Health Net CA has announced this morning that they have received regulatory approval to sell their new January 1 plans to individuals & families.
Health Net CA (not including the Farm Bureau) will only be offering 3 total individual health plans for January 2011. These include:
*HMO 40
*ValueNet PPO
*Optimum Advantage HSA PPO
That's it folks. I have the rates and paper applications available for use until the online quoting and application system goes live for these plans.
Dave (davefluker.com)
Wednesday, 22 December 2010
Saturday, 18 December 2010
Anthem CA Quote Upload Available Today (New Plans)
The Anthem Blue Cross CA quoting and application system has been uploaded and is currently quoting the new approved individual & family health plans for 2011 (PPACA-compliant).
The new plans quoting include:
*Tonik 5000 PPO
*Premium Plus PPO (six deductible choices)
*PPO Share 3500, 5000 and 7500
*HMO plans
You can get quotes for the current plans via my link
Lumenos HSA plans will not be available for online quoting until approximately January 20, 2011. For more information on Lumenos HSA, send me an e-mail as I have the rates available at this time.
Plans still pending CDI approval are
*Core Guard PPO
*SmartSense PPO
*Clear Protection PPO
*some Lumenos PPO & HSA
Dave (davefluker.com)
The new plans quoting include:
*Tonik 5000 PPO
*Premium Plus PPO (six deductible choices)
*PPO Share 3500, 5000 and 7500
*HMO plans
You can get quotes for the current plans via my link
Lumenos HSA plans will not be available for online quoting until approximately January 20, 2011. For more information on Lumenos HSA, send me an e-mail as I have the rates available at this time.
Plans still pending CDI approval are
*Core Guard PPO
*SmartSense PPO
*Clear Protection PPO
*some Lumenos PPO & HSA
Dave (davefluker.com)
Friday, 17 December 2010
Child Only Health Insurance California 2011 -Anthem Blue Cross Live Blog
I am blogging this live while attending an Anthem Blue Cross conference call. Important news concerning Child-only health insurance coverage in California beginning January 1, 2011 for children under 19.
Per CA AB 2244, children may apply for coverage without a parent being a co-applicant during certain periods. This includes both healthy children and children with pre-existing conditions who need guaranteed-issue coverage. Children receiving guaranteed-issue coverage can be rated up in premium (as of today) but cannot be declined.
The enrollment periods will be as follows:
*January 1,2011 - March 1, 2011 Open Enrollment Period
*The Birthday Month of the Child (regardless of which day in the month)
Outside of these open enrollment windows, children will not be able to apply for coverage on child-only coverage policies. Outside of the open enrollment or birthday month, children will only be allowed to apply with a parent as co-applicant (and the parent must be approved for coverage for the child to be offered coverage).
Anthem will be imposing a 15-day waiting period for effective dates on all individual health plans beginning January 1, 2011. So a child-only PPO application submitted January 1, 2011 will be eligible for a start date of January 16, 2011.
As soon as I find out how the rate-ups are going to be set up for children-only guaranteed-issue health coverage, I will post a blog.
Anthem states that the maximum cutoff age to apply is 18 3/4 years of age.
Per CA AB 2244, children may apply for coverage without a parent being a co-applicant during certain periods. This includes both healthy children and children with pre-existing conditions who need guaranteed-issue coverage. Children receiving guaranteed-issue coverage can be rated up in premium (as of today) but cannot be declined.
The enrollment periods will be as follows:
*January 1,2011 - March 1, 2011 Open Enrollment Period
*The Birthday Month of the Child (regardless of which day in the month)
Outside of these open enrollment windows, children will not be able to apply for coverage on child-only coverage policies. Outside of the open enrollment or birthday month, children will only be allowed to apply with a parent as co-applicant (and the parent must be approved for coverage for the child to be offered coverage).
Anthem will be imposing a 15-day waiting period for effective dates on all individual health plans beginning January 1, 2011. So a child-only PPO application submitted January 1, 2011 will be eligible for a start date of January 16, 2011.
As soon as I find out how the rate-ups are going to be set up for children-only guaranteed-issue health coverage, I will post a blog.
Anthem states that the maximum cutoff age to apply is 18 3/4 years of age.
Wednesday, 15 December 2010
The Democrats Had Better Hope the Supreme Court Overturns the Individual Mandate Before the Middle Class Understands How Bad It Is For Them
This post first appeared as a column at Kaiser Health News
Is The Individual Mandate Really A Lynchpin In The New Health Law?
If the Supreme Court does rule the individual mandate unconstitutional will it really bring down the whole law?
I don't see it.
First, the individual mandate isn't even close to what it has been made to be -- a provision that would protect the integrity of the health
Is The Individual Mandate Really A Lynchpin In The New Health Law?
If the Supreme Court does rule the individual mandate unconstitutional will it really bring down the whole law?
I don't see it.
