Anthem Covered California is Leaving Most California Counties

Anthem has announced that their Health Insurance plans will only be available in certain Northern California Counties for the 2018 plan year.

This pull-out does not affect any of their Medicare Supplement, Medicare Advantage or Group Health plans.  This is only for their under age 65 individual and family health insurance plans starting January 1, 2018.

2018 Anthem Counties:

Anthem Covered California Counties for 2018:  Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mariposa, Mendocino, Merced, Nevada, Plumas, San Joaquin, Santa Clara, Shasta, Sierra, Siskiyou, Stanislaus, Sutter, Tehama, Trinity, Tulare, Tuolumne, and Yuba county.

As you can see, Anthem has completely removed their plans from Southern California.  There are going to be a lot of Anthem policy members who need to compare and enroll in new plans.

I will be available 7 days a week during open enrollment because the Covered California phone lines will have very long wait times.

Be sure to look into either Blue Shield or Kaiser depending on where you live.  Both offer very popular plan to choose from.  Blue Shield will have the only State wide traditional PPO plan available.

The same plan levels will be available for 2018; Bronze, Silver, Gold and Platinum plans.

Subsidy and Premium Discount:

Do you qualify for a Subsidy (Discount)?  It depends on your household annual income and how many family members will be enrolling in a health plan.  Below is the income chart which shows the minimum and maximum household income levels to qualify for a subsidy.

Modified Adjusted Gross Income (MAGI)

The figure used to determine eligibility for premium tax credits and other savings for Covered California health insurance plans and for MediCal and the Children’s Health Insurance Program (CHIP). MAGI is adjusted gross income (AGI) plus these, if any: untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest.
  • For many people, MAGI is identical or very close to adjusted gross income.
  • MAGI doesn’t include Supplemental Security Income (SSI).
  • MAGI does not appear as a line on your tax return.

Many Californian’s qualify for a premium subsidy.  If you need help or are not sure if you and your family qualify, just give me a call, I’ll be happy to help.

Regardless of the county you live in, you will have company and plan options available to you and your family.  Call me when you have a few minutes and we can discuss your options.

Call anytime for help with your health insurance needs. If you would like to apply for coverage, I can enroll you right over the phone.  It’s easy.

John Conner
916-682-1117
john@johnconner.com

Information Request:

Covered California Health Insurance Open Enrollment Dates 2018

The 2018 Covered California Open-Enrollment dates are as follows:

November 1, 2017 is the start of open enrollment, and runs through January 31, 2018.

Enrollment Dates:

  • November 1 – December 15 = January 1 start date
  • December 16 – January 15 = February 1 start date
  • January 16 – January 31 = March 1 start date

The above dates are for anyone enrolling through the Covered California health insurance Exchange.  This is the only way one can receive a subsidy or premium discount.  If you enroll for example to Blue Shield, Kaiser or Anthem directly through one of their links, you will not receive the subsidy even if you qualify.

Subsidy or premium discounts are determined by your household income. Add up everyone in the house who receives a full time or part time income, including investment distributions.

If your household income is above $138% and 400% or below, you may receive a premium subsidy or discount.  If you are 138% or below, you or your children may be placed on a MediCal health insurance plan.

Enroll outside of the Exchange:

If you are enrolling or changing plans outside of the Covered California health insurance exchange.  In other words, you do not qualify for a subsidy or premium discount, then your open-enrollment is; November 1, through December 15, 2017.  It is only 6 weeks long.

The benefit chart below will give you an idea of how the different plans (Bronze, Silver, Gold, Platinum) provide coverage.

Be sure to not only compare prices and coverages between companies, but also look at the networks of doctors and hospitals.  You will find that not only do premiums change but also networks.

Your doctor, medical group or hospital may be “in-network” this year (2017) with your current plan / company, but may not be for 2018. Networks change from year to year.  Call me and I can verify your doctors, specialists and hospitals for your 2018 plan.

