Back to Work!

Be in the know of this board overview of the current market


Greetings fellow agent community!

I hope you have enjoyed your summer — it’s been a hot one here in the San Fernando Valley. At least we got to be open for a few months…that COVID-19 Delta variant is now rampant here. Read a great article in MedPage Today recently that reminded me, the media LIKES to make us freak out because then we watch more of it.

That doesn’t mean to take it lightly, but understand that the Delta Variant has made its way through several countries already and numbers went up really fast, then dropped relatively quickly. So, I am going to put out the energy that we will get through this outbreak quickly!

I’m seeing a lot of “Back to School” commercials and posts that remind me FALL is just around the corner and we all know what that means…duh duh duh…


Medicare is a hot topic right now with CAHU Medicare Events happening up and down the state. By the time you read this, one if not two will have already happened. The feedback of agents taking both AHIP and the NAHU Certification is positive. Humana ( is offering a $10 discount on the NAHU Certification, so it is a $90 investment. You get an official certification to include in your signature line and 12 months’ worth of ‘study group’ type content with agents from across the country.

With Individual and Family Plan (IFP) enrollment open now to the end of the year through Covered California ( with increased subsidies, uninsured numbers continue to decline. California’s individual market is one of the strongest in the country with 12 carriers participating this year. See more updates in the “CAHU STATEment,” ( along with a full legislative update as the legislature went into summer recess!

What do I hear from my group agent friends?

Looks like this might be a light 4Q with existing business. Rates are flat for the most part so no need to disturb employees’ benefits. Agents are becoming more intrigued with self-funding and level funding. Virgin groups are coming in — employers DO see the value of offering benefits. HIRING and RETENTION are keywords I keep hearing. The Blues are always competitive, but keep your eyes open to Aetna and Health Net with some competitive plans AND rates too.


  • If a plan has “value” in it, that does not necessarily mean a skinnier network, but could be in the plan design!
  • Mental health requests are increasing – EAP (employee assistance programs) are great tools, and there are many virtual options
  • COBRA 100% subsidies are almost up, so questions are coming regarding how to get
  • Covered California has an ARPA special enrollment through December and people can enroll at any time.

What else is going on from the agent view?

How many of you received an email from Dignity Health asking for support in their Anthem contract negotiations? Let’s consider the ramifications and follow the food chain. When a carrier has to pay MORE $$$ to a provider, where will the impact of that large increase hit? Premiums. Consumers are very price sensitive right now and an increase in premiums will continue to push the needle to a single payer system in California.

Then we will all be employed by the government under a single payer system. While I appreciate that Dignity Health self-proclaims they are the number one Medicaid provider, I imagine Medicaid costs will go up regardless — especially since Gov. Newsome signed into law AB 133 expanding Medi-Cal to anyone income eligible over 50. The buck has to stop somewhere.

Speaking of Medi-Cal — I was excitedly helping a client, with a family of four, move from Medi-Cal into what was estimated to be a highly subsidized Covered California plan because one of the parents acquired gainful employment. After making the update WITH PROOF OF INCOME in the Covered California system, eligibility did not change. I let my client know that to move things along, a call to Social Services might be required.

My client called me back and said the supervisor told her that she probably wouldn’t be happy with the subsidy she would get, and right now she could stay on the Medi-Cal system for FREE until the next annual evaluation because due to COVID-19 they are not dis-enrolling anyone!

Can you imagine? We have government employees encouraging people to take what’s “FREE” whether they qualify for it or not, irrespective of the consumer’s choice to enroll with Covered California.

So, I called in with my client because I couldn’t believe they wouldn’t allow her to choose a plan outside of Medi-Cal — even though she proved her income was in the 380-400% FPL range. This person was almost forceful that my client should stay on the FREE system as long as she could. Guess who pays for that FREE system? All of us, in our premiums when providers raise rates to subsidize low Medi-Cal reimbursements!

That was a lot and yet it’s not everything. If you are reading this and you make a living in this industry and you are not yet a NAHU/CAHU member, the $50ish dollars a month is the best job protection insurance you will ever spend. JOIN Now at

I would be remiss if I didn’t say “Happy 40th Anniversary, Cal Broker Magazine!” Thank you for the honor to write in your publication and for supporting agents through the associations for so many years!

Be kind to each other. Sending out healthy wishes and smooth sailing for the Fourth Quarter!

DAWN MCFARLAND is founder and president of M&M Benefit Solutions Insurance Services. She is passionate about helping individuals — especially Medicare eligible — navigate choosing how they receive their health care. She believes in education as one of the means to help change the high cost of healthcare. Dawn

currently serves as VP of Legislation for CAHU; on the Medicare Advisory Council and the Membership Council for NAHU and is currently a member and past president of the Los Angeles Association of Health Underwriters (LAAHU). Contact: or visit