California IFP Mandatory Maternity Benefits 2012

[Dave020]

SB 222 has been signed into law in CA by Gov. Jerry Brown. SB 222 requires mandatory maternity benefits on ALL individual & family health plans in California beginning July 1, 2012. No more non-maternity plans in CA.

 

[GreenSky]

SB 222 has been signed into law in CA by Gov. Jerry Brown. SB 222 requires mandatory maternity benefits on ALL individual & family health plans in California beginning July 1, 2012. No more non-maternity plans in CA.

And you think this is a bad thing?

Probably reduce insurance costs by 25%.

Rick

 

[taterpeeler]

And you think this is a bad thing?

Probably reduce insurance costs by 25%.

Rick

Explain that goofy comment please

 

[GreenSky]

Explain that goofy comment please

I'm just thinking life a socialist (you know, Gov. Brown, Pres. Obama, etc).

Probably reduce the deficit also.

Rick

 

[VolAgent]

And you think this is a bad thing?

Probably reduce insurance costs by 25%.

Rick

With GI, the state could save a fortune. You're here to sign up for Medicaid because you're pregnant? Great, sign here for a Humana policy.

 

[GreenSky]

With GI, the state could save a fortune. You're here to sign up for Medicaid because you're pregnant? Great, sign here for a Humana policy.

But nothing says it's GI. It's just another government mandate that screws the public by reducing the availablity of affordable insurance.

Rick

 

[Sales71]

That might make health ins more expensive. If clients do not need it why they have to pay for it.

 

[Guest]

That might make health ins more expensive. If clients do not need it why they have to pay for it.

Why indeed? Did they mandate a minimum benefit level too? Can't wait to hear about that! Didn't Aetna leave Colorado for this very same reason?

 

[Dave020]

Anticipated cost per subscriber is under $7 per month to add the benefit mandate. Currently only 12% of IFP plan choices in CA cover maternity.

 

[Guest]

I expect we may see Aetna and Cigna (both offer only non-maternity IFP PPO coverage in CA) head for the hills like Ma Barker. Not that they will be missed since they have a history in CA of doing this.

Anticipated cost per subscriber is under $7 per month to add the benefit mandate. Currently only 12% of IFP plan choices in CA cover maternity.

Interestingly, BS CA and Kaiser were both for it, Anthem, normally opposed, was neutral on this legislation.

I guess it all depends on the benefit. Could be they will do something similar to what Bx does here in GA. Their maternity rider is optional, which is obviously different than a mandate, but it adds about $1900 a year to the premium, then there is a separate $3000 copay, plus a 12 month waiting period (for delivery). Anyway, that is almost $5k out of pocket from the start. And they only sell it on $2500 deductibles and higher which comes into play on the hospital side.

So, if I am reading the benefits correctly, and doing my math correctly (which can be suspect, especially this early) then you would pretty much pay around $7500 in copays, premium additions, and the $2500 deductible with the coverage here in GA. And that is if you deliver as early as allowable with the 12 month pre-x. I would imagine that it would be similar in CA unless the mandate makes it richer.

So I guess if you mandate it, and spread the potential costs around to everyone and not just the ones that choose the coverage, then I guess that is where the $7 or so comes in. I guess it will have to go into effect to see if those numbers go up.