Kevin Knauss: Health, History, Travel, Insurance
Anthem Blue Cross of California has withdrawn their application to offer small group health insurance plans through Covered California.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.
Covered California has already awarded $43 million for public outreach and education. Seven of the recipients that received grant money are organizations that are already involved with the health care industry. Yet we need more money spent just to talk to doctors, nurses and physical therapists?
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.
Covered California hosted another webinar to provide a progress update of the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) website. In short, this is the website Californians will use to enroll in one of the qualified health plans offered in their area through Covered California.
California residents were invited to ask questions about the new Covered California health plans in a live chat held through Facebook this past Thursday. Ken Wood, Senior Advisor for Products, Marketing and Health Plan Relationships for Covered California, answered 47 questions over 90 minutes. While fourteen of the questions dealt with different aspects of the health plans being offered, the bulk of the questions focused on income requirements for the tax credits and coverage options for different family scenarios.
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.
Before Covered California can really get the IPA training going, they have to have the Assister Enrollment Entities (AEE) in place. The AEEs can be a variety of organizations that have the interest and resources to reach out to targeted populations to help enroll individuals into Covered California health plans. These might be nonprofit groups that serve specific ethnic or cultural populations, social service organizations or trade groups.
Staff did respond to an excellent suggestion regarding insurance agents not be able to pay Assisters or provide ‘in-kind support” such as free copies, co-branded material, travel expenses or reduced rent. Covered California staff agreed to the prohibitions that would allow agents or general agencies from essentially co-opting In-Person Assisters or Entities into pipeline of referrals.
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.
