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Showing posts from December, 2008

HIPAA Versus Underwritten: Premium Issue

Hope everyone had a good Thanksgiving and we are now heading into the Christmas season.

I ran across something interesting a few weeks ago and I wanted to share it with you. It forms the basis for the order in which I help people enroll in individual & family coverage in California.

As I mentioned in an earlier blog post, CA PPO plans are able to be rated up from the standard premium in increments determined by each carrier. Some carriers offer more tiers, meaning more chances to get coverage approved.

Anthem Blue Cross (CA) Level 1 (standard), +20%, +25%, +50%, +75%, +100% (6 tiers)
Blue Shield CA Tiers 1-5 (1 being 80% of standard cost which is not always realistic) (5 tiers)
Health Net CA standard, +25%, +50% (3 tiers)
Aetna A (standard), B and C (3 tiers)

As you can see, Anthem offers the best range with 6 full tiers, Blue Shield next with 5 (as stated, Tier 1 is less than likely in the majority of cases), and Health Net and Aetna have less at 3 tiers before decline.

With all of th…