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Showing posts from 2015

2016 Open Enrollment Has Begun

Here to kickoff the 2016 open enrollment period which will run from November 1, 2015 to January 31, 2016.  

It is important to remember that during the open enrollment period all rules regarding SEP (special election period) enrollment dates for loss of employer coverage are off of the tablle. Than means no retroactive start dates on the Covered California health exchange.

Remember during open enrollment you may sign up for any available health insurance plan either off- or on-exchange with no medical underwriting.

My site features live free instant quotes and online applications for off-exchange subscribers.

For Covered California exchange subscribers, I can take your information over the phone and set up your account on Covered CA for you.  You would need to log in with a special code I would provide upon submission of the application and select your plan/pay the initial premium via Covered CA.  

Carrier for 2016 include:

*Anthem Blue Cross PPO, Tiered PPO and HMO
*Blue Shield of Californi…

July 1 Small Employers Face Penalties for Helping Employees Pay Health Premiums/Costs

Beginning Wednesday, July 1st, employers who help employees pay for individual health insurance premiums or assist with healthcare costs outside of small group health coverage could face hundreds of dollars in IRS fines per day.  

Prior to the passage of the Affordable Care Act, with its mandate that all Americans purchase insurance and requirement for businesses to offer employees insurance plans, many small companies provided coverage by directly reimbursing medical costs or for the cost of private insurance plans. Businesses do it because that’s a less complicated process than dealing with an official health insurance plan, but continuing to do so after July 1 could cost them hundreds of dollars in fines each day.
The penalties will only affect businesses with less than 50 employees. Those with more than 50 employees are already required to offer a health insurance plan
Fox News Article


Health Net Acquired by Centene | Adios Health Net

Announced this morning that Centene (a Medicaid provider out of St. Louis I've never heard of) has agreed to buy Health Net for stock and cash worth just over $6 billion.  

Let the unraveling continue.   

The deal comes amid a frenzy of merger talks in the health-insurance industry.St. Louis-based Centene, a Medicaid-focused health insurer, expects the deal to boost its presence in California and other western states, while allowing for $150 million a year in synergies in the second year after closing
Centene to buy Health Net


Anthem Submits New Non-Binding Proposal To Acquire Cigna

Today, Anthem (NYSE: ANTM) submitted a non-binding proposal to acquire Cigna Corporation (NYSE: CI) for $184 per share.  This follows much dialogue and multiple buyout offers from Anthem.  

Read Today's Press Release from Anthem

For sure gone:      Assurant Health (12/31/15 RIP)

Likely gone:          Cigna, Humana

On the ropes:       Aetna

1 1/2 years in and the attrition is scary.  

Mergers and Such: You Can't Tell The Players Without a Program

When I was a kid we used to go to the ballpark for baseball games and always, always, the barker would be shouting "Get your programs, get your programs here.  You can't tell the players without a program".  I think I'm having a deja vu.

If I have this right, it looks like the following.......

Assurant Health is for-sale-by-owner to any buyer Aetna wants to acquire Humana, who is exploring a sale, but...........United Health wants to acquire Aetna (would that deal include Humana?)Anthem wants to merge with Cigna, both of which have been looking at buying HumanaThe Anthem talks for Cigna also show that the next deal in the industry won’t necessarily be a sale of Humana, as many industry watchers expected. Indeed, if Anthem and Cigna were to get together, that would remove two possible buyers of Humana, which could leave it with only one major merger partner, Aetna, which itself now is a takeover target.

Read the entire article here


Assurant Health Announces the End of Operations

Elvis has left the building.  123 years is a long time. Reminds me of my days in financial services whenever a rep would leave the office they would send out the "your representative (insert name here) has chosen to pursue other career interests" letter.  

Assurant, Inc., has concluded the review of its health business and will exit the Individual Medical, Small Group Fully Insured and Short Term Medical markets.
The last day for sales of these products will be June 15, 2015. The wind down of these product lines will begin immediately and we expect to substantially complete the exit by the end of 2016. The company will meet all claims, benefits, provider payments and agent commission responsibilities during this transition.

Good luck, Assurant.   

