Western Health Advantage (WHA) is now available in the Bay Area for large and small group employers. Our partnership with Canopy Health, co-founded by John Muir Health and UCSF, provides access to providers who are some of the most skilled and respected in the United States, and the numerous renowned hospitals and care centers at which they practice have long been recognized for their medical excellence, advanced technology, and compassionate care.
Since 2014 under Affordable Care Act rules, new ACA qualified health plans had just one rate for dependents from ages 0 to 20. In 2018 there will now be 7 different age based rates with the first for ages 0 – 14. Beginning at age 15 there will be a separate age rates per year up to age 20. The new member level age rating does not apply to grandfathered plans.
Thanks to the actions of President Trump, in April I took the unprecedented step authorizing health insurers to file two sets of rates for 2018,” said Insurance Commissioner Dave Jones. “We in California are doing everything we can to keep carriers and plans in the individual market, but President Trump continues to undermine the ACA and as these rate filings demonstrate, California is not immune to his efforts to wreck the Affordable Care Act. If President Trump continues down this path, premiums will increase substantially in 2018. The average premium increase doubles if Trump continues to refuse to fund the cost-sharing assistance in the ACA.
Covered California instructed health insurance companies to submit their rates assuming direct payment to fund the CSR subsidies would be continued, but to also submit a separate CSR surcharge to “load” any costs to fund this program onto Silver-tier plans for those who receive subsidies. As a result, Silver-tier consumers may see an additional “CSR surcharge” that averages 12.4 percent — ranging from 8 percent to 27 percent on the gross price of their premiums
Covered California’s board acted to place any rate increases caused by the uncertainty only onto Silver plans. While Silver level consumers will see an increase in the gross cost of their premiums, they will also see an increase in the amount of financial assistance they receive, leaving their net payment virtually the same.
Insurance Commissioner Dave Jones announced today that he has authorized health insurers filing rates with the Department of Insurance to file two sets of rates, in light of the market instability created by President Trump’s continued undermining of the Affordable Care Act (ACA).
The analysis found that Covered California health plan premiums could rise up to 49 percent if two key elements that have been in place for the past four years are changed: Cost-sharing reduction reimbursements are no longer directly funded as reimbursements to carriers, and the shared individual responsibility payment is not enforced.
Beginning April 1, 2017, Anthem Blue Cross will adjust the base rates for existing business on all California Department of Insurance (CDI) grandfathered medical plans with an April 1, 2017 effective date. Members will also receive an adjustment for age changes. The base rates for members on Department of Manage Health Care (DMHC) grandfathered medical plans, that were effective April 1, 2016, are not scheduled to change in 2017. DMHC members will receive an adjustment for age changes.
Cigna has released their 2017 health plans available in select counties of Northern and Southern California. Cigna has decided not to pay agents commissions for 2017. (Cigna Cuts All Agent’s Commissions to 0% for 2017) Consumers will have limited options for assistance with enrollment and the explanation of the health plans from Cigna in 2017. Most all Cigna plans have been converted to EPO plans. The exception is one Bronze plan that still remains a PPO product.
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.