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.
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.
A little known provision of health plans that also are designated as being a Health Savings Account (HSA) require a single member of a family to meet double the deductible amount of an individual before coinsurance is applied to health care services. Unlike traditional family plans where any one member of the household can transition […]
Covered California doesn’t have a monopoly on individual and family health plans in California. In addition to the carriers participating in the California exchange, Cigna is also offering health insurance outside of Covered California. Cigna is offering eleven different individual and family plan (IFP) options in California: seven Baseline Portfolio plans and four plans that mirror the Covered California standard metal tier levels for 2014. None of their plans are available through Covered California for the Advanced Premium Tax Credit.
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
One of the secondary benefits of the Affordable Care Act is the new plan offerings in the individual market. Both VSP and Blue Shield of California have introduced individual and family vision insurance plans (IFP) with benefits rivaling group plans. Just as we have seen the medical benefits for IFP become equivalent to small group plans, the insurers are reworking their dental and vision insurance products to be more comprehensive as well.
Many Californians are seeing their individual and family health insurance premiums jump with the inclusion of all the new Affordable Care Act benefits and regulations. A small sampling of the new ACA rates shows that Covered California individual health plans are comparably priced with current and future small group plans offered in California.
In communication with their brokers on September 10, Health Net said they would be closing all their California individual and family plans (IFP) as of December 31, 2013. The closures do not affect their small or large group plans. The announcement cited the development of all new Affordable Care Act compliant plans as a reason for scrapping all the old ones.
While some industry analysts point a finger at new guarantee issue rules for individual plans as a reason UHC and Aetna are vacating California, both are still retaining their lines of employer group business which IS ALL GUARANTEE ISSUE. It is rather disheartening that UHC and Aetna have taken such a cynical profit driven approach to the individual market in California and in other states.
Aetna hinted in their announcement that a combination of the new health insurance exchange and required benefits forced them to pull the plug on their individual plans. In recent years, Aetna has never been very competitive in terms of price with other carriers such as Anthem Blue Cross, Health Net and Blue Shield of California