One of the first filters in selecting an EPO or PPO individual and family plan, either through Covered California or off-exchange, is determining if your current doctor is in-network. For all the enhancements to online doctor directory search tools, they still suck. They are not consumer friendly. Consumers are given either too many conditions to select or the provider search tool offers too little information.
I would not have believed it had I not witnessed it with my own eyes. When I renewed the Covered California health plan for a client her monthly premium amount she will be responsible for will actually be lower in 2017. Even though the carrier had an overall rate increase and she was another year older, the Advance Premium Tax Credit monthly subsidy calculated by Covered California will be larger in 2017. The net result is she will be paying less than $5 per month for the same Silver health plan in 2017.
The Department of Managed Health Care (DMHC), who regulates most of the individual and family plans offered through Covered California, has developed a website to allow consumers to compare health insurance companies. The Health Plan Dashboard website does not assign any performance review ratings. But it does give consumers a high level view of some of the data collect on the health plans such as enrollment, complaints, and enforcement actions for medical, dental, and vision plans.
Even with the Obamacare subsidies, many individuals and families still opt for the least expensive Bronze high deductible health plans. The high deductible health plans require the consumer to spend $4,500 to $6,500 in a medical deductible before any real cost sharing with the health insurance company starts. As more consumers opt for these least expensive Bronze plans more insurance companies are creating insurance products to help cover the high deductible of these plans. But are these indemnity plans worth the money and will they actually pay when you need the money?
One of the most frustrating aspects of the Affordable Care Act is that it excludes family members from receiving the premium tax credits to reduce their health insurance if one of the parents is offered affordable employer group health insurance. One way around this problem is for the employer to offer employee only coverage. Covered California for Small Business health insurance exchange offers the employee only option for employers when they set up their group health plans.
Covered California has released a series of marketing videos to develop interest and drive sales to their small employer group plans. Formerly known as SHOP (Small business Health insurance Options Program), the small employer group offerings, authorized as part of the Affordable Care Act, has been re-branded as Covered California for Small Business. The small employer group marketplace exchange initially flopped as it was beset with an online application process that failed and subsequent management problems that resulted in billing nightmares for many clients. Fortunately, they seem to have righted the foundering small group boat at Covered California.
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 […]
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 […]
There was time when an insurance agent could make a decent living enrolling individuals, families and small groups into health insurance plans. With the advent of the Affordable Care Act and the subsequent downward pressure on commission rates, agents can still earn a living selling health insurance but it is not without its challenges. The […]
With the passage of the Insurance Gender Nondiscrimination Act (IGNA), also known as AB 1586, all California health insurance plans must cover medically necessary transgender health care services. Unfortunately, many health plan customer service representatives and many health care providers are not aware of the law and have erroneously denied or delayed coverage and treatment […]