Category Archives: Open Enrollment

Open Enrollment season for California health insurance public exchange, Covered California. Important deadlines, what you need to know to preserve your open enrollment options for affordable healthcare coverage.

Zenefits Transfers 7000 Insurance Accounts

What will happen to Zenefits’ 7000 employers now that the San Francisco firm has announced it will exit the insurance “broker of record” business?

“By partnering with OneDigital, Zenefits is essentially getting out of the broker business, a move that will allow the company to focus solely on making software.” [San Francisco Chronicle, September 21, 2017]

Zenefits: From San Francisco to Atlanta, Georgia

As reported in this recent San Francisco Chronicle story, Zenefits has arranged with Atlanta-based firm, One Digital, to take-over servicing the 7000 insurance accounts.  Atlanta, Georgia? This may be the perfect time to say “no” to Atlanta and transfer your account to a Local Broker.

“With less than two months from open enrollment season, the Zenefits decision provides California Employers a timely opportunity to transfer to a local, California Broker: We are already receiving phone calls.”  [Marc Derendinger, Insurance Broker #0644617]

How To Keep Your Insurance In California

If you have Kaiser Permanente, check with KaiserPlanet.org for a Local Broker.  For employers who offer dual choice benefits or plans from Anthem, United HealthCare or Blue Shield, contact this 50-year California-based benefits brokerage, the San Francisco bay area.

Zenefits exits Broker Business

 Telephone (408) 252-7300 to discuss your options with a local broker, license 0644617

Anthem Individual Health Insurance Changes Again

More Disruption Ahead For Anthem Individual Health Insurance Policyholders, As Anthem drops Covered California In Most Counties

Why is Anthem withdrawing from the exchanges in California?

Which Counties will Anthem keep?

(In Anthem’s own words…)

“While Anthem is reducing its 2018 Individual plan offerings in California, it is not withdrawing from the exchanges. We are pleased to be participating in three key areas”

“On-exchange and off-exchange EPO plans at all metal levels will be offered in three regions of Northern California…”

We give credit to DerendingerIns.com for covering this story:  Read the full article

UnitedHealthcare To Quit Covered California

Another health plan joins the California wall-of-shame, as Covered California announces the departure of UnitedHealthcare. Existing members can continue on through December 31, 2016, allowing them time to find a new plan during the Fall 2016 Open Enrollment.

UnitedHealthCare quits Covered California

UnitedHealthcare Quits Covered California

According to Covered California, UnitedHealthcare’s presence in the Covered California individual marketplace is small, at one tenth of one percent. Yet the impact will be greatly felt in some Northern California regions, where only three plans are available to consumers.

Health plan consolidation is already contributing to the lack of viable options in California. For example, in 2005 United Health Group purchased PacifiCare, which had previously acquired FHP, who had acquired TakeCare in 1994.

Some long-time market stakeholders fear “consolidation” plays into the hands of California legislators who are pushing for a single, government-run plan. They wonder if some legislators go beyond “cheering” for the Affordable Act’s demise, and would stoop so low as to sabotage its successful implementation?  Are there more democrats than republicans, hoping for Obamacare’s demise? Really?

UnitedHealthcare Regions in California

  
Region 1Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, Yuba
Region 9Monterey, San Benito, Santa Cruz
Region 11Fresno, Kings, Madera
Region 12 San Luis Obispo, Santa Barbara, Ventura
Region 13Mono, Inyo, Imperial

As the individual marketplace continues to deteriorate, the small group market has gained a firmer footing, including stable PPO networks and easier participation rules with Kaiser and traditional PPO plans.  Is it time to review available small group plans?   Reserve your appointment early for Open Enrollment, which begins this November.  Find local assistance in San Jose, Santa Clara and the San Francisco bay area or via telephone, throughout Northern and Southern California..

or view online pricing, free of charge

3 Actions To Keep Affordable Health Coverage- CoveredCA

While Federal or Cal-COBRA is the conservative choice (as discussed in Part I of this article), the negative aspects are “higher costs.”  This is true because Federal COBRA administrators add 2% to the premium and Cal-COBRA administrators add 10%. If finding a low cost health plan is your priority, your 2nd action to keep affordable health coverage- CoveredCA should be requesting information from Covered California [Small Employers should read about huge penalties beginning August 2015]

  • Covered California provides access to most private health plans e.g. Kaiser Permanante, Anthem Blue Cross, Blue Shield of California, HealthNet EPO and PPO plans and some regional providers as well (although availability varies among each of California’s counties- check here for assistance): extra caution is advised, because you must complete and submit your application prior to the desired 1st of the month coverage start date to avoid a gap in coverage, and the 60 Day Limit also applies.

Warning:  failure to enroll within the special event 60-day period will not only incur a possible IRS tax penalty, but will consequently lock you out of the U.S. health insurance market until the following open enrollment period i.e. January 1st!  (This is a lessor known problem with the Affordable Care Act).

Need Temporary Health Insurance?   CLICK TO QUOTE

 

Yet there are other reasons to skip CoveredCA and go directly to a private carrier.  Read more about the 3rd of 3 Actions to keep affordable health coverage while looking for a job in Part III of this article.

Return to Part I of this article or proceed to Part III or request assistance now.

California Open Enrollment Extended to

California Open Enrollment Extended to April 30th

Obamacare Choices… Free Assistance Before April 30th

If you (or someone you know) has not yet purchased individual health insurance, good news is here:

Although the California Open Enrollment extended period closed April 30th, you could qualify for a qualifying special enrollment event, if certain circumstances exist. [ Read more about qualifying Special Events here.]

