Today the CA Governor announced that California will not use the MRMIP program as the temporary high risk pool for uninsurable California residents.
Instead, MRMIP will continue to operate alongside the federal risk program to be established by HHS in the next few months.
Stay tuned for more details on the temporary risk pool and how to enroll. Remember, the federal risk pool is a temporary program to 2014 to help cover those who cannot obtain private health insurance and have been without insurance coverage for six months or longer.
MRMIP is a California state risk program for CA residents who are unable to obtain private health insurance. The current waiting list for MRMIP enrollment is 3-4 months from application submission.
Thursday, April 29, 2010
Anthem CA Rate Increase Withdrawn
According to KGO Radio, Anthem Blue Cross CA has withdrawn the proposed 39% rate hike for California. Apparently they will be re-working the numbers for a more moderate change at some point in the future. Members will be given 30 days notice before any rate changes would go into effect.
KGO Article
KGO Article
Friday, April 23, 2010
Anthem Fights Back (Finally!)
On Thursday, a "reporter" at Reuters wrote a story about Anthem/Wellpoint deliberately rescinding health insurance policies on women who developed breast cancer. The article, which was then rebroadcast by other media, is full of factual errors (one of the women was not even insured by Anthem/Wellpoint and another's name was mispelled throughout the article). The media "report" even caused HHS Secretary Sebelius to fire off a nasty letter to Angela Braly (CEO Wellpoint/Anthem).
After getting beaten up over the last few months and being portrayed as an evil cross between Attila The Hun and Adolf Hitler, Anthem finally is fighting back against this kind of lazy and inaccurate "journalism".
Anthem Response to Reuters Article
Anthem Response to HHS Sebelius' Letter
It gets better, folks. The url for the original story is no longer active and the "corrected" story (minus the woman who was not even a Wellpoint/Anthem insured) is available here. Here's the top quote on the "revised" article:
After getting beaten up over the last few months and being portrayed as an evil cross between Attila The Hun and Adolf Hitler, Anthem finally is fighting back against this kind of lazy and inaccurate "journalism".
Anthem Response to Reuters Article
Anthem Response to HHS Sebelius' Letter
It gets better, folks. The url for the original story is no longer active and the "corrected" story (minus the woman who was not even a Wellpoint/Anthem insured) is available here. Here's the top quote on the "revised" article:
Corrected: WellPoint routinely targets breast cancer patients(Removes all references to Robin Beaton in first paragraph and throughout to reflect that the insurance company that canceled her policy was not a WellPoint subsidiary)
Temporary Risk Pool (California)
Just a quick update on one of the provisions of healthcare reform that goes into effect in September--the temporary risk pools for the uninsurable who have 6 months or more uninsured (and are uninsurable).
Each state was given the option to use a federal risk pool (HHS) or, if that state has its own risk pool, to use the state program and receive federal $$ for it ($5 Billion earmarked for these temporary risk pools).
While I assume California will likely us the California MRMIP program for eligible California residents, a decision has still not been made by the MRMIB (Major Risk Medical Insurance Board) in Sacramento.
I called them this week for an update and was told that they are still meeting about it and working through the myriad of implications for using MRMIP.
I will provide updates as they become available and as we get closer to the initial changes under the new Healthcare Reform law.
For more information on California's MRMIP health insurance risk program (and other state programs), visit my CalHealth page.
Each state was given the option to use a federal risk pool (HHS) or, if that state has its own risk pool, to use the state program and receive federal $$ for it ($5 Billion earmarked for these temporary risk pools).
While I assume California will likely us the California MRMIP program for eligible California residents, a decision has still not been made by the MRMIB (Major Risk Medical Insurance Board) in Sacramento.
I called them this week for an update and was told that they are still meeting about it and working through the myriad of implications for using MRMIP.
I will provide updates as they become available and as we get closer to the initial changes under the new Healthcare Reform law.
For more information on California's MRMIP health insurance risk program (and other state programs), visit my CalHealth page.
The HIPAA Tango Continues (Anthem Blue Cross)
For those who may be looking at my HIPAA page and wondering what is going on with Anthem Blue Cross enrollments, I thought this might help (I hope!).
