Medi-Cal’s Paper Waste?

Did you catch the Los Angeles Times opinion piece on Medi-Cal’s provider directory? Some carriers are trying to gain approval to switch from publishing a paper directory to digital only. L.A. Care, for example, submitted a proposal in June to go digital, which would save at least $1 million for the company. California has yet to approve the switch, however. The cost savings and environmental impact ultimately make digital a no-brainer. But the LA Times editorial fails to acknowledge the sizeable amount of research that indicates there’s still work to be done with eliminating racial/ethnic barriers both to internet access and to the willingness to access health information online. In essence, we see why the state is thinking carefully about approving online-only Medi-Cal directories. If directories go digital, we need a way to ensure everyone can access and use them.

Covered CA for Small Biz Announces Rates and Plans
Covered California for Small Business (CCSB) recently unveiled the health plan choices and rates for small-business employers and their employees for the 2018 plan year. The statewide weighted average rate change will be 5.6 percent for employers and their employees, which is down from the 5.9 percent change in 2017.

  • Among the five plans CCSB will offer in 2018:
  • PPOs – Blue Shield of California and Health Net
  • HMOs – Kaiser Permanente and Sharp Health Plan
  • Community health plan– Chinese Community Health Plan in San Francisco.

CCSB will not offer Western Health Advantage in 2018, a change that will affect approximately 350 consumers. CCSB has experienced double-digit membership growth for the third consecutive year.  Currently, more than 35,000 individuals have insurance through CCSB, representing a growth of approximately 7,600 individuals for a 27 percent gain in membership over this time last year. This makes CCSB one of the largest small-business health option programs in the nation.  CCSB spokespeople say that similar to the individual market, consumers may be able to limit increases in their rates or perhaps even save money on their premiums by shopping and switching to the lowest-cost plan in the same metal tier. Businesses with one to 100 employees can apply for coverage. Federal tax credits may be available to employers with 25 or fewer employees. Get more info at the CCSB website.

RAND Study Says ACA Repeal Will Hurt Vets
A new study by the nonprofit, nonpartisan RAND research organization concludes that proposals to repeal or replace the federal Affordable Care Act would likely increase the demand for service in the Veterans Affairs medical system, while also increasing the number of veterans who have no insurance coverage. Under legislation passed by the U.S. House of Representatives, health coverage losses among nonelderly veterans would be concentrated among older, low-income and less-healthy veterans, according to the study. These groups of veterans are more likely than other nonelderly veterans to obtain care from the VA medical system, magnifying the potential impact of ACA repeal on demand for VA care. “Repealing or significantly scaling back the Affordable Care Act is likely to increase the number of uninsured veterans,” said Michael Dworsky, the study’s lead author and an economist at RAND. “Some veterans who lose health insurance coverage as a result of ACA repeal will become more likely to seek care from the VA health system, leading to additional strain on a health care system that already faces challenges in ensuring adequate capacity.” The report “Veterans’ Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs” is available at RAND’s website.

Health Plan Changes Bring Questions
Many of you regularly sleuth out answers to complicated health insurance questions posed by your clients. But maybe you haven’t heard these questions yet. California Healthline answers several interesting dilemmas when it comes to health plan changes. It’s worth the read!

EBN: Macy’s Case Means Wellness Plans May Face More DOL Scrutiny
The Department of Labor recently brought suit against Macy’s Inc., as well as the third-party administrators of the retailer’s health plan, for various violations under the Employment Retirement Income Security Act of 1974. At issue is a tobacco surcharge. The suit alleges that the Macy’s wellness plan doesn’t meet the applicable wellness plan non-discrimination requirements because the plan failed to provide a reasonable alternative standard for participants to avoid the tobacco surcharge levied by the plan. It also alleges the plan continued to charge participants a tobacco surcharge even while participants were enrolled in the wellness plan’s smoking cessation program. More details can be found at Employee Benefit News. Bottomline: if the wellness plan is an outcome-based, health-contingent plan that contains a tobacco surcharge, plan sponsors and administrators should ensure that participants who satisfy any plan requirements for avoiding the surcharge are excused from the surcharge for the entire period of coverage.

Hixme Launches Employer Health Cost Simulation Tool, Invites Broker Inquiry
Agoura HIlls-based Hixme and design collaborator Axene Health Partners (AHP) has launched BundleMe™, a high-tech, big data tool that finds the best core benefits and wraparound plans for each insured in groups 500 to 5,000. Companies routinely end up saving 10 to 20 percent on health benefits, according to Denny Weinberg, Hixme’s CEO and a former senior executive at Wellpoint. “Hixme’s platform delivers a very different and attractive model for large insurers, particularly those who may be starting to think about self funding,” says Weinberg. The two-year-old company is open to creating relationships and training opportunities for large group brokers. Contact the company through Hixme’s website.

It’s Life Insurance Awareness Month
September is Life Insurance Awareness Month. Life insurance is a 200-year-old U.S. institution and more than 85 percent of Americans say it’s important. Yet only half of the population has an individual life insurance policy. Get useful info, infographics, videos and more at LIMRA’s website. Help convince the other half of the population that life insurance is attainable and necessary for their life plans!


Women Who Rock the Industry
Women in Insurance & Financial Services (WIFS) announced its 2017 Circle of Excellence qualifiers. WIFS Circle of Excellence is a recognition program for members who achieve significant income levels. The recognition is based on annual production for the previous year. This year, 178 members qualified for the distinction with a reported combined income of $53.1 million. Qualifiers will be recognized for their achievements on October 26 during the 2017 WIFS National Conference in Minneapolis, Minnesota. Check out the entire list of Circle of Excellence qualifiers here.


World Medical Tourism & Global Health Conference – Oct 2-4 Los Angeles
The fast growing field of medical tourism is creating a need for trained and knowledgeable professionals. Visit the World Medical Tourism & Global Health Conference for workshops and classes to become a Certified Medical Tourism Professional (CMTP). More info at

Women in Insurance and Financial Services 30th Annual National Conference – Oct 25-27 Minneapolis
This year’s conference, Dream It Achieve It, will celebrate the impact that women are making in the insurance and financial services industry.  The conference focuses on empowering women through dynamic educational workshops, networking events and inspirational sessions that help women invest in their futures. An additional element of this year’s conference is a featured session that provides attendees the opportunity to earn continuing education (CE) credits. The exhibit hall will host 50 vendors with products and services aimed at elevating the businesses of those in the industry. Workshop topics include marketing strategies, sustainable investing, Department of Labor policy, best practices, team building and more. Learn more and register at the WIFS conference page.

NAILBA 36 – Nov. 16-18, Hollywood, Florida
Registration is now open for the National Association of Independent Life Brokerage Agencies (NAILBA) 36th Annual Meeting, NAILBA 36.  Scheduled November 16-18, 2017, at the Diplomat Beach Resort in Hollywood, Florida, the meeting will attract high level representatives from brokerage general agencies, life insurance carriers and insurance industry vendors.  This year’s agenda has been expanded to deliver four keynote experiences over three general sessions and more than 15 workshops. Go to for a complete schedule of events.









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