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 do it by Covered CA as part of the rules to participate in Covered CA.  Stop blaming the insurers, the exchange set the rule!

All these cancellations were prompted by a requirement from Covered California, the state's new insurance exchange. The state didn't want to give insurance companies the opportunity to hold on to the healthiest patients for up to a year, keeping them out of the larger risk pool that will influence future rates.

Peter Lee, executive director of Covered California, said the state and insurers agreed that clearing the decks by Jan. 1 was best for consumers in the long run despite the initial disruption. Lee has heard the complaints — even from his sister-in-law, who recently groused about her 50% rate increase.
"People could have kept their cheaper, bad coverage, and those people wouldn't have been part of the common risk pool," Lee said. "We are better off all being in this together. We are transforming the individual market and making it better. 

LA Times Article October 26th 



  1. I have a Healthnet PPO policy and live in Alameda county. Why did Healthnet cancel all policies in Alameda County, and will no longer provide policies in Alameda county in 2014? Healthnet continues to offer policies in all the surrounding counties. Refusing to provide policies in Alameda county is a Healthnet decision, not Covered CA/s.

  2. Two different issues. The cancellation of current non-grandfathered health plans is a directive from Covered California for all carriers selling inside of the exchange in 2014 who have current non-grandfathered heatlh plans on the books.

    For 2014, carriers are making major adjustments to both the areas where they will provider coverage and to the types of plans they will offer. In Alameda, Blue Shield is only offer EPO and in many Alameda County zip codes will offer no health plans at all. Health Net apparently will provide no plans county wide.

    If you review the Covered CA plans brochure on my web site it shows which carriers, plans and plan types will be available in each rating area.


Post a Comment

Popular Posts