Effective 5/1/10, Anthem has a new enrollment process for HIPAA plans. The process works like this: application and supporting documents to get approval to enroll, premium notice sent out upon Anthem's "OK" to enroll (approval), then you pay future premium to get future start date. Gaps can run 30, 60, 90 days or more. Sounds crazy, huh?
I have spent the better part of this week tee-ing off Anthem trying to get clarification and work-arounds for enrollments for Californians in need of HIPAA coverage and don't want to gap coverage.
So, to answer the question of whether or not there would be a necessary gap in coverage from group to HIPAA, a firm "maybe". It is going to depend on how early on we can start the process.
It is possible to enroll under the new system at Anthem and have a seamless start date. But it is tricky. Here's what needs to happen to make it work.
60 days prior to the expiration of continuation (or loss of group is terminating active coverage), we will need to provide some or all of the following to help get you enrolled:
1. Completed HIPAA enrollment application.
2. Copy of Termination Notice (either COBRA, Cal-COBRA or from group. This is a letter you receive about 60 days prior to exhaustion indicating that your continuation coverage will expire on a certain date.
3. Records to reflect payments of premiums for the full period including the final month (bank online statements, letter from administrator, etc.). Something to show you've made 18 or 36 months of premium payments (if continuation coverage).
4. Copy of current health insurance ID card and name of employer (usually on the card)for those not eligible for the Cal-COBRA extension to 36 months.
5. If covered 1st 18 months federal COBRA and now on Cal-COBRA extension, a copy of your group health certificate issued after federal COBRA expiration (from the COBRA Administrator or Health Plan)
The purpose of such documentation is twofold. One, we need to help you get Anthem Blue Cross to generate a premium payment "approval letter" as soon as possible within the 60 days prior to eligibility date so that you can submit your HIPAA premium and receive your desired 1st of month start date. Two, your Group Health Certificate (Certificate of Creditable Coverage/Certificate of Prior Health Coverage, it goes by several names) will normally not be provided until 10 days AFTER the expiration of the group health plan. Anthem has stated that they will accept "substitute" proof of exhaustion in lieu of the CoCC to expedite the enrollment process.
Effective 5/1/10, Anthem has a new enrollment process for HIPAA plans. The process works like this: application and supporting documents to get approval to enroll, premium notice sent out upon Anthem's "OK" to enroll (approval), then you pay future premium to get future start date. Gaps can run 30, 60, 90 days or more. Sounds crazy, huh?
I have spent the better part of this week tee-ing off Anthem trying to get clarification and work-arounds for enrollments for Californians in need of HIPAA coverage and don't want to gap coverage.
So, to answer the question of whether or not there would be a necessary gap in coverage from group to HIPAA, a firm "maybe". It is going to depend on how early on we can start the process.
It is possible to enroll under the new system at Anthem and have a seamless start date. But it is tricky. Here's what needs to happen to make it work.
60 days prior to the expiration of continuation (or loss of group is terminating active coverage), we will need to provide some or all of the following to help get you enrolled:
1. Completed HIPAA enrollment application.
2. Copy of Termination Notice (either COBRA, Cal-COBRA or from group. This is a letter you receive about 60 days prior to exhaustion indicating that your continuation coverage will expire on a certain date.
3. Records to reflect payments of premiums for the full period including the final month (bank online statements, letter from administrator, etc.). Something to show you've made 18 or 36 months of premium payments (if continuation coverage).
4. Copy of current health insurance ID card and name of employer (usually on the card)for those not eligible for the Cal-COBRA extension to 36 months.
5. If covered 1st 18 months federal COBRA and now on Cal-COBRA extension, a copy of your group health certificate issued after federal COBRA expiration (from the COBRA Administrator or Health Plan)
The purpose of such documentation is twofold. One, we need to help you get Anthem Blue Cross to generate a premium payment "approval letter" as soon as possible within the 60 days prior to eligibility date so that you can submit your HIPAA premium and receive your desired 1st of month start date. Two, your Group Health Certificate (Certificate of Creditable Coverage/Certificate of Prior Health Coverage, it goes by several names) will normally not be provided until 10 days AFTER the expiration of the group health plan. Anthem has stated that they will accept "substitute" proof of exhaustion in lieu of the CoCC to expedite the enrollment process.
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