First, the individual mandate isn't even close to what it has been made to be -- a provision that would protect the integrity of the health
Friday, 10 December 2010
Anthem Blue Cross CA Partial Plan Release 12/10
Anthem Blue Cross has announced that a portion of the health plans held up for approval by the CDI (California Dept of Insurance) have been approved and are available for sale today.
In addition to the 3 HMO plans and PPO Share 3500 and 7500 which were previously approved for sale, the following plans are now available today for quoting and applications:
Premier Plus PPO (1000, 1500, 2500, 3500, 5000 and 6000 deductibles)
Lumenos HSA PPO 1500 (non-maternity)
Lumenos HSA 5000 (with maternity)
Tonik 5000 PPO
PPO Share 5000
PPO Share 1000
Anthem has indicated that plan online quotes and applications for the new plans will be available Saturday, 12/18 and after.
Quotes and plan summaries can be found on my Anthem Plan Finder
Click on "Get Quotes" under "individuals & families" and it will open the planfinder in a new window.
Still pending are:
SmartSense Plus
Core Guard Plus
Clear Protection Plus
Lumenos Plus
In addition to the 3 HMO plans and PPO Share 3500 and 7500 which were previously approved for sale, the following plans are now available today for quoting and applications:
Premier Plus PPO (1000, 1500, 2500, 3500, 5000 and 6000 deductibles)
Lumenos HSA PPO 1500 (non-maternity)
Lumenos HSA 5000 (with maternity)
Tonik 5000 PPO
PPO Share 5000
PPO Share 1000
Anthem has indicated that plan online quotes and applications for the new plans will be available Saturday, 12/18 and after.
Quotes and plan summaries can be found on my Anthem Plan Finder
Click on "Get Quotes" under "individuals & families" and it will open the planfinder in a new window.
Still pending are:
SmartSense Plus
Core Guard Plus
Clear Protection Plus
Lumenos Plus
Thursday, 9 December 2010
Back to the Future—Biggest Health Plans Reported to be Building Their Own Political Coalition
I had a real sense of déjà vu this morning reading Bara Vaida’s story in Kaiser Health News:Five of the nation's largest health insurance companies are taking a key step toward building their own inside-the-Beltway coalition to influence implementation of the new health law and congressional efforts to change it. The companies – Aetna, Cigna, Humana, UnitedHealthcare and Wellpoint – are shopping
Wednesday, 8 December 2010
MLR and Agent Commission (and the future) California
As many of you may have heard, the health insurance carriers have begun announcing commission reductions to agents due to MLR (Medical Loss Ratio) requirements under PPACA. Blue Shield CA just left us all a nice voicemail this evening (after business hours BTW) about commission cuts. The average for an agent is approximately 50% pay cut in 2011 (starting in 3 weeks).
No doubt that is going to hurt and it is possible many agents (especially newer agents) will leave the health insurance business. Veteran agents may be able to withstand the slash on new business compensation because of a large client base of older business which will be, at least for now, uneffected by the cuts.
I have observed in the last few days an attempt by agents, insurance carriers and organizations that train, recruit or mentor agents, to justify this going forward. To the extent that reduced earnings on health insurance would allow fewer agents to achieve higher potential production at lower commission (the overall thought process), certainly there could be a place for those fewer agents to continue to succeed in this business. Except.............
What happens on 1/1/2014? Let's say a savvy agent sets up a staffed call center (the chosen model by the carriers, obviously), hires a bunch of service reps, sub-agents and telemarketers and garners a large volume of sales to achieve the highest commission payouts. That could be a lucrative business model right up to the point where the health insurance exchanges open in 2014. Then what?
Imagine an agent selling 300+ health insurance policies in 2011, 2012, and 2013 (over 900 total) and watching the 900+ clients disappear into an insurance exchange offering no compensation or virtually no compensation to the agent. All of that work for a couple of years of income at already-reduced commissions to see it all evaporate in the blink of an eye.
Now there are agents who are whistling past the graveyard saying "that's not going to happen", "repeal is on the way", "NAHU will protect our earning power." Now, they may be right.
I am inclined to believe what I see, not what I think/hope might happen. Sure changes could be made. Sure a panel could be set up to review agent compensation. Since this change has ALREADY happened (compensation and MLR), the pragmatist in me says to anticipate that the 2014 changes will occur basically unchanged and on schedule.
"Well", some might say, "there will still be a place for agents in the system". Don't be so sure. We are not specifically mentioned in PPACA. At best we are included with navigators like Dept of Fish & Game, Trade Unions, Civic Organizations and the like. It's us, community service organizations and someone spawning salmon in the pond.
The California Health Exchange is a fact. It was passed into law and signed by Gov Schwarzenegger a few months ago. It exists and regardless of what happens with PPACA (ObamaCare), the California exchanges would have to be repealed separately.