Enrollment:

If you qualify for a subsidy and wish to enroll in a Covered California health insurance plan, you can enroll over the phone with me, or I can send you a short paper enrollment form for your self and or your family members.

Call me anytime with help with enrollment.  I will also be working weekends during open enrollment.

Please contact me anytime for a free comparison.

John Conner
916-682-1117
john@johnconner.com

Information Request:

Blue Shield Covered California Los Angeles County

The 2018 Blue Shield Covered California PPO is the only company offering their PPO health insurance plans in every county of California including Los Angeles County.

Los Angeles County in 2018 will have limited PPO plans available to its residents.  Anthem has decided to leave all southern California Counties for the upcoming plan year.  So if you are looking for a traditional PPO style plan, I recommend looking at the different Blue Shields plan for yourself and family.

Open-Enrollment Dates:

The 2018 Blue Shield Covered California open-enrollment dates are as follows:

  • November 1 – December 15 = January 1 start date
  • December 16 – January 15 = February 1 start date
  • January 16 – January 31 = March 1 start date

The above dates are for anyone enrolling through the Covered California health insurance Exchange.  This is the only way one can receive a subsidy or premium discount.  If you enroll for example to Blue Shield, Kaiser or Anthem directly through one of their links, you will not receive the subsidy even if you qualify.

Subsidy or premium discounts are determined by your household income. Add up everyone in the house who receives a full time or part time income, including investment distributions.

If your household income is above $138% and 400% or below, you may receive a premium subsidy or discount.  If you are 138% or below, you or your children may be placed on a MediCal health insurance plan.

If you Enroll outside of the Exchange:

If you are enrolling or changing plans outside of the Covered California health insurance exchange.  In other words, you do not qualify for a subsidy or premium discount, then your open-enrollment is; November 1, through December 15, 2017.  It is only 6 weeks long.

Doctors & Hospitals

If you have certain doctors and hospitals you want access to, please contact me and I can verify or look up doctors, specialists, medical groups and hospitals to see if they are contracted with Blue Shield in 2018.

Available Plans

Bronze (Basic Plan):  The Basic plan is designed for people who want affordable coverage with low monthly rates in exchange for a higher deductible for protection in the event of a serious medical emergency.  Benefits like preventive care and three doctor visits are available for a fixed copayment before meeting the deductible.

Bronze (Basic HSA Plan):  If you are looking for a plan with lower monthly rates and a way to better manage your healthcare coverage spending, look to the Blue Shield Basic Plan for high deductible health plans that are Health Savings Account eligible.  With an HSA, you can prepare for future medical costs by contributing pre-tax money to your own healthcare related expenses.  And preventive care is received before the deductible.

Silver (Enhanced Plan):  The Enhanced plan offers a good balance between you premium and your out of pocket costs.  You’ll receive benefits like doctor visits and generic drugs prior to meeting the annual deductible.  Other covered medical services, such as hospitalization, are covered after you meet the annual medical deductible.

Gold (Preferred Plan):  Our Preferred plan offers good coverage with manageable out of pocket costs, so it’s easier to predict additional expenses.  There are no deductibles, so Blue Shield starts paying for all covered benefits immediately, including popular benefits such as doctor visits, prescriptions and urgent care.

Platinum (Ultimate Plan):  Blue Shield’s Ultimate plan offers you the lowest out-of-pocket costs for medical services.  There are no deductibles, so we start paying for covered benefits right from the start.  By paying higher monthly premiums, you’ll usually pay less when accessing care for medical services such as doctor visits, prescription drugs and hospitalization.

Help with Enrollment

I will be working 7 days a week during the open enrollment period.  And can help if you are anywhere in California.

Please contact me anytime for a free comparison.

John Conner
916-682-1117
john@johnconner.com

Questions & Comments:

2018 Covered California Open Enrollment Dates

The 2018 Covered California Open-Enrollment dates are as follows:

November 1, 2017 is the start of open enrollment, and runs through January 31, 2018.

