Covered California 13 Individual Health Plans

[houcoogster]

BCBSTX is having big problems renewing their contract with Memorial Herman System it's about 20 hospitals. You know BX will be on the tx exchange but it looks like without the biggest hospital network in the Houston area. Also employer plans use BX and I'm sure if they can't strike a deal many of the employers will look for another carrier that has this network. Stuff is happening behind the scenes big time.

 

[taterpeeler]

BCBSTX is having big problems renewing their contract with Memorial Herman System it's about 20 hospitals. You know BX will be on the tx exchange but it looks like without the biggest hospital network in the Houston area. Also employer plans use BX and I'm sure if they can't strike a deal many of the employers will look for another carrier that has this network. Stuff is happening behind the scenes big time.

yea, typical bcbstx... if you recall the same saber rattling took place last month with Methodist hospital chain up here in dallas... they settled that one last week....

time will tell but highly likely they will settle this,

 

[stuy119]

Remember, this cuts both ways. The Blues don't want to lose members, but the hospital ystem would take a hit with fewer patients.

It will get worked out. It's MAD principles in effect.

 

[Yagents]

This is NUTS ! And they bitch that broker commissions are causing premiums to rise. That's more than I receive now. What a farce this whole law is!

ICYMI: LA Times: Some Consumers to Face “Sharply Higher Premiums” in California Exchange | AHIP Coverage

In addition, California is imposing a new fee of $13.95 per member per month to run the exchange. That amounts to approximately $56 per month – or over $670 per year – in higher costs for a family of four purchasing coverage in the new health care exchange.

 

[AllenChicago]

This is NUTS ! And they bitch that broker commissions are causing premiums to rise. That's more than I receive now. What a farce this whole law is!

ICYMI: LA Times: Some Consumers to Face “Sharply Higher Premiums” in California Exchange | AHIP Coverage

In addition, California is imposing a new fee of $13.95 per member per month to run the exchange. That amounts to approximately $56 per month – or over $670 per year – in higher costs for a family of four purchasing coverage in the new health care exchange.

When there are HUNDREDS OF BILLIONS OF DOLLARS flowing out of Washington, every entity that can get its grubby hands into the stream of cash is going to do it. It's like blood in the water at sea. Can't wait to see what other entities show up with creative excuses for claiming some of this gold-mine. I can even see the IRS taxing families on the subsidies that are sent to the insurance company on their behalf.

Sadly, the California monthly FEE is higher than some of the Agent Commission estimates!
-ac

 

[Ann H]

In YAgent's post above, he gave a link to the article, and also quoted one paragraph from it. In that paragraph, the word "fee" is a link. I followed that link to slides of a presentation, and on page 10 it says:

Assessment Per Member Per Month (PMPM) Assumptions
• Based upon sustainability using estimated premium at the time PMPM was finalized for model
contract
• $13.95 is reflected in the proposed rates of the Plans

New Rate Information
• Based upon negotiated premiums, average premium of ~$320 for individual coverage results in
effective Assessment Rate of 4.4 percent

Covered California is expected to impact administrative expenses for insurance carriers offering products through the Exchange (Milliman Report March 28, 2013)
• Potential Reductions – Underwriting; Marketing & Sales; Broker & Agent Commissions; Streamlined
Plan Designs
• Potential Increases – Exchange interface; Reporting requirements
• No assumed reduction to administrative fees due to changes in cost of operations
• However, change in distribution channel from Brokers & Agents to the Exchange may result in lower
administrative costs, impacting premiums by ~-4.5 percent​

This is maddening. They charge 4.4% in fees (isn't that a "commission"?). And that commission is on top of the grants and funding they received from the Feds. Then the last paragraph quoted above mentions broker/agent commission reductions, and touts an anticipated change in distribution channel from broker/agents to the exchange. I have often said that the exchanges are government takeover of private business provided currently by brokers and agents. The driver of spiraling health care costs is not rooted in agents and brokers commissions, nor in our ability to compare policies on "exchanges" that we've had for years through quote engines. The exchange is trying to do our job, only worse and more costly.

 

[AllenChicago]

How can the CA exchange people give a hard 4.5% savings number on commissions when it's up to each insurance company how much in commissions they will pay to brokers for sales of their particular product?

 

[Yagents]

The writing is on the wall but i cant read chinese

 

[taterpeeler]

The writing is on the wall but i cant read chinese

get out guys... this ship has sunk.......

 

[RayNY]

I thought the admin fee was something we went over in 2010? Remember everyone going "3.5%!? That's basically what you pay brokers to do what you want to do without us!" FFE's are 3.5%, State run was up to them. A $13.95 flat fee is not that out of hand, especially considering the ES/EC/Family rates. Overall, it will probably end up being <3%.