Health Insurance Blog

Anthem Blue Cross which is a subsidiary of WellPoint, INC has notified some policyholders in California, Maine, Oregon and other states that individual health insurance rates are going to increase.  This is according to the article “Individual Insurance Rates Soar in 4 States” by The Associated Press on msnbc.com.

In California the rates are to increase up to 39% by March 1.  This is going to be devastating to many individuals who are already struggling to pay bills.  In Maine they are asking for increases up to 23% this year.  Last year alone they increased rates in Maine by 32%.  In Oregon many health insurance companies were granted rate increases of 15% or more this year after about 25% increases from last year.

Health insurance quotes are much more volatile for individual policies when compared to policies under employers and other large groups.  Those types of groups often have bargaining tools and a large pool of people to spread out the risk.  This makes it tough for those who aren’t part of groups and must get individual health insurance.  These rates increases are going to hurt a lot of people financially.

Anthem Blue Cross is delaying their proposed rate increase to their California individual health insurance customers after much criticism, and a request by the California Department of Insurance.

The proposed health insurance rate increase would have raised monthly premiums for some members by as much as 39%.  According to Anthem the rate increase represents anticipated medical costs.

Regulators do not believe the sizable rate increase is justified given how profitable parent company Wellpoint was in 2009.

Situations like these, where health insurance companies have been coming off record profits, and then request significant rate increases based on actuarial data are not endearing themselves to the American public, and to politicians looking to solve the country’s health care issues.

The state of California has launched a website that will help California residents select the best PPO health plan for their needs.  The site contains both summary ratings as well as more detailed underlying metrics of each plan measured.

California has provided similar information to HMO customers since 2002.

Their are currently 5 California PPOs measured on the site, and none of them received an overall 4 star rating (highest score).  Aetna, Cigna and Healthnet each received 3 stars while Anthem and United HealthCare received 2 stars.  Blue Shield of California was late on providing data necessary to included in ratings amd will be included in ratings in 2011.

More information about California health insurance.

Open enrollment for Medicare Advantage plans is rapidly approaching (November 15 - December 31).  We thought we’d blog about some of the top rated plans in each state according to US News and World Reports annual rankings.

In California, Kaiser Foundation Health Plan boasts the 2 top ranked plans in the state. Kaiser Foundation Health Plan of Southern California was the top rated Medicare health plan in California with an overall score of 88.1, followed by Kaiser’s plan covering Northern California (86.8).  These two plans were followed by Health Net of California (83.2), Pacificare of California (81.7) and Aetna Health of California (80.4).

None of the twenty California Medicare Plans ranked in this study received a customer assessment score of greater than three stars out of five.  However, both Kaiser plans faired very well in both treatment and prevention measures, with five stars.

More information about California health insurance.

Effective January 1, Blue Shield of California will be removed from the Major Risk Medical Insurance Program (MRMIP) because their premiums were substantially higher than the rates offered by the other two insurers that make up the Program.

The MRMIP currently covers almost 7,000 California residents who are unable to purchase private health insurance due to pre-existing conditions.

Health insurance companies that participate in the MRMIP Program are allowed to charge 25% higher premium than the market rate for a given health insurance policy, and if the insurer loses money they will be reimbursed by the state.  Despite the state subsidization, Blue Shield’s health insurance rates were much higher than both Kaiser Permananete’s or Anthem Blue Cross of California.

Current enrollees in the MRMIP Program via Blue Shield will be able to keep their existing coverage until January 1, and then must enroll with one of the other health plans that participate in the Program.

More information about California health insurance.

A rare bi-partisan bill in the California legislature, allowed more than 700,000 children in low-income California families to maintain their health insurance coverage through the Healthy families Program.

The deal restored about $200 Million that was slashed from the budget this summer.  For this to happen, health insurance companies agreed to impose a tax on themselves.  In addition, Healthy Families participants will pay slightly higher premiums.

Healthy families provides health, vision and dental coverage for nearly 1 million children whose families aren’t poor enough to qualify for Medi-Cal but can’t afford private health insurance.

More information about California health insurance.

According to the PRWeb article through medicaresupplementplans.com entitled “California Health Insurance Assistance Program Awarded 2009 Grant Funding”, California health insurance assistance programs are expected to receive about $3 million in grants to help Medicare beneficiaries in need of information on health insurance topics.

This is an ongoing effort to better assist these citizens who are often lacking comprehensive and accurate information about their health care options.  The funds being used are part of a $35.8 million grant from the Centers for Medicare and Medicaid Services.  The grants to California health insurance assistance programs are part of the 1st installment of funding that began in April ‘09 and will end in March ‘10.

Seniors often underestimate how time consuming researching and understanding their benefits can be.  And sometimes it gets really complicated.  These funds will support programs designed to make this process for them a little easier.  The assistance is personalized and local while providing a wide range of health insurance information best suited to each individual.

According to J.D. Power and Associates, Kaiser Foundation Health Plan was the top rated California health plan based on their 2009 survey.

Based on their survey and analysis of more than 130 health plans nationally (broken up into 17 distinct regions), Kasier Foundation Health plan was the tops in the California region and among the best nationally.

The other health plans from California that were surveyed all performed below average.  They included:  Blue Cross of California, Blue Shield of California, Aetna, HealthNet, Pacificare, and CIGNA.

More information about the J.D. Power 2009 Health Plan Ratings.

More information about California health insurance.

Bobby Caina Calvan from the Sacramento Bee reports that the state of California has settled with Anthem Blue Cross regarding its cancellation of individual health insurance policies. The settlement requires that the insurer reinstate coverage for those whose policies were unfairly rescinded between 2004 and 2008, regardless of any medical conditions they may have. Qualified consumers will be contacted over the next three months via phone. In addition, Anthem Blue Cross must reimburse $14 million worth of out-of-pocket health expenses paid by these consumers.

The California health insurance company also has to pay a $1 million fine to the Insurance Department, with an extra $2 million tacked on if they fail to change their policies, Bobby says.

The city of San Francisco has filed suit against California insurance regulators alleging that they have approved a health insurance rating system that allows California health insurance companies to charge women more than men for health insurance coverage.

In the state of California, gender rating is permitted in setting health insurance rates, which allows a customers gender to be used as a rating factor in determining their health insurance premium.  A practice that has resulted in women paying on average 39% more than men for identical coverage.

Currently 10 states outlaw the practice of gender rating with regard to individual health insurance rates, however California is not one of them.

Blue Shield of California representatives have claimed that their actuaries crunched the numbers based on healthcare data and indeed found that women are more injury prone than men and more likely to break bones or become sick, thus justifying the relevance of using gender as a rating factor.