Covered California has begun the renewal process for 1.12 million people who enrolled in plans in the exchange last year. Open enrollment will begin Nov. 15 and continue through February 15. Open enrollment is the next opportunity for all Californians to benefit from new insurance rules, including the requirement that insurance be offered regardless of health status. In addition, Californians can buy subsidized coverage starting in 2015. Consumers who complete the renewal process will hear from their insurance plans in December. Their selected health plan will send a statement reflecting coverage starting January 1, 2015. Consumers who take no action will be renewed into their existing plan. More than 12,000 certified insurance agents, 10,000 county eligibility workers, and 6,400 certified enrollment counselors will help enroll consumers.
People who have health coverage through Medi-Cal can renew their coverage throughout the year, on a rolling monthly schedule. Medi-Cal will contact them directly if they need to take action. Unless they are contacted by Medi-Cal, these people don’t need to go to the Covered California website to renew or apply.
Covered California also provided updated enrollment numbers for 2014. Eighty-one percent of Californians who selected a plan during the initial open enrollment had their coverage take effect by paying their first month’s premium. A total of 1.12 million people have coverage and will be part of the renewal process. Covered California expects this number to increase with about 1.3 million Californians participating in the renewal process through the end of the year.
“This is our very first experience with renewal, and we will learn things during this process just as we learned a great deal about open enrollment during 2013 to 2014. We do believe many significant improvements have been made that will assist our consumers during renewal and open enrollment this year. We know this open-enrollment period will be more challenging in some ways. Consumers will only have three months to enroll, compared with the six months they had last time. This is complicated by our knowledge that many who are uninsured have adapted to a culture of coping and have become accustomed to living without health insurance,” said Covered California executive director Peter Lee.
Covered California will start open enrollment with more than double the number of service center representatives — state employed and contractors — to dramatically reduce wait times and help consumers enroll. More than 1,300 representatives will help consumers over the phone, by chat or by processing their paper applications or documents. This year, Covered California will have 254 reps who can serve consumers in languages other than English, compared to 55 in 2013. Covered California is working with health plans to make it possible for consumers to make their first premium payment online as soon as they have selected a plan. This will give consumers evidence that their payment has been received and that they will have coverage in place.
Covered California is redesigning its interactive voice response (IVR) system to handle more consumer calls while reducing wait times. With less than one month before open enrollment begins, consumers can begin the process of shopping for 2015 coverage. They can find out if they are eligible for financial assistance and find out how much a health plan will cost them, by using Covered California’s Shop and Compare Tool (on CoveredCA.com at www.CoveredCA.com/shopandcompare/#calculator). Covered California also offers a full listing of the plans and their rates at www.CoveredCA.com/PDFs/CC-health-plans-booklet-2015.pdf).
Report Card on Health Plans
The California Office of the Patient Advocate released a report card on the state’s 10 largest HMOs, six largest PPOs, and more than 200 medical groups. For more information, visit www.insurance.ca.gov.
Free Health and Wellness Conference in LA on Saturday
The California State Board of Equalization is holding its free Health, Wealth and Wellness Conference and Resource Fair Saturday, October 25 in Inglewood, Calif. from 9:00 a.m. to 2:00 p.m. The event features an eclectic lineup of 19 guest speakers with expertise in business and health care. Attendees will also have the opportunity to meet their elected representatives who make decisions that effect small businesses. To attend, visit www.boe.ca.gov/taxevents or call 888-847-9652.
The NFL Players Assn. PA Teams with Petersen
The NFL Players Association launched a disability insurance program created and administered by Petersen International Underwriters, based in Valencia, Calif. The program will provide members of the National Football League Players Association with career-ending, permanent total disability insurance on a guaranteed issue basis, and make protection available to players on and off the field. Scott Petersen, Petersen International’s resident expert on the professional athlete disability market said, “This new guaranteed issue athlete DI plan, has allowed Petersen International to turn a longtime friendship with the NFLPA into the chance to provide their members with the strongest and most necessary of insurance benefits when considering the physically hazardous nature of the occupation.” Petersen International Underwriters is a Coverholder at Lloyd’s and can be contacted at 800-345-8816 or at firstname.lastname@example.org.
