In addition to paying a $2.8 million fine, Anthem Blue Cross has agreed to a Corrective Action Plan (CAP) that represents a fundamental shift in how the plan handles enrollee grievances.
I grew up in California, went to college in California, and like most West Coast parents, I was conditioned to view the large private universities and University of California institutions as the gold standard of college education. I readily admit that I was wrong and can now see the glaring deficiencies of my college experience at UC Davis. The deficiencies are not a failure of the any of the large universities. They are just the nature of the system trying to push through five or ten thousand students each year to graduation.
By the time I had all the fun in the urologist’s office, the prostate pain had virtually disappeared. My PCP and I had theorized before the PSA test that the new mountain bike I bought, with the knife-like seat, may have traumatized the pudendal nerve, a common problem among cyclists. I had stopped riding my new bike and the pain gradually subsided. The next PSA test result was a 4, confirming that I needed to buy a new bike seat.
Prior to the 19.4 update, I could always review the documents and correspondence for an account as an agent. This information was vital to see when letters were sent out and if they were returned to Covered California. It also showed which documents we had uploaded for verification purposes like income or residency. As of Monday, May 20, this section has vanished.
Until Covered California fixed the glitch, all women who reported they were pregnant were channeled into the Full Scope Medi-Cal for Pregnant Women program and had their Covered California health plans automatically terminated. This was a nightmare for many families as it completely disrupted their plans for the OBGYN they wanted to see and where they wanted to have their baby delivered.
The HIPP program pays the medical insurance premiums, coinsurance, deductibles, and other cost-sharing obligations for the individual. The annual cost of the premiums and member cost-sharing is compared to the estimated cost of an equivalent set of Medi-Cal services. Outlined in in an ACWD Letter 09-02, DHCS uses a specific formula to determine the cost-effective nature of the private insurance over Medi-Cal FFS.
The 1095-A is almost as important as filing taxes. Even if you did not owe taxes in 2017, but still received the APTC, you have to file a tax return. Covered California has been notified by the IRS if a current household, receiving the subsidy, has not filed a 2017 tax return. Covered California is sending out letters to consumers that their current monthly APTC subsidy will be terminated if they do not resolve the issue.
At first, I was only going to get one tattoo of the cubist couple. But it seemed unbalanced, so I designed the second part of the cubist couple for the other leg. Then I was hooked. I loved the creative process of taking an image I enjoyed pondering over and decided to design more simple tattoos. Only this time, I decided to incorporate my interest in clocks and watches.
If you think regular health insurance is filled with loop-holes and caveats to avoid paying health care claims, read the fine print on the HCSM. It can be difficult to know if the HCSM will pay on certain claims under certain conditions. Then there is the wild card of denial because of how the injury or illness occurred that is not explicitly included or excluded in the plan. For example, if you are at a gay bar and are dancing, then trip and break your ankle, will it be covered if the HCSM does not approve of activities involving the gay community?
Between the single carrier option or the small group exchanges, it doesn’t appear that one has better rates over the other. In general, HMO plans will always be less expensive than PPO plans. You should get quotes for plans from a single carrier as well as the small group exchanges. Even though the information can seem overwhelming, that’s where your insurance agent can help filter out carriers and plans that don’t fit your needs.