Health Insurance Blog

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.

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.

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.