A key service agents provide to ACA health insurance eligible clients is assisting them to determine their Modified Adjusted Gross Income, MAGI. This unfortunately puts agents in the role of being income and tax experts. One of the biggest questions agents get is what qualifies as household income for the purpose of receiving the Advance […]
Archives for August 2014
Anthem Blue Cross set to terminate 79 health plans in California
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 […]
Blue Cross waives network restrictions for Napa quake victims
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 […]
Covered California 2015 rates by region and plan comparison
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 […]
Covered California leans against health insurance rate regulating proposition 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 […]
Covered California updates income section
Covered California has updated the CalHEERS income section of the individual and family plan application to accommodate partial year employment. This was accomplished with the insertion of simple date fields. Now, instead of the annualized income from a job a client has left, the employment can just have a start and end date. Changes to […]
Robin Williams would still be alive if he had been homeless
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 […]
Agent Medi-Cal payments delayed again
Contrary to Department of Health Care Services (DHCS) statements in their Medi-Cal Essentials webinar, agents will not be receiving any payments for assisting clients that were enrolled into Medi-Cal through a Covered California application in the near future. Recent email communication from Covered California to Certified Insurance Agents suggests thatcompensation of approximately $58 per Medi-Cal […]
Health Net drops PPO plans from Covered California
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 […]
Covered California 2014 versus 2015 health benefit comparisons
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 […]