Healthcare Plan Renewal Loophole Divides CA Insurers

Interesting article in today's LA TImes regarding whether or not the state will allow any carrier selling California individual & family health plans in 2014 to reset a December 2013 renewal on non-compliant non-grandfathered health plans to "ride it out" for all of 2014.

The Covered California health plan solicitation requires those plans providing exchange coverage to terminate their non-grandfathered individual health plans by the end of 2013.  Any carrier not participating in Covered California that intends to sell plans outside of the exchange is not bound by this solicitation rule.

The primary concern with this strategy is that carries who do not terminate in 2013 may cherry pick young healthy people and offer them the option to keep potentially lower plan rates for an extra year.  Given that the participation of these same young healthy individuals is critical to the success or failure of Covered California in the short term, this could create a large problem down the road.  

Many of these young healthy people will be subsidy-eligible to buy from Covered California and would lose out on a year of subsidized health insurance by electing to play this extended renewal game.

Dave
www.davefluker.com

Agents, Shmagents! LA Unified to Empower Students to Sell Obamacare

In a June 20 Heartland article, the Los Angeles Unified School District received almost $1 Million in grant money from Covered California to teach students how to sell Obamacare plans to their families and friends.  Apparently the students, in addition to learning the three Rs, are going to be schooled in the ways of Obamacare, PPACA and Covered California so that they can act as "messengers to their own families".  It also appears that in addition to students, staff and perhaps even teachers will be involved in selling health insurance plans for Covered California.

LAUSD will also use tax-paid staff to promote ObamaCare through phone calls to students’ homes, in-class presentations, and meetings with employees eligible for ObamaCare’s taxpayer-covered healthcare, the grant award says.

If the project is successful, Los Angeles families can expect more use of students to push government-preferred messaging.

“Teens are part of a ‘pilot’ program to test whether young people can be trained as messengers to deliver outreach and limited education to family and friends in and around their homes,” said Gayle Pollard-Terry, a LAUSD spokesman, in an email. “Teens will be educating adults that they already know (e.g., family or friends) and not other adults.”

Unlicensed Navigators, unlicensed Direct Benefit Assisters and now unlicensed high school students and staff.  All selling health insurance and not accountable to the California Dept of Insurance for market conduct or sales activities.

And of course agents, the only licensed assisters out there, have to wait until the absolute last minute before the health insurers (of which there won't be even a handful) condescend from on high to tell us what they might actually pay us to sell this stuff.  

I am all for outreach and I understand that certain groups/areas may be underserved currently, but I wonder where the accountability for this is going to rest when mistakes are made (and they will be made, agents carry E&O insurance exactly for that reason).


Dave
www.davefluker.com

Will the Affordable Care Act's ("ObamaCare") Federal Health Insurance Exchanges Be Ready On Time? Finally the Facts!

After months of speculation on just where the Obama administration is toward the development of the new health insurance exchanges, the Government Accountability Office (GAO) has issued a 48-page report complete with timelines and a detailed report on just where the Obama administration is––or at least was last month.

The key summary:



"Much  progress  has  been  made,  but  much  remains  to

Aetna Suspends Individual Health Sales in California July 1

Aetna has announced this morning that it will suspend any further sales of individual & family health insurance in California effective July 1.

This follows on to the announcement on Saturday that Aetna would be (again) abandoning the California Individual Health Market.

Effective July 1, 2013, Aetna will no longer offer Aetna Advantage Plans for Individuals, Families and the Self-Employed in California.

After reviewing our individual health insurance plans in California, we determined we can no longer meet our customers' needs and remain competitive in that market. A number of factors were considered in making this decision. While it was a difficult decision, in keeping with the best interests of our customers, we believe there are other insurers that can better meet their needs

Aetna is no longer accepting applications for California health insurance for both individual underwritten coverage and HIPAA.

Dave
www.davefluker.com

Aetna Pulling Out of California Individual Market

The Wall Street Journal is reporting that Aetna will stop selling individual & family coverage in California by the end of 2013.  

Aetna leaving individual insurance market in California, WSJ says
As the federal health law is set to reshape the insurance market in 2014, Aetna will stop selling health insurance to individual consumers in California at the end of 2013, says the Wall Street Journal.

 I will advise if and when I receive information on how Aetna plans to handle in-force grandfathered health plans for individuals & families.  I would suggest anyone with an Aetna individual health plan be prepared to move onto new Obamacare compliant coverage on January 1, 2014.

Wall Street Journal Article

Dave
www.davefluker.com

Will the Affordable Care Act's Health Insurance Exchanges Be Ready On Time? The Obama Administration's Top Secret Enterprise

Last week, I received my weekly email update from the Maryland health insurance exchange:



Maryland Health Connection completed its Final Detailed Design Review (FDDR) live system demo on Thursday, May 30. The FDDR is a federal stage-gate required of all state-based exchanges. Maryland Health Connection successfully demonstrated end-to-end enrollment of a split family scenario including user

Flawed Analysis––Medical Loss Ratio Rules Led to $1.9 billion in Lower Premiums

The Kaiser Family Foundation is out with a study contending that the Medical Loss Ratio (MLR) requirements of the Affordable Care Act ("ObamaCare") saved consumers $1.9 billion in premiums in 2012:

"So how might these (new MLR requirements) changes have affected premiums? As noted above, one way to address this question is to compute what these consumers would have paid in premiums in 2011 and

Intern Academy agenda updated

The agenda and speakers list for the June 18th CT Health Intern Academy have been updated. Free and open to anyone interested in learning more about health policy, the event will be June 18th, from 9:30 am to 2 pm at the Legislative Office Building. The agenda includes panels on Health Policy Trends, State & Congressional Advocacy, Health & the Media, Networks & Collaboration and a tour of the Capitol. Speakers include State Comptroller Kevin Lembo, along with small business, nonprofit, lobbying, insurer, broker, policy and fiscal analyst, provider, state legislative and Congressional staff, state agency, community organizer, reporter and social media experts. Lunch and parking are available, but registration is required. The Academy is made possible with support from the CT Health Foundation. For more information, visit www.cthealthinern.org.

Bill directing exchange to negotiate premiums died on House calendar

SB-596, a bill that would have implemented active purchasing in Connecticut’s health insurance exchange, died yesterday without action by the House on the last day of the session. The bill passed the Senate last week. The bill directed exchange staff to negotiate premiums with insurers. Negotiations in California and Massachusetts’s exchanges have kept costs down for consumers and small businesses. According to reports, the insurance industry lobbied heavily against 596. Members of the House worked hard to pass the bill, but were overridden by leadership. Exchange staff was not supportive of the bill. The administration agreed to language in a budget implementer bill that the exchange “may” negotiate premiums with insurers, a largely meaningless move. But in the end, an amendment was added removing even that language.

Anthem proposed rates for inside and outside exchange filed

Yesterday, Anthem’s proposed 2014 rates were posted on the insurance department’s website. Proposed base rates (costs for an average 21 year old in an average plan before adjustment for age, geography and benefit plan) average $296.49 and $440.30 per month for individuals and small businesses respectively. Rates reflect an 8.6% increase over 2013. These averages are for products inside and outside the exchange. Consumers will compare these rates with those proposed by HealthyCT, ConnectiCare and Aetna at $427, $397 and $364 per month for individuals. It is not clear that these numbers compare apples to apples.