Kevin Knauss: Health, History, Travel, Insurance
Posts related to health insurance for individuals, families, small groups, enrollment, eligibility in California, plans, coverage, benefits.
Not all Blue Shield health plans will be receiving the premium credit. The credits will be applied to fully-insured employer groups (except flex-funded), dental and/or vision plans, Medicare Supplements, and individual and family dental and/or vision plan subscribers. Blue Shield states they are issuing premium credits as permitted by state regulators and Covered California.
Therefore, I request that all health insurance and specialized health insurance companies provide their policyholders with a partial premium refund no later than December 31, 2020. These refunds should be reflected in the November or December 2020 premium statements sent to policyholder or certificate holders, if refunds have not already been issued.
Blue Cross will offer the standard benefit design metal tier plans through Covered California and off-exchange, direct from the carrier. They will also offer a few non-standard benefit design plans available off-exchange. Blue Cross will offer a Silver HMO plan off-exchange with no medical deductible and 0 percent coinsurance for medical services. The copayments are a little higher than the standard Silver 70 ($50 office visit, $85 specialist visit, emergency room visit $750) and the maximum out-of-pocket is $8,550 versus the $8,200 for a standard Silver 70.
California is broken into 19 different rating regions. Sutter Health Plus HMO plans are offered in 9 of those regions. The least expensive rates – based on the Bronze plan for a 40-year-old individual – are in the Sacramento, El Dorado, Placer, Yolo counties service area. The most expensive are found in Santa Clara County, 15.92% higher than the Sacramento region.
LifeSpring, a free meal delivery service, is also available to Trio HMO members experiencing a serious illness. In addition to meals, Trio HMO members can also use the Call the Car benefit. Call the Car is free non-emergency medical transportation for medical appointments, dialysis or other healthcare service appointments. Blue Shield Case Managers will determine eligibility for the Call the Car program.
For eligible plan members only, Blue Shield will offer an option to defer up to 75% of April’s premium to remain a paid current Member / Small Group customer (i.e. must pay a minimum of 25%). For example, April premium is $1,000. Member can defer $750. April payment due is $250. So long as the Member or Small Group enrolls in the program or pays the Total Amount Past Due before the end of the grace period, the Member or Small Group will not be cancelled after the applicable grace period ends.
Blue Shield of California is taking additional steps to remove barriers and help its members receive the health care they need during the coronavirus (COVID-19) pandemic, announcing today it will cover members’ coinsurance, copayments and deductibles for COVID-19 medical treatments through May 31, 2020.
There are a couple of different reasons why health insurance companies may be reluctant to extend a grace period beyond the current 30-day date range. The first reason is California’s expanded Medi-Cal option. If an individual or family has a sudden decrease of income – below 138 percent of the federal poverty level for adults – and they do not have employer sponsored health insurance, they can immediately apply for Medi-Cal and get coverage at no cost.
This is a review of the responses to the Coronavirus Covid-19 health care issues from the websites of most of the individual and family plan carriers in California. Some websites detail the response and cost of Covid-19 health care issues better than other. They all seem to be covering Covid-19 testing at no cost. The cost of other health care services are subject to the plan benefits.
The extra $3,000 is clearly stated on the 1095-A. I have seen it. The question is, “What did Kaiser do with the extra $3,000 and how did they not figure out that they were receiving no consumer premium to attach to the monthly subsidy?”
