Blue Shield CA Agrees To 60-Day Rate Hold On Individual Plans

Blue Shield of California (and Blue Shield Life & Health) announced this afternoon that the company will abide by the request of Insurance Commissioner Dave Jones and hold the March 1, 2011 rate increase for 60 days so that the rates can be reviewed.

Late last week Blue Shield stated that they were satisfied with the rate increase and would not honor the request of the CA Insurance Commissioner.

For those with Blue Shield CA individual & family health plans who are not in your initial rate guarantee period, your rates will not be increasing on March 1 as projected.

Blue Shield will notify agents as to when, if and by how much the rate increase will actually go into effect.

Anthem Blue Cross CA Finally Gets Approvals!

Just received a voicemail from Anthem Blue Cross California that the plan portfolios held up by the California Dept of Insurance have finally been approved.

These plans have been pending approval since September 22, 2010.

According to the voicemail the new plans (all PPACA-compliant) will be available for sale tomorrow (1/14/11) to the public.

I will update this post with the particulars of the plans now available as soon as I receive the written confirmation in the morning.

Health Net CA Individual Plans Approved!

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.

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

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.

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

Health Net CA Blackout Coming Up

Health Net of California has announced a blackout for individual & family coverage plans (IFP) in a couple of weeks. The blackout will be lifted when the new PPACA-compliant plans are approved and available for January 1, 2011.

The blackout will occur on November 18th (online quoting), and the last day to submit applications for December 1, 2010 start dates will be November 22nd. Any applications received after 11/22 will not be processed.

Any application submitted on or before 11/22 that is not approved and enrolled by 12/10/10 will be cancelled and returned to the applicant.

Health Net CA will advise agents as to the progress of the PPACA-compliant plans and at what point applications and online quoting will be made available after the blackout.

This blackout does not effect HIPAA plans, only underwritten coverage plans.

LA City Attorney Sues HealthMarkets

The Los Angeles City Attorney's Office has filed a lawsuit against HealthMarkets, Mega Life & Health, Midwest National and has included Goldman Sachs and Blackstone Group.

The lawsuit alleges, amongst other things, deceptive sales practices, inadequate insurance coverage and intentionally misleading marketing practices.

Read the story here

October 1 Rate Increases on Individual Health

October 1 will see major rate increases by both Anthem Blue Cross and Blue Shield of California.

Blue Shield will average 18.2% increase but some age groups may experience rate increases as high as 50%!

Anthem Blue Cross will average 14% with a max rate of 20% increase.

Interesting article from today's Sacramento Bee.

In addition, Anthem Blue Cross has currently blacked out all individual and family health plans for new enrollments on 9/23 and after to replace the current plans with newer, PPACA-compliant plans. I have heard rumors that we may see the end of lower-deductible versions of some plans in favor or high and very high deductibles to offset preventive benefits and childrens guaranteed-issue.

California Health Insurance Legislative News (Lots of it!)

Big day in Sacramento today. And with 8/31 deadlines looming, we will likely see more activity.

California AB 1602 (Perez) and SB 900 (Alquist) has passed and is awaiting the Governor's signature to make it law. AB 1602 sets up the California health insurance exchange. I expect this to be signed as Gov Schwarzenegger indicated earlier this year that he wants the exchange model set up before he leaves office.

SB 900 sets up the exchanges, and AB 1602 which is a companion bill delineates the specific duties of the exchange.

AB 1825 has passed the Senate and now goes back to the Assembly for final action. AB 1825 requires mandatory maternity benefits on all health plans sold in the individual market.

AB 2244 prohibits insurers from refusing coverage to children simply because they have a pre-existing condition. AB 2244 also goes back to Assembly now for final action.

Other Bills to watch:

SB 890 (Alquist) - sets requirement for health plans to offer only 5 plan designs either inside or outside of the exchange. Gold, Silver, Bronze, Platinum and Catastrophic.

AB 2345 (De La Torre) - prevents insurers from charging an additional co-pay for cancer screenings and other types of preventive care

AB 2042 - (Feuer) - prohibits insurers from raising premiums more than once per year.

