Health Insurance

Posts related to health insurance for individuals, families, small groups, enrollment, eligibility in California, plans, coverage, benefits.

How Are Health Insurance Premium Rates Determined?

March 9, 2017 By Kevin Knauss 2 Comments

Since the beginning of health care reform under President Obama there has been intense speculation about how the health insurance companies will react when setting rates for the various health plans they offer. Health insurance is not a commodity like wheat, oil, or pork bellies where the market place of buyers and sellers agree upon a price. While competition does impact the rates to a certain degree, health insurance prices are largely determined by the health care services to be covered, the cost of health care services, and the expected claims for those services within a geographical location where the plan is being offered.

Health Insurance For Fitness Buffs And Gym Owners

February 20, 2017 By Kevin Knauss 3 Comments

Now there is an alternative to traditional health insurance that is aimed at fitness buffs and gym owners. SHM FIT combines a health care expenses sharing group with a high deductible catastrophic health plan to offer health insurance premiums that may be less than traditional insurance.

Will Trump Executive Order Waive ACA Premium Tax Credit Repayments?

January 23, 2017 By Kevin Knauss Leave a Comment

Under an Executive order signed by President Trump on January 20, 2017, he gave federal bureaucracies the discretion and authority to waive any provision of the Affordable Care Act that might impose a fiscal burden on individuals and families. Two of the most prominent fiscal burdens are the repayment of excess Advance Premium Tax Credits and the Shared Responsibility Payment also known as the individual mandate penalty for not having health insurance.

Insurance Commissioner Slams Trump Executive Order On Obamacare

January 21, 2017 By Kevin Knauss 3 Comments

California Insurance Commissioner Dave Jones slammed President Trump’s Executive Order relaxing enforcement of the Affordable Care Acts provisions as potentially destabilizing to the health insurance market.

What is an Obamacare ACA Health Plan From Covered California?

January 19, 2017 By Kevin Knauss 7 Comments

With all the discussion about congress repealing the Affordable Care Act, there is confusion over what exactly is an Obamacare health plan. Some people think the federal government is dictating the type of health plans that must be sold to individuals and families. It is up to each state to set the rules for their health insurance plans. The federal government under the regulations of the Affordable Care Act (ACA) stipulates what type of health plans are eligible for the Premium Tax Credits that make health insurance affordable for individuals and families.

Thanks Donald For Crashing My Income

December 31, 2016 By Kevin Knauss 5 Comments

I try to be pretty pragmatic when it comes to presidential elections. Regardless of the promises made by any candidate, we rarely see any real change in the U.S. with the election of a new president. However, Donald Trump ran on a platform to repeal and replace Obamacare. Since 90% of my income comes from enrollment generated by the Affordable Care Act, I am facing a drastic reduction of my income if Trump fulfills his promise.

Price Transparency: A Prescription For Lowering Health Insurance Rates

December 19, 2016 By Kevin Knauss 10 Comments

The one aspect of health insurance that the Affordable Care Act did not address is the cost of health care services. Without a governor on the prices that doctors and hospitals can charge, the health insurance companies must constantly increase their rates to cover the cost of health care expenses that seem to rise faster than the national average for inflation. One way to reign in the ever increasing costs of health care is by providing consumer information on the cost of health care services through price transparency. The Health Care Transparency Project has started an online petition to request the Trump administration implement price transparency for consumers.

Beware Bundled Health, Life, Accident, Cancer, Dental Plan Scams

December 9, 2016 By Kevin Knauss Leave a Comment

Consumers should be cautious when a health insurance agent wants to bundle a bunch of other products such as life and accident insurance with the Covered California health plan. These agents and marketing organizations are more interested in selling higher commission products such as life, accident, cancer, stroke, heart attack, and dental plans than they are health insurance. They may try to convince a consumer to drop the health plan to a Bronze level so they can sell questionable indemnity plan products as extra protection for the higher deductible.

California Health Plans Combat Insurance Fraud To Keep Rates Low

December 5, 2016 By Kevin Knauss Leave a Comment

California individual and family plan health insurance carriers have been combating fraudulent enrollment for open and special enrollment periods. Many of the health insurance companies have placed additional requirements on applicants to verify California residency. Unfortunately, enrollments through Covered California, which have virtually no verification of special enrollment eligibility, continue to be a source of high-cost claims from fraudulent enrollments.

Blue Shield PPO Out of Network Allowable Amount Limitations

November 26, 2016 By Kevin Knauss 4 Comments

For most Covered California consumers there will be only one PPO health plan to select. Blue Shield is the only health insurance company participating in Covered California that will offer a PPO health plan in the major metropolitan regions of California. While the PPO plan design signals to consumers that they have some freedom to use out-of-network providers, the Blue Shield benefits may be very restrictive.

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