Blue Shield of California sent notices to their appointed insurance agents that the agent’s Social Security number had been displayed during the course of member’s online payment. The letter from Blue Shield, dated February 18, notifying agents of the breach to their private personal information does not mention how many agents had their Social Security number’s compromised. While I was not shocked to receive the letter informing me that my personal information was displayed, I was angry that Blue Shield let this happen.
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Health Net slashes agent commissions
Health Net notified all their California agents by a letter dated January 29th, that effective March 1, 2014, they will slash the sales commission by over 50% on four of their five individual and family plans offered in California. This further reduction in compensation for agents since the ACA was passed continues to make customer service oriented health insurance agents a “family of dinosaurs” who will quickly become extinct.
Insurance companies deny health care with restricted networks
When the insurance companies are having their risk for unexpectedly high health care expenses subsidized they should not have the luxury of creating tight doctor and hospital networks. The restrictions on network providers for cost containment purposes is exceptionally irritating when it is the plan members that are helping fund part of the risk reduction provisions by having to pay for the reinsurance fee on qualified health plans. Restricted networks and new EPOs are just a “work around” solution to allow health insurance companies to selectively limit health care like they have done in the past.
How do I find a Medi-Cal Doctor?
Now that you, your children or your entire family are now enrolled in Medi-Cal, the next challenge is finding a doctor. Virtually all of the Medi-Cal plans will be HMOs (Health Maintenance Organizations) where you will have to select a primary care physician (PCP). Your PCP will be your initial contact point for referrals to other health care services he or she may not be able to perform in their office.
Blue Shield set to acquire GEMCare of Bakersfield
Blue Shield has introduced a very competitive Medicare Advantage plan in ten select counties through out California. With the acquisition of GEMCare, Blue Shield will be able to more easily offer a version of their Blue Shield 65 Plus HMO plan in the GEMCare service area. While some Medicare Advantage plans seem to be reducing plan benefits and dropping counties, Blue Shield has been selectively increasing their MA-PD footprint in California.
ACA group health plan rule set to punish families
The Affordable Care Act regulations preclude individuals and families from receiving tax credits to lower health insurance premiums bought through an exchange if they are offered employer sponsored health insurance that is deemed to be affordable and meets minimum value. This rule is actually denying some families access to affordable health insurance and is set to penalize other families with a huge IRS tax bill in 2015.
ACA plows way for single-payer health plan
I was dumbstruck when the mother of one family whose household income is $134,000 per year was quizzing me on they could avoid the penalty associated with the individual mandate. She was hoping that I could figure out how to make their income low enough so the insurance premiums were more than 8% which triggers an exemption. The parents of this upper income family were seriously considering not providing health insurance to their children. That is just so irresponsible.
Kaiser Permanente
2024 Evidence of Coverage documents were previously referenced as Member Agreements. They contain specifics of how the health plan operates. Monthly Rates Kaiser has not published regional monthly rates for their health plans for 2024. If you are not enrolling through Covered California, you need to get the off-exchange rates through their quoting tool. Kaiser […]
Small group health plan special enrollment period
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.
Bronze versus Silver Plan Pharmacy Benefits
Even though health insurance plans have been greatly simplified with the introduction of the metal tiers of Bronze, Silver, Gold and Platinum under the ACA, careful consideration should still be given when comparing the coverage and benefits. In particular, for many people that have recurring brand name prescriptions medications, selecting the least expensive Bronze plan […]