Covered Calif Error Ridden Network

My associate has a client that works on the commercial side of building networks for Anthem. She stopped in today and I had a chance to ask her questions about the network. Basically our sales reps aren't telling us how bad it is. They have purposely created a narrow network (pathway) and are relying on the rural clinics to handle the overflow. She referred to these clinics as a safety net. She also said that the network last year under Prudent Buyer reimbursed doctors $67-70 for an office visit. Now, it is $25. She said this year it is temporary and next year the reimbursement moves to Medicare type reimbursement, around $20 a visit. We have a private Medi Cal system folks.
She said the system was imploding and Anthem did not have enough Healthy members and rates would have to be bumped higher next year. Don't know about you but I'm done with individual.
Health Net is paying 2%. Assurant pays 6% year 1 and 1% year 2 and on. I am making 10-20% today of what I made 5 years ago. Not enough margins unless you are Ehealth.

Michael
 

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