Here are all the articles I've written about WellPoint. Enjoy!

April 6th, 2012

UPDATED – Anthem Blue Cross In-Network Hospital Update

*******************I M P O R T A N T****I M P O R T A N T****I M P O R T A N T****************

Good news!  Anthem Blue Cross has announced that Hospital Corporation of America’s California hospitals once again participate in Anthem BC’s’ network.

In Southern California:

  • Los Robles Regional Medical Center
  • West Hills Hospital
  • Riverside Community Hospital
In Northern California: 
  • Regional Medical Center of San Jose
  • Good Samaritan Hospital in San Jose

Despite the terminations announced in March, both parties continued active negotiations with the hope that the hospitals would again participate in Anthem BC’s’ network.    These ongoing discussions resulted in the successful negotiation of new multi-year contracts effective April 1, 2012.

The reason an insurance company negotiates provider contracts is simple – to provide you with a broad network of providers who have agreed to accept negotiated rates — for you that means discounts — lower out-of-pocket expenses, more bang for your buck.

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March 20th, 2012

Anthem Blue Cross In-Hospital Network Update

IMPORTANT IMPORTANT IMPORTANT IMPORTANT

Anthem Blue Cross has been unable to re-negotiate its contracts with the following hospitals, so they are now considered out-of-network.

In Southern California:

  • Los Robles Regional Medical Center
  • West Hills Hospital
In Northern California:
  • Regional Medical Center of San Jose
  • Good Samaritan Hospital in San Jose
If you are currently in the middle of treatment at one of these hospitals and are concerned about the disruption of care, please let me know and I’ll tell you how to handle it.

But, just because there is no contract with these hospitals right now, doesn’t mean there won’t be one in the future.   Negotiations continue behind the scenes.

To find alternate hospitals in your area, go to www.anthem.com/ca and click on Find A Doctor.

Sometimes I just hate being the messenger!

 

 

 …

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August 26th, 2010

Take A Hike!

Please… sit up straight and pay attention class, elbows off the desks.   If you currently have an individual (not group) California health insurance plan with either Anthem Blue Cross OR Blue Shield, prepare for rate hikes heading our way October 1, 2010.

The rate hikes range from 14% to 20% with Anthem Blue Cross, and 19% to 29% for Blue Shield customers.  Most of you will be affected by the hikes.   However, if you bought your individual policy recently, you’ll still have your 12-month rate guarantee.

Watch your mail boxes within the next 3 weeks for announcements from your health insurance company.    Be sure to read the information, it’s important for you and your budget!   Of course,  you’re welcome to be in touch with The Insurance Mom if you have any questions or kvetches.

NOW is the time to be sure that you’re in a plan you can afford to pay for every month.  Remember, the monthly premiums are mandatory.   Medical expenses (the deductible) can be paid off over time, based on what your budget can handle.   The higher the deductible, the lower the premium.   So, even if you have to downgrade your plan to one with a higher deductible, you’ll still have affordable protection against catastrophic medical expenses.

The Insurance Mom strongly urges you to have a medical plan with a high deductible… as high as you can stomach.    Don’t give all of your premium money to the insurance companies, they have enough, don’t you think?

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May 12th, 2010

The Anthem Saga

Here’s an interesting opinion piece from the NY Times.   At least they’re willing to acknowledge that the rising health care costs are a primary reason for rising health insurance premiums.…

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April 29th, 2010

For Your Immediate Reading – Anthem Blue Cross will not be raising rates

As I told you at the beginning of this actuarial dance, the State’s findings will be different from those of Anthem BC’s.  Et voila!  As a result of the State’s actuarial analysis, the following is hot off the presses:

Commissioner Poizner released the following statement today regarding Anthem’s decision to withdraw its rate filing:

“This is a great victory for California consumers. I’m pleased that California consumers will not face rate hikes of up to 39 percent. In late January, because I was highly skeptical of the rate increase, I ordered an outside review to ensure that Anthem’s filing complied with state law. Anthem agreed to delay their increase pending this review. The independent actuarial analysis found numerous and substantial errors in their filing that would have led to massive and unjustified rate increases.  We notified Anthem of these errors and they admitted to the mistakes.”

The independent, outside actuarial analysis was performed by Axene Health Partners, LLC. The report was conducted over a 10-week period and required 500 hours of work by four licensed actuaries. The summary of the review is available at www.insurance.ca.gov and the entire report is expected to be completed next week.

[Or you can simply read the initial report.]

Based upon a thorough review of Anthem’s calculations, Axene found numerous errors in the methodology used by Anthem to project total lifetime loss ratios. Correcting these errors resulted in lower lifetime loss ratios than initially calculated by Anthem.

The errors identified included:

  • Error #1: Double counting of aging in the calculation of underlying medical trend for the projection of total lifetime loss ratio.
  • Error #2: Anthem overstated the initial medical trend used to project claims for September 2009 for known risk factors.

Both of these errors are errors of math and not differences in actuarial …

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April 24th, 2010

Anthem Blue Cross alert

For subscribers in California, Anthem Blue Cross has announced that it will NOT be increasing individual premiums on 5/1/10 and for the foreseeable future, or at least until the State’s actuaries have completed their analysis of the proposed increase that had been scheduled for 3/1/10.    The company must give subscribers a 30-day written notice prior to increasing premiums.    Read the whole article.

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April 20th, 2010

Hey Kids, This One’s for YOU (and parents too)!

If you are:

1.  A parent whose young adult child is about to be taken off of your health insurance plan because they’re all grown up (well done!), or

2.  A young adult who is about to be taken off of your parents’ health insurance plan because you’re all grown up (good job!),

… then this is good news is for you!

There is a provision in the newly enacted health care reform legislation that will allow young adults up to age 26 to stay on their parents’ health insurance plan, regardless of marital status or the availability of other health insurance.

While this provision doesn’t take effect until September, 2010, there are four insurance companies which have announced they will immediately comply with the new law, without waiting until September.

Humana, Kaiser Permanente and UnitedHealthcare say they will immediately allow young adults to stay on their parents’ plans.    And WellPoint (in some states, that’s Blue Cross) says they’ll implement the new provisions starting June 1.

Here’s an easy-to-read description about this portion of the new law.   I promise it won’t make your eyes bleed!

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February 15th, 2010

More news for Anthem Blue Cross members

This past weekend Anthem BC announced that, due to public and political reactions, the anticipated 3/1/10 rate changes have been postponed for a couple of months, to 5/1/10.

Prior to an insurance carrier raising rates, CA State law says an insurer must prove that at least 70% of its income (your insurance premiums) is legitimately being spent on your medical expenses.   Once the insurance company files the actuarially prepared documents, and the data is approved by the State, then the company can raise its rates.    CA Insurance Commissioner Steve Poizner’s office approved Anthem BC’s actuarial data in November, 2009.   But that wasn’t made public.

Now, Commissioner Poizner has appointed an outside insurance actuary to review Anthem BC’s data.   Needless to say, we all know that number crunching is an art not a science, right?   Numbers can be crunched to skew one way or the other, depending on who’s doing the crunching.

I think it’s pretty safe to say that the State-appointed actuary’s review will result in completely different findings than that previously provided by Anthem BC.

So, for at least the next couple of months while the State’s review is being conducted, there will be no rate increases from Anthem BC.   I’ll be very interested to see what they ultimately do.

And one more little tidbit of clarification… as seemingly outraged as the Obama administration and HHS Secretary Kathleen Sebelius may be, remember that the Federal government has no jurisdiction over the states and how each state constructs and mandates its insurance laws.

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