During the 2017 renewal process the incorrect Advanced Premium Tax Credit (APTC) amount was sent to the health plan for some consumers. The eligibility determination and notice the consumer received from Covered California displayed the correct APTC amount. However, because the incorrect APTC was sent to the health plans, they invoiced the consumers with overstated APTC and understated premiums owed.
Anthem Analysis of Trump and Republican Positions on Obamacare
We conducted an analysis of the House Republican Platform released over the summer, which may serve as a starting point for legislative changes. The below chart shows how some of President-elect Trump’s campaign proposals line up with the House Republican Platform released earlier this year.
Sharp Health Plan Transitioning From Diplomat to CVS Specialty Pharmacy
Effective February 25, 2017, Sharp Health Plan is moving from Diplomat to CVS Specialty Pharmacy. According to Sharp, they found that CVS provides greater flexibility on how members can fulfill their specialty medication needs.
Covered California Extends Enrollment Deadline Until December 19
Consumers now have through midnight on Monday, Dec. 19 to sign up and have their coverage begin starting Jan. 1.
Blue Shield Billing Issues Result In Credits And Extra Charges To Members
Blue Shield of California has experienced ongoing system issues that have recently been corrected. As a result of these issues, some Individual and Family Plan members received past billing statements showing incorrect amounts due. Affected members will receive a detailed statement of corrections for these past months and, in some cases, previous years, in their January billing statements. Those who have been over billed will be credited, and those who have been under billed will only be responsible for adjustments to the December premium, not for past months of accrued charges.
Covered California Extends Enrollment Deadline to December 17th for January 1, 2017 Start Date
Consumers now have until midnight on Dec. 17 to sign up for health care coverage that will begin on Jan. 1, 2017, Covered California announced.
Zenefits Hit With $7 Million Fine For Unlicensed Agents
Insurance Commissioner Dave Jones today announced the enforcement action taken against Zenefits for multiple license violations has resulted in a $7 million penalty. Zenefits was charged with allowing unlicensed employees to transact insurance and circumventing insurance agent education requirements. This is the largest penalty assessed by any commissioner against Zenefits and one of the largest penalties for licensing violations ever assessed in the department’s history.
Blue Shield of California Responds to ACA Questions After Presidential Election
After the presidential election, it is likely that you will receive questions regarding the future of the Affordable Care Act (ACA) and how it could affect our customers. While we do not yet know the full outcome, we do know that the ACA and Covered California is working for over 21 million Americans and repealing or replacing it would not be a simple or fast process.
Blue Shield and Health Net Alert Agents to Potential Loss of Sutter Hospitals and Doctors
Blue Shield of California and Health Net are two of the health plans that are currently in negotiations with Sutter Health regarding contracted in-network doctors and hospitals for 2017. Both health insurance companies are alerting agents to the potential that Sutter hospitals and doctors may not be covered in many of their health plans in 2017 if they don’t come to an agreement soon.
New online tool to search for life insurance benefits launches
Created by The National Association of Insurance Commissioners (NAIC) the service is designed to offer consumers who may suspect they or a family member is the beneficiary of a life insurance policy or annuity, but may now have some of the key information typically needed to search, such as a policy number or name of the insurer.
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