Kevin Knauss: Health, History, Travel, Insurance
Posts related to health insurance plans offered by Anthem Blue Cross in California for individuals, families, small groups, Medicare, Medi-Cal.
Anthem Blue Cross announced that it will issue rebates to members enrolled in their Medicare Supplement plans in five different states. The rebates are a result of the Medicare supplement or Medigap plans failing to meet the medical loss ratios (MLR). Rebate checks being sent out in September will range from $3.51 to $487.08 per member.
In September, Anthem Blue Cross will be mailing members enrolled in California plans that their health insurance may not be renewed in 2014 as certain plans will be discontinued. Because Blue Cross is selling individual and family insurance through Covered California, the new health care reform insurance market place, they are not allowed to offer non ACA-compliant plans outside of the exchange.
Covered California has been assuring health insurance agents that they will be an important part of the effort to enroll millions of residents in affordable health insurance. Unfortunately, many of the health plans they have selected for the California market place are giving insurance agents the cold shoulder.
Anthem Blue Cross of California has withdrawn their application to offer small group health insurance plans through Covered California. Unlike the individual and family market health plans purchased through Covered California that will be invoiced directly by the respective carrier, the SHOP plans are to be purchased and administered by Covered California.
One of the spillover effects from the Affordable Care Act is that the insurance companies are streamlining not only their health insurance plans but their ancillary insurance products like dental and vision. Anthem Blue Cross has just released new dental and vision plans that are straight forward and easy to understand.
Children’s dental insurance options have now been added to the line of plans being offered through California’s health insurance exchange Covered California. Part of the ten Essential Health Benefits that must be offered through the new health insurance exchanges or Marketplaces is pediatric dental. The state exchanges can meet this requirement in various ways and Covered California has opted to offer stand alone plans.
Part of Covered California’s mission is to improve health care quality and lower costs. In an attempt to meet these goals they announced a partnership with the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely initiative. The Choosing Wisely initiative seeks to encourage better dialog between patients and physicians to reduce duplicative tests based on evidence when charting the most effective course of treatment.
While the filed rate increases of Anthem Blue Cross may be unreasonable that hardly justifies their being banned from the Covered California small employer group program. There is also the prospect that Anthem Blue Cross might be forecasting a sharp drop in membership of their small group plans as small businesses abandon the plans or employees leave to purchase subsidized health insurance through Covered California.
Anthem Blue Cross of California will be notifying certain small employer groups that they will be receiving a rebate under the Affordable Care Acts’s Medical Loss Ratio (MLR). They missed the 80/20 target for small group plans overseen by DMHC. These plans consist of Health Maintenance Organizations (HMOs) that are overseen by DMHC.
Covered California will be offering 13 different health insurance plans to individuals and families. Some of the plans will be offered through large commercial insurance companies and other from smaller regional organizations. Ten of the thirteen plans have some form of easily accessible report card on their services from either a state agency or accreditation organization.
