Best Carrier?

[PhxSunsFan]

I told a friend I would ask this.. for a family that qualifiies for enhanced silver 87 in Oceanside Ca 92054, which plan would be the best. ( they have no docs they see now and wife is pregnant)
hnet silver 87 hmo 57/month
bl shield silver 87 ppo 158/month
anthem silver 87 epo 134/month

are they able to change carriers at will? thanks.

 

[CABenefits]

I told a friend I would ask this.. for a family that qualifiies for enhanced silver 87 in Oceanside Ca 92054, which plan would be the best. ( they have no docs they see now and wife is pregnant)
hnet silver 87 hmo 57/month
bl shield silver 87 ppo 158/month
anthem silver 87 epo 134/month

are they able to change carriers at will? thanks.

Health Net Silver. Stay away from Anthem BC. Make sure to check with their hospitals and doctors by calling them to find out what they accept. Health Net has the best network where Anthem is the worst.

Michael

 

[Quotebroker]

Health Net Silver. Stay away from Anthem BC. Make sure to check with their hospitals and doctors by calling them to find out what they accept. Health Net has the best network where Anthem is the worst.

Michael

In your estimation why is Health Net HMO superior, network-wise?

 

[CABenefits]

Throughout California I find Shield may be accepted at a hospital like Scripps but Anthem is not. And vice versa with Anthem. Health Net has been contracted with near 100% of hospitals and providers. What are you seeing in your area?
In our rural area in the valley, the pathway PPO with Anthem has lost a major clinic along with a handful of the best dr groups. Shield had to beg an orthopedic surgeon to stay in network and agreed to reimburse them based on the narrow SHOP network level.

Michael

 

[Quotebroker]

Generally I'm seeing each subscriber want to keep their current doctor. I'll contact the doctor as well as check them against the networks to see what plans they're taking, then go from there. It seems like most sales are made on network rather than price if they already had health coverage. If they're new to insurance, they almost always want lowest price no matter what I may say.

I'm seeing the Health Net PPO have a fairly large network size, but also only available in Bronze for most of my clients. To get Silver+, only an HMO is available much of the time.

From a name-value perspective, many clients want UCLA and Cedars. UCLA takes Anthem EPO or Health Net Bronze. Cedars just Health Net PPO. Health Net HMO accepted by neither. Since 80% of our business has been silver, the Health Net Bronze PPO network size has been marginalized. Anthem also has City of Hope, UCSF, UCSD, UCI

Blue Shield is making a late run, now that they secured Hoag in OC to go with Scripps, Keck and the St. Joseph's and John Muir networks.

Based on reviewing the top hospitals in CA, it seems very few of them accept several on-exchange plans. Long Beach Memorial is the only one I've found to accept Anthem, Shield, AND Health Net. The rest seem to have chosen to do business with only 1 plan or 1 plan plus partial coverage with a second.

All in all, it just depends on the pre-existing relationship the client already has. I'm not really seeing a one-size-fits-all network, especially as 99% of my existing clients don't come from an HMO.

 

[CABenefits]

Health Net reduced commissions to 2%. I won't be selling HN any longer. Amazing what can change in a week

 

[Quotebroker]

Health Net reduced commissions to 2%. I won't be selling HN any longer. Amazing what can change in a week

and yet, on the exchange, they expect us to show all plans and options. 2%! Remember 20/10?

 

[CABenefits]

and yet, on the exchange, they expect us to show all plans and options. 2%! Remember 20/10?

Yep, from 20% to 2% in 5 years. The writings on the wall already

 

[hankavocado]

Correct me if I'm wrong, but H/Net is still paying 5% on the silver, gold, and platinum products. What has changed is on bronze and catastrophic plans, instead of a measly $30 one-time reward, it is a 2% commission. While not great, I would prefer a 2% commission over a reward. That is why I would have anyone choose any carrier over Kaiser IFP, because they don't pay me.

 

[Dave020]

Correct me if I'm wrong, but H/Net is still paying 5% on the silver, gold, and platinum products. What has changed is on bronze and catastrophic plans, instead of a measly $30 one-time reward, it is a 2% commission. While not great, I would prefer a 2% commission over a reward. That is why I would have anyone choose any carrier over Kaiser IFP, because they don't pay me.

No, you are incorrect. Re-read the memo from Health Net dated 1/29/14.

Item 1 replaces the $30 payment with 2% on Bronze effective 1/1/14 (retroactive).

Item 2 amends 3/1/14 as follows for the first exhibit D:

Plat 5%
Gold 5%
Silver 5%
Bronze 2%
Cat 5%

On the back of the page exhibit D is further amended for 3/1/14 as follows:

Plat 2%
Gold 2%
Silver 2%
Bronze 2%
Cat 2%



As to Kaiser, IFP comp is $100 per member 1st year, $50 per member renewal.