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Showing posts from 2016

The CA Law That Never Was? (SB 10)

Looks like California SB 10 will die on the vine. The bill was passed and signed into law by the Governor last summer. SB 10 would allow undocumented immigrants to enroll their children in Medi-Cal (California Medicaid) and was further expanded to allow adults to enroll (without subsidy) in Covered CA health plans.  

Although SB 10 was signed into law, it requires a waiver from DC (HHS) in order to be implemented. I recently spoke with Governor Brown's office and was told that no waiver has yet been granted. Given the change in Presidential administration and the stated goal of replacing ObamaCare, I highly doubt that a waiver will be forthcoming from the new director of HHS. 

www.davefluker.com

How Will Donald TRUMP ObamaCare?

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With the election of Donald Trump as the next US President, healthcare reform and ObamaCare are on the chopping block.  There is media speculation that a transformation away from the current ObamaCare system will be rather immediate once Donald Trump is sworn into office in January.  


While changes are certainly coming, I would not expect a wholesale changeover immediately, but rather over the course of 2017.  My hope is to see an open market available at any time during the year (like it used to be) instead of an abbreviated Open Enrollment Period.  

Below are some key points to a Donald Trump-Care system and a link to his Healthcare Reform Paper which goes into more detail...



 1. Completely repeal Obamacare. 2. Modify existing law that inhibits the sale of health insurance across state lines. 3. Allow individuals to fully deduct health insurance premium payments 4. Allow individuals to use Health Savings Accounts (HSAs). 5. Require price transparency from all healthcare providers.6. Bl…

CA Small Group Special Enrollment Coming Up

One of the provisions of Obamacare is an annual one month guaranteed issue  "Special Enrollment" window for small employer groups.

The Guaranteed Issue Special Open Enrollment period runs from November 15th to December 15th each year for a January 1st effective date.
Carriers are required to offer a special open enrollment window to Small Employers that do not meet carrier participation and/or contribution requirements. These groups must meet all other Underwriting Guidelines. Small Employers that have struggled to attain coverage due to participation or contribution requirements can obtain coverage during this special open enrollment window.
Small  employers who have not been able to establish a group plan due to low participation among employees and/or wishing for lower contribution requirements can use this special enrollment window to establish a plan.

With all of the havoc in the individual health markets (particularly tiny networks and ever-changing drug benefits/formulari…

California Obamacare Rate Increases Much Less Than Other States

Covered California's Peter Lee explains why California's individual & family health plan rate increase for 2017 is much lower than the national average.  This is a good read and shows that California was far ahead of the curve.

Covered California has already posted average premium increases of 13.2 percent, compared with a nationwide average of 25 percent. Part of that jump is due to the end of “reinsurance” payments to cover insurers’ losses the first three years, but also because of pricier prescription drug and medical costs, as well as more unhealthy consumers signing up.A big part of where other states has floundered has been because of political opposition by state governments. They adopted policies like not expanding Medicaid (to enable more individuals to qualify for subsidies). In many states, the politicians who have been so against Obamacare have brought upon their own citizens the rate increases we’re seeing across the country. ... In California, for four years …

Anthem Blue Cross (CA) Adding SilverSneakers® Fitness Program

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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 …

Covered CA Plan Rates and Increases 2017

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The 2017 Covered CA health premiums are now quoting. And folks, some plans just don't want to play. Here is the breakdown for myself in Santa Clara County between 2016 and 2017 on Silver plans on-exchange in order of monthly premium price:

Valley Health HMO was flat for 2017 rate increase below 1% ($701)
Anthem Blue Cross PPO for 2017 rate increase 11% ($781)
Kaiser HMO for 2017 rate increase 7.5% (785)
Health Net HMO for 2017 rate increase 23% ($916)
Blue Shield PPO for 2017 rate increase 23% ($993) Give me a call for rates and options for your coverage in 2017. There will be cases where buying off-exchange may be less expensive depending on subsidy levels. A licensed agent can shop both markets.  www.davefluker.com



Short-Term Health Plans Limited To Three Months?

The government is considering placing limits on short-term (temporary) health insurance plans. This could go into effect on January 1, 2017 and would limit the enrollment in short-term plans to around 3 months maximum with no renewals.  From CNBC...

Federal officials Wednesday moved to improve the financial outlook of Obamacare insurance plans by calling for limits on increasingly popular short-term health plans that are siphoning off healthier customers from coverage sold both on government marketplaces and outside those exchanges. The government's move would limit short-term health coverage for an individual to less than three months each year and bar renewal, as opposed to the almost 12-month term that some of those non-Obamacare-compliant plans are offering, along with a chance to renew. The proposed rule, one of several moves announced Wednesday, is designed to nudge those healthier customers now in short-term plans into Obamacare plans sold on and outside of government-run e…