Understanding California Health Care Reform / Obamacare / Affordable Care Act / ACA

September 6th, 2013

We’ve prepared easy-to-understand videos that explain the new health care reform law (Affordable Care Ace, ACA, Obama Care). Topics include how to complete the required notices (Exchange, SBC & Glossary); an overview of individual and family coverage including Covered California; and problems of the current system that the ACA solves.

Covered California Small Business Health Options Program (SHOP) Exchange Rates

August 13th, 2013

Given the rates SHOP released and the new rules for rating individual and small group health insurance, I am led to the conclusion that some small groups (and individuals) will likely pay much more than they currently do – while some may pay less.

Covered California (Exchange) Announces a Few Individual Rates

May 24th, 2013

Today, May 23, 2013, the California Health Benefit Exchange, Covered California, released the 2014 individual health plan rates for 25 and 40 year olds. As they said in their press release, “it is impossible to make a direct comparison of these rates to existing premiums in the commercial market.” Still, at first glance the rates don’t look too high – but there..

Health Care Reform Update: Action in Sacramento

May 17th, 2013

Much is in flux with the ACA and we should accept that many good questions do not have answers – yet. Michael Lujan, Director of Sales and Marketing for Covered California 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. ”

Health Insurers to Continue Medical Underwriting in 2014 Despite ACA Prohibition

April 19th, 2013

It is my understanding that the Affordable Care Act (ACA) forbids medical underwriting in the individual and group markets beginning in 2014. However, today, April 18, 2013, I attended a panel discussion of large group health insurance carriers , where representatives from Aetna, Anthem Blue Cross, CIGNA and Health Net all stated that they would continue to medically underwrite groups with 50 or more employees.

CA Exchange Website Could Spell Trouble for Insurers & Consumers

April 15th, 2013

On April 8th, 2013 Covered California/exchange/HBEX held a webinar for agents to describe their online enrollment process. Buried at the end of the presentation, slide 37 of 39 slides, was a screenshot of the page someone will see when he/she goes online to select a health insurance plan through Covered California. Bad news for consumers who want a […]

California Exchange (HBEX) Shocks Insurance Industry with Selection of SHOP Administrator

April 8th, 2013

California’s Health Benefit Exchange (HBEX)  also known as “Covered California,” sent an email to agents on Friday, April 5, 2013 to announce that they had selected Pinnacle Claims Management, Inc. to run the California SHOP exchange for small businesses. This shocked many in the insurance community including carrier reps, general agents and agents because most […]

Price War for California Small Group Health Insurance

March 21st, 2013

California insurance companies are engaged in a price war for small business health insurance.  I never thought that I would ever write that sentence. However, it’s true. As I previously reported on this blog, Health Net started the war in January 2013 when they offered ANY group with 6 or more employees the lowest rate (RAF […]

Enroll in Medicare or Stay on Your Employer’s Health Plan – a Helpful Guide

March 13th, 2013

I’ve just written a helpful guide for people who continue to work and must decide whether they should enroll in Medicare or stay on their employer’s group medical plan. It turns out that the decision is a bit complicated and the answer depends on:
•who’s paying for the group plan (employer or employee);
•whether the employee also has dependents enrolled on the group plan; and – oddly enough –
•how much the employee earns…

The article is sprinkled with a few funny things – so it’s not as dry as you might imagine. If you’re in this situation or if you know someone who is, you should read the article. Learn more by clicking on the link above.

Health Net Special Offer for Low Rates to Most Small Groups in California

March 1st, 2013

Health Net of California is guaranteeing small group employers (2-50 employees) with the lowest rate possible. New groups that enroll 6 or more employees in a Health Net plan will receive the lowest possible “Risk Adjustment Factor” (RAF) of 0.90. Health Net’s RAF Special expires April 15, 2013.