On August 25th Anthem Blue Cross was approved for a proposal they submitted for a Rate Increase for the state of California. The average of the rate increase is to be 14% to individual policy holders. Blue Cross is the state of California’s largest insurer. Effective October 1, 2010, some increases will be as much as 20% for some policy holders.

Last April, Anthem Blue Cross had a request for premium increase to take effective May 1, 2010 which they withdrew. The increase would have been as high as 39% for some policy holders. Anthem withdrew their proposal after there was an investigation report by external actuaries regarding the high increase. The investigation was found to have discovered significant errors with their proposal.

Another Insurer has been approved for a Rate Increase proposal they submitted as well. Blue Shield’s request has was also approved by regulators. The proposal shows a raise in premiums for some Blue Shield members of an average of 18.2%.

There are requirements and rules that the Insurance Carriers have to follow when raising trying insurance premiums. Steve Poizner, CA Insurance Commissioner can and ordered an independent reviews which he did for Blue Shield and Anthem Blue Cross as well as other state insurers. The review makes sure the Insurance carrier is in compliance with state law that does require to spend at least 70% of premiums on Medical Care.

Both Anthem Blue Cross and Blue Shield were in compliance with the state’s medical loss ratio requirements, which is why the rate increases will be coming soon.

Insurance companies will be notifying their members of the rate increases in the next week.

If you are with Anthem Blue Cross or Blue Shield and would like a Free review of your policy and to see other options for you or your family, please give me a call. I will place you with another carrier or plan that works for you and price range.

For Free Health Insurance Quotes:

http://www.health-insurancecalifornia.com

Follow us on Twitter:

http://www.twitter.com/lesleypoliti

Health Care Reform Bill has made changes being made, Dependent Coverage Extended until age 26:

Starting January 1, 2011 the provision must go into effect for individual and family plans as well, Allowing any dependent age 26 or younger to be able to be on their parents Health Insurance Plan, no matter Health condition.

On September 23, 2010 Group plans (employer sponsored) will give the option of letting dependents stay on their parents plan until age 26 regardless of student, resident, employed or marital status. Most health plans (currently) imposed a limit of age 19 years old for Non Full Time students and age 23 for Full Time Students.

Some Health Insurance Carriers that are starting to implement the provision early for its members. Dependents will have to re-enroll on their parents plan during their open enrollment period for Group plans. Re-enrollment is NOT automatic, members must take actions on or after October 1, 2010 to have their dependent back on their plan if not already.

For Individual and family plans, the dependent will have to be added before January 1, 2011. Dependents only have until January 31, 2011 to be added on the plan without underwriting. Once 1/31/11 is passed, normal underwriting policies will be enforced.

Be sure to get yourself or dependent added on during the time frame. Once the time has passed dependent may not be approved due to normal underwriting guidelines.

Check with your current Health Insurance to see if you are able to add your dependent this soon or at least get your forms lined up.

On Wednesday July 14th, White House unveiled new requirements for Health Insurance Carriers to provide preventive care services without copays. Obama Administration put together rules to follow, allowing people with Health Insurance to receive certain preventive care services with no cost to them, waiving deductible and any out-of-Pocket charges.

The new rule was created under the Federal Health Reform Law. The preventive care will be lab tests and screens that are recommended by government advisory boards. Insurers will be required to cover routine vaccinations, cancer screenings, well baby care, prenatal care and other preventive care services.

This all will take effect in September of this year. All new health plans that are effective after September 23rd will be required to have the new coverage inforce. Anyone with a current Health Insurance plan will also benefit from the rule.

It is being said, this new requirement will increase premiums by 1.5% on average.

If you have any questions please give us a call anytime.
Free Health Insurance Quotes:

http://www.health-insurancecalifornia.com

Follow us on Twitter:

http://www.twitter.com/lesleypoliti

Finally decideing you are ready for a baby there are millions of things going through your mind of what you need to do to get ready, a major item to think about is if your current Health Insurance is the right plan for you when you give birth? Does your Insurance Plan have maternity coverage? A few important questions any one should ask before they get pregnant and preparing for a baby.

1. Does Your Current Insurance Plan have maternity coverage?
Seems like a dumb and obvious question but not all Health Insurance Plans cover maternity coverage, espically individual plans. If your current plan does not cover maternity coverage that means it will not pay for any doctors visit, ultra sound, prenatal visits, prenatal testing, giving birth etc. Anything that has to do with your pregnancy and baby. One should check their current plan.

2. Is your OBGYN In-Network?
Most woman already have an OBGYN or have figured out who will deliver your baby, you need to make sure that your doctor and the hospital your doctor is affiliated with are In-Network with your Health Insurance Carrier.
If you have a PPO, you will have the option of going in and Out-of-Network, which is nice because you do have flexibility but when you do go Out-Of-Network your percent of the cost is much higher then staying In-Network.
My advise is to always try and stay with doctors and facilities that are In-Network to pay the least amount possible.

