Health insurance consumers in Contra Costa County will have an additional health plan to choose from in 2022. Bright HealthCare individual and family plans will be offered through Covered California and off-exchange, directly through Bright HealthCare. Who is Bright HealthCare?
Bright HealthCare Kind of New to California
Unlike some of the more established health insurance carriers in California that have a long history in the individual and family market, Bright HealthCare is new to California. They have been selling health insurance in many other states for several years. In addition to individual and family plans, they also market small group plans and Medicare Advantage plans. Bright HealthCare offers Medicare Advantage plans in approximately 24 counties in California.
The good news for consumers is that all of the plans are the standard benefit design metal health plans – Bronze, Silver, Gold, and Platinum. These plans, designed by Covered California, must cover all the same benefits and member cost-sharing as any other standard benefit health plan. All of the Bright HealthCare plans will be HMO. The following are the in-network providers for Bright HealthCare.
Medical Physician Groups
- John Muir Health
- Hill Physicians
Hospitals include
- John Muir Medical Center – Concord Campus
- John Muir Medical Center – Walnut Creek
- San Ramon Regional Medical Center
Pharmacy Network
- Walmart
- Walgreens
- CVS pharmacy
Pediatric dental through Liberty Dental Plans. Pediatric vision benefits from EyeMed. Acupuncture services through American Specialty Health.
Search for a Bright HealthCare HMO provider https://brighthealthcare.com/search
Similar to some other health plans, Bright HealthCare is offering up to $200 to members for taking a short survey, selecting a Primary Care Physician, and documenting other health related tasks. Of course, most of the tasks require members to create an online account at Bright HealthCare. The online account usually also provides information related to amounts accrued to meeting any deductible, premium payments, claims, contact information, etc.
Bright HealthCare does not support a dedicated California website. You must make the correct selections to find the information pertinent to Contra Costa County. For example, Bright Health Transparency of Coverage webpage makes reference to out-of-network coverage and balance billing. HMO plans, like the ones Bright is offering, have no out-of-network coverage. If you go out-of-network (excluding emergency life threatening situations), you will be responsible for the full cost of the services.
Bright HealthCare usually holds the Second Lowest Cost Silver Plan spot in Contra Costa County. This means that most consumers will see a Bright HealthCare Silver plans at a very reasonable rate, if not $0 monthly premium. With their current network of doctors and hospitals, there should be minimal risk with selecting a Bright HealthCare HMO plan for 2022.
What About Bright HealthCare Customer Service?
There is a reasonable expectation that Bright HealthCare individual and family plans will fulfill all of their contractual obligations for paying claims and adhering to the member cost-sharing structure of the health plans. The weak spot for some health plans is the customer service department. An understaffed customer service unit can lead to long wait times on the phone or emails not being promptly returned. There can also be issues with prior authorization for medical procedures, durable medical equipment, and prescription medications.
Bright HealthCare does have experience in all of the afore mentioned areas with their Medicare plans. Medicare Advantage plans usually have a dedicated customer service department. Medicare scrutinizes the member service of Medicare Advantage plans. Poor performance can lead to low star ratings, fines, and sanctions.
Of course, Bright HealthCare has only published marketing material for their plans. This marketing collateral – like most of the health plans – is meant to sell the plan and not necessarily crafted to educate the consumer of the ability of the company. For the details of the plan you must read through the Evidence of Coverage documents. I was able to find the evidence of coverage documents for their California plans, listed below.