CA Individual Plan Upgrades (PPACA)

As of today, this is what I am being told regarding individual & family health plan updates to comply with PPACA benefit requirements.

Anthem Blue Cross upgrading for 9/23 currently blacked out pending approvals (no plans currently available for sale after 9/22 start dates).

Blue Shield, Health Net and Kaiser are all targeting plan change dates of 1/1/11 to upgrade new plans to PPACA compliance. Their current plans will be available for purchase through 12/31/2010.

Exising plans purchased before these upgrade dates will also be upgraded, but each carrier will decide when and how the upgrades will occur. They can either upgrade on the renewal month of the plan or at one time.

PPACA Update on Existing CA Plan Upgrades

I wanted to add that it may happen that some or all carriers choose to make the PPACA-compliant changes to existing plans on one unified date. Likely this will be the portfolio renewal date.

So, it may be that your existing pre-9/23 healthcare plan gets the upgrade at the renewal of your plan anniversary or on January 1, 2011.

Realistically it makes more sense cost- and logistics-wise for a carrier to make the unified upgrade instead of spacing them out over a period of 12 months.

I will post when I receive clarification from each carrier on how they intend to process the upgrades to existing coverage plans.

Welcome To The Blackout

As of today, individual and family health plans in California can only be purchased with start dates of 9/22/10 and prior. There are literally no health plans available for sale starting 9/23 or after at this time. Several carriers have already shut down online quoting for start dates of 9/23 and beyond, pending the regulatory approval of the new, PPACA compliant plans. All health plans for "new enrollment" sold 9/23 and after must meet the PPACA guidelines which include such things as no-cost preventive care, no lifetime maximums nor annual maximums and child GI coverage ages 0-18.

All of the IFP carriers have submitted new plans to the two regulatory bodies, DMHC and CA DOI for approval. Now the waiting begins until the new plans are approved for sale to the public. This could be very soon or could take a few more weeks. I will advise once plans begin to be made available.

HIPAA plans are also included in the "transformation", so anyone with a HIPAA eligibility date of 9/23 or after will need to hold tight until the plans are available for 10/1 and after.

It is my hope that the regulatory agencies work quickly to approve the new plans. If they are slow, it is possible (not probable, but possible) that there could be a period 9/23 and after with no plans available. I am especially concerned about HMO plans as the DMHC has been slow to approve new plans in California.

I suspect most carriers will choose not to re-invent plans and portfolios, but to make PPACA-compliant changes to existing plans/portfolios. Unfortunately, we will have to wait and see what will be available.

PPACA Update

It appears that Anthem Blue Cross and Health Net are planning to re-tool their individual and family plans products for 9/23.

Anthem will close online quoting for any plans with a start date of 9/23 or after on Saturday (8/14). Online quoting will resume once the plans are filed and approved.

Health Net CA is currently not quoting any plans with effective date of 10/1 or after. Probably a similar change-over.

Blue Shield CA has taken a different interpretation of PPACA. The law allows carriers to make the change-over on 9/23 OR at the next subsequent product renewal cycle. Blue Shield CA has its next cycle on Jan 1, 2011 and intends to hold off on all PPACA compliant plan changes until January. My understanding is that this will include the preventive benefits AND guaranteed-issue coverage for children 0-19.

PPACA Preventive Benefits

Under the PPACA (aka Obamacare), effective 9/23/10 all new health plans available on or after that date will be required to provide certain preventive benefits at no cost to the subscriber.

As noted in my earlier blog, Anthem Blue Cross CA has already begun the process of plan re-tooling and, as of today, you cannot view any plans that will be available on or afte 9/23. I expect the other CA IFP carriers to follow this lead.

Here is a link to the PPACA Preventive Benefits List.

Anthem CA Re-tooling For Obamacare

Effective August 14th, quoting for individual health plans will only be available for start dates of Sept 22 or before. If you request an effective date on or after Sept 23, the system will have a pop up message stating that no plans are available for the requested effective date.

