February 3rd, 2012 by Sandra
Many of us would rather do almost anything else instead and so rush through the process and simply pick whatever plan looks like it is a good deal at the time. But even the most popular plan from a top rated insurer like Anthem Blue Cross California health insurance can end up costing you big financial headaches if you do not spend a little time paying attention to the fine print. Here are two surprises to avoid.
1) Check the network.
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Two Surprises to Look Out For With Health Insurance
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February 2nd, 2012 by Sandra
In these tough economic times we all need a little extra help saving money, especially on our health care bills. Here are a couple of tips that can save you big bucks on a high quality health insurance plan from one of the top rated carriers in Texas, like Anthem Blue Cross Blue Shield.
1) Increase your deductible.
It is a common fact that the more you are willing to pay out of pocket toward your own health care expenses, the lower your health insurance bills will be. But be careful, this can be a double edged sword.
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January 31st, 2012 by Dan
Retail clinics, which are walk-in medical clinics found in supermarkets, drug stores, and pharmacies is on the rise among young healthy people. Not only are these facilities available more often than typical doctor’s offices, they are usually staffed with nurse practitioners and physician’s assistants, much like their typical doctor’s office for non-severe illnesses. Most cases were seen for minor conditions, such as coughs, colds, and sinus infections, and expressed that should the clinics not be available to them, they were not likely to seek out the care with their primary care physician. This is not only due to convenience; it also was shown that these costs were 30% to 40% cheaper than their doctor’s office, and up to 80% less expensive at the emergency room. With a drop in general practitioners nationwide, this also may be a reflection on the need for more providers in these fields. However, as long as access to inexpensive and quality care is available, people will seek out means that are easily fit into their hectic schedules.
In this day and age where every minute counts, and we are constantly on the move, being able to seek out quick care at the drop of a hat is priceless.
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Tags: added benefits, health insurance, individual health, preventative care, wellness
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January 24th, 2012 by Sandra
Anthem Blue Cross policyholders who remained on grandfathered plans (those administered by the Department of Managed Health Care rather than the Department of Insurance) faced an unexpected surprise. Along with increased premiums, their plan benefits changed as well. Co pays, deductibles, and out of pocket maximum amounts all increased as a result of these changes. Anthem said this was a necessary move to keep up with increasing health costs, but policyholders had enough, and Consumer Watchdog stepped in. The lawsuit that has been filed states that Anthem used “bait and switch” tactics, leaving “consumers are left with no certainty about what they will have to pay and what coverage they’ll receive.” Many customers who had met their deductible earlier in the year were surprised to receive bills from their providers stating that they had not yet reached their portion of medical expenses, though the patient was under the impression they had.
The lawsuit serves to protect the 100,000 policyholders who have experienced what they feel is a misrepresentation of plan coverage. Company spokespeople from Anthem state that there is no violation of state laws and regulators were made fully aware of the proposed plan changes. Consumer Watchdog stated that even though these state regulators were aware of the plan changes, they in no way received a stamp of approval to move ahead with them. Per Jerry Flanagan, staff attorney at Consumer Watchdog, “Basically, higher deductibles mean you’re paying more for less health care. It’s a change to the essential definition of a plan.”
While it is understandable that changes need to be made to policies from time to time, it is important that these changes be presented in a clear and concise manner. This will help to avoid confusion and allow members to make necessary adjustments ahead of time.
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Tags: deductibles, health insurance, individual health, premiums
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December 8th, 2011 by Carol
In an effort to give consumers more knowledge when it comes to premium rate increases, the Department of Health and Human Services can now require that all insurance carriers file their rate increases online via a government website -http://companyprofiles.healthcare.gov. As of September 1, 2011 insurers who plan on raising their rates 10% or more must not only provide the rate detail, but the reasons justifying the need for such an increase. This information will now be made available to consumers, allowing them to not only be made aware of premium changes, but also allow them an option to add their questions, concerns, and comments – giving them a voice where previously they felt powerless to fight against the insurance companies. It also allows them to make more educated decisions when choosing to purchase a policy with a company, or move to another more competitive carrier. During a time when most Americans are struggling while big corporations continue to reap in big profits, holding them to some accountability is a big relief.
