In addition to paying a $2.8 million fine, Anthem Blue Cross has agreed to a Corrective Action Plan (CAP) that represents a fundamental shift in how the plan handles enrollee grievances.
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Posts related to Anthem Blue Cross individual, family, small group, and Medicare health insurance.
Short term medical plans are a less than perfect bridge for individuals and families in between credible minimal essential health insurance coverage. Even though short term medical plans can deny applicants for pre-existing conditions, charge more for being a female, and have caps on how much the plan will pay, they can be a solid backstop to ridiculous emergency room bills. The rates for short term medical plans will usually be in the neighborhood of a California Bronze individual and family PPO health plan.
American Indians and Native Alaskans have access to special $0 cost share health plans that are available through Covered California. A recent enrollment by a member of a federally recognized Indian tribe was offered four different Anthem Blue Cross PPO $0 cost share plan where each one had a different premium rate. This is odd since regardless of the metal tier level of the $0 cost share American Indian-Native Alaskan (AI-NA) health plan, they all have the same exact benefits: zero dollar cost share for all services.
Anthem Blue Cross, following internal policies to protect agents, prevents their members from selecting their preferred health insurance agent through Covered California. The Blue Cross policy of not recognizing an agent delegation made by a household in their Covered California account prevents the selected agent from properly representing the family members and being compensated for his or her time. The Blue Cross agent of record policy occurs when the Covered California member originally enrolled with another agent or without an agent and the member is considered a house account.
Anthem Blue Cross of California announced that they are shipping new and improved membership cards for individuals and families in the Exclusive Provider Organization (EPO) health plans in California. The new cards will have the very important three little letters of EPO actually imprinted on the card.
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.
In what could be the first consumer driven attempt in California to push down rising health care costs Anthem Blue Cross is flagging facilities in California that are unwilling to pass on deep discounts to its members. Anthem Blue Cross has introduced Tiered Networks into several counties in California with its new ACA compliant health plans in hopes that subscribers will choose less costly facilities
In September, Anthem Blue Cross will be mailing members enrolled in California plans that their health insurance may not be renewed in 2014 as certain plans will be discontinued. Because Blue Cross is selling individual and family insurance through Covered California, the new health care reform insurance market place, they are not allowed to offer non ACA-compliant plans outside of the exchange.
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.
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.