Assurant Health to Close Business by 2016

Health brokers received an e-mail from Assurant Health this week indicating that the carrier plans to close all individual health business.
According to Assurant, the company intends to close both IFP (individual & family plans) and Employee Benefits divisions and either 1) sell them off to another carrier or, 2) to simply close them by end of 2015 if no buyer can be found.  The decision likely hinges on excessive losses on individual health under the ACA.  
As it stands today, Assurant will continue existing policies until the end of 2015 (and next open enrollment).  They state that they will not sell any health insurance in 2016 as Assurant Health.
Assurant began in 1892 as the La Crosse Mutual Aid Society in Wisconsin.  The also operated for many years as Fortis and also Time.  
For California residents, the loss of Assurant (with it's very broad Aetna network) represents the third carrier to exit the market since ObamaCare went into effect.  United Healthcare (UHC) closed Paci…

Medicare To Remove SSN From Beneficiary ID Cards

Per April 20 New York Times article, Medicare will begin to integrate a 8-year plan to replace current Medicare ID cards with new cards.  The current Medicare ID card contains the beneficiary's (or spouse's) social security number and uses that number as the ID number for services.  

The new ID cards will remove the SSN and replace with a new ID code.

Medicare officials have up to four years to start issuing cards with new identifiers. They have four more years to reissue cards held by current beneficiaries. They intend to replace the Social Security number with “a randomly generated Medicare beneficiary identifier,” but the details are still being worked out.

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Blue Shield CA To Issue One-Time Refund on Grandfathered IFP Plans in California

Received notice from Blue Shield that they will be issuing a one-time premium refund to approximately 31,500 grandfathered individual & family plan members.  This is a result of 2015 rate review by the CA Dept of Insurance.

Refund will be applied to the May billing and represents a one-time 26.6% credit to those members May 2015 bill.  The amount due back will appear as a credit in the summary section on their May bill which will arrive around mid-April. There is no action required for these members to receive the credit.

Letters to the affected members will be sent out prior to the arrival of the May bill.


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Covered CA Sending Out Corrected 1095-A Forms

Covered California, the California state health exchange, has sent out over 120,000 corrected tax forms and plans to have the remaining forms sent out by April 1.  According to the exchange, tax filers won't be required to amend 2014 tax filings to reflect the corrected data, but may file and amendment if they wish to.

LA Times Article


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Senators warn that Obamacare rule may be 'particularly harmful and disruptive'

The Washington Examiner is reporting that a handful of Democratic Senators have requested HHS delay the 2016 rule that would make groups of 51-100 employees part of the small group health market and take them out of the more flexible large group market.  

Currently small group is defined as 2-50 employees and in 2014, under a 'Grandmothering' provision, were allowed to maintain non-Obamacare coverage through 2017 (2016 in California).  

Grandmothering in California only applied to small groups 2-50 who had a plan renewal in the 4th quarter of the year.  All other groups were not allowed to exercise the Grandmother provision and were forced to move to ACA compliant coverage at their group renewal.

According to the article, only 9% of employers with 51-100 employees actually offer health insurance coverage.  Will be curious to see this play out.  They are asking for at least a two year delay on implementation.  

Washington Examiner Article


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Data breach at Premera Blue Cross in the Pacific Northwest

On March 17, 2015, Premera Blue Cross announced that it was the target of a cyber attack that affected as many as 11 million people.  This is a similar attack to the Anthem cyber attack.  The incident affected Premera Blue Cross, the Blue Plan in Washington, Premera Blue Cross Blue Shield of Alaska, and their affiliate brands Vivacity and Connexion Insurance Solutions, Inc.

Primarily affected members residing in Washington (state) and Alaska.  However, like the Anthem cyber attack, anyone on Anthem Blue Cross CA or Blue Shield of California plan who received services in a Premera area under the BlueCard PPO program may also be compromised.  


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Anthem Announces "New To Medicare" Plan F Discount

Anthem Blue Cross CA has announced the implementation of a "new to Medicare" discount on only Supplement Plan F.  The discount is $15 per month for the first year and is available to those who enroll in the supplement as "new to Medicare" on or after 3/1/15 effective dates.

The discount is available to those 65 and over who are new to Medicare and within six months of their Medicare Part B effective date.  

Blue Shield of CA continues to offer a similar discount however Blue Shield allows the discount on all Supplement Plans not just Plan F.  Another difference, Blue Shield's discount cannot be combined with certain other discounts (2 party household, etc.) whereas Anthem will allow the discount in combination with certain other discounts.  Both carriers also offer a further discount for those paying their premiums by EFT (check or savings deduction).  