Commissioner Complains About Blue Cross Rate Increase
Anthem Blue Cross is imposing a 9.8% premium increase on its small group health insurance policies. Insurance Commissioner Dave Jones is calling the increase unreasonable. “This…is the fourth consecutive rate increase by Anthem on small employers that the Department of Insurance found excessive and unreasonable. Over the last 24 months Anthem has raised rates on members in these small group policies an average of 24.9%. The Department of Insurance’s finding that Anthem’s rate increase is unreasonable is based on Anthem’s excessive return on equity or profits, its excessive pre-tax pricing margin, its unjustified high-pricing trend of 8.6 percent, which includes a prescription drug trend of 21.4%, and its failure to adjust the rate for the better health status of its remaining members. Also, last year, Anthem shifted $75.5 million of income to a premium deficiency reserve. This accounting maneuver was unwarranted and unjustified and decreased Anthem’s reported net income for 2013 and masked the fact that the company’s profit was over 20%. In five out of the last six years Anthem has attained a greater than 20% profit,” Jones said.
The Uninsured Are in the Dark About Open Enrollment
Eighty-nine percent of the uninsured are not aware that the next ACA open enrollment begins in November. In addition, two-thirds of the uninsured know little or nothing at all about the exchanges, and 53% are not aware that there is the financial assistance to help low- and moderate-income people purchase insurance, according to a survey by the Kaiser Family Foundation.
Fifty-nine percent expect to get coverage in the next few months including 15% who expect to get coverage from an employer, 15% who expect to purchase it (from a private insurance company or through an exchange), and 8% who expect to get it through Medicaid. Twenty-one percent expect to get coverage, but are not sure where. Most of those who expect to remain uninsured think they won’t be able to find an affordable plan (18%) or they don’t want to be forced to buy anything (12%, including 3% who say they would rather pay the fine than pay for coverage).
This month’s tracking poll finds more people view the ACA unfavorably (43%) than favorably (36%). Fifty-six percent Most Americans say the health care law has had no direct effect on their families. For those who report an effect, 26% say the law has hurt them while 16% say it has helped them. The ACA does not stand out as a top issue for the mid-term elections among registered voters. The ACA ranks fourth as voters’ most important issue. For more information, visit www.kff.org.
State Medicaid Programs Are Trying to Adjust to the ACA
The main focus for state Medicaid directors is implementing the ACA and reforming delivery systems in fiscal years 2014 and 2015, according to a report by the Kaiser Family Foundation. “Whether a state elected to expand or not, Medicaid programs across the nation are being transformed with new enrollment procedures and outreach efforts combined with increased emphasis on delivery systems reforms,” said Diane Rowland, executive vice president of the Foundation and executive director of the KCMU.
All states are streamlining Medicaid enrollment and renewal, transitioning to uniform income eligibility standards, and coordinating with new ACA insurance exchanges. State Medicaid officials are implementing or expanding Medicaid health homes, patient-centered medical homes, and initiatives to integrate care and financing for dual-eligible beneficiaries. The majority of states are expanding long-term care services in home or community-based settings. With improvements in the economy, more states have been implementing provider rate and benefit enhancements.
States expect the number of people enrolled in Medicaid to increase 13.2% in fiscal year 2015, which runs through June in most states. The 28 states (including the District of Columbia) that are implementing the Medicaid expansion for fiscal year 2015 expect to see the largest enrollment and spending growth — an 18% increase in enrollment and an 18.3% increase in total Medicaid spending in fiscal year 2015. For more information, visit www.kff.org.
Eliminating Subsidies Would Increase the Number of Uninsured
Ending ACA subsidies would increase premium costs in the individual exchanges by as much as 43% and cause enrollment to drop 68%, according to a RAND study. The tax subsidies have been challenged, in federal courts across the country, on the grounds that the wording of the law only allows aid to people who buy policies through state-run exchanges. “If subsidies are eliminated entirely, our research predicts substantial disruption in the individual health insurance market,” said Christine Eibner of RAND.
