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Showing posts from September, 2012

The Cost of Mandatory Maternity Benefits in California

Under CA SB 222, all individual & family health insurance plans in California were required to provide, or add and provide, mandatory maternity coverage to all plan members. 

Prior to July 1, 2012 when the mandate went into effect, plans offering maternity coverage were priced higher in terms of monthly premium to reflect actuarial maternity benefit utilization.  

Because the PPACA allows HHS (federal) to review and approve or reject insurance company rate increases on health plans that are 10% or more, and because the California Insurance Commissioner can make enough bad press for a carrier (he currently does not have rate authority in California--that is pending under AB 52), insurance carriers had to add the benefit and try to make the plans actuarially sound. 

Looking at California's two largest PPO insurers for individual & family plans (HMO plans were and are always required to provide maternity benefits) the effect is a bit stunning.

Blue Shield Life & Health (Blue …

Anthem Blue Cross CA Closing More PPO Plans 2012

Anthem Blue Cross (Blue Cross of California and Blue Cross Life & Health) has announced additional closures in California for individual & family health plans.  
In addition to the plan closures earlier this year (2012) which were posted on my blog, the following individual & family health plans will close on November 1, 2012:
*SmartSense Plus PPO 1000 Standard Rx *SmartSense Plus PPO 1000 Upgrade Rx *Lumenos 3000 HSA PPO (single) *Lumenos 4500 HSA PPO (single) *Lumenos 3500 HSA PPO (family) *Lumenos 1500 HSA PPO
Members currently enrolled in these plans may stay on the plan after it closes on November 1.  Applications for enrollment into any of these plans will not be accepted after October 16, 2012. Applicants may enroll in these plans so long as their effective start date is prior to November 1, 2012.

Blue Shield CA Medicare Plan Changes Coming

Blue Shield of California has announced some changes for Medicare beneficiaries in California. Medicare Supplement plans will have a plan premium rate change effective December 1, 2012. I will post the December California Medicare Supplement rates on my site 
(Medicare Supplements) in a few weeks. In the meantime I have the rates available for quoting via telephone or e-mail. In addition, 

Blue Shield CA will be adding two new Medicare Supplements to their portfolio. Additions will include High Deductible Plan F and Plan N. The current $20 per month "new to Medicare" discount will be reduced to $15 per month for those enrolling in Medicare Part B for the first time. As always, Blue Shield of California Medicare Supplement Plans include the Silver Sneakers health club membership at no additional cost. For more information about Blue Shield Medicare products, visit my web site. 


SB 1431 Moved to Inactive File

On August 31, SB 1431 was moved to the Inactive File. This bill was ordered to inactive file on the request of Assembly Member Charles Calderon.

Inactive file bills may be opened again at a later date for reconsideration. As of now, it appears that SB 1431 (the "stop-loss" bill) is no longer on the table in California.

Small group plans may continue to utilize current 'self-funded' plans for their employee health benefits.

SB 1431 Status

Previous Blog updates on SB 1431:

July 24 SB 1431 Update

May 21 SB 1431 Update

April 20 Original SB 1431 Blog Post


As always, for specific information on health insurance plans and programs, visit my site using the link above