Kevin Knauss: Health, History, Travel, Insurance
The health insurance rate regulating Proposition 45 on the November ballot is relatively simple in that it attempts to curb excessive premium increases by health insurance companies by allowing the Insurance Commission to deny any rate he or she deems as being unreasonable high. California, on the other hand, has developed a complex review process for rate […]
At the September Covered California Board meeting the members voted to adopt voter registration regulations that will mandate that Certified Enrollment Counselors (CEC) and Certified Insurance Agents (CIA) offer voter registration assistance to individuals that are applying for health insurance through the state exchange. In essence, CECs and CIA will now be doing volunteer work […]
In the proposed rate increase filing with California Department of Managed Health Care (DMHC) on August 1, 2014, Anthem Blue Cross included 79 health plans that they would be terminating at the end of year. Titled Exhibit P – Terminated Plans, effective 2015, Anthem Blue Cross lists 39 pre-ACA and 40 post-ACA individual and family […]
2023 Plan Documents As of September 1, 2020, L.A. Care and UCLA Health have expanded their collaboration, and offer new L.A. Care Covered enrollees the benefit of receiving primary care from the UCLA Medical Group. This is part of a three-year contract, which allows members to receive advanced and highly specialized care, when deemed medically […]
It what seems to be a core principle of Covered California, they have sent out another confusing letter, this time regarding the Learning Management System and agent certification. In a relationship where agents take nothing for granted when it comesto Covered California, hundreds of certified agent called the SHOP line to inquire if they were […]
Thanks to the Affordable Care Act all individual and family plans now include coverage for maternity care. These new health services, many of which are provided at no cost to the patient, also extend to the new born. Prominent in many private health plans is coverage for routine infant circumcision.
Covered California staff is forecasting that SHOP enrollment will double by the end of 2014 and double again during open enrollment for 2015. A list of assumptions was given for the stellar forecast enrollment during the May 2014 Board meeting where the topic was revenue projections from fees charged on individual small group members. Based […]
Aside from the enumerable website issues of both Healthcare.gov and Covered California, perhaps the largest problem of the ACA open enrollment centered around accessible and reliable information concerning how to enroll for the new ACA health plans. California health agents and brokers, who were handling hundreds of client enrollments each, bore the brunt of this […]
While the Insurance Gender Nondiscrimination Act (IGNA), also known as AB 1586, prohibits health plans from denying medically necessary health care to transgender individuals, the exact treatment options covered for individuals with gender dysphoria remain unclear in California. The determination of whether a health plan will cover a certain medical procedure to facilitate the transition to the opposite and identified sex of the health plan member hinges on the medical necessity of the procedure.
At a hastily arranged conference call for insurance agents to address a variety of issues involving new individual and family health plans for California, the Anthem Blue Cross Regional Sales Manager for Northern California announced they were extending the payment deadline until January 31st for policies sold through Covered California with effective dates of January 1st, 2014. This is the third time Anthem has extended the deadline for new enrollments.
