Kevin Knauss: Health, History, Travel, Insurance
Posts related to health insurance for individuals, families, small groups, enrollment, eligibility in California, plans, coverage, benefits.
The California Assembly Republican Caucus has declared that people with pre-existing conditions are the root cause of escalating health care costs. From their statements on their website Covering Health Care: A California Resource Guide, one can only come to the conclusion that California Republicans feel that sick people should be denied guarantee issue health insurance so premiums of healthy people won’t be adversely affected.
Covered California has estimated that nearly 100,000 households have started an application but have not selected a health plan. To help “Jump Start” these stalled applications Covered California will be distributing the contact information of these stalled applications to Certified Agents to call the applicants and offer assistance to help them make a health plan selection for an effective date of January 1, 2014.
Health Net and several other administrators of Medicare Advantage plans were issued fines from the Center for Medicare and Medicaid Services (CMS) for errors in their updates to people enrolled in the MA-PD plans. The penalties, issued in October 2013, were for incorrectly stating plan information in annual notices to Medicare beneficiaries enrolled in the Advantage plans and ranged from $23,410 up to $86,530.
Compared to existing small group quoting and enrollment systems from the insurers and the Cal Choice private exchange, the Covered California SHOP program seems a little clunky and unfinished. If an employer wants to realize the tax credits for contributing to employee health insurance premiums they have to have a small group plan through Covered California. Except for the option to purchase pediatric dental plans for dependent children, SHOP offers no adult dental or vision insurance.
Insurance Commissioner Dave Jones continues to wage not only a regulatory turf battle with Covered California over the issue of policy cancellations, he is also waging a war of words. No sooner had the California Health Benefits Board voted to continue with the planned cancellation of health plans for December 31st, Commissioner Jones fired off a press release to announce how unhappy he was at the Board of Covered California.
In what could be the first consumer driven attempt in California to push down rising health care costs Anthem Blue Cross is flagging facilities in California that are unwilling to pass on deep discounts to its members. Anthem Blue Cross has introduced Tiered Networks into several counties in California with its new ACA compliant health plans in hopes that subscribers will choose less costly facilities
For a brief window of time, small businesses and nonprofits can enroll in a small group health plan without meeting all the minimum requirements. The Affordable Care Act has a special provision to encourage employers to offer a small group health plan to see if it is right for the employees and the owners. Consequently, some of the rules have been waived so that small groups can test the waters.
Consumers looking to select a new affordable Care Act health plan will have to carefully consider the benefits and limitations of the different provider networks associated with each plan. In addition to the familiar PPO and HMO designs, many carriers have added the EPO. Which network is best for your family?
The enrollment of individuals and families under the expanded Medicaid provisions of the ACA is not a slam dunk with either the mailing in of an application or clicking “enroll” on a website. A variety of documents will usually need to be sent to complete the enrollment at the county level. Not submitting the verification documents could ultimately delay enrollment for people who desperately need the insurance.
If a Medicare Advantage plan has been awarded a 5 Star rating from Medicare you’ll see that trumpeted in TV commercials and print advertising. The star rating that either the Medicare Advantage or Part D Prescription Drug plan must display is a composite of 35 different measurements. Perhaps the most important rating for most beneficiaries is the level of customer service if there is a problem.
