On January 1st 2014 many people lost their plans because the coverage they had was not ACA compliant.  This was especially true in the individual and family insurance sector (plans that are not provided by an employer), because there was less “grandfathering” in this health insurance sector.

 

In 2014 some companies stopped selling health insurance to individuals and families and all of them made huge changes.

 

Anthem Blue Cross no longer had a PPO network for IFP policyholders in Los Angeles  County in 2014 and 2015.  Their members had to choose between an HMO or EPO.  Many members could not find their PCP (primary care doctor) in these networks, many favorite specialist and hospitals were not in these networks and there was a high risk that referred specialists would not be in network.

 

Blue Shield of CA had a PPO network but they treated on ex hnage and off exchange providers the same.  During 2014 their provider finder tool was not reliable, in 2015 Many doctors and other providers dropped out of Blue Shield’s PPO network for lack of adequate compensation.

 

Cigna, charged higher premiums, but their network was not as inclusive as Health Net’s.

 

Kaiser, of course is an HMO, and unless you are a Kaiser member, your doctor is not likely to be available.  Kaiser started 2014 with the highest premiums but they were more competitive in 2015.

 

This year Health Net is only offering HMO and HSP plans in LA,  The HSP plan is similar to an EPO plan.

 

It is very important to stay in network.  HMO, EPO and HSP plans cover out of network costs only in an emergency.  In a situation where you or a family member has a medical event, your are not fully protected.

 

Our job is to protect your health and wealth… we have a shared interest with you and your family, your job too is to protect your health and wealth.

 

As we did last year, we will research the best plan for you.  We will need

a list of PCPs for each enrollee

A list of medications, frequency and dose and whether they are generic or Brand

Your preference for specialist

Your preference for hospitals

 

We recognize that health insurance today is too expensive, the consumer has much less choice and volumes more complexity.  We can help you thru this but need your help.

Please:

As we did last year, we will research the best plan for you.  We will need

a list of PCPs for each enrollee

A list of medications, frequency and dose and whether they are generic or Brand

Your preference for specialist

Your preference for hospitals

Also let us know

if you think you would qualify for a subsidy

Think you qualify for Medi-Cal

 

Janice will research and then have a screen share or phone conversation to go over all the nuances.

 

Thank you for your continued support