CA Health Care Reform Update

The new Covered California Health Insurance Exchange is on target to begin enrollment on October 1, 2013.  Insurance plans will be offered through the state exchange and outside of the exchange.  The primary reason for buying through the exchage is that income relative premium subsidies may be available to those who qualify.  Following are some important points to note about the changes forthcoming relative to healthcare reform:

• Those who currently possess a health plan from an insurance company participating in the exchage will have to change to a health care reform compatible plan by 12/31/2013 or be moved to the closest available plan by the insurance company.  In Orange County, the companies participating in the exchange include Anthem Blue Cross, Blue Shield, Health Net and Kaiser.  For other counties, you can visit the Covered California website to determine the participants.  The exception to this is that if you have a "grandfathered" plan issued prior to 3/23/2010, you will have to do nothing.
• Open enrollment for 2014 individual health plans runs from 10/1/2013 through 3/31/2014.  You will not be able to enroll in a new plan after 3/31/2014.
• Covered  California will be hiring enrollers and facilitators as well as utilizing independent brokers to assist in enrollment.  However, enrollers and facilitators are non-licensed personnel and cannot assist in comparing plans and helping you decide which plan is best for you and your family.  Only licensed insurance brokers and personnel can assist in comparing plans.
• There will be an analysis tool available for us to use in helping you determine whether you are available for a subsidy and to compare available health plans.

Brokers must beciome certified to represent the Covered California Exchange just as we are
certified and appointed to represent individual insurance companies.  This certification is set to
begin in early September.  I will be certifying myself and additional personnel to assist you in procuring the best plan value for you and your family.  We should be able to start the analysis process around October 1.  We will be reaching out to our clients, however it will be very helpful if you can contact us after mid-September to set up either a telephone or personal appointment to review options.

 

Small Group Health Plans and Covered California

 
We do not anticipate major change in the small group marketplace during the end of 2013 and
the first half of 2014.  Covered California will offer small group plans, however the only companies participating in L.A. and Orange Counties are Blue Shield, Health Net and Kaiser
Permanente.  Most companies are allowing an early renewal 12//1/2013 at current December rates to lock in the rate through 11/30/2014.  Please contact us for more information on the early renewal program.  We do not foresee much rate instability in the small group market for year 2014.

 

Summary

 
There will be much advertising and propaganda directed at consumers through the end of the
year promoting the Covered CA Health Insurance Exchange.  This source may work well for some but not so well for others.  I have taken the philosophy of trying to assist and maintain my current client base as opposed to hiring telephone solicitors to pursue new business.  I hope to work as your partner in assisting you in maneuvering through this new Health Insurance Maze and obtaining the most value and cost effectiveness in your health insurance policy.  Once we have accomplished this, I will appreciate your serving as my sales force and referring me to your friends, neighbors and business associates who need assistance. Please call or email me if you have questions.

 

Article on Obamacare - The Orange County Register

Obamacare will see you now | insurance, people, health - News - The Orange County Register

A new Obamacare flaw: Many could face a precipitous ‘subsidy cliff’ as income approaches certain limits | AEIdeas

A new Obamacare flaw: Many could face a precipitous ‘subsidy cliff’ as income approaches certain limits | AEIdeas

Health overhaul may contain surprises | health, insurance, care - Business - The Orange County Register

Health overhaul may contain surprises | health, insurance, care - Business - The Orange County Register

Health law shift may flood exchange | health, people, income - Business - The Orange County Register

Health law shift may flood exchange | health, people, income - Business - The Orange County Register

The Politicians Versus the Health Insurance Industry

Personally, I am sick of the adversarial relationship between politicians and the health insurance industry. Everyone is promoting their own agendas. The insurance companies keep raising rates in order to make profits, and the insurance commissioner of California continues to make ludicrous politically motivated comments about the big bad health insurance companies. Would it not make sense for a coalition of these people to sit at the same table and figure out a way to offer affordable health insurance to this country instead of creating questionable programs that may continue to drive rates higher? The people I work with and talk to want one thing, and that's for their health insurance rates to be more affordable. 

 

Instead of striving to reach this objective, everyone is playing a game of one-upmanship, and the consumer winds up getting shafted.  The biggest challenge for the near future is separating truth from fiction, as we are about to be bombarded with a multi million dollar advertising program from the State of California regarding the new Covered CA health insurance exchange.  Whether it's me or someone else, please consider working with a knowledgeable person who can help you sift through this new health insurance maze.

California’s Modest Rates: Behind the Numbers

by: Bruce Shutan

June 6, 2013

 

A 40-year-old Californian reportedly would pay anywhere from about $40 to $300 per month for a mid-level health plan in the state’s HIX, depending on the individual’s income. But there’s more to the story than these modest numbers reveal.

Anthony Wright, executive director of the advocacy group Health Access, recently told Reuters that the premium projections represent “a revolutionary improvement to move from a broken market where people are charged by how sick they are, to a competitive market where people pay what they can afford, based on a percentage of their income, on a sliding scale.”

Not exactly, according to California Republican Assemblyman Dan Logue, who compared the rates to “a shell game” and predicted that a tax hike would be needed to fund subsidies, which would trigger higher prices at the gas pump, grocery store and other venues.

Thirteen of the more than 30 health insurers that had applied to participate in the California Health Benefit Exchange will offer coverage in the HIX. Peter Lee, the exchange’s executive director, has noted that residents can expect to pay up to 29% less than current rates for small businesses.

The public exchange rates being reported in California and some other states across the U.S. do not necessarily reflect what individuals may pay once their age, location, smoking status and income are all factored into the mix, cautions Robert Zirkelbach, a spokesman for America’s Health Insurance Plans. Another consideration is the regulatory environment that’s in place in each of these states.

“Many people are going to be required to purchase coverage that’s much more comprehensive, but also more expensive than what they’re purchasing today,” he says. A recent Milliman report estimated that premiums could climb an average of 30% next year for many of the roughly 1.3 million middle- or higher-income Californians with individual-market coverage.

Conspicuously absent from the recent announced rates in California is how they compare to what people are paying today, which Zirkelbach says could vary significantly from one individual to the next. Some young people, however, are expected pay nothing at all, depending on their earnings, while others will qualify for subsidies to help finance their coverage.

One bright spot is that market forces are already shaping the HIX model. “We’re seeing plans offer a variety of innovative benefit packages in a lot of these exchanges, including a high-value provider network, as well as programs that promote prevention and wellness, and coordinate care for patients with complex medical conditions,” Zirkelbach observes. The underlining goals are to improve care, while also making coverage more affordable, he adds.

Concern has been voiced about a lack of HIX competition in some states, such as Alabama and Alaska, where certain health insurance carriers dominate those markets. But Zirkelbach explains that “just because one health plan has large market share doesn’t mean there’s not competition in the marketplace or there are not choices for consumers.”

He points to a variety of coverage options from different health plans as well as multiple policies being available within any given carrier – information that’s easily accessible at www.healthcare.gov and categorized by Zip code.

Bruce Shutan is a Los Angeles freelance writer.