By paying for prescription drugs out-of-pocket, and not having them accumulate toward the maximum out-of-pocket amount for the health plan member helps the insurance company, not the consumer. Not having the drug costs go through the health plan could cost the consumer thousands of extra dollars in health care expenses because they did not meet their maximum out-of-pocket amount for the year.
With the constant erosion of the commission structures to agents for enrolling consumers into health plans in California, many agents have expressed their desire to stop assisting individuals and families with enrollment into Covered California health insurance. There has been renewed talk of allowing agents to charge a consultation fee to make up for the dwindling commissions they earn from the health plans and insurance companies. However, if agents want to make a decent return for enrolling consumers into health plans they need to provide the service so many of them advertise. We need to move from order-takers to consumer advocates, and we need fair compensation for our services.
While the Affordable Care Act has brought transparency for consumers to compare health insurance plans, it has failed to lift the veil of secrecy surrounding how much health care services actually cost. This is particularly important for consumers who have high deductible PPO Bronze plans who would like to learn the health plan’s negotiated rate for a health care procedure.
If you purchased an Individual and Family Plan through Covered California or off-exchange directly from an insurance company or health plan, I would like you to take a short, anonymous survey on your experience with your health plan in 2014. Your participation and responses are anonymous and in no way can they be used for […]
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.
Consumers are growing frustrated as they find their current doctors aren’t included in new Covered California individual and family plan (IFP) health insurance networks. There is also widespread uncertainty about the rules of in-network providers with the new Exclusive Provider Organizations (EPOs) and California’s new 19 pricing regions. When California consumers are craving information the doctors have been silent and the insurance companies along with Covered California are providing scant information.
It is a myth that patients or consumers will be able to have a measurable impact on health care costs when the majority of Californians receive health care arranged through a health insurance company.