California Health Care
by John Hansen
At the Summit 2016, CAHU President, Michael Lujan stated the objectives of the California Association of Health Underwriters. The top objective is to support the interests of California health agents. And the #1 goal related to this objective is to make the argument for fair compensation for brokers. Lujan shared 4 key goals of CAHU at the convention:
Many are shocked that this would even be in question. However, since the implementation of the Affordable Care Act (ACA), some California health plans have said they would not pay agent commissions at all.
There should be no grandfathered contracts. If a California health agent enrolls a client, that agent should get credit for and be paid commissions on that health insurance contract. This may have only been an issue for Anthem Blue Cross of California.
Anthem was keeping old records of agent enrollments. If another broker signed someone up who had previously had a different insurance agent, even though that previous agent h...
by John Hansen
California has 11 major health insurance carriers. But the top health insurance companies in California for the past three to four years have been Anthem Blue Cross, Blue Shield, Oscar and Kaiser Permanente. In 2015 and the previous year, Anthem Blue Cross had the highest number of enrollments in the annual open enrollment program through Covered California.
In 2016, Blue Shield took over the top spot from Anthem. This was largely due to the expansion of their coverage to various parts of the state. Oscar and Kaiser Permanente also increased their membership. Here are details about the top health insurance companies California residents prefer.
Anthem and Blue Shield have been strong competitors in the health insurance market in California, striving to outdo each other for network expansion and rates. In 2015, Blue Shield worked hard to expand its network while offering competitive prices. By 2016, their efforts paid off as they turned out to be the number-one California he...
by John Hansen
Dave Jones, Commissioner of the California Department of Insurance (DOI), stated the goals of his department. Those objectives are to protect consumers and to maintain or increase competition in the Health Insurance Marketplace.
Jones said, “We want to make sure consumers are well served and have someone on their side.” One objective of the DOI is to protect consumers from California health plans as well as predatory agents. Toward this end, the DOI licenses agents who sell in the Health Insurance Marketplace, requiring them to take courses in ethics. This government agency also prosecutes agents, health plans, networks and providers that go against the law to the harm of California consumers of insurance.
Options are important. The more options there are in the Health Insurance Marketplace, the more competition. When there is competition, health plans lower prices and improve benefits in order to attract consumers. Ultimately, this leads to higher quality and more affo...
by John Hansen
GEO Blue’s motto is “Cover Your World.” They offer global health insurance plans and services for leisure, study, mission, marine and business travel. GeoBlue includes concierge-level service 24/7, 365 days a year.
HCC competes with GeoBlue, but HCC only offers short term health insurance and short term travel health insurance. GEO Blue offers both of these along with long term travel. Long term travel medical insurance plans are helpful for expatriates and missionaries.
Anthem Blue Cross owns 30% of GeoBlue. This Anthem connection has led GeoBlue to include the Blue Card on health plans that include coverage in the United States.
GeoBlue has an app that can be used during national and international travel. It includes GPS technology to help you find medical, dental and mental health services that are covered on your plan.
According to this short/long term travel insurance company, “GeoBlue provides support to members in need of expected or unexpected access to quali...
by John Hansen
According to a CA State Exchange representative from Covered California, Kaiser plans have some of the highest retention rates in the state. When California consumers enroll with Kaiser Permanente California, they tend to stick around. There are three main reasons that those with Kaiser insurance tend to keep their health plans.
Kaiser Permanente CA’s integrated system makes access to health care services very simple. Those on Kaiser insurance often can get all their medical needs met under one roof or on one Kaiser campus.
Visit your primary care physician. Walk down the hall to see a specialist. Get your labs and blood tests downstairs, and grab your prescription drugs on the way out the door. And, before you leave, don’t forget to visit grandma in the Kaiser hospital just across the way.