If you enroll between November 1 and December 15, you will have a January 1, start date for your new policy.  If you enroll December 16 through January 15, your start date will be February 1.  The last effective date will be March 1st.  That is for individuals and families who enroll January 16 through the 31st.

The above dates are for anyone enrolling through the Covered California health insurance Exchange.  This is the only way one can receive a subsidy or premium discount.  If you enroll for example to Blue Shield, Kaiser or Anthem directly through one of their links, you will not receive the subsidy even if you qualify.

Subsidy or premium discounts are determined by your household income. Add up everyone in the house who receives a full time or part time income, including investment distributions.

If your household income is above $138% and 400% or below, you may receive a premium subsidy or discount.  If you are 138% or below, you or your children may be placed on a MediCal health insurance plan.

 

Enroll outside of the Exchange:

If you are enrolling or changing plans outside of the Covered California health insurance exchange.  In other words, you do not qualify for a subsidy or premium discount, then your open-enrollment is; November 1, through December 15, 2017.  It is only 6 weeks long.

The benefit chart below will give you an idea of how the different plans (Bronze, Silver, Gold, Platinum) provide coverage.

Be sure to not only compare prices and coverages between companies, but also look at the networks of doctors and hospitals.  You will find that not only do premiums change but also networks.

Your doctor, medical group or hospital may be “in-network” this year (2017) with your current plan / company, but may not be for 2018. Networks change from year to year.  Call me and I can verify your doctors, specialists and hospitals for your 2018 plan.

Enrollment:

If you qualify for a subsidy and wish to enroll in a Covered California health insurance plan, you can enroll over the phone with me, or I can send you a short paper enrollment form for your self and or your family members.

Call me anytime with help with enrollment.  I will be working weekends during open enrollment.

John Conner
916-682-1117
john@johnconner.com

Questions & Comments:

 

2018 Covered California Health Insurance

Individual & Family Health insurance

The upcoming Covered California open enrollment will start November 1 and ends January 31, 2018.  All enrollments from November 1 through December 15 will have a January 1 start date. Enrollments after December 16 through January 15 have a February 1 start.  Enrollments after January 15, have a March effective date.

Please call anytime for help with your enrollment.

Everyone in the U.S. is eligible for an individual and family health insurance policy of their choice regardless of health status.

There are 2 ways to enroll in a plan: Inside the Covered California Exchange, this is typically for the individual or family who qualify for a subsidy (premium discount) because of household income.  The other way to enroll is outside of the exchange through an online link.  This is for the individual or family who do not qualify for a subsidy. Please contact me anytime for help with your enrollment.

If you do not know if you qualify for a subsidy, please call and I can help with your situation.

Plan Design:

Bronze (Basic Plan):  The Basic plan is designed for people who want affordable coverage with low monthly rates in exchange for a higher deductible for protection in the event of a serious medical emergency.  Benefits like preventive care and three doctor visits are available for a fixed copayment before meeting the deductible.

Bronze (Basic HSA Plan):  If you are looking for a plan with lower monthly rates and a way to better manage your healthcare coverage spending, look to the Blue Shield Basic Plan for high deductible health plans that are Health Savings Account eligible.  With an HSA, you can prepare for future medical costs by contributing pre-tax money to your own healthcare related expenses.  And preventive care is received before the deductible.

Silver (Enhanced Plan):  The Enhanced plan offers a good balance between you premium and your out of pocket costs.  You’ll receive benefits like doctor visits and generic drugs prior to meeting the annual deductible.  Other covered medical services, such as hospitalization, are covered after you meet the annual medical deductible.

Gold (Preferred Plan):  Our Preferred plan offers good coverage with manageable out of pocket costs, so it’s easier to predict additional expenses.  There are no deductibles, so Blue Shield starts paying for all covered benefits immediately, including popular benefits such as doctor visits, prescriptions and urgent care.

