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Showing posts from June, 2012

SCOTUS on PPACA (ObamaCare) June 28, 2012

Live blog while watching the decision on Scotusblog.

PPACA (ObamaCare) is upheld and will go forward! Individual mandate deemed constitutional.

I will blog later with more details.

Well, that was an interesting morning and for many a bit of a surprise. The Supreme Court ruled that the individual mandate to purchase health insurance coverage is considered a "tax" and not a "penalty" and, as such, falls under Congressional authority and is constitutionally legal.

Undoubtedly there will be many announcements, blogs and video responses from the various parties with regard to this decision.

Below is a link to the PDF of the court's decision (all 67 pages):

SCOTUS Decision


Martin Vs. Blue Shield CA (The Next Feller-Freed)

After the Feller-Freed and Serencsa-Lichtman class action settlements with Anthem Blue Cross (Blue Cross of California) I assumed it would simply be a matter of time before similar action was taken against Blue Shield of California. That action was announced by Consumer Watchdog last week.

Blue Shield recently announced (and I blogged) the closure of the majority of their current individual health plans to be replaced by new plans July 1,2012.

Until this case is settled there really isn't a lot to talk about. I will blog when we get information regarding any potential settlement with Blue Shield and the plan migration choices that might be available to those on closed or closing individual plans.


Update: Anthem Blue Cross CA Closing Clear Protection Plus 1000 PPO

Anthem Blue Cross California has announced the options available to those who are currently members of the Clear Protection Plus 1000 PPO plan.

In my prior blog (CP Plus 1000 Closing) Anthem Blue Cross CA announced the closure of the plan on June 30, 2012. Today, Anthem provided clarification on the options available to those who are enrolled on the plan or those who will enroll before the end of the month. The options are as follows:

*Members currently on the Clear Protection Plus 1000 policy may remain on their policy and add family members to the policy subject to medical underwriting. They may do so until or unless they request a plan change via current underwriting procedures.

*Members may elect to change plans during a special open enrollment period from September 1, 2012 to September 30, 2012 with no medical underwriting. Clear Protection Plus 1000 members can move to the following plans during the open enrollment period:

*CoreGuard Plus 750 (06B6)
*CoreGuard Plus 1500…

Blue Shield HIPAA Plan Update

To follow up on my May 25th blog post regarding Blue Shield of California HSA 4000 plan closure for HIPAA, I wanted to post an update.

After several days of run around and legalese, I finally was able to determine that Blue Shield of California's current HIPAA portfolio is heavily weighted on DMHC (CA Dept of Managed Health Care) registered health plans (3) with only 1 CDI-registered plan (California Dept of Insurance). A normal arrangement would be 2 plans from each registration and, in the case of Blue Shield prior to 6/1, 3 DMHC and 2 CDI registered plans.

California Health & Safety Code requires an insurance company selling individual plans in California to offer two "popularly marketed health plans" to the HIPAA risk pool for each registration. Over the last several years most insurers have registered PPO plans with the Dept of Insurance (CDI) as opposed to the DMHC.

Blue Shield of California is opening a new portfolio of plans on July 1. The entire portfolio of…

Blue Shield CA Extends Medicare Supplement Special Enrollment Period

Blue Shield of California has announced the extension of their "special enrollment period" for Medicare Supplement plans in California to November 30, 2012. Previous end date was September 30, 2012.

The special enrollment period is basically a full-time "birthday rule". In California, those who are covered by Original Medicare and a Medicare Supplement Plan (Medi-Gap) (A-N) have the right, on their birthday, to move to any other insurance companies' like or lesser Medicare Supplement Plan with no medical underwriting. California is one of the few states that has a "birthday rule" in regard to Medi-Gap plans.

The current Blue Shield CA special enrollment period allows those covered by a Medicare Supplement with another insurer to move to a "like or lesser" Supplement plan with Blue Shield with no medical underwriting in any month, not just the month of your birthday.

Additionally Blue Shield CA has also extended the "new to Medicare"…