Under the Department’s new rule, AHPs can serve employers in a city, county, state, or a multi-state metropolitan area, or a particular industry nationwide. Sole proprietors as well as their families will be permitted to join such plans. In addition to providing more choice, the new rule makes insurance more affordable for small businesses. Just like plans for large employers, these plans will be customizable to tailor benefit design to small businesses’ needs. These plans will also be able to reduce administrative costs and strengthen negotiating power with providers from larger risk pools and greater economies of scale.
But how does an enrolled individual in a standard Silver 70 plan, who is not eligible for the CSRs, feel about subsidizing lower income plan members? Could the argument be made that some individuals are paying an inflated premium, close to a Gold plan, but only receiving Silver plan level benefits? At a very minimum, the inflated Silver plan rates are a distortion of the health insurance market place. One of the goals of the ACA and the exchanges like Covered California was to bring more transparency and accountability to the health plan selection process for consumers. If the inflated Silver plan rates, along with artificially inflated subsidies, do become a reality, the market place for health insurance will take a step backwards as plan selection becomes more confusing for consumers.
Covered California has updated their online application and enrollment program to allow families receiving premium assistance to select different metal tier levels and health plans for each household member. Previous to this update, only households who enrolled without qualifying for premium assistance could split the family member up between different plans. Beginning August 1, 2016, families receiving Advance Premium Tax Credits to reduce their monthly health insurance bills will have more consumer choice.
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.
Both the health plans and the doctors practice subtle and overt forms of discrimination against people with Covered California health insurance. Some of the discrimination is legally built into the health plans. Other discrimination takes place in the form of denying health care services because the prospective patient has a Covered California health plan.
In the confusing landscape of health insurance regulations post ACA implementation, numerous health insurance companies have sent out renewal letters to members with errors. Blue Cross, Blue Shield, Health Net and even Covered California have had to send follow-up letters to correct erroneous information. Unfortunately, this incorrect correspondence only leads to more confusion surrounding the benefits and renewal […]
After four years in the health insurance business I have learned to read the fine print. Health insurance is like a can of fruit cocktail; the essential elements might be in the package but the manufacturer might be adding something you don’t want. Never trust the marketing of any insurance product because they always over […]
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 […]
Covered California will be hosting bi-monthly webinars for agents, enrollers and navigators on the 2015 renewal and open enrollment period. The first presentation was on the automatic enrollment for existing consumers and some of the technical issues that might occur. The webinar itself, Sales Partner Renewal Webinar October 8th 2014, was approximately 48 minutes long. […]
When it comes to keeping Certified Enrollment Counselors (CECs) informed about updates and changes, Covered California has been doing a great job. I only wish the communication was as good when it comes to keeping Certified Insurance Agents (CIAs) current with information. The September 10th Community Partner Webinar has lots of good information that is […]