Platinum (Ultimate Plan):  Blue Shield’s Ultimate plan offers you the lowest out-of-pocket costs for medical services.  There are no deductibles, so we start paying for covered benefits right from the start.  By paying higher monthly premiums, you’ll usually pay less when accessing care for medical services such as doctor visits, prescription drugs and hospitalization.

Enroll Today … Choose one of the companies, find the plan of your choice, and enroll, it as simple as that!  Your new ID and policy will be mailed within a couple weeks and you can start using your policy right away after the effective date.

No Broker Fees … My advice and services are free of charge, and the premium you pay should you buy a policy through us will never be higher than going direct to the insurer.

John Conner
916-682-1117
john@johnconner.com

Quote and Information Request:

Blue Shield Covered California Health Plans 2018

2018 Blue Shield Health Plans.  Review, compare and make changes during the open enrollment.

The upcoming Covered California open enrollment will start November 1 and ends January 31, 2018.  All enrollments from November 1 through December 15 will have a January 1 start date. Enrollments after December 16 through January 15 have a February 1 start.  Enrollments after January 15, have a March effective date.

The 2018 Blue Shield Covered California Health Insurance plans will be available for viewing during the upcoming open enrollment period and will be available for Individuals, Families and Children.  Call me today for the appropriate enrollment options. 

  • Blue Shield – Quotes 
  • Covered California Quote – See if you qualify for a subsidy (discount).  Call for a quote.

If you need help enrolling through Covered California, call me I can enroll you over the phone.

Enroll in a Blue Shield plan “On or Off” of the Covered California Exchange .. Enrolling Inside the Covered California Exchange is typically for the person or family who qualifies for a subsidy due to their income (see the chart below).  Individuals and families who do not qualify for a state subsidy, will usually enroll outside of Covered California (the plans are the same) although the application process is much quicker because you don’t have to state your income totals.

Other Companies:  Kaiser   –   Anthem

Find a Plan Design you can Afford … From the basic to the fully loaded, Blue Shield offers plans designed to fit your varying budgets and needs.  All of our plan options are compliant with the Affordable Care Act, and align with the four “metal” levels of coverage established by the law.  Ultimate (Platinum), Preferred (Gold), Enhanced (Silver) and Basic (Bronze).

Blue Shield also offers Get Covered (Catastrophic) plan.  Each plan varies according to price and amount of coverage, allowing you to find the premium, copay and deductible combination that’s right for your unique situation.

Plus, all of our plans provide coverage for all the essential health benefits:  Ambulatory patient services, Emergency services, Hospitalization, Maternity and new born care, Mental health and Substance abuse, Prescription drugs, Lab and X-Ray, Preventive care, Pediatric services including dental and vision care.

Help Paying for Coverage … Under the Affordable Care Act, eligible individuals and families can qualify for financial assistance to help with monthly rates and out-of-pocket healthcare expenses to ensure that everyone has easier access to quality healthcare coverage that’s affordable for them.  Covered California offers financial assistance depending on your income and family size (see the chart above).

The following table depicts incomes and federal poverty level percentages. Those making 138 percent of the federal poverty level or less may qualify for Medi-Cal, the low-cost or no-cost health insurance program in California.

Bronze (Basic Plan):  The Basic plan is designed for people who want affordable coverage with low monthly rates in exchange for a higher deductible for protection in the event of a serious medical emergency.  Benefits like preventive care and three doctor visits are available for a fixed copayment before meeting the deductible.

Bronze (Basic HSA Plan):  If you are looking for a plan with lower monthly rates and a way to better manage your healthcare coverage spending, look to the Blue Shield Basic Plan for high deductible health plans that are Health Savings Account eligible.  With an HSA, you can prepare for future medical costs by contributing pre-tax money to your own healthcare related expenses.  And preventive care is received before the deductible.

