In 2017, we will be selecting a primary care physician (PCP) for you so you can begin building a relationship with your doctor. As a PPO member, read our frequently asked questions about choosing a PCP.
Blue Shield Partners with CVS for New Pharmacy Drug Benefits Program
Blue Shield has entered into an agreement with CVS Health to support manufacturer rebate and pharmacy network contracting for its outpatient pharmacy benefit and has received approval from the Department of Managed Health Care.
Kaiser Releases 2017 Individual and Family Health Plan Information
Kaiser Permanente has released information pertaining to their individual and family health plans for 2017. Most of Kaiser’s health plans are available through Covered California and are eligible for the monthly tax credit subsidy. These standard benefit designs are also offered off-exchange, in addition to several non-standard benefit design plans only offered direct through Kaiser.
Department of Insurance Receives Health Plan Compliance Grant
The Centers for Medicare and Medicaid Services at the U.S. Department of Health & Human Services announced today it awarded a $1.84 million grant to the California Department of Insurance to enhance enforcement of key market reforms under the Affordable Care Act.
Covered California 2017 Individual and Family Dental Plans
For individuals and families who enroll in a health plan through Covered California they may also select a family dental plan. Any monthly subsidy awarded to the family for health insurance is not applied to the dental plan. Only household members eligible for the APTC monthly tax credit are able to enroll in an on-exchange Covered California dental plan. This means children who are Medi-Cal eligible or adults who have other coverage such as Medicare can’t be included in the family dental plan.
Health Plan Report Cards Released for 2017 Open Enrollment
The California Office of the Patient Advocate (OPA) has released their health plan quality report cards in time for the 2017 open enrollment period. Now in its 16th year, the 2016/2017 OPA Health Care Quality Report Cards are available online at www.opa.ca.gov. This timely release of the Report Cards is critical as consumers prepare in making the important decision of choosing a new health plan for themselves and their families during 2017 open enrollment. Quality matters when consumers choose a health plan or medical group, and this free tool helps ensure they have the information they need to make an educated decision.
Health Net 2016 PPO Plans to be Discontinued
Health Net has announced that they must discontinue their 2016 PPO plans at the request of the California Department of Insurance. Health Net had originally filed for a 23% rate increase for their 2017 PPO plans. Through negotiations with the Department of Insurance, Health Net lowered the rate increase to an average 12.1%. Because of the changes to the PPO plans, Health Net will need to cancel their 2016 PPO Plans on December 31, 2016 and offer a new PPO plan design to new and existing members. On October 4, 2016, the Department of Insurance concluded that the lower rate increase was not unreasonable.
Beware of deceptive sales practices during Medicare’s enrollment
The California Department of Insurance is alerting seniors and their advocates to be on their guard against improper sales practices during the annual open enrollment period for Medicare Advantage plans (Part C) and the Medicare Prescription Drug (Part D) Program.
CalOptima Orange County Medi-Cal Data Breach
On or about August 17, 2016, a departing CalOptima employee downloaded data, which included protected health information, to an unencrypted USB flash drive. Shortly after, the departing employee returned the USB flash drive to CalOptima. While we are still investigating the contents of the flash drive, we do not believe the information was shared.
2017 Medicare Advantage Plan Star Ratings
The Centers for Medicare and Medicaid Services have released the 2017 Medicare Advantage Star Ratings in an effort to help guide Medicare beneficiaries in their selection of a MA-PD or Prescription Drug Plans during open enrollment.
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