Tags: health care costs, health insurance, premiums
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December 1st, 2011 by Dan
Assembly Bill 52, the bill that would allow California officials to regulate health insurance rates, did not gain enough support from the Senate, and has been put aside for now. Assemblyman Mike Feuer (D) said that he would wait until next year before trying to pass the bill again. Fears of AB 52 reigned mostly from health plans, doctors, and hospitals, fearing that the low premiums would mean lower reimbursement rates along with increased bureaucracy and red tape. The president of the California Association of Health Plans stated “AB52 hit a major roadblock because it’s flawed. It failed to address the underlying pressures that drive up the cost of coverage”.
Tags: health care costs, network provider, reform laws
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November 24th, 2011 by Candace
Recently, the autism insurance reform bill was passed, and SB 946 will be signed into law by Governor Jerry Brown. This means that as of July 1, 2012, services will be subject to the mental health parity law and require that health plans subject to this bill provide coverage for treatment to “develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism.” Such programs that will fall under behavior health treatment are applied behavior analysis, occupational therapy, and speech therapy. Benefits for such therapies cannot be subject to age limits or dollar limitations.
Much of this is thanks to the organization called Autism Speaks, as they have been a strong force in pushing legislators to bring the law to fruition. While many families were faced with paying for medical care and much needed therapies out of their own pockets, this bill will help them get the care they need. Visit Autism Speaks to learn more, and urge Governor Brown to sign this bill as quickly as possible.
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Tags: added benefits, health care costs, health insurance, pre-existing
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November 17th, 2011 by Sandra
Alarming trends show that almost half the United States population will be obese by 2030. In California, rates have doubled in the last 20 years – resulting in over 20% of the State’s residents falling under the category of obese. With increasing size comes increasing health problems, such as diabetes and heart conditions. In 2009, obesity related medical costs were 15.2 billion in California, which is the highest in the country. The rest of the country in not far behind, however, and only further demonstrates a need for change.
According to a CDC report:
- Obesity rates were higher among people ages 50 and older (most likely due to an aging population)
Tags: Chronic Condition, health care costs, pre-existing, preventative care
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November 10th, 2011 by Susan
A surprising number of employees make vital errors during their company’s open enrollment process, often resulting in unexpected out of pocket costs. By not understanding deductibles, coinsurance, or premiums amounts responsible out their own pockets, many find out too late that they have made an error and must wait until their next anniversary date to make a change. Some of the most common mistakes are not knowing what benefits they have, not clearly understanding costs for the coverage chosen (for themselves and their dependents), and not taking advantage of pre-tax premiums and/or flexible spending plans, and not electing ancillary benefits (i.e. dental and vision), all by not taking advantage of face to face interaction prior to enrolling or renewing their benefits.
As your agency, we will assist you in every step of your open enrollment process, whether you are the employer or employee. We will walk you through the plan options, explain out of pocket exposure, and break down your monthly portions for you and your family members before you enroll, ensuring that you are on the best plan for your needs. Our enrollment meetings are not only a great way to get to get to know us, it also guarantees your complete understanding of your company’s benefits.
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Tags: deductibles, group health, health plan, health savings accounts, premiums
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September 13th, 2011 by Dan
Health care administration under the Affordable Care Act is tricky enough, but none more so than in California. Currently there are two options for the golden state – either consolidating into one regulatory agency or combining between two agencies, the California Department of Insurance (CDI) and Department of Managed Health Care (DMHC), to properly maintain a system that will ensure consumer protection. Those supporting consolidation believe that the fewer hands in the pot will avoid confusion and conflicting interpretations of federal laws. Oversight between two entities can also result in added government and administrative burdens, and difficulty in monitoring what is being purchased and sold in the marketplace.
This is a preview of
Health Insurance Regulation in California Under Health Care Reform
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Tags: group health, health care costs, health care reform, premiums, Universal Health Care
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