Silver (Enhanced Plan):  The Enhanced plan offers a good balance between you premium and your out of pocket costs.  You’ll receive benefits like doctor visits and generic drugs prior to meeting the annual deductible.  Other covered medical services, such as hospitalization, are covered after you meet the annual medical deductible.

Gold (Preferred Plan):  Our Preferred plan offers good coverage with manageable out of pocket costs, so it’s easier to predict additional expenses.  There are no deductibles, so Blue Shield starts paying for all covered benefits immediately, including popular benefits such as doctor visits, prescriptions and urgent care.

Platinum (Ultimate Plan):  Blue Shield’s Ultimate plan offers you the lowest out-of-pocket costs for medical services.  There are no deductibles, so we start paying for covered benefits right from the start.  By paying higher monthly premiums, you’ll usually pay less when accessing care for medical services such as doctor visits, prescription drugs and hospitalization.

Enroll Today:

Help with enrollment or if you have questions, please contact me anytime.

John Conner
916-682-1117 – phone
916-258-0296 – fax
john@johnconner.com

Information Request:

2018 Kaiser Permanente Covered California Health Plans and Rates

kaiser 1

2018 Kaiser Permanente Covered California health insurance plans for individuals and families will be available for viewing November 1.

The upcoming Covered California open enrollment will start November 1 and ends January 31, 2018.  All enrollments from November 1 through December 15 will have a January 1 start date. Enrollments after December 16 through January 15 have a February 1 start.  Enrollments after January 15, have a March effective date.

Anyone can get Kaiser coverage as long as you live in a Kaiser service area.  You can no longer be denied coverage because of a medical condition, and you don’t have to pass a medical exam to qualify for a Kaiser health insurance plan.

  • Quick Quote
  • Enroll Online
  • Covered California Quote – Call to see if you qualify for a subsidy (discount), also help with enrollment.

2018 Qualifying Events – Situations which allow you to enroll in a Kaiser plan “outside” the Open-Enrollment period:

  • Divorce, termination of domestic partnership or civil union.
  • Change in full time employment status.
  • Loss of employer sponsored insurance.
  • Voluntary or involuntary termination of employment.
  • Death of parent or spouse.
  • Change in dependent status – i.e. dependent child turning 26.
  • Existing coverage is being changed to a qualified health plan.
  • Marriage.
  • Domestic Partnership (in states which allow).
  • Birth of child.
  • Adoption of child.
  • Placement for adoption of child.
  • Guardianship or court order dependent.
  • Permanent move to a new state.

Other Companies:   Blue Shield   –   Anthem

Be sure to enroll by December 15 to receive a January 1, 2018 effective date. The only way to enroll in a plan after December 15 is if you have a “qualifying event” such as, you are coming off of an employer health insurance plan, or you move to an area where your current plan is not available or if you are moving on or off of MediCal.  There are a few other situations but typically if you miss the Open Enrollment period you will not be able to enroll for the balance of the year.

4 Levels of Coverage …  With all companies including Kaiser you will see four levels of coverage; Bronze, Silver, Gold and Platinum.  Each level provides a different level of coverage to meet your needs.  Bronze offering the lowest level, while Platinum is the highest.

All plans will offer the “essential health benefits” which are; doctor visits, hospital care, prescription coverage and maternity care, and will include certain preventive care for no charge.

Enrolling “On and Off the Covered California Exchange .. Enrolling “On” the Covered California Exchange is typically for the individual or family who qualify for a subsidy due to their income level.  Individuals and families who do not qualify for a state subsidy, will usually enroll “Off” Covered California (the plans are the same) although the premium amounts are quite different.

Health Care ... Almost everyone gets sick or hurt, or needs some sort of medical help.  To get better you usually need care, like seeing a doctor or staying in a hospital or taking prescription medications.  Health Care includes many different services such as; Doctors office visits, hospital stays, emergency room visits, X-Ray and Lab, prescription drugs, preventive care, well baby visits, well woman visits, immunizations and screenings.

