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Health Net of California has announced the rollout of a new Medicare Supplement Plan.  

Available beginning with August 1 start dates, Health Net will offer their Innovative F Supplement in California.  Earlier this year, Anthem Blue Cross introduced their Innovative F plan.  Health Net's plan marks the second "Innovative" Medicare Supplement in California.

One huge difference between the two Innovative F plans--unlike Anthem's plan, Health Net's Innovative F is available to upgrade from your Plan F to Innovative Plan F during California's "Birthday Rule" Guarantee Issue Period.   Health Net considers Innovative Plan F an "equal benefit" plan compared to Plan F.

Health Net Innovative F offers additional hearing and vision benefits that include:


    • Routine Hearing Exam - One Hearing Exam every 12 months
    • Hearing Aid(s) - includes fitting evaluation. $1000 benefit maximum for two hearing aids (one pair) or $500 for one hearing aid
    • Routine Eye Exam - One Vision Exam every 12 months
    • Eyewear - Up to $250 allowance for frame and lens package once every 24 months or contact lens once every 12 months.
The Innovative F also includes the Silver&Fit gym membership program which is similar to SilverSneakers.  

Health Net has increased the "New To Medicare" discount from $15 to $20 per month for the first 12 months and Innovative F is also eligible for this discount.  




Dave
800-509-0659





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Anthem Blue Cross (CA) has announced the relaxation of rules with regard to small employer group coverage beginning with July 1st enrollments.

The biggest change?  Anthem will now allow your employees covered under individual & family health plans ON or OFF exchange a valid participation waiver.  Your employees with individual coverage will no longer be forced to drop that coverage in favor of your group health plan to meet participation requirements.

Relaxation of participation requirements.  Anthem will allow groups with 5 or more enrolled subscribers to meet a mere 25% participation requirement.  Groups 1-4 enrolled subscribers is also reduced from 70% to 65% participation requirement.

Specialty Dental will receive a 24-month rate guarantee if enrolled by December 15th, 2018.

Dave
www.davefluker.com




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Oscar Health, known for low premium individual health plans with high tech features, has expanded their product offerings in California.

Small businesses in Los Angeles and Orange Counties will now have access to Oscar group health plans.  These plans will have the same features enjoyed on individual plans including 24/7 telemedicine & concierge services and fully functional smart app.

I am hoping that Oscar Health will expand their offerings to larger portions of California.

If you are interested in a free, no obligation quote for the new Oscar Health plans, send and e-mail or give me a call (1-800-509-0659).  

Dave
www.davefluker.com




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As with anything new, there are those who will find a way to take advantage of people to line their own pockets.  Such is the case with the new Medicare ID cards.  New cards are scheduled to be sent in waves with California beginning in May, 2018.

As reported by The Motley Fool earlier this month, scammers are using two techniques to obtain personal and private information from vulnerable seniors.  Two basic techniques that are being used are - 

1.  Telephone calls claiming to be from Medicare requesting seniors pay a fee for their new ID card (claim it's not free which is not true) and,

2.  Telephone calls claiming to be from Medicare requesting personal and banking information for verification in order to get your new ID card from Medicare.

No doubt there will be more attempts and techniques employed in these phishing schemes.  

It is important to remember that Medicare will never call you to obtain any personal, financial or private information (just like the IRS).  Medicare does not charge any fee or assess any cost for ID cards.  

Please be careful and never give out personal information to anyone you don't know.  Your new Medicare ID Card will contain an encrypted ID number replacing the use of Social Security Number.

Dave
www.davefluker.com




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California Senate Bill 910 (Hernandez), which was re-referred to Health Committee on March 14th, would prohibit any health insurer from selling short-term health insurance in California.

"This bill, commencing January 1, 2019, would prohibit a health insurer from issuing, selling, renewing, or offering a short-term limited duration health insurance policy, as defined, for health care coverage in this state."

"10123.61. (a) Commencing January 1, 2019, a health insurer shall not issue, amend, sell, renew, or offer a policy of short-term limited duration health insurance policy for health care coverage in this state."

Some California residents use short-term health insurance in lieu of compliant but more expensive Obamacare coverage or as an interim coverage between compliant health plans.  