Replacing subsidies with vouchers would make the health insurance exchanges more sensitive to changes in the age mix of those enrolling. For example, with vouchers instead of tax credits, each 1% reduction in young adult enrollment would trigger a premium increase of about three-quarters of 1% on the insurance exchanges. A 1% reduction in young adult enrollment would trigger less than one-half of 1% – with the ACA’s tax credit structure. For more information, visit www.rand.org.
HealthCare Consumerism Conference
The IHC Forum on heath care consumerism will be held November 10 to 12 in Las Vegas. For more information, visit http://www.theihccforum.com.
Medicare Supplement Insurance Association Offers Conference Scholarships
The American Association for Medicare Supplement Insurance (AAMSI) is offering a limited number of $300 scholarships to attend the organization’s 2015 national industry conference. The scholarships are available to insurance professionals who market and sell Medicare Supplement insurance and MedAdvantage protection and have not attended a prior conference. The conference will be held in Orlando, Fla. from April 13 to 15. The scholarships will reduce the early registration price to $275. For more information, visit http://www.InsuranceExpos.com
Recognizing Employer Excellence
Aon Hewitt launched the “Aon Hewitt Best Employers” program. Marriott is the first organization to be certified globally under the new Aon Hewitt Global Best Employers program; the company was also recognized at the country and regional levels. Mary Kay, Sodexo, and Teleperformance Group have achieved best employer status at the regional or country level. Employers are assessed on these four measures:
- Employees speak positively about their employer, intend to stay, and are motivated to do their best work every day.
- Leaders define a clear vision, recognize the importance of their employees, and lead employees to success.
- Employees get rewarded and recognized for their contributions.
- Employees are proud of the company; and know what makes their employer a great place to work.
MassMutual Expands Support for Taft-Hartley Retirement Plans
MassMutual’s Retirement Services has expanded its sales teams to keep pace with its fast-growing Taft-Hartley retirement plans practice and the retirement savings needs of unionized workers. MassMutual has one of the largest staffs dedicated to Taft-Hartley retirement plans, according to Doug DeNigris, national practice leader. MassMutual now serves more than 140 retirement plans sponsored by unions representing more than 278,000 members and $11.25 billion in retirement plan assets under management as of June 30, 2014. MassMutual is aggressively growing its share of the Taft-Hartley retirement plan market, adding 50 plan sponsors and more than $4 billion in assets since 2012, DeNigris said. For more information, visit YouTube.com/RetireSmart.
Hospital Cost Transparency Tool
Global Excel Management launched FairChex, a hospital value-ranking tool. FairChex prompts the user to select a clinical category and geographic area. It ranks facilities by value – a weighted blend of cost and quality. FairChex highlights estimated costs for a procedure, provider mark-ups, Medicare reimbursements and quality rankings specific to the procedure selected. Benjamin Tabah, product development and marketing manager said, “There are a lot of tools out there for shopping routine care, but we wanted to focus on inpatient care, which is where the value is, and to use the most objective data we could find. With more patients acting like consumers now, the ability to influence behavior through incentives is ripe.” For more information, call 819-437-2277.
Employer’s Guide to Voluntary Benefits
Purchasing Power released an employer’s guide to voluntary benefits designed to help companies match exchange options to employees. For more information, visit www.PurchasingPower.com.
Benefit Engagement Software
Navera enhanced its benefit engagement software, which helps employees and consumers choose healthcare and voluntary benefits. Enhancements to the cloud-based system include the following:
- Improved visual design and rich animation.
- Up-to-date and easily readable content on healthcare and voluntary benefits.
- Better navigation that enables self-paced learning.
- A unified consumer experience for healthcare, ancillary products, defined benefits, defined contribution models, group benefits, and direct-to-consumer channels.
- Personalized decision support.
- Medical and ancillary plan recommendations based on plan details and user profiles.
- A portfolio approach providing ancillary plan recommendations in the context of medical plan choice.
- Configurability of benefit plan details and plan options, including flexible plan comparisons.
- Company-specific messaging that supports internal HR initiatives.
- Simple integration with existing enrollment technologies or benefit administration systems.
For more information, visit www.navera.com.
PlanSource expanded its PlanSource OneMarket Exchange. Brokers can create an exchange with carriers and benefits tailored to their clients’ needs or join a national proprietary exchange with pre-configured plans and options. For information, visit http://www.plansource.com.