Health Coverage Health Insurance is a lot like the insurance people get on their car or home.  Some people get their health insurance through their jobs, while others buy it themselves.  Without insurance, high medical bills can wipe out savings and even lead to bankruptcy.  Insurance helps protect you financially, if you have a serious illness or injury that requires extensive care.

How you Benefit … Peace of mind .. You shouldn’t have to worry how you are going to pay if you get sick, injured or pregnant.  Life is unpredictable, but when you have Kaiser, you have more control and you can rest easy knowing you are going to get the care you need.

Care when you need it .. You can see a doctor when you are sick or just need preventive care like a check up or screening.  You don’t need to ignore symptoms, or hope they’ll go away.  You can get treated before they get worse.

Quick Quote:   Anthem   –   Blue Shield   –   Kaiser 

Stay on a Healthy Course .. Preventive care helps you catch minor symptoms before they become problems.  Screenings like mammograms and cholesterol level tests can catch problems early, when they are easier to treat.

Kaiser:  Quick quote & enroll online

Questions?  Or help with enrollment, call or email anytime.

John Conner
916-682-1117
john@johnconner.com

Quote & Information Request:

Sacramento Group Health and Employee Benefits

Group Health Insurance and Employee benefits in Sacramento County for the employer with 1 to 100 employees.  Flexible benefits and payment options for the employer who provides medical coverage for their employees.

Sacramento Businesses with 1-100 employees are able to provide small group health insurance plans to their employees.  If you have questions about your current plan or would like information on a new company plan, call anytime at 916-682-1117.

Can the Employer reimburse employees for “individual or family health insurance plans?

Reimbursement for individual plans is no longer allowed. This arrangement is is subject to a $100 daily excise tax, or fine per employee ($36,500 per year, per employee). Yikes.

I provide help with …

  • Open-Enrollment
  • Rate Comparison
  • COBRA Administration
  • Change Plan or Company
  • Anthem, Aetna, Kaiser, United Health Care, Blue Shield.

4 Common Group Health plans employers choose:

PPO (Preferred Provider Organization) This is one of the two most popular Group Plans.  With a PPO the true benefit is the ability to have freedom of choice with doctors and hospitals.  Although there is a network of contracted providers with a PPO, the member has the freedom to choose. You will always pay less out of pocket costs when you see a provider who is in the PPO network.

HMO (Health Maintenance Organization) This is the other most popular plan.  The benefit of an HMO is you have much lower out of pocket costs compared to a PPO style plan.  An HMO typically has a very low or no annual deductible, and copay amounts. The big difference is when you enroll in an HMO you need to choose a Primary Care Physician (PCP) who is typically a general practitioner or internist from a list of contracted doctors.  This PCP organizes you health care, meaning when you need see a specialist or have a medical procedure, your PCP will refer you to the appropriate doctor or facility within the same medial group.  With an HMO you do NOT have freedom to choose different doctors, your PCP will refer you to different specialists.

EPO (Exclusive Provider Network) An EPO looks and feel a lot like a PPO plan, but the big difference is you must stay within the contracted network of providers.  There is no coverage outside of the companies EPO network except for emergencies.  Be very careful with an EPO, because you may be referred or have a medical procedure and one of the doctors may not be an “contracted” doctor, which means you will be paying that doctor for their services.

HSA (Health Savings Account)  This is a 2-part plan.  Fist you have a high deductible health insurance plan which must be HSA qualified.  The second part is the Health Savings Account, which is a special bank account which allows you to deposit money pre-tax, and use these funds for medical expenses tax free.  If used properly, this is a very good way of saving on you premiums and paying for care.  The HSA bank accounts can be opened at most financial institutions; banks, mutual funds, brokerages, etc.

