Covered California has reaffirmed their policy that only Certified Insurance Agents can call into the agent service center and request assistance for a Covered California consumer for whom they have been properly delegated. Support staff to the agent cannot call the service center on the agent’s behalf and make any changes or inquiries. Callers to the service center will authenticated by the agent’s name and Department of Insurance license number.
Report 2016 Income to Avoid 2017 Medi-Cal with Covered California
Covered California Certified Enrollers entering consumer income into the online application (CalHEERS) need to report the correct date in the First Date Paid field in order to get the correct eligibility results. Consumers applying for 2017 coverage may incorrectly receive Medi-Cal eligibility if they do not report their current income for 2016.
New Anthem Blue Cross Silver HMO Plan, Expanded Los Angeles Network
For 2017, Anthem Blue Cross will offer a new Silver Pathway HMO 2650 plan for Individual business. This plan meets Affordable Care Act (ACA) rules and will be sold off the exchange only. We also will expand our Pathway HMO network in Los Angeles County for members who buy plans on or off the exchange.
Oscar Health Plan Information for 2017
Oscar is expanding their health plan availability into San Francisco County for 2017. They will continue to serve part of Los Angeles and all of Orange counties. They have notified members enrolled in some of their 2016 off-exchange plans that they will no longer be offered. The Simple Silver, Simple Gold, Simple Platinum, and Simple+ Platinum will not be offered in 2017. Individuals and families in these health plans must select a new health plan no later than December 31, with Oscar to maintain coverage.
2017 Medicare Parts A & B Premiums and Deductibles Announced
The Centers for Medicare & Medicaid Services (CMS) announced the 2017 premiums for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs.
Owners of sober living facilities arrested for health insurance fraud
California Department of Insurance detectives, assisted by multiple law enforcement agencies, arrested Chris Bathum and Kirsten Wallace on multiple felony counts of grand theft, and identity theft for allegedly conspiring to defraud patients and insurers out of more than $176 million through an elaborate conspiracy. Simultaneously, search warrants were also executed at 15 locations throughout Los Angeles and Orange County.
San Diego Sharp Health Plans Sends out Wrong Premium Rates
Sharp Health Plan of San Diego has sent letters to existing members alerting them that a previous notice of 2017 rates was in error. It is unclear from the member letters why both the 2016 and 2017 rates were stated incorrectly. From limited information, it looks as if the both the 2016 and 2017 were high. The 2017 rates are actually lower than originally reported to members. The corrected rates match the Sharp 2017 IFP rate sheet and rates posted to Covered California.
Cigna California 2017 Individual and Family Plans
Cigna has released their 2017 health plans available in select counties of Northern and Southern California. Cigna has decided not to pay agents commissions for 2017. (Cigna Cuts All Agent’s Commissions to 0% for 2017) Consumers will have limited options for assistance with enrollment and the explanation of the health plans from Cigna in 2017. Most all Cigna plans have been converted to EPO plans. The exception is one Bronze plan that still remains a PPO product.
Anthem Blue Cross Simple Off Exchange Plan Change Forms
Anthem Blue Cross has made it easier for members with off-exchange plans to change plans without filling out a new application. Current off-exchange members who want to change from their 2016 ACA compliant Anthem plan (purchased off the exchange) to a different off-exchange plan for 2017 can use the appropriate new form instead of having to complete the full enrollment application.
Health Net 2017 Californnia Individual and Family Plans
For 2017, Health Net is offering a variety of health plans throughout California. There are EPOs, HSPs, HMOs, and PPOs plans. Some of the plans are offered through Covered California and some, like the PPO plans, are only offered off-exchange direct from Health Net.
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