United Health To Take Over TRICARE West Region 2013

Effective April 1, 2013, TriWest, the current administrator for TRICARE west region, will be replaced by United Healthcare for administration of TRICARE in the west region.  

TriWest recently dropped a 2013 requirement for all premium payments by electronic transfer until UHC takes over the administration.  Premium payments for TRICARE under TriWest can continue by check or telephone.

For those of us on TRICARE, we are hopeful for a smooth and uneventful transition from TriWest to UHC administration.  

TRICARE West Region includes the following states:

ALASKA, ARIZONA, CALIFORNIA, COLORADO, HAWAII, IDAHO, IOWA (EXCEPT FOR THE ROCK ISLAND ARSENAL AREA), KANSAS, MINNESOTA, MISSOURI (EXCEPT FOR THE ST. LOUIS AREA), MONTANA, NEBRASKA, NEVADA, NEW MEXICO, NORTH DAKOTA, OREGON, SOUTH DAKOTA, THE EXTREME WESTERN PORTION OF TEXAS, 

UTAH, WASHINGTON AND WYOMING

Dave

www.davefluker.com

Exchange staff back off eroding essential health benefits

At yesterday’s CT Health Insurance Exchange meeting we learned about an attempt by Exchange staff and the Insurance Dept. to reduce the Essential Health Benefit Package that had been agreed to earlier this year in a contentious but inclusive and public process. Like the last process that rejected active purchasing, this process happened in evening conference calls not open to the public in a very short time frame. This time, however, providers and advocates on the committees voted down the benefit package erosion (active purchasing was not part of the reconsideration) and the staff finally agreed to pull the proposal from the Board committee agenda yesterday. However at the meeting, staff stated that they plan to lobby the fed.s to let them re-consider, and lower, the agreed-upon essential benefit package. The issue is CT mandates for coverage in state law – whether they cost or save money in premiums and how much. A public commenter noted that affordability is very important, but eroding mandates may not work to keep costs down. Active purchasing is proven to reduce costs, but the Board and staff have rejected that proven tool and have indicated no interest in re-visiting that decision. Other news included a strong theme of affordability in the Healthy Chat public events. Staff noted that many people were new faces to health care, not traditional activists. They also noted that people had “done their homework” and were very sophisticated in their understanding of active purchasing and its potential for affordability. The staff is still working on the details of the health plan benefit standards and benefit design, how plans will be rated for innovation and plans for quality monitoring. Advocates will be watching this process carefully for further standards that erode consumer protections, if there is any transparency or opportunities for meaningful public input.

Anthem Blue Cross Raising Medicare Supplement Rates in 2013

Anthem Blue Cross California has announced a rate increase for Medicare Supplement plans for March 1, 2013.  

The following open plans will experience a 5% rate increase March 1, 2013:

Plan F
Plan G 
Plan N

In addition, many standardized closed plans (pre-June 2010) and non-standardized closed plans will experience rate increases on march 1, 2013 ranging from 1.3% to 9.9%.

Open plans are Medicare Supplement plans currently available for sale to California residents on Medicare or going onto Medicare.

Dave
www.davefluker.com

State Decisions For Creation of Health Insurance Exchanges

As of December 14, 2012, 19 states, including California, have declared a state-based exchange for the PPACA.  The District of Columbia, while not technically a state, is included in this number.  7 states plan to run a partnership exchange (combined state/federal exchange) while 25 states (most recently Arizona) will default to the federal exchange and will not create nor set up a state exchange.

The California Health Benefits Exchange will be a state-run exchange and will go by the name 'Covered California'.

States may choose to set up their own exchange, run a partnership exchange with the federal government or do nothing and allow the federal government to run the exchange for that state.

The Kaiser Family Foundation web site has a list which is current as of 12/14/12.  Link below.

State Decisions For Creating A Health Insurance Exchange

Dave
www.davefluker.com

Aetna CEO "Get Ready For Rate Shock" In 2014

From today's Forbes Magazine Blog by Avik Roy.  Aetna CEO Mark Bertolini discusses the likelihood that individual & family rates under PPACA (Obama Care) may experience a large premium increase over the current health plan rates as well as a narrowing of provider networks  and cutting of reimbursement rates to medical providers.


Aetna CEO Bertolini: Get Ready for 'Rate Shock' as Some Health Insurance Premiums to Double in 2014

I am curious to see the 'Covered California' individual & family rates for 2014 however I don't expect them to be available for quite some time as the plan designs for the Qualified Health Plans are still in the infant phase of development.