Sacramento employers who offer group health to their employees know that health insurance is one of the most important employer-provided benefits currently offered in the workforce. If you are thinking about offering this benefit, or are reevaluating your insurance needs, consider which group insurance benefits are right for you. Call today for a free comparison 916-682-1117.

Optional Employee Benefits …

  • Dental … PPO and HMO dental plans are available, with many plan benefit options.
  • Vision … Several popular vision companies and plans for your company employees.
  • Life Insurance … Group life is also a widely used employee benefit.  Low premiums and high life insurance benefits are the attraction.
  • Disability … Short and Long-term group disability plan provide this much needed benefit.
  • Long Term Care … Many companies take advantage of the “guarantee-issue” LTC policies available to employees, management and ownership.

Looking for a new Group Health policy or a free comparison, call today. I’ll be happy to help.

John Conner
916-682-1117
john@johnconner.com

Information Request:

2018 Anthem Health Insurance

Anthem Blue Cross Medicare Supplement2018 Anthem Covered California health plans and rates for Individuals, Families and children.

Anthem is offering their 2018 plans in the following California Counties: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mariposa, Mendocino, Merced, Nevada, Plumas, San Joaquin, Santa Clara, Shasta, Sierra, Siskiyou, Stanislaus, Sutter, Tehama, Trinity, Tulare, Tuolumne, and Yuba county.

The upcoming Covered California open enrollment will start November 1 and ends January 31, 2018.  All enrollments from November 1 through December 15 will have a January 1 start date. Enrollments after December 16 through January 15 have a February 1 start.  Enrollments after January 15, have a March effective date.

Other Companies:  Blue Shield   –   Kaiser

All plans are guaranteed-issue basis, regardless of your current or past health status, as long as you enroll during an open-enrollment period.

2 Ways to Enroll:

Enroll “In or Outside” the Covered California Exchange .. Enrolling Inside the Covered California Exchange is typically for the individual or family who qualify for a subsidy (premium discount) due to their household income (see the chart below).  Individuals and families who do not qualify for a state subsidy, will usually enroll outside of Covered California (the plans are the same) although the application process is much quicker because you don’t have to state your income totals.

Anthem of California offers 4 levels of coverage both inside Covered California and out.  The plans are categorized into four metal levels of coverage based on the percentage of costs covered for an average population:

  • Platinum:  You pay 10% of health costs, Anthem plan covers 90%
  • Gold:  You pay 20% of health costs, Anthem plan covers 80%
  • Silver:  You pay 30% of health costs, Anthem plan covers 70%
  • Bronze:  you pay 40% of health costs, Anthem plan covers 60%

All plans will offer the “essential health benefits” such as; doctor visits, hospital care, prescription coverage and maternity care, and will include certain preventive care for no charge.

What is a Health Insurance Marketplace?  It’s a website that is set up to allow the government to regulate health insurance plans.  People can buy health insurance from the marketplace (Covered California) with government aid called subsidies.  All Health Insurance Marketplaces like Covered California must be fully certified and running by January 1, 2015, by federal law.  Also known as an “Exchange.”

Do I have to buy from the Health Insurance Marketplace Covered California Exchange?  You can choose to buy insurance from an insurer like Anthem from the state Insurance Marketplace (Covered California).  If you are eligible to get a subsidy and want to use one, you must buy your plan from a Health Insurance Marketplace like Covered California.

What are my Health Care Reform plan choices in 2018?  Under the new health care law, all new plans fit in one of four levels: bronze, silver, gold or platinum.  These levels make it easier to compare costs and benefits so you can choose the right plan for your needs.

Other Companies:  Blue Shield   –   Kaiser

Questions or more information.

John Conner
916-682-1117
john@johnconner.com

Quote & Information Request:

Group Health for your California Company

Starting or changing your group health insurance policy for your California Company can be done at anytime of the year.

To start a new plan you only need two people.  An employer and one employee, or a partnership.  It doesn’t matter if you are a sole proprietor, incorporated or other.

