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Showing posts from September, 2010

California PCIP (Federal Risk Pool) Delays Open to October 7

The California PCIP (Pre-existing Condition Insurance Program) has announced a delay of one week for opening of the coverage program.

MRMIB anticipates coverage to go into force on October 7, 2010.

Anthem Blue Cross HIPAA Enrollment Change (California)

Effective October 1, 2010, Anthem Blue Cross California will institute a new enrollment process for HIPAA applicants.

Beginning 10/1, applicants will have start dates as follows based on application submission (WITH premium):

1st-15th of the month, 1st of the next month
(ex. Apply 11/1-11/15 start date is 12/1) (one month gap)

16th-31st of the month, 1st of the second month
(ex. Apply 11/16-11/30 start date is 1/1)(two month gap)

In order to avoid gaps in coverage, I need all Anthem HIPAA applications to be submitted to my office at least 30 days PRIOR to the requested effective date.

Anthem Health Plan Blackout (California IFP)

Anthem Blue Cross of California has today suspended it's online application program for individual & family health plans. The application will be unavailable until approximately October 1. I will update when it becomes available.

For those seeking quotes for Blue Cross coverage plans (non-HIPAA), currently over 75% of the plan portfolio is not available for sale pending Dept of Insurance approval of plan designs and rate changes. The PlanFinder tool will still work via my web site (www.davefluker.com) however it is currently only quoting the DMHC registered plans that have been approved (the expensive plans). I will update as soon as I receive word as to the availability of the new DOI-registered PPO plans.

These plans are currently being changed to meet PPACA guidelines including elimination of lifetime caps and addition of no-cost preventive services.

Currently Anthem is pending approvals for the following plan portfolios:

-SmartSense PPO
-Clear Protection PPO
-Core Guard PPO
-Prem…

Anthem Blue Cross CA Eliminates Child-Only Enrollments

Effective 9/23, Anthem Blue Cross CA will no longer offer individual coverage plans to children under 19 as a stand-alone enrollment. Children of any age may apply for coverage as long as they are applying with parents/guardians over the age of 19. However, Anthem will no longer accept applications for children-only under the age of 19.

Several carriers in many states have taken similar action in recent weeks. It appears that Anthem across the 14 states they cover will take this action in all states. Other carriers have also instituted the same policy.

PPACA requires insurers who provide child-only coverage to insure all children under 19 regardless of health conditions. HHS is supposed to provide guidance to the insurance companies regarding open enrollment periods, however such guidance has not yet been forthcoming. As such, Anthem CA (so far) has chosen to stop selling health coverage plans to children under 19 at least until HHS provides clarification on the open enrollment.

Carriers…

PacifiCare Fined $9.9 Billion by CDI

PacifiCare is once again the target for CA Dept of Insurance regulatory action.

A couple of years ago, the carrier was fined $1.2 Billion for poor claims practices.

Aocording to the article below, PacifiCare committed over 1 million violations of California law between 2006-2008.

I have maintained for several years my refusal to contract with this carrer, as have many CA health agents.

This is going to hurt if enforced.

LA Times Article