List of California Carriers Participating in the Exchange Released
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Dennis Jarvis
Jun 23, 2013, 5:27:03 PM6/23/13
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Article Title: List of California Carriers Participating in the Exchange Released
Author: Dennis Jarvis
Word Count: 588
Article URL: http://www.isnare.com/?aid=1846023&ca=Finances
Format: 64cpl
Contact The Author: http://www.isnare.com/eta.php?aid=1846023
Easy Publish Tool: http://www.isnare.com/html.php?aid=1846023
*********************** ARTICLE START ***********************
The information on California health reform is gaining momentum and today was the first of two very important pieces of information to be released. We received a notification of which carriers will participate in the Health Exchange in California starting Jan 1st, 2014. There were few surprises but the list of carriers is smaller than we expected. Let's look at what we can expect.
Four major California carriers plus 9 Regional Players
The big four that will participate in the Individual and Family market (Group health market called SHOP will be announced next month) will be Anthem Blue Cross of California, Blue Shield of California, Kaiser, and Health Net of California. These carriers probably make up a good 90% of the individual and family market anyway but there are some notable exclusions. Aetna, Cigna, and United Health have announced that they will not participate in the IFP (Individual and Family plans) for the year 2014. They publicly stated that they will wait to see how the market settles out over the initial year and then re-evaluate. There were also smaller regional California carriers which can find on the full State announcement here.
Different Plan Types by Area
There will be 19 different geographic areas in California and more interestingly, the carriers are offering different network types (PPO, HMO, and EPO) by area. In some cases a carrier may offer a PPO in one region but offer an EPO in another region of the State. A quick refresher on the three. HMO's provide richer benefits but access to providers is more regulated (primary care physician, referrals, etc). The PPO offers more flexibility in terms of providers available and access to those providers but requires more cost sharing on behalf of the member. The EPO (or Exclusive Provider Organization) generally uses the PPO network but does not provide benefits outside the network in non-emergency situations.
The California health exchange also provided initial plan pricing which was the big deal. These rates may fluctuate as the State still needs to approve them but we have both average prices and the specific rates by area for a 40 year old. The rates confirm what we expected. We took an example of a person who was on a grandfathered $4000 deductible plan which is very comparable to the Bronze. The family rate for two 42 year olds (plus 2 kids) is about $850 ($288 for two 40 year old adults each plus we're estimating about $150 for each child). They're current rate is $550 or a $300/difference. $300 is a pretty big jump from $550. Granted, the Grandfathered plans are better priced than some of the currently available plans (depending on which one you have...the old Share plans are pretty high) but the real important piece is whether you can apply a health subsidy to this amount.
Health Subsidy calculation shown in rate grid
If the above family makes under 400% of the Federal Poverty Level, that roughly $850 premium will come down significantly depending on what percentage of the the FPL, the family makes. Let's say that between 250-400% of the FPL (qualifies for subsidy) will probably break even. They will pay about the same as they did before Health Reform. If the famly makes between 138-250% of the FPL, that family will probably pay less than they before. If they make below 138% of the FPL, they will be eligible for free Medi-Cal. Over 400%? They'll pay the full $850 and that's going to be tricky. All of a sudden, the 4 times FPL becomes very very important!
About The Author: Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual and Small Group California health insurance market. http://www.calhealth.net
Please use the HTML version of this article at:
http://www.isnare.com/html.php?aid=1846023
*********************** ARTICLE END ***********************
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Message delivered directly to members of the group:
publish-the...@googlegroups.com
*****************************************************************
Please consider this free-reprint article written by:
Dennis Jarvis
*****************************
IMPORTANT - Publication/Reprint Terms
- You have permission to publish this article electronically in free-only publications such as a website or an ezine as long as the bylines are included.
- You are not allowed to use this article for commercial purposes. The article should only be reprinted in a publicly accessible website and not in a members-only commercial site.
- You are not allowed to post/reprint this article in any sites/publications that contains or supports hate, violence, porn and warez or any indecent and illegal sites/publications.
- You are not allowed to use this article in UCE (Unsolicited Commercial Email) or SPAM. This article MUST be distributed in an opt-in email list only.