Within the last year or so we have seen two carriers terminate their short-term health offering in California.  HCC Tokio Marine dropped their plans in 2017, and Petersen International Underwriters (Lloyd's of London) dropped their plans in February of this year.

I am only aware of one insurer selling short-term health in California right now, IHC.  



Dave



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California Attorney General Xavier Becerra has sued Sutter Health, accusing them of illegally quashing competition and overcharging customers and employers.

"A 2016 study found that hospital prices at Sutter and Dignity Health, the two biggest hospital chains in California, were 25 percent higher than at other hospitals around the state. Researchers at the University of Southern California said the giant health systems used their market power to drive up prices — making the average patient admission at both chains nearly $4,000 more expensive."

Of the lawsuit, "it said Sutter employs a variety of improper tactics, such as gag clauses on prices, “punitively high” out-of-network charges and “all-or-nothing” contract terms that require all of its facilities to be included in insurance networks."

I'll be keeping an eye for updates on this as many in my area of California use Sutter Health services.  This limits the choice of health insurance plans significantly.

Read the full article at kaiser Health News


Dave
www.davefluker.com





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California's MRMIP (Major Risk Medical Insurance Program) has apparently survived the proposed budget cut last year.

In 2017, the proposed 2018 budget would have eliminated the MRMIP and the MRMIF (Fund) and transferred the fund balance to the newly established Health Care Services Plans Fines and Penalties Fund.  See my blog post from 2017

MRMIP is qualifying health coverage for mandate/penalty issues.  It is available year round for enrollment (assuming no waiting list) to California residents who are denied enrollment in a qualifying health insurance plan (Obamacare).  

Online 2018 MRMIP Brochure with benefits, rates and application form


Dave
www.davefluker.com





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Vox.com has released some details about Idaho Blue Cross' plans for new, non-ACA health insurance plans.  As mentioned in my blog post of February 1, Blue Cross received legislative approval to offer skinnier and less expensive health insurance plans to individuals & families.

http://davefluker.blogspot.com/2018/02/the-idaho-experiment-exit-obamacare.html

Apparently the five new plans will be dubbed "Freedom Blue" and will come in between 25%-50% cheaper than Obamacare plans.  From what I am reading, it appears that the plans will have some new provisions as well...


  • Up to 50% rate up for applicants with health conditions
  • Pre-existing conditions exclusions for those who fail to maintain prior coverage
  • Lifetime maximum benefits $1,000,000
There will likely be issues between Idaho and the federal government.  

Read the full article on Vox


Dave



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Aetna is currently being investigated by the California Dept of Managed Healthcare (DMHC) and the California Dept of Insurance (DOI) in relation to recent testimony in a lawsuit.

"The Department of Managed Health Care, which regulates the vast majority of health plans in California, said Monday it will investigate Aetna after CNN first reported Sunday that one of the Hartford, Conn., company's medical directors had testified in a deposition related to the lawsuit that he did not examine patients' records before deciding whether to deny or approve care. Rather, he relied on information provided by nurses who reviewed the records — and that was how he was trained by the company, he said."


"In an emailed statement Monday, Aetna did not directly address the question of case reviews by non-physicians. It said its "medical directors review all necessary available medical information for cases that they are asked to evaluate. That is how they are trained, as physicians and as Aetna employees." It added, "adherence to those guidelines, which are based on health outcomes and not financial considerations, is an integral part of their yearly review process."


Read the full LA Times Article 


Dave
www.davefluker.com



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Blue Shield CA has made changes to the discount programs available to California Seniors going onto or already on Medicare Supplement coverage.

There are currently two discounts available.  

1.  New to Medicare premium discount of $25 per month for the first twelve months from original Part B effective date.  Another $3 available if paying by Easy$Pay.  This discount applies to plans A, C, D, F & G.  Does not apply to plans N nor HD F.

2.  Household Savings Program discount of 7% for two party enrollments.

In the past, the two party discount and New to Medicare discount could not be combined and the optimal setup was to separate spouses for at least the first year.  Now couples can enjoy both of the discounts at the same time.

The ability to combine these discounts makes for great premium savings.Call or email for a free quote and information.  

Dave
www.davefluker.com






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