Or, call the Kaiser Permanente California advice nurse hotline and speak to a nurse 24/7. Often, Kaiser insurance patients can avoid going to the doctor by getting support over the...
by John Hansen
SB 908 was written by State Senator, Dr. Ed Hernandez. This bill has some ramifications for those covered by health insurance in California. The California Association of Health Underwriters (CAHU) recommends a light oppose unless the bill is amended.
This bill would create certain cost sharing changes that could have negative ramifications especially for small businesses. The bill would permit an insured who received an “excessive increase” mid-year to get a Special Enrollment Period.
One agent asked, “How could this happen? Our groups only get a rate increase once a year at their Open Enrollment.” Broyles responded, “If a group was sold a plan that later was determined to be unreasonably priced by the Department of Insurance, this would create a Special Enrollment Period” for that particular group if this legislation passes.
The bill presents problems for businesses with California group health insurance. It gives the option to groups to change plans mid-year...
by John Hansen
Juli Broyles spoke out Tuesday, May 17, regarding the interests of California health insurance brokers. She spoke about several bills related to health care. She mentioned the need for all agents to have the opportunity to be a Covered California Storefront and she spoke to various issues related to broker compensation.
Being a Covered California Storefront can be a huge advantage to a health insurance broker who is selling Obamacare California products in the Health Insurance Marketplace. When an agent has a Storefront, that means consumers can find them on the Covered California website. When an agent can acquire customers without having to pay expensive advertising fees, that is always a plus.
Juli Broyles said that CAHU is fighting so that “all agents can have a Storefront.” Signing up to be a Storefront is easy. Agents can fill out an online form to submit their request to Covered California. Certain requirements apply such as having the proper signage. Apparent...
by John Hansen
In a talk Tuesday, May 17 at the CAHU Summit 2016 to a room full of brokers, Michael Belote said, “We are on a good will mission” to the legislators in California. He went on to argue for the importance of health insurance agents in California.
He asked, “What area of commerce is more complicated than health care?” Consumers need agents, and legislators need to hear from agents. He said regarding the state congressmen, “They know less than you do about health insurance.”
He continued, “We’re all selling something. You’re selling health insurance. I’m selling ideas.”
Belote alluded to the battle to keep agents in California. He said, “You weren’t supposed to last… You saved the exchange!” Insurance agents were the primary enrollers of health insurance in California. The Department of Insurance Commissioner, Dave Jones, admitted on the same day that brokers did the “lion’s share” of enrollments.
Belote encouraged this room full of Californi...
by John Hansen
United Health Care (UHC), through their Select Plus Network, offers one of the largest PPO networks in California. They have an HMO network as well, which is stronger in Southern California.
In support of affordable health insurance for California, United Health Care took a rate reduction the beginning of 2016 for small business health plans.
United Health Care is a national carrier that offers California group health insurance. This is very helpful for multi-site groups who have some employees in California. It allows these businesses to keep some continuity in their coverage across multiple business locations.
For small businesses of 1 to 100 employees, they only need 5 California employees to enroll on a slice along with Kaiser Permanente. Many other carriers require 50% enrollment, so for some business owners this helps a lot.
United Health Care backed out of Covered California, the California Exchange, in 2014. In 2015, they entered back into the Health Insurance Marke...
by John Hansen
I questioned Assemblyman Jim Wood (Democrat) on May 17 regarding the difficulties of providing quality California health care insurance and provider options for rural areas. Wood is from the 2nd District, so he knows what rural is all about. He is also currently the head of the California State Assembly Health Committee. He is a strong advocate for improved health insurance for California rural areas.
Wood commented, “In my district, it takes 6 hours to drive from one end to another, to get from Sacramento to Arcata, so transportation is a challenge. The problem is that the rural areas are not attracting enough physicians. People go where they can pay off education debt.” He added that we need programs to pay off school debt for physicians who are willing to commit to practicing in more remote areas.
He added that living in rural areas is not attractive to many people. “The lifestyle in the rural community is not for all. We don’t have a Nordstrom in my district, a...