California Health News

WHA Expands To Bay Area, But Leaves Covered California

Western Health Advantage

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.

It’s Official!

We have obtained approval from the Department of Managed Care (DMHC) for our expansion into the Bay Area. Effective January 1, 2018, Western Health Advantage will be a viable health plan option for employers in San Francisco, Contra Costa, Alameda and part of San Mateo counties.

We have partnered with Canopy Health, an alliance of healthcare professionals providing access to the region’s top medical systems. Employees and their families will have access to John Muir Health, UCSF, Dignity hospitals and physicians associated with Hill Physicians. Marin General, Sonoma Valley Hospital and their associated physicians will also fold into Canopy in the new year.

In addition to our expansive network, all WHA products that you know and love will be available in this region. For both the small group and large group markets, we will offer the same traditional, deductible and high-deductible health plan portfolio. This includes WHA participation in CaliforniaChoice. Please note WHA will not be offered in the individual market within these new counties (keep an eye on 2019 for that!).

WHA collateral with the new network and small group rates for 2018 will be available for your marketing very shortly. We will also host broker roll-out meetings in the new region, dates to be announced. In the meantime, start thinking of your business clients who would be a prime candidate for WHA. We can quote your large group clients now!

WHA ends offering in Covered California for Small Business

As we expand and evaluate our markets, we have determined the complexities of offering plans within Covered California for Small Business (CCSB) outweighs the enrollment in these plans. Therefore, we have elected not to recertify for 2018. Current groups will be active until their renewal in 2018, at which point, WHA members will need to elect other coverage within CCSB. As an alternative, of course, that employer can consider electing a plan directly with WHA or through CaliforniaChoice!

This withdrawal from CCSB does not affect our individual offering within Covered California. WHA remains strong fulfilling a competitive niche in the individual marketplace.

WHA also announced that they have added NationCare PPO plans for companies with employees who do not reside in a WHA service area.