Thoughts of Kevin Knauss

Posts by Kevin Knauss on a variety of topics: health insurance, history, hiking, politics, LGBTQ+, railroads, plus whatever piques my interest.

Evolving Market Share Of Health Plans In Covered California

October 8, 2018 By Kevin Knauss Leave a Comment

Anthem Blue Cross started out as carrier with the largest enrollments in 2014 and 2015. They dropped to 26% market share in 2016. They dropped again 2017 down to 19%. Part of the drop, from my perspective, was related to the cost of the health plan versus their EPO network. People didn’t see the value of the smaller network and no out of network coverage relative to other alternatives. Then in 2018 Blue Cross pulled out of most of California. They offered plans only in region 1 (Northern California), region 7 (Santa Clara County) and region 10 (Central Valley counties). This dropped their market share down to 5%.

Kaiser’s Portfolio Of Stable Family Health Insurance Plans For 2019

October 8, 2018 By Kevin Knauss

Kaiser Permanente has seen their market share increase with the Affordable Care Act. Their percentage of Covered California enrollments has steadily increased from 24% in 2015 to 33% in 2018.They have also been very stable in their plan offerings on and off exchange. Kaiser rates increased 3% – 7% in Northern California and 6% – 10% in Southern California in 2018. In 2019, the average rate increase will be 9% throughout California.

Medi-Cal Duplicate Application Errors And Covered California

October 5, 2018 By Kevin Knauss Leave a Comment

The Medi-Cal representatives also confirm that erroneous information can pop into Covered California applications after an individual or family has been terminated from Medi-Cal. Once a person is deemed no longer eligible for Medi-Cal, the SAWS Soft Pause is released and the individual and family can then enroll in a Covered California plan with the tax credit subsidy. Unfortunately, the data on the Covered California can be missing or in accurate from what was originally entered.

Health Net California Individual And Family Plans For 2019

October 5, 2018 By Kevin Knauss Leave a Comment

Health Net is making it easier to add adult dental and vision to their off-exchange plans. They call the added dental and vision benefits the Plus package. For the EnhancedCare PPO, PureCare EPO, and PPO plans the Plus package of dental and vision benefits is $14.42 per adult. The maximum dental benefit per year is $1,000. Instead of a member cost-sharing percentage these plans have a fee schedule. For example, a filling on one tooth would be $22.

California Won’t Allow Trump’s Small Group Association Plans For 2019

October 1, 2018 By Kevin Knauss Leave a Comment

Why should your employment dictate whether your health insurance is worse or exponentially better than your neighbors? Shouldn’t all health plans be the same? The human condition does not change depending on who you work for. The individual who works for the State of California, a union, or a self-insured plan can have the same health conditions as a self-employed individual. People routinely move from large group plans to individual and family plans and their health conditions don’t change. But the price and member cost sharing is far higher under small group and individual and family plans than it is with some of the union plans. Is that fair?

Odd Covered California Error Message Before Open Enrollment

September 27, 2018 By Kevin Knauss Leave a Comment

In another situation I, as the agent on behalf of a client, had made a routine address change. Everything was going smoothly until we went to update the plan selection. That’s when we got the error message. Nothing I could do (logging out of the system and logging back in) changed the error code. We could not select the plan for the new region the clients were moving to.

Gov. Brown Kills Short Term Health Plans In California

September 24, 2018 By Kevin Knauss 1 Comment

By banning all short term medical plans, California is punishing people who are not out to manipulate the system for their own benefit. All they wanted was a little assurance that if something really nasty happened, they wouldn’t have to declare bankruptcy. Now these families, who just forgot about the enrollment deadlines, will be subject to the wolves of the health care field.

Blue Shield BlueCard Program Benefits Get Trimmed For 2019

September 19, 2018 By Kevin Knauss Leave a Comment

The limitations to the BlueCard program for 2019 on PPO plans means the out-of-area health care services are no different than Blue Shield’s Trio HMO plan for individuals and families. Unless the health care services are for emergency or urgent care they won’t be covered unless the member has prior authorization from Blue Shield of California.

Blue Shield Of California Individual & Family PPO, HMO Plans For 2019

September 13, 2018 By Kevin Knauss Leave a Comment

Blue Shield individual and family plans also come with Teladoc for phone call consultations, NursesHelp 24/7 online chat, and the BlueCard program that allows member’s access to providers when they are travelling out-of-network. The plans also include a physician home visit. The home visit, Heal on-demand house calls, is subject to the member’s location. There is also Telebehavioral health benefit that helps members with mental or substance abuse challenges access therapy online with mental health professionals.

New Medicare Advantage Open Enrollment Period For 2019

September 11, 2018 By Kevin Knauss Leave a Comment

You must have been enrolled in a Medicare Advantage medical plan to take advantage of the MA OEP. If you never enrolled in a MA or MA-PD, you can’t join one during the MA OEP. You can’t switch standalone Part D Prescription drug plans during the MA OEP. Additionally, if you go from a MA-PD to a MA plan, you can’t add a standalone Part D Prescription Drug plan. The MA OEP doesn’t apply to Medicare Savings Accounts (MSAs) or Cost Plans.

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Thoughts of Kevin Knauss