Dave
www.davefluker.com

Blue Shield CA To Return $50 Million In Premium Credit

Blue Shield of California has announced that the insurer will return $50 million in premium credits for the 2012 2% Pledge.  

From the Blue Shield web site:

As a not-for-profit health plan dedicated to providing access to quality health care at an affordable price for all Californians, Blue Shield of California believes health care is a fundamental right. But access to care will only be achieved if coverage is affordable. That's why we made this pledge: if we earn net income of more than 2% of revenue in any year, we will give back the difference to our customers and the community. Blue Shield is committed to the 2% Pledge, as long as our board of directors determines that the company remains financially solvent, with sufficient funds to make the investments needed to stay competitive. To date, Blue Shield has returned more than $470 million to customers and the community to offset net income earned above the 2% threshold in 2010 and 2011. In 2012, Blue Shield will again fulfill our 2% Pledge commitment and will return $50 million to our customers. The funds will be returned to eligible customers in the form of credits on their billing statement for December 2012 dues/premium.

The 2% Pledge credits will be returned as follows:

Fully insured individual plan (including Medicare Supplement) and group customers will receive a 9% credit on one month's dues/premium Customers with whom we share risk with will receive a 3% credit on one month's dues/premium Self-funded groups are not eligible for the credit, nor are persons covered under certain federal and state government contracts that don’t provide a way to give credits

Customers will be sent a letter notifying them of their credit amount, which is based on their August 2012 dues/premium. Customers must have coverage in effect from August 1, 2012 through December 31, 2012 to receive the credit.

Dave
www.davefluker.com

Blue Shield CA Increase on IFP Rates 3/1/13

Blue Shield of California has announced a rate increase on their individual & family health plans for March 1, 2012.  

Rate increases on some members may be as high as 20% with an average rate increase of 12% across the board.  

LA Times Article

This rate increase comes at a time when recent news of Anthem Blue Cross' (Blue Cross of California) has notified subscribers of a 25% rate increase February 1, 2013 and Aetna has also indicated a rate increase for 2013.  I would expect Health Net PPO to adjust rates as well in 2013.

Dave
www.davefluker.com

More Predictions of Rate Shock Because of the New Health Law

Last week, I reported on my informal survey of health insurance companies and their estimate for how much rates will rise on account of the Affordable Care Act ("Obamacare").

Today, there are press reports quoting the CEO of Aetna with their estimate. The Aetna estimate is worse than mine.

From Bloomberg:

Health insurance premiums may as
much as double for some small businesses and individual

HHS approves CT insurance exchange plan

Along with six other states, CT’s health insurance exchange received approval yesterday from the federal agency providing funding. CT was among the first six states to apply to HHS for approval – 14 states have applied to date. No state’s application has been denied. CT’s exchange has been criticized for their plan to accept any willing plan and refusing to negotiate with insurers to control costs and reduce consumer premiums. CT’s exchange also voted not to conduct a secret shopper survey to monitor whether people who purchase their insurance plans can find a provider. The exchange has also been criticized for having no independent consumer Board members, having Board members with close ties to the insurance industry and for members with insurance company investments.

Conservative States: Do a Partnership Exchange? Expand Medicaid?

Should states build their own health insurance exchanges under the Affordable Care Act (ACA) ("Obamacare")?

Should states expand their Medicaid programs under the ACA?

These are the tough questions many, particularly conservative, states are now wrestling with. While it is too late for a state to now decide to build an exchange before the fast approaching launch date, it is still possible to

The Affordable Care Act: Ten Months to Launch "Obamacare"––Get Ready for Some Startling Rate Increases

What will health insurance cost in 2014?

Will the new health insurance exchanges be ready on time or will the law have to be delayed?

There Will Be Sticker Shock!
First, get ready for some startling rate increases in the individual and small group health insurance marketplace due to the changes the law dictates.

In a November 2009 report, the CBO estimated that premiums in the individual

Outreach recommendations for reform

Small grants, engaging an army of trusted community messengers, ubiquitous marketing, and robust monitoring will be critical to enrolling the estimated 130,000 newly eligible CT Medicaid members in January 2014, according to a report by the CT Health Policy Project. Best opportunities for outreach include small businesses, providers, current HUSKY members, faith-based communities, connecting with employers and other state programs, targeting life transitions, improving application and enrollment processes, and thanking outreach partners. It will require strong, concerted efforts to overcome the program’s stigma and other barriers to enrollment. The report draws on the experience of community organizers, consumer advocates who worked on HUSKY outreach, providers that care for CT’s uninsured patients, and lessons from other states. While aimed at Medicaid, many of the report’s findings also apply to the new CT Health Insurance Exchange. Report