Next year UnitedHealthcare will offer individual plans through the Exchange in a limited number of states. This change in market footprint reflects our longstanding goal to offer products that are both affordable for consumers and financially sustainable for our company.
Blue Shield to offer identity protection to members
We are pleased to share that Blue Shield of California will be offering these services at no cost to eligible health plan members and their dependents on May 2, 2016.
Anthem Blue Cross California Class Action Lawsuit Settlement Notice
Subscribers on Anthem Blue Cross (Anthem) individual ACA plans during 2014 are class action members under a class action settlement known as the Felser-ACA Settlement. Class members may receive payments automatically under the settlement, or pursuant to claim forms, or simply the benefit of process and other improvements.
Anthem Blue Cross moves to single drug list for small groups
In 2016 Anthem released a single enhanced Rx Select Drug List for the Small Group portfolio. This was a change from the prior year’s plan offering of both Select & National Formulary Drug Lists.
Blue Shield requests missing Social Security numbers for 1095-Bs
On January 6, 2016, we sent letters to off-exchange plan members who did not provide their Social Security numbers (SSNs) upon enrollment. The letter requests completion of a form as required by an ACA mandate. The ACA mandate requires insurers, including Blue Shield of California, to provide annual reporting of Minimum Essential Coverage (MEC). We sent the January 6, 2016, mailing only to new members with missing SSNs who joined during open enrollment and were not included in the previous mailing.
Health Net California PPO plans to require proof of residency
Effective immediately, Health Net has implemented required proof of California permanent residency for IFP PPO policies. Applications for IFP PPO policies will now require the attached Proof of Permanent Residency form to be completed prior to proceeding with the enrollment process.
Blue Shield 2014 provider directory member settlement notification
Blue Shield will notify certain ON and OFF Exchange Individual & Family Plan members that they are eligible to resubmit out-of-network claims for covered services received in 2014 for review if they feel that they were led to believe that their provider was in their plan’s network by Blue Shield or the provider. Should their claims qualify under the settlement, Blue Shield will reprocess and pay the claims as if they were from an in-network provider.
Oscar extends California enrollment deadline until December 31st
Oscar has extended the deadline to enroll into their off-exchange health plans in California until December 31st for a January 1st effective start date. This is in addition to Covered California extending the deadline for enrollment into all on-exchange plans through December 17th. Oscar will offer both the standard benefit design plan offered through Covered California and their non-standard off-exchange benefit design plans for during the extended enrollment period. Health Plans purchased directly from Oscar are not eligible for the Advance Premium Tax Credit subsidy to lower the monthly health insurance premium.
Public meeting on acquisition of Health Net by Centene
The Department of Managed Health Care (DMHC) invites you to a public meeting on the acquisition of Health Net of California by Centene.
Anthem Blue Cross adds travel benefits to California plans
You may recall that in 2015, BlueCard was limited to hospital and urgent care only for Individual PPO members, while Small Group PPO members enjoyed full BlueCard access. But all that changes for 2016, when our Individual PPO members will also now have full access to BlueCard. So for example, if they want to go to a chiropractor while traveling, it’s a covered service under BlueCard.
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