United HealthCare Warns of Commission Cuts

[VolAgent]

*Standardized plans similar to the standard concept of MedSupps
*10 Plans: 5 PPO 5 HMO Gold, Silver, Bronze, Platinum and Catastrophic, all same design and benefits
*No plans outside the 10 plan design after July 2011
*GI on all plans
*Anniversary Plan changes to like or less plans GI at policy anniversary (kind of like the "birthday rule")

So what happens if I buy Bronze today, and a few years from now I want to upgrade to Silver or Gold?

 

[Dave020]

So what happens if I buy Bronze today, and a few years from now I want to upgrade to Silver or Gold?

Good question. I would assume it can be underwritten, like using the birthday rule to try and move from Plan C to Plan F Supplement.
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Where's Cahu?

They sent out two brokers blasts today about SB 890.

CAHU Legislative Watch: SB890

By Steven Lindsay, CAHU Legislative Advocate
CAHU has three bills it is currently watching closely as they progress at the State Capitol. Of the three, SB890 is of primary concern. Proposed by Senator Elaine Alquist, this bill reduces the number of individual plans from 138 to 10 of which 5 are PPO and 5 are HMO. CAHU feels this bill, if passed in its current state would negatively impact many Californians in variety of ways. Therefore, we hope you will take a moment to read the following key points that were distributed to both attendees and legislators at CAHU's Day at the Capitol.

• SB 890 is the antithesis of an open marketplace. The assumption that this bill can design the best product for 2.5 million Californians who are purchasing their own insurance is breath taking in its nature. It is inconceivable that with 100 plus different cultures in our state, the full range of incomes from poverty to billionaires and the broadest selection of job titles and duties in the nation the 10 plans they have designed will work for every one. While we acknowledge that there needs to be parameters we cannot imagine 10 plans being best for the incredibly diverse 2.5 million Californians who are purchasing their own coverage.

• The method proposed in the bill for rate setting and renewal is a radical departure from the current methods and we can find no compelling study or verifiable information that it would work as proposed. All the flexibility to adjust benefit design to assure they are actuarially sound is removed. Why put 2.5 million Californians in an untried rating system?

• Adverse selection will flow to the products richer in design. The individual market has not seen a $5.00 copay for ten years. With the ability to switch plans every year only the very sick will take the richer benefit and when they get well they will take a lower benefit plan to control their premium costs. This will cause huge price disparities between products and is not how a successful marketplace works.

• The Patient Protection and Affordability Act already narrows the number of plans to five categories defined by an actuarial value. These are not specific plan designs. They allow carriers limited flexibility to design plans in each category that better fit the needs of the insured individuals. The Congress considered this option and rejected it. They recognized the dangers in a system with no flexibility.

• The bill creates a commission to oversee the individual market which is for the most part redundant to the oversight of California's Insurance Commissioner and the Department of Managed Health Care. It adds confusion to who actually has regulatory authority over these products while increasing the cost to the state. Who pays for this- the taxpayer? California already has a 20 billion dollar deficit. (Maybe it should be added to the premium and make health insurance even more unaffordable?)

• CAHU will support the standardized enrollment form if it includes a bank of questions from which the carrier can select. As California does not have guaranteed issue health insurance, the bank of questions will allow the carriers to accurately underwrite the risk and thereby keep rates affordable until 2014 when guaranteed issue goes into effect.

• This bill will create a premium cliff. The proposed benefit plan designs are richer than the current products being used in the marketplace. In July of 2012 all individuals who currently have coverage will have to move to the new benefit plans and pay significantly higher premiums if they want to keep their coverage while not receiving any subsidies. The subsidies in the Patient Protection and affordability Act do not start until 2014.

 

[CHUMPS FROM OXFORD]

And no commission?

 

[Dave020]

And no commission?

It's not addressed in the bill, so who knows.

 

[dave74]

Grandfathered into what????

And does grandma know about this????

Dan

Grandfathered - means you keep your commissions at the same percentage you signed up your clients.

 

[Norwayguy]

Seems the some States are in a rush to prove they can do something just as dumb or dumber than the Federal government. Maine which is GI has now mandated that their be no cap on insurance benefits...Since the plans are GI you could always change plans if you got near the limit on your plan.....oh wait since the Individual market only has Anthem and Mega. Gee wonder what that will do to the cost of insurance?

 

[TXINSURANCE]

Maternity should be mandated on all plans. All states. Costs hardly anything when mandated across the board.

I am fine with 9 to 12 month wait to prevent those wanting a free ride.
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It is already free on poor and illegals.

 

[somarco]

Costs hardly anything when mandated across the board.

The folks at KP & Blue might disagree.

For years all the plans with KP came with maternity. They got slaughtered.

All Blue family plans with deductibles under $3500 automatically included maternity. Even though they had a 12 month wait for conception, they still lost money.

A few years ago KP introduced Balance plans that, among other things, did not include maternity. Blue introduced new plans that had a maternity option.

Their plans with maternity are still among the highest in Atlanta and non-maternity plans are only slightly higher than comparable PPO plans.

As a reaction to Obamacrap, we only have two carriers offering maternity now. Blue and KP. Neither are good values.

 

[TXINSURANCE]

The issue with maternity is sick babies. The actual maternity is not all that expensive after network discounts. Again if all carriers had to cover you would not have adverse selection and you would have a larger pool / block to spread cost.

Some things should not be excluded as matter of principle. Breathing, heart beat, cancer, and being female.

This is one area I agree with the libs on. Yes I said it. Lol.

 

[Dave020]

CA AB 1825. Mandatory maternity benefits on all IFP policies in California registered either with the DMHC or CDI.

http://info.sen.ca.gov/pub/09-10/bill/asm/ab_1801-1850/ab_1825_cfa_20100419_093911_asm_comm.html