For more information on the Anthem Blue Cross CA Medicare Supplement Plan F discount, please contact my office.


CA Franchise Tax Board Revokes Blue Shield's Tax Exempt Status

The California Franchise Tax Board has revoked the State Tax Exempt Status of Blue Shield of California.  As a result, Blue Shield may be required to pay tens of millions annually as well as file tax returns retroactively back to 2013.  This move could undermine the 'not for profit' status of the carrier.  

Blue Shield currently holds approximately $4.2 Billion in reserve, an amount deemed excessive by the state of California and well above the amount recommended by the Blue Cross Blue Shield Association (of which both Blue Shield CA and Anthem Blue Cross are licensees).  

From theLA Times

"The main motivation for any state that wants to see a conversion of a health plan is they would capture the assets," he said.  That idea could prove popular in Sacramento, experts say, where state lawmakers are searching for money to boost Medi-Cal reimbursements for doctors and hospitals and to expand coverage for millions of uninsured Californians who don't qualify for feder…

Blue Shield CA Extends Medicare Supplement Year Round SEP to 2016

Blue Shield of California has announced that they will be extending the year round SEP for Medicare Supplements until June 30, 2016.

This SEP (special election period) is sort of a year round  "Birthday Rule".  In California, Medicare Supplement subscribers may change their Supplement to any like or less Supplement on their birthday plus 30 days.  In this case, that privilege is  offered by Blue Shield at any time during the year.  

If you currently have a Medicare Supplement Plan with another carrier, now might be a good time to check and see if Blue Shield offers a more competitive rate.  Remember, Medicare Supplement Plans (A-N) are standardized supplements.  Every carrier's Plan F Supplement is identical, as are all lettered Supplement plans.  


Anthem Blue Cross offers Tax SEP Off-Exchange through 4/30

Anthem Blue Cross CA is the only carrier currently offering off-exchange enrollment SEP for the period 2/23-4/30/15 for those impacted by the 2014 tax penalty who are not currently insured in 2015.  Details below.  

New Off Exchange Applications (we are only accepting paper applications for this SEP):

Not be currently enrolled in a health care plan Attest that they did not realize there was a tax penalty (complete this attestation form) In addition, individuals applying for coverage during this SEP must write “I Did Not Know About the Tax Penalty” somewhere on the first page of the application, submit a completed and signed attestation form, and submit payment or select auto payment method. Applications submitted between the 1st and 15th of the month will have an effective date of the 1st of the following month. Applications submitted after the 15th, will have an effective date of the 1st of the month after next.  Applications submitted without “I Did Not Know About the Tax …

Anthem Security Breach - Cyber Hacked (again!) February 2015

In 2010 Anthem Blue Cross was hacked by a subscriber in San Mateo, CA.  This morning Anthem announced a new intrusion that may involve over 80 million people, both past and present members of Anthem companies in various states.  Link below to Anthem's explanation.


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Blue Shield PPO Contracts With Cedars-Sinai

Effective March 1, 2015, Blue Shield of California (and Blue Shield Life & Health) will be contracted with Cedars-Sinai Medical Center for on- and off-exchange Platinum, Gold, Silver and Bronze Individual & Family (IFP) Health Insurance PPO plans.  Below is the broker release from Blue Shield this morning.......

Cedars-Sinai is now part of the IFP provider network
We are very pleased to announce that Blue Shield of California has signed a new agreement with Cedars-Sinai Medical Center for on- and off-exchange (mirrored) Platinum, Gold, Silver, and Bronze Blue Shield Individual and Family Plan (IFP) PPO plans that will take effect March 1, 2015.With this agreement, Blue Shield's IFP PPO members will also have access to Cedars-Sinai Medical Group and Cedars-Sinai Health Associates beginning March 1, 2015.  Additionally, members will have access to other Cedars-Sinai Medical Center identified independent physicians. 

Blue Shield Signs New 2-Year Sutter Contact!

Blue Shield announced this morning that they have completed a new 2-Year contact with Sutter. Health.  The Contact will go into force on February 1st.  This will end the transitional period. Letters should be going out next week to Blue Shield subscribers both on Covered California and off-exchange.