BCBS of California Ridiculously Expensive?

[RJT Consulting]

I have a buddy in my office who is insured on his employers plan through BCBS of California. It's a traditional PPO plan with $500 deductible, 80/20, copays. His family rate is right at $2,000 per month. I have thousands of clients on employee benefit plans so I am well aware of how this works but the family rate is nothing short of shocking to me. Even my worst performing clients have single rates less than $1400 per month. Is California that much more expensive then other states when it comes to group benefits?

This is an employer of 200 and are headquartered in California but have employee's throughout the US. Heck, if any of you are licensed in California and have carrier contracts there, let me know and I can at least tell you who to get in touch with to see if you can help.

Bob

 

[GreenSky]

Something "just ain't right." First of all, there is no such thing as BCBS in CA. Anthem Blue Cross and Blue Shield of California are separate companies. And there is no way that the monthly premium can be in the $2,000 range with either of these carriers.

My guess is that the policy originates in another state and that the employees in CA are covered under an indemnity option rather than a PPO (just a WAG).

Hope that makes sense. Let me know if I can be of further help.

Rick

 

[STIBROKER]

Its the $500 deductible that is running up the rates......

 

[JayIvy]

There is no BCBS in California. There is Anthem BlueCross and BlueShield of California.

If he is an older guy with a family, I can see the rates being that high for a 500 deductible PPO plan. Especially with Blueshield. They are not always the cheapest.

There are definitely opportunities for savings there though.

 

[ABC]

That rate does not surprise me.

For you to insure 1000's of people I am shocked that you have not seen that before especially in Illinois.

Without details of the plan there is no way to make any kind of judgement.

 

[RJT Consulting]

He's 35 years old so not old by any means. In the meantime, I did find out that a decent potion of the employees are 45 years old or older so the age/sex is skewed. Even still, that seems outrageous.

 

[Dave020]

It's composite rated at that size which, in older groups, creates a pricing problem. Also, welcome to California. We cover everything out here on domestic group plans. Lyposuction - no problem. Gastric Bypass - no problem. Rhinoplasty - no problem. FYI Aetna (and other east coast carriers) doesn't cover any of those in CA, even when medically necessary. Heck, every other person in CA sees a therapist, with meds all non-severe - someone's got to pay for that.

Group health premiums in California are substantially higher than most other areas on the US. We have almost as many uninsured in CA as your entire Chicagoland population (current 8.3 Million uninsured in CA). Utilization of benefits in California borders on retarded. $10 office visits, count a family using maybe 100 a year.

I always chuckle when people talk about selling plans cross-border. Just wait until the first time an IL plan sells into California. Watch your rates quaduple after 6 months of CA benefit utilization. I can hear it now--"who would have thought if we didn't limit office visits they would go that many times?"

 

[Norwayguy]

It's composite rated at that size which, in older groups, creates a pricing problem. Also, welcome to California. We cover everything out here on domestic group plans. Lyposuction - no problem. Gastric Bypass - no problem. Rhinoplasty - no problem. FYI Aetna (and other east coast carriers) doesn't cover any of those in CA, even when medically necessary. Heck, every other person in CA sees a therapist, with meds all non-severe - someone's got to pay for that.

Group health premiums in California are substantially higher than most other areas on the US. We have almost as many uninsured in CA as your entire Chicagoland population (current 8.3 Million uninsured in CA). Utilization of benefits in California borders on retarded. $10 office visits, count a family using maybe 100 a year.

I always chuckle when people talk about selling plans cross-border. Just wait until the first time an IL plan sells into California. Watch your rates quaduple after 6 months of CA benefit utilization. I can hear it now--"who would have thought if we didn't limit office visits they would go that many times?"

Question....What is it about CA that makes you people so depressed? I can't be the weather....I bet if we transplanted some Californians in Maine they would be dead in a year

 

[GreenSky]

Question....What is it about CA that makes you people so depressed? I can't be the weather....I bet if we transplanted some Californians in Maine they would be dead in a year

We're responsible for Nancy Pelosi, Barbara Boxer, and more commies in government than they had at the peak of the USSR.

'Nuff said?

Rick

 

[AndreaSti]

We're responsible for Nancy Pelosi, Barbara Boxer, and more commies in government than they had at the peak of the USSR.

'Nuff said?

Rick

Doesn't Charlie Sheen live there too?