The architect of the future California Exchange is the same person who set up the Massachusetts Connector Exchange. I won't mention his name here but you can certainly Google it.
Agent compensation in Massachusetts for indivdiual & family health insurance is..........zero, nothing , nada, bupkiss, the big 'goose egg' (insert your favorite phrase here).
So, the same guy who set up 'the big goose egg' in agent compensation in Massachusetts will be very heavily involved in setting up the California Exchange. Sure, it could be different out here, but are you really willing to bank on it.
Health insurance agents in California will have to make some hard decisions going forward. Some will bury their heads in the sand and hope it all goes away. Some will swear on all that is Holy that big brother NAHU (National Assn of Health Underwriters) and Janet Trautwein will ride in on a white horse to save the day. Some will move on to other things like life insurance. And some will stick it out and try to make the best of a lousy situation over which they have no control.
The bottom line is this for agents: "Am I willing to work twice as hard for half as much with the very real risk that it could all go away anyway in three years?" I wish I had the answer, for myself and for other agents. As of today, I just don't know.
No doubt that is going to hurt and it is possible many agents (especially newer agents) will leave the health insurance business. Veteran agents may be able to withstand the slash on new business compensation because of a large client base of older business which will be, at least for now, uneffected by the cuts.
I have observed in the last few days an attempt by agents, insurance carriers and organizations that train, recruit or mentor agents, to justify this going forward. To the extent that reduced earnings on health insurance would allow fewer agents to achieve higher potential production at lower commission (the overall thought process), certainly there could be a place for those fewer agents to continue to succeed in this business. Except.............
What happens on 1/1/2014? Let's say a savvy agent sets up a staffed call center (the chosen model by the carriers, obviously), hires a bunch of service reps, sub-agents and telemarketers and garners a large volume of sales to achieve the highest commission payouts. That could be a lucrative business model right up to the point where the health insurance exchanges open in 2014. Then what?
Imagine an agent selling 300+ health insurance policies in 2011, 2012, and 2013 (over 900 total) and watching the 900+ clients disappear into an insurance exchange offering no compensation or virtually no compensation to the agent. All of that work for a couple of years of income at already-reduced commissions to see it all evaporate in the blink of an eye.
Now there are agents who are whistling past the graveyard saying "that's not going to happen", "repeal is on the way", "NAHU will protect our earning power." Now, they may be right.
I am inclined to believe what I see, not what I think/hope might happen. Sure changes could be made. Sure a panel could be set up to review agent compensation. Since this change has ALREADY happened (compensation and MLR), the pragmatist in me says to anticipate that the 2014 changes will occur basically unchanged and on schedule.
"Well", some might say, "there will still be a place for agents in the system". Don't be so sure. We are not specifically mentioned in PPACA. At best we are included with navigators like Dept of Fish & Game, Trade Unions, Civic Organizations and the like. It's us, community service organizations and someone spawning salmon in the pond.
The California Health Exchange is a fact. It was passed into law and signed by Gov Schwarzenegger a few months ago. It exists and regardless of what happens with PPACA (ObamaCare), the California exchanges would have to be repealed separately.
The architect of the future California Exchange is the same person who set up the Massachusetts Connector Exchange. I won't mention his name here but you can certainly Google it.
Agent compensation in Massachusetts for indivdiual & family health insurance is..........zero, nothing , nada, bupkiss, the big 'goose egg' (insert your favorite phrase here).
So, the same guy who set up 'the big goose egg' in agent compensation in Massachusetts will be very heavily involved in setting up the California Exchange. Sure, it could be different out here, but are you really willing to bank on it.
Health insurance agents in California will have to make some hard decisions going forward. Some will bury their heads in the sand and hope it all goes away. Some will swear on all that is Holy that big brother NAHU (National Assn of Health Underwriters) and Janet Trautwein will ride in on a white horse to save the day. Some will move on to other things like life insurance. And some will stick it out and try to make the best of a lousy situation over which they have no control.
The bottom line is this for agents: "Am I willing to work twice as hard for half as much with the very real risk that it could all go away anyway in three years?" I wish I had the answer, for myself and for other agents. As of today, I just don't know.
Monday, 6 December 2010
What Would Happen If You Were To Pass a Big Health Care Bill Without Bipartisan Support?
During the recent health care debate I heard many people on both sides of the debate worry out loud about passing a heath care bill that did not enjoy broad support.I guess this question is no longer a theoretical one.December will be a big month when it comes to seeing some of the fallout accruing from the very partisan passage of the Patient Protection and Affordable Care Act.First, the White
Friday, 3 December 2010
"Care and Cost"
Good friends David Kibbe and Brian Klepper have finally started their own blog--aimed at becoming a forum for many contributors to the health care debate.I suggest you add, "Care and Cost"––"Health Care Conversations About Hard Choices and Emerging Solutions" to your bookmarks.
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