Anthem  –  Blue Shield  –  Kaiser  –  Aetna

Changing plans or company .. If you simply wish to change plans within the same insurance company, it’s best to make the desired changes during your policy anniversary month.  If you wish to switch companies, that can be done at anytime throughout the year.

Health  –  Dental  –  Vision  –  Life  –  Disability

The product features are going to be the same.  All companies offer the 4 metalic tier levels; Bronze, Silver, Gold and Platinum, along with the traditional plan types; PPO, HMO and HSA qualified plans.

When requesting a proposal, typically all you need are the ages of the employees and their dependents.

Participation Requirement …

The participation requirements for a Group health plans are:  70% for groups with 1-14 eligible employees.  50% for groups with 15 or more eligible employees.

Remember, group policies have a “participation” requirement.  Meaning, in order for a company to qualify for a group health policy there must be at least 50% – 70% of all eligible employees on the plan. If an employee is covered on their spouse’ group health plan, they do not count towards the participation requirement.

Also, employees must be on traditional payroll, independent contractors are not eligible for coverage on the group plan.

Advantages of a Group Health Policy …

  • Access to the largest networks of doctors, hospitals and other providers. Individual plan policies have seen their networks slashed. And many doctors are no longer contracting with Individual insurance providers.
  • Better prescription services.  Group plans typically provide better access to more prescriptions, and the costs can be significantly lower.
  • Optional Benefits … Dental, vision, life and disability plans with better coverage and flexible benefit options.
  • Mix and match plans with your employees.  You have the options to offer 1 or several plans to your employees. Some may want a ppo others may choose an HMO.  Flexibility!

Pediatric vision and dental coverage is included …

All small business medical plans PPO, HMO and HSA medical plans include PPO pediatric dental and vision coverage for age-eligible members.

Many Group Plans Include Wellness Programs …

Wellness discount programs offer a variety of member discounts on massage sessions, gym memberships, LASIK eye surgery, and even a popular weight management program. Online discounts of up to 40% off retail items (many with free shipping) include vitamins and supplements, yoga and fitness equipment, and much more. •

  • Discount Provider Network – Take 20% off the published retail prices when you use a participating provider in the Discount Vision Program network for exams, frames, lenses and more.
  • Alternative Care Discount Program – Get 25% off usual and customary fees for acupuncture, massage therapy, and chiropractic services, plus get discounts on health and wellness products, with free shipping on most items.
  • MESVision Optics – Take advantage of competitive prices on contact lenses,3 sunglasses, readers, and eyecare accessories, with free shipping on orders over $50.
  • QualSight LASIK – Save on LASIK surgery at more than 45 surgery centers in California. Services include pre-screening, a pre-operative exam, and postoperative visits.
  • NVISION Laser Eye Centers – Receive a 15% discount on LASIK surgery from experienced surgeons with offices in Southern California and Sacramento.
  • Hearing-aid discount – Save 30% to 60% off manufacturers’ suggested retail prices on major brands through EPIC Hearing Service. • Weight Watchers – Get discounts on three- and 12-month subscriptions, monthly passes, and at-home kits.
  • 24 Hour Fitness – Enjoy waived enrollment, processing, and initiation fees and discounts on monthly membership dues.
  • ClubSport and Renaissance ClubSport – Obtain a 60% discount on enrollments when joining with a month-to-month agreement. Enrollment fees are waived when joining with a 12-month agreement. There is a onetime $25 processing fee when you enroll.
  • NurseHelp 24/7 – Speak with registered nurses anytime, day or night, and get answers to your health-related questions, or go online to have a oneon-one chat. The NurseHelp 24/7SM phone number is conveniently located on the back of the Blue Shield member ID card.

Changing plans, switching companies, even changing brokers is easy. Please contact me anytime with questions.

John Conner
916-682-1117
john@johnconner.com

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