The proposed rule, which applies only to employer-sponsored health insurance, would allow employers to join together as a single group to purchase insurance in the large group market. These improvements stand to open health insurance coverage for millions of Americans and their families by making it more affordable for thousands of small businesses and sole proprietors. By joining together, employers may reduce administrative costs through economies of scale, strengthen their bargaining position to obtain more favorable deals, enhance their ability to self-insure, and offer a wider array of insurance options.
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.
Western Health Advantage (WHA) has announced that the Department of Managed Health Care has approved their expansion for small group plans into the Bay Area. They also noted that they will not seek re-certification of their Covered California small group plans because of this expansion. WHA’s exit from the Covered California for Small Business plans does not affect their individual and family plan offerings through Covered California.
Members can make an appointment with a licensed doctor to come to their home or office in two hours or on their schedule. Hours of availability are from 8 a.m. to 8 p.m., seven days a week, including holidays.
Starting October 1, 2016, American Specialty Health (ASH) will process all acupuncture claims, in and out of the network, for our California fully insured large and small group PPO (Preferred Provider Organization) plans. ASH also will review claims for acupuncture care to make sure the services members get are medically necessary.
Covered California announced today the rates and expansion plans for its small group health insurance exchange, Covered California for Small Business. The statewide weighted average rate increase is 5.9 percent, for employers and their employees beginning Jan. 1, 2017, which is down from the 7.2 percent increase in 2016.
The Center for Medicare & Medicaid Services (CMS) has released a review of the rules regarding when a family becomes ineligible for the Covered California subsidy after being offered employer-sponsored health insurance. While the presentation is geared toward health insurance agents, there is good information relevant to everyone in the file. As CMS notes, gaining employer-sponsored health insurance while enrolled in Covered California is a Common Complex Situation.
Health Net has filed new small group health insurance premium rates for 2017 with the California Department of Insurance. In the filed rates, Health Net is proposing an average expected annual increase of 15% to their PPO and EPO plans.
UnitedHealthcare has filed for a small group rate decrease with the California Department of Insurance. The new rates would be effective October 1, 2016. The new UnitedHealthcare rates are for the Select, Select Plus, Core, and Non-Differential insurance plan products.