Individual grandfathered members enrolled in Anthem Blue Cross Life & Health Insurance Company (CDI regulated) policies at least one day in September of 2016 will be receiving a refund as a result of funds left over from a 2013 settlement of a class action lawsuit (Kreuzhage v. Anthem). This includes the majority of the grandfathered members. Members on Affordable Care Act (ACA) On and Off Exchange plans, and grandfathered members on Anthem Blue Cross (DMHC regulated) plans are not included.
Blue Shield of California and Sutter Health Have Signed a New 2017 Agreement
We are pleased to announce that Blue Shield and Sutter Health have signed a new 3-year agreement effective January 1, 2017. This means that Sutter Health hospitals and providers are part of Blue Shield’s statewide network.
Blue Shield – Sutter Health Contract Expired, Negotiations Continue
Blue Shield of California and Sutter Health have been engaged in discussions on rates and terms for a new network contract (HMO/PPO and in some cases, Group Medicare Advantage). Though we are still actively involved in negotiations, the current contract expired at 11:59 p.m. on December 31, 2016 and Sutter Health is no longer Blue Shield’s in-network provider effective January 1, 2017.
Covered California Calculates Incorrect 2017 Monthly Subsidy for Consumers
During the 2017 renewal process the incorrect Advanced Premium Tax Credit (APTC) amount was sent to the health plan for some consumers. The eligibility determination and notice the consumer received from Covered California displayed the correct APTC amount. However, because the incorrect APTC was sent to the health plans, they invoiced the consumers with overstated APTC and understated premiums owed.
Covered California Extends Enrollment Deadline to December 17th for January 1, 2017 Start Date
Consumers now have until midnight on Dec. 17 to sign up for health care coverage that will begin on Jan. 1, 2017, Covered California announced.
Zenefits Hit With $7 Million Fine For Unlicensed Agents
Insurance Commissioner Dave Jones today announced the enforcement action taken against Zenefits for multiple license violations has resulted in a $7 million penalty. Zenefits was charged with allowing unlicensed employees to transact insurance and circumventing insurance agent education requirements. This is the largest penalty assessed by any commissioner against Zenefits and one of the largest penalties for licensing violations ever assessed in the department’s history.
Blue Shield and Health Net Alert Agents to Potential Loss of Sutter Hospitals and Doctors
Blue Shield of California and Health Net are two of the health plans that are currently in negotiations with Sutter Health regarding contracted in-network doctors and hospitals for 2017. Both health insurance companies are alerting agents to the potential that Sutter hospitals and doctors may not be covered in many of their health plans in 2017 if they don’t come to an agreement soon.
New online tool to search for life insurance benefits launches
Created by The National Association of Insurance Commissioners (NAIC) the service is designed to offer consumers who may suspect they or a family member is the beneficiary of a life insurance policy or annuity, but may now have some of the key information typically needed to search, such as a policy number or name of the insurer.
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.