Health Care Reform Update: Action in Sacramento

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Health Care Reform Update: Action in Sacramento

I just returned from a 2 day trip to Sacramento where I met with leaders of the health insurance industry, legislators and Covered California, the health benefit exchange. The meeting was sponsored by the California Association of Health Underwriters (CAHU), the association of health insurance agents and brokers.

Michael Lujan, director of sales and marketing for Covered California, was a key note speaker at the event. Before his presentation to the group I had an opportunity to speak with him about some of my concerns about “Smart Sort,” the health plan selection tool that Covered California will use to help individuals chose a medical insurance plan. Michael assured me that they will be testing the site and that the algorithms in the selection process will fairly allocate members to all plans, a fear that I raised in an earlier blog post.

I also had an opportunity to meet with David Zanze, president of Pinnacle Claims Management. Covered California selected Pinnacle to coordinate all of the quoting and enrollment for the SHOP small business exchange – a huge task with very little time. David told me that they will be working closely with the companies that provide quotes for agents to ensure that the Covered California SHOP plans appear when we seek quotes for small group clients. By including Covered California rates, benefits and provider networks in the quoting systems of agents, we will be able to easily offer Covered California as an option to our clients.

Michael Lujan, Director of Sales and Marketing Covered California, Bruce Jugan, President BenefitsCafe.com, David Zanze President Pinnacle Claims Management

In Michael’s presentation to CAHU, he said something that struck me as particularly insightful.  He advised us to “get the facts.” We should be comfortable saying: “here is what we know now and here is what has not been determined. We don’t have the information to answer all of the questions… at this time. ”  Much is in flux with the ACA and we should accept that many good questions do not have answers – yet.

Michael stressed that Covered California is an “active purchaser” and has required each insurance company (“Qualified Health Plan” QHP) that applied for inclusion in the exchange to offer a unique value to consumers.  Michael explained that many of the QHPs are regional and may only offer coverage in a few counties inCalifornia.  Agents are accustomed to representing health insurance plans that offer coverage throughout the state. That will change.

Aside from Michael’s remarks, I know that approximately 33 QHPs submitted letters of interest to Covered California for inclusion into the exchange.  This number is vastly more than the big 6 or 7 health insurance companies currently offering coverage in California (Aetna, Anthem Blue Cross, Blue Shield of California, Health Net, Kaiser, United Health Care and See Change).  Interestingly, Aetna and United Health Care have announced that they will not participate in the California Exchange (HBEX).

Michael also stressed that Covered California must be financially self-sustaining by 2015. At this point I had to leave Michael’s presentation because I had an opportunity to meet with Assembly Member Cristina Garcia, the newly elected representative of the 58th Assembly district, which includes Montebello, where BenefitsCafe.com is located.

Assemblymember Cristina Garcia, Bruce Jugan President BenefitsCafe.com

Assembly Member Garcia expressed concern that the Affordable Care Act (ACA) will offer many people access to health insurance yet these people may not know how to enroll.  Like the leaders of Covered California, Assembly Member Garcia wants people to obtain accurate information so that they can make wise choices regarding their health insurance.  To accomplish this, she and her staff will organize meetings in the 58th Assembly District to help educate individuals and businesses about the ACA.

I left Sacramento with the knowledge that many hard working; intelligent people are collaborating to ensure that health care reform happens as smoothly as possible California.  I think that they may just make it happen. I know that I will do my part to help.

2018-02-04T13:11:24+00:00 May 17th, 2013 |Categories: ACA, Covered California, Health Benefit Exchange, Health Insurance Reform, Small Business Articles|