Anthem Bronze PPO members with contract codes 1FZ3 and 1FZ4 received Benefit Comparison Charts in their 2016 Open Enrollment Kits that had incorrect coinsurance amounts listed for Tier 4 pharmacy benefits. The 2016 Tier 4 Retail Pharmacy benefits were listed as 0% coinsurance up to $500, and the Tier 4 Mail Order Pharmacy benefits were listed as 0% coinsurance up to $1,500. These amounts are not correct. The correct pharmacy benefits for 2016 are as follows:
Covered California sent notices to consumers who are enrolled or pending in a Covered California Health Plan in 2015 to renew for coverage in 2016. These notices explain the renewal process and the importance of retaining health insurance to consumers. Below, find the important information you need to know.
In California Kaiser Permanente will be offering ten different health plans for 2016. Six of the plans are the standard benefit design that will be offered through the Covered California Marketplace. Four of the plans are of a non-standard benefit design and will only be available off-exchange directly from Kaiser.
The exclusive provider organization (EPO) is now a tiered preferred provider organization (PPO) plan. Members on 2015 EPO plans will be transitioned to Tiered PPO plans effective 1/1/16 (unless they choose a different plan).
Some Blue Shield highlights for IFP plans include:
•79 percent of Blue Shield members will receive an increase of less than 10 percent
•63 percent of members on a Silver Plan will receive a rate decrease
•Four Southern California regions will experience a decrease on average for the rates for those regions
•Blue Shield will replace its EPO plans with PPO plans in four Northern California EPO regions (Rural North, Wine Country, Alameda, and Monterey) for 2016 which means out-of-network benefits and access to out-of-network providers
COVERED CALIFORNIA HOLDS RATE INCREASES DOWN FOR SECOND CONSECUTIVE YEAR July 27, 2015 Average Increase Is 4 Percent; Consumers Who Shop Can Lower Their Premium by an Average of 4.5 Percent SACRAMENTO, Calif. — Covered California announced its rates for 2016 and unveiled which health insurance companies will be offering plans through the marketplace. The […]