Anthem is currently working on the mandatory changes and rates for plans to be sold Sept 23 and after. Plans sold on or after Sept 23 must meet new guidelines as outlined in the PPACA legislation.

I will post when the new information is available for quoting.

Anthem Blue Cross CA Security Breach Update Pt IV

Further updates regarding the security breach of Anthem's online application tracker program.

As of today, 470,000 individual subscribers have been notified of a potential compromise. 230,000 are in California, the rest across the various Anthem states.

There are some disturbing bits of information surfacing.

Apparently the breach went on for quite some time and was only discovered in March when an attorney who breached the system filed a class action lawsuit regarding the breach. I have at least two clients who were breached as far back as November, 2009.

Perhaps the most troubling is that, according to the Atlanta Journal-Constitution, a company investigation has yet to identify 10 computer addresses (IPs) that accessed information. This is of concern as this would indicate that these 10 breaches were not conducted by the attorney(s) and are IP addresses of unknown hackers.

I will update when I receive additional information. Questions for California subscribers should be addressed to Anthem individual membership at 800-333-0912.

Some current press articles on the Wellpoint/Anthem breach:

Reuters

Associated Press

Anthem Security Breach Update

Article from the Orange County Register indicating that more than 200,000 affected so far by the security breach of the Anthem Blue Cross Online Application Tracker.

Orange County Register Article

According to the article, the attorneys who breached the system have returned all of the improperly obtained private information to a custodian of the court system. I expect that means that everyone who was affected by the breach can be assured that their private information is now safeguarded.

For clarification to the majority of my clients, this security breach does not impact HIPAA applications (nor small group). The application tracker program allows applicants (and apparently others) for individual & family plans to view a PDF of the electronic application. This PDF file contains the full application information including PHI and financial information.

HIPAA applications, like other "paper" applications, are not rendered to PDF for viewing and list on agent services as "application not submitted online -- not available for viewing". They are also not eligible for the application tracker program even though an e-mail is generated indicating it's availability.

Anthem Security Breach Update

I have a couple of updates regarding the security breach of the Anthem Blue Cross "Application Tracker" system.

1. Anyone who submitted an application for a minor child/children only that was breached and has received ID theft protection for the minor(s) will, if there was information breach for the parent/guardian, also receive the protection. Anthem is currently sorting applications on minors-only to determine if any breach of the parent/guardian information also occurred. This may take a bit of time as the original determinations were made based on the applicants. Anthem will have to research applications in full to determine who else may have had PHI or private information compromised in regard to that application. You can contact member services at 800-333-0912 at Anthem Blue Cross for assistance.

2. It is important to bear in mind that, while Anthem Blue Cross has ultimate responsibility with regard to this hacker manipulation, the responsible party(s) is/are mainly attorneys who are looking to file a law suit against Anthem. Yes, the carrier is ultimately responsible for 100% security of your information, as are we agents.

3. I have never really understood the need for an "application tracker" program in the first place. Anthem has provided this "link" to track you own application online and, unfortunately, this is an unintended result. The application generates e-mail updates (which are secure) at any change of application status for any applicant who provides a valid e-mail address. Since you have to provide a valid e-mail address and select opt-in on e-mail notification to even receive the application tracker link, you will automatically receive the e-mail updates anyway. Unless you have a burning desire to view the PDF of your application, anything else will automatically be communicated by secure e-mail, thus rendering the application tracker program redundant.

This hack was not of an agent's database or agent log in access to the insurance company web site. This hack was on a program designed to let anyone who applies for individual coverage online with Anthem to track their own application. It is not necessary unless you have applied direct with the carrier since your independent agent will be monitoring progress and advising you (or should be!).

Blue Shield CA To Hold Current Rates For July 2010

Blue Shield of California announced today that the company would make no rate or benefit changes to individual & family health plans in California at this time.

Blue Shield's "product cycle" normally allows adjustments of rates and plan benefit changes two times per year, in January and July.

Communication to agents indicates that everything will remain as current in terms of price and benefits until the next product cycle, which will be announced at a later date.