- If you distribute this article in an ezine or newsletter, we ask that you send a copy of the newsletter or ezine that contains the article to http://www.isnare.com/eta.php?aid=1846023
- If you post this article in a website/forum/blog, ALL links MUST be set to hyperlinks and we ask that you send a copy of the URL where the article is posted to http://www.isnare.com/eta.php?aid=1846023
- We request that you ask permission from the author if you want to publish this article in print.
The role of iSnare.com is only to distribute this article as part of its Article Distribution feature ( http://www.isnare.com/distribution.php ). iSnare.com does NOT own this article, please respect the author's copyright and this publication/reprint terms. If you do not agree to any of these terms, please do not reprint or publish this article.
*****************************
Article Title: List of California Carriers Participating in the Exchange Released
Author: Dennis Jarvis
Word Count: 588
Article URL: http://www.isnare.com/?aid=1846023&ca=Finances
Format: 64cpl
Contact The Author: http://www.isnare.com/eta.php?aid=1846023
Easy Publish Tool: http://www.isnare.com/html.php?aid=1846023
*********************** ARTICLE START ***********************
The information on California health reform is gaining momentum and today was the first of two very important pieces of information to be released. We received a notification of which carriers will participate in the Health Exchange in California starting Jan 1st, 2014. There were few surprises but the list of carriers is smaller than we expected. Let's look at what we can expect.
Four major California carriers plus 9 Regional Players
The big four that will participate in the Individual and Family market (Group health market called SHOP will be announced next month) will be Anthem Blue Cross of California, Blue Shield of California, Kaiser, and Health Net of California. These carriers probably make up a good 90% of the individual and family market anyway but there are some notable exclusions. Aetna, Cigna, and United Health have announced that they will not participate in the IFP (Individual and Family plans) for the year 2014. They publicly stated that they will wait to see how the market settles out over the initial year and then re-evaluate. There were also smaller regional California carriers which can find on the full State announcement here.
Different Plan Types by Area
There will be 19 different geographic areas in California and more interestingly, the carriers are offering different network types (PPO, HMO, and EPO) by area. In some cases a carrier may offer a PPO in one region but offer an EPO in another region of the State. A quick refresher on the three. HMO's provide richer benefits but access to providers is more regulated (primary care physician, referrals, etc). The PPO offers more flexibility in terms of providers available and access to those providers but requires more cost sharing on behalf of the member. The EPO (or Exclusive Provider Organization) generally uses the PPO network but does not provide benefits outside the network in non-emergency situations.
The California health exchange also provided initial plan pricing which was the big deal. These rates may fluctuate as the State still needs to approve them but we have both average prices and the specific rates by area for a 40 year old. The rates confirm what we expected. We took an example of a person who was on a grandfathered $4000 deductible plan which is very comparable to the Bronze. The family rate for two 42 year olds (plus 2 kids) is about $850 ($288 for two 40 year old adults each plus we're estimating about $150 for each child). They're current rate is $550 or a $300/difference. $300 is a pretty big jump from $550. Granted, the Grandfathered plans are better priced than some of the currently available plans (depending on which one you have...the old Share plans are pretty high) but the real important piece is whether you can apply a health subsidy to this amount.
Health Subsidy calculation shown in rate grid
If the above family makes under 400% of the Federal Poverty Level, that roughly $850 premium will come down significantly depending on what percentage of the the FPL, the family makes. Let's say that between 250-400% of the FPL (qualifies for subsidy) will probably break even. They will pay about the same as they did before Health Reform. If the famly makes between 138-250% of the FPL, that family will probably pay less than they before. If they make below 138% of the FPL, they will be eligible for free Medi-Cal. Over 400%? They'll pay the full $850 and that's going to be tricky. All of a sudden, the 4 times FPL becomes very very important!
About The Author: Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual and Small Group California health insurance market. http://www.calhealth.net
Please use the HTML version of this article at:
http://www.isnare.com/html.php?aid=1846023
*********************** ARTICLE END ***********************
- To distribute your articles go to http://www.isnare.com/distribution.php
- For more free-reprint articles go to http://www.isnare.com
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