CA HBEX Standardized Plan Benefit Designs
- Thread starter Dave020
- Start date
- 15,319
The fewer plans the less the need for agents to assist.
Rick
Rick
We are an afterthought, an "oh by the way", and HHS gives the states an out to not use agents. "Got to have navigators, got to have in person assistance (CAP), but you can determine if you need agents.
read pages 12-17
http://media.lifehealthpro.com/lifehealthpro/article/2013/01/03/partnership-guidance-01-03-2013.pdf
It's crazy that they continue to ignore an already trained agents in exchange for a newly uneducated navigator and CAP. Why is HHS so hell bent on destroying our value?
read pages 12-17
http://media.lifehealthpro.com/lifehealthpro/article/2013/01/03/partnership-guidance-01-03-2013.pdf
It's crazy that they continue to ignore an already trained agents in exchange for a newly uneducated navigator and CAP. Why is HHS so hell bent on destroying our value?
- Thread starter
- #15
- 3,384
If you look at the December CA HBEX materials you'll note that agents are only mentioned once (and not in the DBAs discussion) as being able to use Navigators as subcontractors 
DBA (direct benefit assistors) discussion only deals with community groups, trade unions, fish & game, medical groups, hospitals and the like.
Look at page 5
http://www.healthexchange.ca.gov/St...handEducationGrantProgramWebinar_12132012.pdf
DBA (direct benefit assistors) discussion only deals with community groups, trade unions, fish & game, medical groups, hospitals and the like.
Look at page 5
http://www.healthexchange.ca.gov/St...handEducationGrantProgramWebinar_12132012.pdf
- 1,007
why would an agent or broker want to be a Navagator? it clearly states there is no compensation. I suppose they want us to work for FREE.
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Dave,
any word why such a reduction in plan offerings? There was some good news for you guys.
The primary target population of Covered California's marketing and outreach efforts are the 5.3 million California residents projected to be uninsured or eligible for tax credit subsidies in 2014:
–2.6 million who qualify for subsidies and are eligible for Covered California qualified health plans; and
–2.7 million who do not qualify for subsidies, but now benefit from guaranteed coverage and can enroll inside or outside of Covered California.
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Dave,
any word why such a reduction in plan offerings? There was some good news for you guys.
The primary target population of Covered California's marketing and outreach efforts are the 5.3 million California residents projected to be uninsured or eligible for tax credit subsidies in 2014:
–2.6 million who qualify for subsidies and are eligible for Covered California qualified health plans; and
–2.7 million who do not qualify for subsidies, but now benefit from guaranteed coverage and can enroll inside or outside of Covered California.
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Those plans look like crap for what they are probably going to cost.
Agreed. The compression of plan choice is worrisome for the agents in California. What happened to the benefit design alterations for varying degrees of FPL? Why did they eliminate HSA's?
Believe me, I understand that the subsidized market will make one of 3 choices - 2nd lowest silver (because that's what the subsidy is based on), slightly better silver, or bronze (because the person's premium is only partly subsidized). So, I understand that carriers wouldn't be offering too many other plan choices anyway. And, from what I saw on the prior CA HBEX materials, California was going to restrict those at 250% of FPL or lower from buying-up to the Gold or Platinum level anyway. But yet, it's worrisome that they took off Bronze HSA's which could have been attractive to those who are partly subsidized, and it's worrisome that they limited consumer choice so drastically. I fear for our agent friends in CA if these are the only plan designs allowed on the exchange.
Believe me, I understand that the subsidized market will make one of 3 choices - 2nd lowest silver (because that's what the subsidy is based on), slightly better silver, or bronze (because the person's premium is only partly subsidized). So, I understand that carriers wouldn't be offering too many other plan choices anyway. And, from what I saw on the prior CA HBEX materials, California was going to restrict those at 250% of FPL or lower from buying-up to the Gold or Platinum level anyway. But yet, it's worrisome that they took off Bronze HSA's which could have been attractive to those who are partly subsidized, and it's worrisome that they limited consumer choice so drastically. I fear for our agent friends in CA if these are the only plan designs allowed on the exchange.
Here is a comment from a top CA NAHU officer. Maybe HSA's are still part of the CA exchange mix:
"The plan offering chart was designed for a particular meeting and presentation and wasn't intended to exclude H S A's. It just covered the basic metallic plan offerings".
"The plan offering chart was designed for a particular meeting and presentation and wasn't intended to exclude H S A's. It just covered the basic metallic plan offerings".
- Thread starter
- #20
- 3,384
Be careful on that document and read it again. It is not Navigator related.
These are "Direct Benefit Assisters" which is also the category agents fall under.
As mentioned above, it was apparently for a specific presentation.
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