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Showing posts from February, 2010

Part Deux: Is The California Individual & Family Health Insurance Market In Critical Condition?

Having recently watched the "bi-partisan" meeting in Washington and many videos on youtube, I wonder if the problem is "un"-fixable.

Speaker Pelosi, in a recent youtube video answering questions on the meeting, pointed out two things which are absolutely of concern. 1, our health insurance system is employer-based in design and function. 2, there are many more people not covered under the employer-based system who choose to remain on the sideline than those who participate in the non-employer health insurance market.

I won't go through the numbers again since they are covered under part one of this topic below. Suffice to say, nearly two-thirds of those who should participate in the health insurance market in California for individual & family coverage do not. No employer-sponsored health plan, whether fully insured or self-funded, could operate at a participation level of 33% or less. Employer plans require 75% of all eligible employees to participate. …

Anthem: The Tale of the Tape in California

I was curious about the impact of the now-delayed Anthem Blue Cross rate increase on premium levels. I could only think of one way to find out, so I ran quotes on myself in Gilroy for four comparative coverage plans from the four California health carriers. Kaiser and Blue Shield are not-for-profit, so they should win, right? The results may surprise you!

The rates below include the Anthem rate increase scheduled for March 1, 2010.

1500 Deductible HSA Plan (or closest match)

#1 Anthem Blue Cross Lumenos 1500 HSA...............$243.00
#2 Health Net CA 2500 HSA (closest).................$246.00
#3 Blue Shield CA 1800 HSA (closest)................$311.00
#4 Kaiser 1500 HSA..................................$349.00

3500 Deductible Traditional PPO (or closest)

#1 Health Net Value PPO 4000 (closest)..............$179.00
#2 Anthem Blue Cross 3500 PPO.......................$224.00
#3 Kaiser 3000 Plan (closest).......................$277.00
#4 Blue Shield CA Essentials 300…

Poizer Asks For Temporary Halt To Anthem Rate Increase

California Insurance Commissioner Steve Poizner has sent a strongly-worded communication to Wellpoint/Anthem requesting that they hold off on the proposed 3/1 rate increase until 5/1 so that an independent actuary retained by the DOI can review Anthem's payout ratios.

Additionally, the Obama Administration has expressed serious concerns about such a large rate increase in California.

A link to Mr. Poizner's letter here.

Is The California Individual & Family Health Insurance Market In Critical Condition?

With the recent LA Times article and notifications to approximately 800,000 CA residents by Anthem Blue Cross of California, the future of individual & family health insurance coverage is looking bleak. Anthem announced a rate increase for March 1, 2010 ranging between 30-39% on many private health plans.

I received information just yesterday that Aetna has now laid off the IFP staff support for northern California (and I supposed SoCal as well). The last time Aetna laid off people in these positions, they exited the market in California.

First a look at some "interesting" numbers and how they relate to this issue.

California population (2009) - 36,900,000 (probably 37,000,000 by now)

# California residents covered by private health plans - 2,100,000
# California residents on average uninsured - 6,000,000
# California residents covered under Group/Medicaid/Medicare - 28,800,000

Those numbers tell us a lot about what is going on. IFP (Individual & Fam…