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Showing posts from November, 2013

Covered California Says No to Obama/Jones

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Today Covered California, the California state health exchange, stood by their rule requiring all exchange carriers to terminate non-grandfathered coverage plans on 12/31/13.  

President Obama's recent decision to allow a one-year extension of non-grandfathered coverage had no real force as each state must decide independently whether or not to allow it.

California has chosen not to allow it for carriers participating in the exchange.



As a recap, any health insurer participating in the Covered California exchange is required, per the terms of the exchange health plan solicitation, to terminate non-grandfathered health plans on 12/31/31 or have a plan to terminate in place by 12/31/13.

Certain non-grandfathered plans will be extended a bit into 2014 but the majority will terminate on 12/31/13.

The following plans are terminating during the first 3 months of 2014:

*Health Net Life & Health PPO plans with effective dates on or after 10/1/13 extend to 3/31/14
*Anthem Blue Cross Life &…

Obama Authorizes Extension of Non-Grandfathered Individual Plans for One Year

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This morning President Obama announced that the administration will allow insurers to extend non-grandfathered individual & family plans for one year out to 2015.  This is in relation to the rash of required cancellation notices of non-grandfathered health plans that have been all over the news.

He left it up to each state's Insurance Commissioner to determine which plans could be sold in the state and also the insurer to determine if the carrier will provide the extended option for the non-grandfathered health plan.

We will have to wait a bit for both Dave Jones and the health insurers in California to announce what they plan to do with regard to non-grandfathered health plans that currently terminate sometime between 12/31/13 and 3/31/14.

I will advise as soon as I receive any official information from any carrier or from the CA Dept of Insurance.

Dave
www.davefluker.com

100,000 Views, Wow!

Earlier this year I noted that my blog has around 64,000 views and wondered when it would cross over the mythical 100,000 view mark.  I figured a couple of years but today it hit that magic number and sits right now at 100,099 views.

The last few days my blog has averaged over 700 views per day with some days over 1,000 views.  

I hope that you have found these blog posts to be of value and helpful to you in your search to better understand health insurance, the market, reform and other topics.

Now let's go for 250,000!

Have a great day!

Dave
www.davefluker.com

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

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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…

Anthem Blue Cross L & H Extends Some Members Non-Grandfathered Plan To 2/28/14

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Insurance Commissioner Dave Jones announced this morning that Anthem Blue Cross Life & Health will be offering an extension of non-grandfathered individual health plans out to Feb 28, 2014.

Similar to the Blue Shield situation, notifications of plan terminations were not done "timely" and did not provide sufficient time (90 days) advance notification.


This only pertains to Anthem Blue Cross Life & Health PPO plans registered with the CA Dept of Insurance.  

Letters will be mailed out immediately to the 104,000 members affected by this change with the option to elect the extension.  Not all Anthem Blue Cross Life & Health PPO members will be eligible as this has to do with a late mail drop on a portion of the existing plans.  If your plan is involved, you will receive a letter from Anthem.

As with Blue Shield Life & Health, there will be a deadline to elect the extension and the member must personally contact Anthem Blue Cross to elect the extension.  For Anthem, …

Electing Blue Shield Life & Health PPO Extension Requirement

Just FYI, if you are currently covered on a non-grandfathered Blue Shield Life & Health PPO plan and have received the letter offering to extend the plan until March 31, 2014, you as the member must call into to Blue Shield by December 7th to elect the extension of the plan.

Blue Shield has set the requirement that only the member may elect the extension and only by contacting Blue Shield directly in order to ensure compliance with certain legal issues involved in the extension.

No one else, including your agent, can do this for you.  Blue Shield is very strict on this requirement.

Dave
www.davefluker.com

EPO, PPO How Does It Work?

Both Anthem Blue Cross and Blue Shield of California are offering EPO or PPO plans in select areas of California.  For example, in LA and Orange Counties, Anthem offers EPO only whereas Blue Shield offers PPO only.  

To further complicate the matter, each carrier treats crossover services differently.  As I am getting this question frequently, I want to clarify how this works.

For Anthem Blue Cross members:

If you have a PPO in 2014 and use services from an EPO provider, you pay per the terms of your PPO contract.  

If you have an EPO in 2014 and use services from a PPO provider, you will be treated as "in-network" but will have to pay for benefits at the higher Tier 2 price level (you get the lower Tier 1 price level with EPO Providers).


For Blue Shield members:

If you have a PPO in 2014, all EPO providers are in the PPO network so you can use the EPO providers the same as the PPO Providers.

If you have an EPO, you cannot use any PPO providers at all and if you do they are conside…

HealthSherpa - How To Build A Good, Fast and Accurate Reform Quote Site

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3 young men in San Francisco, Ning Liang, George Kalogeropoulous and Michael Wasser, got together to design a functional, easy-to-use and fast healthcare reform shopping site.

HealthSherpa.com works great, I tried it!  The only thing is that it sends you to carrier contact information to buy directly from the carrier but that is not an issue really as obviously they can't link out to the agents.  It also doesn't seem to link to the exchange.  
I understand that they put this site together in very short time and it is outperforming healthcare.gov and coveredca.  It's fast and accurate.  Give it a try!
healthsherpa.com



They have also added a subsidy calculator on there so you can see whether or not to visit the exchange (Covered CA) or buy in the private market.
They did a great job, I like the look and feel and the very rapid results with a minimum of information input required.
Dave www.davefluker.com

Blue Shield CA and Health Net CA Extend Non-Grandfathered Until March 31, 2014

California Insurance Commissioner Dave Jones announced this morning that he has received agreement from Blue Shield Life and health to extend current non-grandfathered coverage plans through March 31, 2014.

Blue Shield had already notified members that their non-grandfathered individual & family health plan PPO would terminate on December 31, 2013 and that they would be transferred or elect new coverage with a January 1, 2014 effective date.

As of today both Blue Shield and Health Net* have agreed to provide continuation of non-grandfathered coverage for the extra 3 months up to 3/31/14 (only PPO plans). This will allow individuals and families more time to shop for new coverage as well as allow time for the provider networks to mature and solidify.

*Health Net is only extending Health Net PPO plans that were purchased with effective dates on or after 10/1/13.  Any PPO plan including Farm Bureau and all HMO Health Net plans terminate on 12/31/13.  Only Health Net PPO plans with effec…