOne is a Golden Valley based health insurer dedicated to offering affordable quality health plan options. This company 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 provider network. 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 puts a more specific emphasis on health plans for employers.

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.

What PreferredOne plans are available?

Most of the listed PreferredOne health plans on the website are different types of employer health plan, so they are only available as employee health benefit plans. 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 visiting an out-of-network healthcare provider.

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%, even when visiting an out-of-network provider.

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.

Employer Plans

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 plan 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 the health care cost for employees as well as employers.

Are the rates cost-effective?

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 Preferred One 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 raised premiums.

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 health insurance coverage can be had for a similar monthly rate; medical plans with higher deductibles can be had for much less. All things considered, you may be able to get a more affordable rate if you get your coverage from a different healthcare provider.

How are claims processed?

According to the PreferredOne site, they have processed 2.2 million electronic claims for medical services. 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 PreferredOne customer service line. It is unclear if you are able to file a claim with a customer service representative.

Are ratings and consumer reviews positive?

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 depending on the plan type, 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.

What’s the bottom line?

If you are in the market for individual coverage and affordable health insurance, 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 for medical care. With only one individual health insurance 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.