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Showing posts from October, 2017

California Obamacare Quoting Goes Live Tonight At 9 PM (PST)

I have been informed online instant quotes for 2018 ACA California health insurance plans will be live tonight beginning 9 PM PST.  For both agents and consumers, this will be our first comprehensive look at plan choices and rates.  

Take a spin to the link below and 'shop til you drop' for your complimentary quote.  Think of it as "Black Tuesday" for California health insurance.  Quoting both Marketplace (Covered CA) and off-exchange plans.  

Get My Quote Now


Unintended CSR Consequences? Super Cheap CA Bronze Plans for 2018?

With the removal of the cost share reduction subsidies by the federal government, and the resultant additional silver premium changes to cover the CSR in 2018, some interesting results are found on Covered CA (and likely all marketplaces).  

Quick Primer.  CSR (cost share reduction) subsidy is the subsidy used to reduce the share of cost on a silver health plan.  These are known as enhanced silver plans and the CSR helps reduce things like copays, deductible, out of pocket annual max and drug costs.  CSR is available to adults wit incomes in between 138%-250% federal poverty level.  These enhanced silver plans are expressed as Silver 73, Silver 87 and Silver 94.  Which one you qualify for depends on income level.

Note: families with children under 19 years of age can qualify for enhanced silver in California.  However, the children under 19 will not be entitled to enroll  in the enhanced silver plan with their parents  The income level for Medi-Cal (California Medicaid) is raised to 266…

Direct Primary Care A Growing Market Under ObamaCare/TrumpCare

Direct Primary Care, also known as 'concierge medicine', is gaining traction across the country.  DPC is primary medical care without insurance or other third party payer,

Direct primary care is essentially becoming a member of a primary care doctor's practice.  Monthly membership fees are reasonable and may include certain services at little or no additional cost.  

DPC doctors normally feature transparent pricing for services they provide.  Often services include telemedicine (Skype, e-mail, etc,,), longer and more thorough office visits and may even include house calls.  

Coupling a DPC membership with a lower cost, high deductible health insurance plan can provide for comprehensive coverage and lower premium costs.  This can also be used with a MedicaidPlus strategy (I will cover this in a future blog) to create even more premium savings.  

While expansion of DPC providers continues, there are still areas where no DPC providers are nearby.  For Santa Clara County residents…

Trump Administration Terminates Cost Share Reduction Subsidy Payments

On Thursday, in addition to issuing an executive order to make changes in health reform, the administration announced that the federal government would cease paying all CSRs immediately.

Cost Sharing subsidies are not the same as tax credit subsidies. 

Tax credit subsidies, which can be advanced, are applied to the premium payment on a health insurance plan purchased through the marketplace.

Cost Share Reduction subsidies are available to help lower the costs of services under the health plan,   CSR applies to things like deductible, co-pay, drug cost and out of pocket annual maximum.  All CSRs are in the Silver metal tier and, depending on income level, can be at 73%, 87% or 94% reduction.  

In California the CSR is available to people who have income between 138%-250% of the federal poverty level (see chart).  

In response, health insurers have increased the premium rates for all indiviudal & family Silver tier plans to make up for the loss of funding.  

Those enrolled in Enhanced Si…

Trump Executive Order Changes Health Insurance Landscape

Today, President Trump signed an executive order to make changes in the health insurance marketplace.

The Executive Order mainly addresses three areas and goes a ways towards the Rand Paul concepts.

1.  Association Health Plans.  Health plans sponsored by an association could be sold to groups who are members of the association.  These plans would not have to meet ACA (Obamacare) essential benefits and coverage mandates.  This could reduce premium costs.

2.  Selling Across State Lines.  Association health plans could be sold across state lines which, in theory, could reduce premium costs.  

3.  Short-Term Health Insurance.  Currently these plans are only available for 90 days or less.  This EO would restore short-term plans to a longer period (six or twelve months depending on state).  Prior to the rule change under Obama HHS/CMS, short-term plans in California were limited to six months duration per enrollment.  

I suspect there will be some fighting over this executive order.  California…

Covered CA Slaps CSR Surcharge On 2018 Silver Plans

Covered California, California's state health insurance marketplace, went live this afternoon to shop and compare plans for 2018.

California Healthline reports that Covered CA chose to raise rates an additional 12.4% (weighted average) on Silver plans.  This action is due to uncertainty about the Trump Administration continuing to fund the cost-share reduction subsidy.

In August, Covered California announced that 2018 premiums would rise by 12.5 percent, on average, statewide. That ticked down slightly to 12.3 percent during regulatory review. But the exchange also warned that the additional increase, averaging 12.4 percent, would be added to the silver-tier plans if President Donald Trump failed to commit to continued funding for the so-called cost-sharing subsidies that help reduce some consumers’ out-of-pocket expenses. Those payouts total about $7 billion this year nationwide.California Healthline Article

Stay tuned for more updates and information regarding 2018 California healt…

Anthem Blue Cross Announces Innovative F Medicare Supplement Plan for CA

Anthem Blue Cross (CA) has announced that they are releasing a new Medicare Supplement (Medigap) Plan for California residents.  The plan will be available beginning January 1st, 2018.

'Innovative F' will offer benefits not covered by a Medicare Supplement base plan.  These will include a hearing benefit (exam, fitting and allowance) and a vision benefit (exam, lens co-pay and allowances for frames and contact lenses).

Anthem states that the Innovative F will have a very competitive premium rate.  Innovative F will include the Silver Sneakers fitness program and will be eligible for the Plan F 'new to Medicare' $20 per month first year discount.


Anthem 2015 Cyber Attack Settlement Agreement Reached

Anthem has reached a settlement agreement related to the 2015 cyber attack.

Under the settlement, which was preliminarily approved by the court on August 25, 2017, Anthem does not admit any wrongdoing or acknowledge that any individuals were harmed as a result of the cyber attack.
$15 million of the fund will be allocated to pay actual out-of-pocket costs, up to a set amount, that settlement class members claim they incurred due to the cyber attack.It will pay for two years of credit monitoring and identity protection services for settlement class members who want them.It will allow settlement class members who already have credit services to submit a claim to receive alternative compensation for up to $36 instead of credit services.

Kurtzman Carson  Consultants (KCC) will manage the settlement and is the best resource for questions.

Anthem Announcement

Click here to register for the settlement


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