The California individual and family plan market place will be changing quite a bit in 2017. Next to confirming if your favorite doctors are covered by the new health plans, many consumers want to make sure their chosen hospital is in-network as well. From information provided by Covered California and the health plans, I have put together a table of California hospitals by region and the health plans they accept.
While Covered California standard benefit design health plans have very specific limitations on member responsibility for in-network health care services, the coverage for out-of-network services can vary greatly between PPO health plans. The insurance carriers that offer PPO health plans through Covered California (Anthem Blue Cross, Blue Shield of California, and UnitedHealthcare) with out-of-network coverage seem to have made up their own rules for this PPO benefit. Because the Covered California individual and family health plans have such narrow networks, many families are finding that they must go out-of-network to receive certain health care services.
Individual and family plans offered through Covered California in 2016 will include new pharmacy prescription drug benefits. The benefit, also mirrored in many off-exchange health plans, caps the amount a consumer must pay every month for a particular prescription. While that sounds straight forward, the rules surrounding any pharmacy deductible and tiered drug formulary can be complicated and confusing.
As I had just started my second year as a Placer County Grand Jury member I was surprised at the similarities between Holacracy and the structure of the California county Grand Jury system. I realized that Grand Juries in California have been using the Holacracy concept where people in the organization have multiple roles while working on different teams, without being micromanaged by a supervisor, for over 100 years.
Whenever a health insurance company or health plan wants to change their health insurance rates in California they must submit a justification for the rate change in the monthly premium amounts to the Department of Managed Health Care or Department of Insurance. Regardless of which agency they must submit their rates to, the agencies just […]
In a May 18th op-ed in the Sacramento Bee Even in a drought, selling some water makes sense, Einar Maisch, General Manager of the Placer County Water Agency (PCWA) argued his agency was merely fulfilling their environmental duty to release 12,000 acre feet of water into the American River so it can be sold to […]
With Governor Brown’s declarations of a drought emergency in 2014 and subsequent State Water Resources Control Board’s (SWRCB) decisions that some water districts must conserve up 36% of their consumption over the baseline 2013 year, many homeowners are wondering how they can conserve enough water without killing their entire landscaping. While some homeowners have voluntarily […]
While some health insurance companies are thriving under the ACA with record enrollment numbers, Assurant, Inc. announced they will either sell their health insurance business, Assurance Health, or shutter it completely. Assurant Health will not be participating in open enrollment in the fall of 2015 for new individual and family health plans in 2016. Assurant […]
Sometimes the craziest ideas actually become reality. In 1870 one man proposed tunneling underneath the Sierra Nevada mountain range to ship Tahoe lake water to San Francisco. While that may seem like an audacious scheme today, similar projects were already underway in the 19th century and parts of the tunnel project under the Sierras have […]
In the winter of 2015 the time had come for me to make my front yard grass disappear. After researching various labor intensive methods of removing turf, I finally settled on smothering the grass with wrapping paper and shredded cedar mulch. While this isn’t a full proof method, killing the grass in place is […]