In the proposed rate increase filing with California Department of Managed Health Care (DMHC) on August 1, 2014, Anthem Blue Cross included 79 health plans that they would be terminating at the end of year. Titled Exhibit P – Terminated Plans, effective 2015, Anthem Blue Cross lists 39 pre-ACA and 40 post-ACA individual and family […]

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Anthem Blue Cross relaxes guidelines for victims of the Napa earthquake.

Anthem Blue Cross announced that they were temporarily revising some of their health insurance guidelines for residents in Napa, Solano and Sonoma counties impacted by the Napa earthquake. Important for Anthem Blue Cross members in these counties is that they can see any physician for necessary health care, urgent care and emergency room services even […]

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Covered California 2015 rates by region and plan comparison

Posted August 25, 2014 By Kevin Knauss
2015 Covered California rates will vary by plan within each region.

How health insurance companies and health plans determine premium rate increases is a little bit of a mystery. Covered California didn’t add to the consumer’s understanding of this process when they released their 2015 health insurance booklet. The plan rates booklet is mostly marketing material and fails to provide specific rates by region, carrier, and […]

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Covered California leans against supporting rate regulating Prop. 45

In a presentation by Executive Director Peter Lee to the Board of Covered California on the potential effects of the health insurance rate regulation proposal to go before California voters in November, known as Prop. 45, it was clear the passage of the California Department of Insurance supported proposition could present significant challenges to the […]

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Robin Williams would still be alive if he had been homeless

Posted August 15, 2014 By Kevin Knauss
Why don't homeless men commit suicide like Robin Williams?

We see them across the United States. Homeless men and women, filthy, pushing shopping carts, diving in dumpsters, sleeping in tents and suffering from mental illness and substance abuse. Short of becoming a mercenary, they have sunk almost as low as any human being can and still be considered somewhat civilized. Yet, through all the […]

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Health Net drops PPO plans from Covered California

Posted August 11, 2014 By Kevin Knauss
Current Health Net members will be surprised to learn their individual and family PPO plans are changing to EPO in 2015.

A significant change to the plan types offered for individuals and families through Covered California for 2015 will be Health Net dropping their Preferred Provider Organization (PPO) plans. In place of the PPO health plans, Health Net will offer Exclusive Provider Organization (EPO) health plans. This change may be particularly significant for members who relied on […]

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Small changes between 2014 and 2015 health plan designs offered through Covered California.

There have been few changes to the standard benefit design between 2014 and 2015 health plans offered through Covered California. A comparison of the metal levels offered in 2014 to the standard benefit design announced by Covered California for 2015 individual and family plans reveals modest changes to copayment amounts for prescription drugs, maximum out-of-pocket […]

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Is Sacramento ready to build another dam?

Posted August 7, 2014 By Kevin Knauss
Maybe the Sacramento metropolitan region needs to build several small reservoirs to improve water reliability for the area.

If you’ve ever served on any committee you know that the topics of conversation can veer off course to peripheral discussions. At the last San Juan Water District Drought Committee meeting one of the participants threw out for discussion the possibility of San Juan Water District building their own dam for water storage. While the […]

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Covered California requires applicants to prove their identity.

On August 4th Covered California rolled out another enhancement to their CalHEERS program called “identity proofing”. Before an account holder, Covered California customer service representative (CSR) or Certified Insurance Agent can either Report a Change or create a new enrollment for a health plan, the primary applicant’s identity must be verified. This “Identity Proofing”, as […]

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The basics of Medi-Cal and how it works with Covered California.

Medi-Cal was one of the biggest mysteries during open enrollment in the new ACA health plans. Even though Covered California advertised a “no wrong door” approach to signing up for health insurance, when a client had to go through the Medi-Cal door, not even Covered California could tell them what to expect. Finally, seven months […]

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