Read why Everybody’s Happy With Obamacare in California

Questions About Special Events?  Get Local Assistance Now

Covered CA Website Causes Suffering During Open Enrollment

Covered CaliforniaCovered CA website causes suffering during open enrollment this week after being fortified for high utilization.  An interview with a San Jose-based Certified Agent provided the following observation:

Today, I assisted at least 4 different clients on their renewal process and/or to start a new application.  The website directed all of the clients into Medi-Cal, even if their income was well above 140% FPL

Calling Covered California directly is not an option, due to five-hour wait times.  Cases such as these require special handling, which is a free benefit of Certified Agents.  For example:

I had a family of three come in with a total annual household income of $49,666.73 and they were placed on Medi-Cal.

Certified Agents can provide local assistance with such glitches, and often times are willing to meet you in person. Read our related article about avoiding Open Enrollment mistakes.  Open Enrollment is here, changes are coming, and websites are frustrating.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Obamacare: Not Easy!   ............  Cake Pop, Anyone?

Obamacare: Not Easy! ………… Cake Pop, Anyone?

Kaiser California Individual Members Pay Twice in December 2014

California Marketplace

The Affordable Care Act hits Kaiser Members hard

Yes, Kaiser California Individual members pay twice in December 2014, in order to help Kaiser Permanente catch up with industry standards.

As explained in a Kaiser Permanente November news briefing to its marketplace partners, Kaiser’s status as a prepaid health plan requires monthly payments before the last day of each month. Apparently, throughout 2014 Kaiser has not been billing its members for prepayment, and now plans to catch up in time for January 2015.  Read our related article about avoiding Open Enrollment mistakes this year.

What Kaiser California Individual & Family members need to know:

  • You will receive two separate bills in December- one for the December 2014 premium and a second bill for the January 2015 premium
  • Both bills must be paid by December 31st.

The news briefing goes on to say certain members may have extra time to pay, based on their Evidence of Coverage or Membership Agreement.  To get free assistance from a California Kaiser agent, send a request to info@coverage-ca.com or phone 1 (408) 641-8950.

Remember, Open Enrollment begins November 15th:  Changes are coming and websites are frustrating. Read our related article about CoveredCA’s problems. If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Anthem Blue Cross Doctors & Hospitals

Which Anthem Blue Cross network accepts your plan?

Covered California

Covered California

Deciphering the confusing Anthem Blue Cross Doctors & Hospital networks [This story was updated in December 2014]

California insurance consumers should be extra cautious during open enrollment season (November 15, 2014 to February 15, 2015) that their doctor was not been dropped by their health plan (see related story about the thousands of California HealthNet plan members who are forced to take action by December 15th).

Don’t ask your doctor- he or she probably won’t even know it happened, due to the confusing network games that insurance companies play.  For example, see the confusing Anthem Blue Cross Doctors & Hospital network references in the table below…

Provider Directory Reference Guide

PLAN NAME AT COVERED CALIFORNIAOR IT MAY LOOK LIKE THIS ON YOUR ID CARDOR LIKE THIS ON THE ANTHEM WEBSITE
Anthem Silver 70 PPOAnthem Silver Direct AccessPathway X-PPO via Exchange/Silver Direct Access
Confused?Call for free assistance:1 (408) 641-8950

For what its worth, we are providing a link to the entire directory guide from Covered California:

PROVIDER DIRECTORY GUIDE

There are lot’s of doctors, coming and going from these networks…some accept group plans and others accept individual plans, but the names are confusing for them, too.  We strongly advise you to hook up with a local Certified Agent (it’s a free service from Coverage California) and make sure you don’t make a big mistake for all of 2015.

Remember, Open Enrollment began November 15th:  Changes are coming to certain PPO & HMO networks.  Read a related article about CoveredCA here.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Coverage California and are here to help.

HEALTH NET PPO PLAN CLOSURES AT COVERED CALIFORNIA

Health Net PPO Plans California

Health Net PPO Plans

Open Enrollment 2015 begins November 15th

Open Enrollment 2015

Health Net has shipped 90-day plan closure notices to Health Net PPO members (see related story about Anthem Blue Cross) in Covered California who are currently enrolled in PPO plans (Individual or Family PPO plans).  These notices shipped October 2nd, as Health Net moves its PPO portfolio off-exchange.  For the time-being, Health Net will not offer an individual or family Health Net PPO plan through Covered California.

What can you do to keep Health Net PPO plan coverage?  Fortunately, you have options… If you wish to keep the same doctor and stay on a similar plan directly (i.e. off-exchange) with Health Net, CLICK HERE to request free assistance.

If you wish to talk with someone to get information about the remaining PPO plans at Covered California, CLICK HERE.

Caution should be observed if you purchased a plan during the last open enrollment:  Effective after this Open Enrollment, Insurers are shifting doctor and hospital networks.  Do not take chances with your policy.  Before you renew, talk with one of our representatives for FREE.

See our related story about Covered California Open Enrollment Notices.

Remember, Open Enrollment begins November 15th:  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Covered California Open Enrollment Notices

Covered California Notices

Covered California is shipping envelopes by Mail for Open Enrollment season (see above)

Members will receive Covered California open enrollment instructions over the next two weeks, informing them of the Renewal Process.  If you need assistance understanding the 2015 changes, click here to request help.  Read story, If you want to review details about last year’s open enrollment or just get a free quote at this website.

Due to an online systems limitation from October 13 to November 3, 2014 only, you will be unable to login to your account in order to report changes for the 2014 plan year.  Covered California has developed a work-around during this period and you can receive assistance from Certified Insurance Agents here.

Remember, Open Enrollment begins November 15th:  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.