At the August 2015 Covered California Board meeting James DeBeneditti, Deputy Director of Plan Management, reviewed the options and challenges for offering vision insurance on the Covered California online enrollment website. The only viable option reported was to put a simple link on the Covered California website to vision insurance providers. For the inclusion of the hyperlink Covered California would charge $10,000 and take a 10% commission. The $10,000 implementation fee is essentially an advertising cost for the vision plan while Covered California acts like an unlicensed insurance agent collecting a 10% commission for selling vision insurance.
See the full Covered California recommendations from the Board meeting below.
Vision insurance not included in ACA
The major challenge for any state Marketplace exchange to include vision insurance alongside health insurance is that the vision plans can’t be subsidized by the ACA Premium Tax Credits. The Covered California CalHEERS online enrollment software is geared to determining the eligibility tax credits for the consumer and not ancillary benefits such as dental and vision insurance.
Dental insurance snafus on website
Covered California has not had the best luck when it comes to expanding the CalHEERS system beyond the basics. They had a hard enough time trying to implement standalone pediatric dental plans that parents were supposed to purchase for their children. The children’s dental option failed to display in the early months of the 2014 open enrollment period and thousands of children went without one the essential health benefits mandated in the ACA. (Where are the Pediatric Dental Plans? ). In 2014 Covered California promised to offer family dental insurance online in 2015. With little explanation in early 2015, Covered California scrubbed the roll-out the family dental plans. (Covered California drops family dental for 2015 ).They are scheduled to debut for 2016.
VSP threatens to leave California
The absence of vision insurance in the original iteration of the Covered California enrollment system caused the CEO of vision insurance plan VSP to threaten to locate the company out of state if vision was not included. (VSP threatens to leave California if dental plans aren’t offered ). VSP didn’t leave the state and two years after the threat Covered California is proposing a glorified advertising link to outside vision plans. Covered California has no intention of offering or billing for vision insurance. But they do have every intention of trying to make as much money from their online real estate as possible.
Covered California stamp of approval
Covered California is proposing that they develop a standard benefit design for vision insurance being offered through their website and they be allowed to review the rates. If they like the proposals from the carriers who submit visions plans, they’ll place hyperlinks on their website to the plans. Consumers won’t be able to enroll in the vision plans through their Covered California accounts. Covered California will just be putting their stamp of approval on the vision insurance. Of course, Covered California has approved many health plans that have exceedingly narrow provider networks causing members to incur more expenses than they might otherwise accumulate.
Covered California pay-to-play ploy
In return for Covered California’s gold seal of approval, the vision carriers will have to pay $1,000 just to submit a proposal and another $10,000 called an implementation fee. Then they will have to pay Covered California either a 10% commission or a flat rate per member per month under the revenue scheme outlined to the Board on August 20th. Lest we forget, Covered California is a commercial endeavor that is supported by the fees they collect form insurance carriers. Vision plans represent another revenue stream for Covered California to pay its bills.
Glorified vision insurance advertising
The vision insurance proposal is nothing more than an attempt at selling advertising on the Covered California website. The vision plans will be asked to plunk down $10,000 just for a hyperlink to their own online enrollment portal. But if the extortion of the $10,000 of the implementation fee wasn’t enough, they will have to cough up an addition commission amount to Covered California. A commission implies that Covered California is now acting as an insurance agent. Yet, they explicitly state they will give no advice or information about the vision plans to consumers.
No new vision plans will be offered
I apologize for being so cynical, but Covered California’s vision plan proposal is nothing more than a thinly veiled attempt to generating advertising revenue. Vision insurance is pretty competitive and the benefits are fairly standard across the carriers. More than likely the vision plans offered through a hyperlink on the Covered California website will virtually mirror the major vision plans on the market currently.
Vision insurance is readily available from reputable agents
Any California resident in the market for vision insurance can find several plans with the click of a mouse. I even offer them on my website, buy I can’t charge the carriers $10,000 just for putting a link to their insurance plans on my site. I also vet insurance plans that I offer on my website. If a consumer actually calls me wanting my opinion on the different insurance plans I offer it; I’ll give an honest opinion. Unlike Covered California who will refuse to endorse any plan or provide any assistance with consumer grievances with the insurance. Bonus, insurance agents actually help clients with insurance issues. We just don’t throw up links to insurance plans and collect money for having the link on our websites.
Covered California will sell vision insurance advertising
I would like to think the vision insurance companies would boycott such a blatant pay-to-play advertising ploy on the part of Covered California. Unfortunately, marketing departments drool over the exposure that a website such as Covered California could give their products. Consequently, we’ll probably see several vision plans “advertised” on Covered California. Just remember Covered California doesn’t endorse them but they might be collecting hefty fees to advertise them.
Covered California Vision Coverage for Consumers proposal