UHC has released a California plan overview brochure, prescription drug formulary, and Summary of Benefits. These documents can documents can be downloaded from United Healthcare California Individual and Family Plans along with a link to a doctor and hospital directory.
Oscar California 2016 health plan documents
Oscar has posted plan specific documents relating to their California individual and family on and off exchange plans. These documents will help educate consumers about the Oscar health plans. In particular, consumers should carefully review and understand Oscar’s Simple and Simple Plus series of non-standard, off-exchange health plans quite different from the standard benefit design. Oscar will be offering plans in Region 16, Southwest Los Angeles County, and Region 18, Orange County.
Blue Shield seeks 9% rate increase on grandfathered family plans
Blue Shield of California has submitted a rate filing with the California Department of Insurance proposing an average increase of 9% in premium rates for older off-exchange plans. The rates would become effective January 1, 2016. Individual and family slated for the rate increase are from Blue Shield Life PPO Plans
Blue Shield ordered to pay mid-year rebates in 2016
If the emerging utilization and trend projections yield an updated projected federal MLR that is more favorable to Blue Shield than the current projections filed with the Department as part of the rate review process for Plan Year 2016, then Blue Shield must issue amid-year rebate to consumers by July 31, 2016.
Aetna accused of unreasonable rate increases
Insurance Commissioner Dave Jones announced today that Department of Insurance actuaries found Aetna Life Insurance Company’s most recent small group health insurance rate increase excessive and unreasonable. Aetna is increasing rates for small businesses and their employees by an annual average of 27.4 percent.
Oscar trickles out information on California health plans
Oscar, a new health plan carrier to California, is slowly trickling out information on their individual and family plans for 2016. All of Oscars plans will be EPOs offered in parts of southwest Los Angeles County and all of Orange County.
Health Net closing some California PPO plans for 2016
Health Net of California, Inc. and Health Net Life Insurance Company (Health Net) will offer a simplified line-up of IFP products for 2016. There are differences in the plans we offer through Covered California and those available direct from Health Net. As such, the changes and what members have to do, if anything, depend on how they enrolled.
What’s driving small group rates up
Anthem Blue Cross of California has released an infographic summarizing the factors which cause a grandmothered or legacy small group to realize a higher than expected increase in rates. In 2016 all small group plans must become ACA compliant. This means they must include certain new medical elements, but how the rates are determined are also affected.
Blue Shield releases 2016 California health plan information
Blue Shield released information and documents relating to their California individual and family plans (IFP) for 2016. They have dropped their 2015 Exclusive Provider Organization (EPO) plans that offered no out-of-network coverage. All Blue Shield of California IFPs will be PPO with their Exclusive PPO Network of providers. Blue Shield will also be expanding coverage areas to offer plans in the counties of Alpine, Monterey, Sutter and Yuba counties in 2016.
New California online healthcare price and quality tool released
Commissioner Jones directed the California Department of Insurance to obtain federal Affordable Care Act grant funds to enhance transparency in healthcare pricing. Commissioner Jones then partnered with UCSF and Consumer Reports to create California Healthcare Compare (HealthcareCompare.insurance.ca.gov), a first step in achieving cost and quality transparency in California’s healthcare marketplace.
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