Skip to main content

No More Phony CA Health Exchange Web Sites - CA AB 1761

We've all seen them.  Web sites touting themselves as the "California Health Exchange" or something similar.  Some provide a disclosure (usually at the bottom and often in small type) that the site is, in fact, an insurance agent's web site and is in no way actually affiliated with the 'real' CA Health Benefits Exchange.  Lately I have seen a couple with no disclosure at all.  

Well, that party is now over in California and those of us who have been following the HBEX (Health Benefits Exchange) knew it was coming.  

On September 30, 2012, Governor Brown signed into law California Assembly Bill 1761.  The bill, now law, prohibits agents (and other entities) from claiming any affiliation with the CA HBEX as well as any advertising including social media that makes any such claim.  It is now against the law in California for an agent or agency to pretend that they are somehow representing or affiliated with the California Health Exchange.

From AB 1761:
(j) Holding oneself out as representing, constituting, or
otherwise providing services on behalf of the California Health
Benefit Exchange established pursuant to Section 100500 of the
Government Code without a valid agreement with the California Health
Benefit Exchange to engage in those activities.
This bill would prohibit an individual or entity from holding
himself, herself, or itself out as representing, constituting, or
otherwise providing services on behalf of the Exchange unless that
individual or entity has a valid agreement with the Exchange to
engage in those activities. The bill would specify that it is an
unfair business practice for health care service plans, entities
engaged in the solicitation of health care service plan contracts,
and persons engaged in the business of insurance to violate this
provision. Because a willful violation of the provisions governing
health care service plans is a crime, the bill would impose a
state-mandated local program. [emphasis is mine]
I expect that agent marketing guidance will be forthcoming from the HBEX or the Insurers next year as we prepare for the initial open enrollment beginning October 1, 2013.  As of today, we have not received any information on either certifying for the exchange or what specific agent marketing will be allowed.  All agents selling HBEX plans to the public will be required to be certified with the CA exchange prior to engaging in any sales activity.

In the meantime, if you run across any sites that are not the official exchange web site, you know that the site is not approved and that the agent is committing a crime by pretending to be or be affiliated with the CA HBEX.


As always, for specific health insurance information please visit my web site.


Post a Comment

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.


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…