Skip to main content

Blue Shield HIPAA Plan Update

To follow up on my May 25th blog post regarding Blue Shield of California HSA 4000 plan closure for HIPAA, I wanted to post an update.

After several days of run around and legalese, I finally was able to determine that Blue Shield of California's current HIPAA portfolio is heavily weighted on DMHC (CA Dept of Managed Health Care) registered health plans (3) with only 1 CDI-registered plan (California Dept of Insurance). A normal arrangement would be 2 plans from each registration and, in the case of Blue Shield prior to 6/1, 3 DMHC and 2 CDI registered plans.

California Health & Safety Code requires an insurance company selling individual plans in California to offer two "popularly marketed health plans" to the HIPAA risk pool for each registration. Over the last several years most insurers have registered PPO plans with the Dept of Insurance (CDI) as opposed to the DMHC.

Blue Shield of California is opening a new portfolio of plans on July 1. The entire portfolio of PPO plans (Shield Secure Plus, Shield Secure, Shield Wise and Shield Savings) are registered with the DMHC in total with no new PPO plan registered with CDI. It totally took me by surprise as I can't remember the last time a carrier in California registered a PPO plan with DMHC.

So, because Blue Shield only has one remaining PPO plan registered with the CDI, that is the plan they offer in the HIPAA portfolio (Spectrum 5000).

Until such time as Blue Shield of Californa (and Life & Health) registers a second PPO plan with CDI, there will be no additional plans for HIPAA and the portfolio will consist of:

*Access+ HMO (DMHC)
*Access+ Value HMO (DMHC)
*Spectrum PPO 5500 (DMHC)
*Spectrum PPO 5000 (CDI)

Dave
www.davefluker.com

Comments

Popular posts from this blog

Anthem Blue Cross (CA) Adding SilverSneakers® Fitness Program

Anthem Blue Cross (CA) announced this morning that they will be adding the SilverSneakers Fitness Program to California Medicare Supplement Plans A, F, and N.  The added benefit will begin on January 1st, 2017. 

Once approved for release into the market, more states have been added to the list as existing and new members in our marketed plans will enjoy the value-added benefits of the SilverSneakers Fitness program at no additional cost! Effective January 1, 2017, California members in our marketed plans will enjoy SilverSneakers, too.  The program offers members their choice of paths to better health. For those who enjoy a traditional workout setting, SilverSneakers offers access to more than 13,000 fitness locations across the country, including use of classes and guidance from a Program AdvisorTM. In addition, for those who can’t get to a fitness center, SilverSneakers Steps® kits focus on at-home or on-the-go general fitness, walking, strength training or yoga. And if that is not …

Anthem Blue Cross Announces Innovative F Medicare Supplement Plan for CA

Anthem Blue Cross (CA) has announced that they are releasing a new Medicare Supplement (Medigap) Plan for California residents.  The plan will be available beginning January 1st, 2018.

'Innovative F' will offer benefits not covered by a Medicare Supplement base plan.  These will include a hearing benefit (exam, fitting and allowance) and a vision benefit (exam, lens co-pay and allowances for frames and contact lenses).

Anthem states that the Innovative F will have a very competitive premium rate.  Innovative F will include the Silver Sneakers fitness program and will be eligible for the Plan F 'new to Medicare' $20 per month first year discount.  

http://www.davefluker.com/innovative-f-supplement.html



Dave
www.davefluker.com





What Multi State Plan (MSP) Really Means (Covered CA)

Lots of confusion on this term and many people think it involves coverage across state lines.  It does not.

This explanation from Anthem Blue Cross is the best one I have seen:



The U.S. Office of Personnel Management (OPM) Multi-State Plan Program (MSPP) was recently established under the Affordable Care Act. It directs the OPM to contract with health insurance carriers to offer at least two plans (one at the silver level and one at the gold level) in each local exchange. The MSPP is intended to promote competition in the Marketplace and help ensure consumers have more high-quality, affordable health insurance options. All MSPP plans will include “a Multi-State Plan” at the end of their name when listed on the exchange - this designates it as an OPM-sponsored plans.  It does NOT mean that consumers selecting the plan will have health plan coverage in multiple states.Select silver and gold level Individual plans that our company currently offers have been designated as OPM-sponsored MSPP…