Covered California Exchange Web Site Now Live

[AllenChicago]

Cigna and UHC not so much, Aetna is a bit of a surprise.

Ah, Aetna, wish I never met.........nevermind

Even though Aetna has consistently stated that it will only be in a "handful" of state exchange-marketplaces, not seeing AETNA participate in the huge, diverse state of California caught many by surprise. Here's Aetna's explanation:

"Our decisions about which Exchanges to participate in on are based on a careful review of key attributes, such as our current market presence, our ability to offer strong networks and competitively priced products and the regulatory environments in each state."

Source: Why Aetna ain't in Covered California exchange - San Francisco Business Times

The Kaiser Permanente statements make it sound like they were pushed into participating and are very nervous.
-ac

 

[AllenChicago]

None of the California Exchange-Marketplace companies are keeping their full provider networks. This "network shock" will offset the premium rate satisfaction that media and officials are now proclaiming.

"People who want UCLA Medical Center and its doctors in their health plan network next year, for instance, may have only one choice in California's exchange: Anthem Blue Cross. Another major insurer in the state-run market, Blue Shield of California, said its exchange customers will be restricted to 36% of its regular physician network statewide."

Source: Insurers limit doctors, hospitals in state-run exchange plans - Los Angeles Times

If an insurer chooses to offer the same plan outside of the exchange, does it have to have the same provider network as its exchange counterpart?

-Allen

 

[taterpeeler]

None of the California Exchange-Marketplace companies are keeping their full provider networks. This "network shock" will offset the premium rate satisfaction that media and officials are now proclaiming.

"People who want UCLA Medical Center and its doctors in their health plan network next year, for instance, may have only one choice in California's exchange: Anthem Blue Cross. Another major insurer in the state-run market, Blue Shield of California, said its exchange customers will be restricted to 36% of its regular physician network statewide."

Source: Insurers limit doctors, hospitals in state-run exchange plans - Los Angeles Times

If an insurer chooses to offer the same plan outside of the exchange, does it have to have the same provider network as its exchange counterpart?

-Allen

first off.... 36% of its regular network... wow.... like I have said before we will be selling these plans in much the same way we do MAPD now.... check dr's and rx and present the plan that fits that criteria.

Next, I think there has been talk about the networks being wider outside the xchange however I personally have seen nothing to back that up... yet....

 

[Yagents]

This is a form of rationing under ocare. Medicaid for all. So sad.

 

[Ann H]

Yes, the networks are narrow. Some of them are scrawny.

There were a lot of narrow things about those plans. Look at the Dr. visit copays for the Silver plan - $45 for Primary Care and $65 for a Specialist.

Those Silver Plan rates don't look nearly so "affordable" when you factor in the high copays, high out-of-pocket, narrow networks, and the fact that most of them are HMO's.

I can't wait to see more details, like the Rx formulary, for instance. The government claims the benefits are "richer", but they mean for things like guarantee issue and unlimited essential health benefits. They forgot to tell the customer the copays would be high.

 

[Quotebroker]

LA Times holding a live chat about the CA Exchange, however nobody from Covered CA scheduled to be on the chat:

State-run health insurance market and its effect on you [Live chat] - latimes.com

With enrollment starting in four months, California's new state-run health insurance market unveiled proposed rates last week that came in better than what many experts predicted.

Still, some consumers who don't qualify for premium subsidies under the federal healthcare law could see substantially higher rates for their health coverage next year.

Join us for a live video chat about these issues at 2 p.m. with reporter Chad Terhune. You can join in on the conversation with your questions or comments.

Other guests on the chat will include Micah Weinberg, a senior policy advisor at the Bay Area Council, an employer-backed San Francisco group, and Bruce Jugan, an agent in Montebello and president of Benefitscafe.com, which sells health insurance to individuals and businesses.

 

[stuy119]

Please ask why the media isn't talking about the limited networks the exchange plans represent.

 

[Yagents]

LA Times holding a live chat about the CA Exchange, however nobody from Covered CA scheduled to be on the chat:

.

Also ask them why they are comparing these new rates to small group plan rates, vs comparing them to existing individual insurance rates in the current market.

 

[Ann H]

And ask why they are not using the Platinum plan for comparison, since its benefits are closer to current copay PPO benefits than the Silver plan is.

 

[taterpeeler]

is it to late to ask them if they even understand obamacare?