Skip to main content

Posts

Showing posts from October, 2013

Why CA Non-Grandfathered Plans Are Being Cancelled

The Covered CA health plan solicitation requires all health Insurers who participate in the Covered California Individual Exchange to "terminate all non-grandfathered health plans not later than December 31, 2013 or have a plan in place to terminate them by December 31, 2013".

Apparently some of the media and some of our less-than-truthful politicians are not trying to spin this as though the insurance companies have made some decisions on their own to cancel your coverage.  This is not even remotely true.

I noticed that Covered CA has moved the links to information on the health plans solicitation requirements (on the hbex site) so I will, as time permits, find the actual solicitation requirement which states what I wrote above.

Peter Lee is on record with the LA Times just 4 days ago (October 26th) confirming the same thing.  And he runs the exchange!  

Anthem is not canceling your plan because they want to.  Neither are Kaiser, Blue Shield nor Health Net.  They are forced to …

Anthem Blue Cross CA 2014 Provider Directories Finally Available

The Pathway Network provider directories are now online for searching.  Anthem will be using the Pathway/Pathway-X networks for all 2014 Individual & Small Group health plans in California.

Use the link below to access the PDF directories (it's not searchable online yet) for your area to find out which providers are in-network for ObamaCare coverage plans from Anthem Blue Cross.

Anthem Provider Directories



Dave
www.davefluker.com

Understanding Anthem Blue Cross CA 2014 Plans & Networks

Anthem has not yet rolled out all of the plans/networks/information for 2014 ACA plans but I want to update what we will all be seeing in the near future as choices for health insurance enrollment with Anthem Blue Cross.  


Some areas will not have a PPO option like LA county/Orange county and will have an EPO and HMO option.  Other areas will have a PPO option.  The Anthem program for 2014 will break down like this:

Networks:

The ACA networks for Anthem individual plans will be called "PATHWAY" and all participating providers will need to be contracted with the appropriate Pathway network.

Pathway PPO
Pathway HMO
Pathway Tiered (EPO)

Provider searches (once available online) will show two versions of Pathway for searching, Pathway and Pathway-X.  Pathway indicates off-exchange and Pathway-X indicates on-exchange.

EPO will be a tiered network with lower costs for inpatient & outpatient services in tier 1.

Plan names will reflect if plan is on-exchange or off-exchange as follows:

On…

Covered CA Certified Agents - How To Get To Your Account, Agent Number & Dashboard

Because I'm a nice guy and I'm hearing that many CA agents don't know how to get to their profile/dashboard/account on Covered CA once they have been certified, I wanted to post how to do it.  Covered CA will not advise you of the steps to access your agent # or certification #.

Once you have completed training and the final exam, and have provided the signed contract pages and E&O and all of that to Covered CA, the following steps:

Before I forget, you need to use Internet Explorer for part b as it won't work on Chrome nor Safari (I didn't try Firefox but heard that it won't work either).  You will also need your original log in username and password from when you originally registered with Covered CA back in August (not your learning center log in) so I hope everyone kept that log in information from the registration.

A

1.  Go to www.coveredca.com and click on the start button
2.  Once the Calheers screen comes up, click on the "find help near you' li…

Sorry To Be Gone So Long

Wanted to get a quick update out here.  Covered California Certification has been a complete time drain and far more lengthy process than I could have imagined.

First the 8 hour mandatory in-person training followed by 4-6 hours (turned into a lot more as the sliders on the slide screens online were jacked up) online followed by an open-book test. Once all of that was done waiting for the follow up e-mail from Covered California letting me complete the contract and become fully certified.  I guess i should be grateful it only took a full week to get that e-mail after I passed the exam (LOL).  

So yesterday I got the famous "e-mail" and contracting paperwork to fill out and sign.  Sent that in this morning so I wonder how long it will be until they actually let me know my login and let me do the profile updates.  

Man, what a process.  AHIP for Medicare Advantage is waaaaaay easier than this even with the carrier specific certifications after the AHIP training.  

Anyway, some day…