If you have an HMO, no need to worry. Your PCP will have referred you to a OBGYN that is in your Network.

3. What is your total Cost of Birth?
The total cost of the birth does differs from plan, person and kind of birth.
Every Health Insurance Plan has a Out-of-Pocket Maximum. That is the most one will spend in one calendar year on all medical bills. Once this amount is met, you will not longer be charged for any service and the Insurance Carrier will pay 100%.

The Out-of-Pocket max can be as low as $2,500 on PPO plans to $10,000. On HMO plans they tend to be less.
When you think about all the doctors visits, ultra sounds and tests you have before you even give birth you may already hit your Out-of-Pocket MAX.

4. Be sure you have Maternity Coverage!
If you do get pregnant and do not have maternity coverage, you will not be able to get your own individual plan. Being pregnant is a pre-existing condition. Another option would be to join group coverage (from an employer) or to try Medical depending on your income.

For Free Health Insurance Quotes go to:

http://www.health-insurancecalifornia.com

Follow me on twitter:
http://www.twitter.com/lesleypoliti

Most people don’t know that you can add a term life insurance policy to their current Individual Health Insurance Plan. Most major Carriers in California give their memebers the option to add a Term Life Insurance plan or dental with no underwriting. A member is guaranteed coverage on approval of their individual plan. There is no additonal applications or medical exams to take, its simple you just choose the amount of benefit that would fit your families needs.

If one were to add Life Policy to their current Medical Plan it would usually range from $15,000 to $100,000 benefit. These are aviable to all individual memebers (which makes one under 65).

A member at the age of 32 could pay as low as $6.50 per month for a $30,000 benefit, for example. This extra policy can added to your current medical insurance bill, all you need to do is make one payment.

Adding this Life Policy is an inexpensive and great way to protect your family in their time of need. Make it easier and less stressful worrying about finances.

Memebers also have the option to add a dental plan to most carriers as well. Your dental insurance can range from as low as $8-$55 per month per person. All plans would give you the option to go have your teeth cleaned 2 times a year, which is always nice. Depending on which dental plan you go with, there are services that range from X-Rays, fillings and major services.

Each company has number of different plans. The two most popular are the PPO and HMO plans.

HMO dental plans are similar to an HMO medical plan in the sense that you will chose one dentist/dental office and that will be your Primary Care office. You will go to that dentist/dental office for all services needed. If you need to see say a specialist your PCP will refer to one also in network.The best part regarding the HMO dental is there is no maximum per year, it is unlimited.

PPO dental plans are opened to go to any dental office at anytime, but will see the best price when staying in-network. A PPO plan does have a maximum per year depending on the plan. Ranging from $500 to $2,000. Once you meet your maximum the the carrier will no longer pay any claims.

To inquire about adding a Term Life Policy or Dental plan to your current Medical Insurance, give your Carrier or Broker a call.

For Free Health, Dental and Life Insurance quotes please give me a call toll free, 877-707-9898.

www.health-insurancecalifornia.com

Follow us on twitter:

www.twitter.com/lesleypoliti

I am a huge believer in Preventive Care. Anyone that has ever discussed Health Insurance or Health Insurance Plans with me most likely heard me discussing it two or more times.

Today I thought I would give everyone a clear understanding on some preventive care services that are recommended by the American Cancer Society, the Advisory Committee on Immunization Practices and U.S. Preventive Services Tasks Force.

More of the plans that have come out in the past 3 years will either pay 100% or waive a members deductible for their Preventive Care services (please see your current Health Plan). It is a great coverage to have on your Health Insurance policy and one should take full advantage of, if you can.

The two main categories for Preventive Care are Screening Tests and Immunizations. There is also different preventive care guidelines for Children and Adults.

Screening Tests:

For Adults what is included/recommend depending on the plan:

Cholesterol level screening
Blood glucose test to screen for diabetes
Mammography screening and Breast Exam
Routine blood and urine screenings
Hearing Screening
PAP, contraceptive and pelvic exam for females
Bone density test
Cancer Screenings:
-Prostate Cancer, may include PSA test and Rectal Exam
-Colorectal Cancer, may include blood test and colonscopy screening
Screening for STD’s

For Children they include/recommend depending on the plan:

Vision screening
Hearing screening
Pelvic exam, PAP and Contraceptive management

Immunizations:

For Adults what is included/recommend depending on the plan:

Hepatitis A & B
Chicken Pox (Varicella)
HPV (Human Papilloma Virus)
Tetanus, Diphtheria
Shingles (Herpes Zoster)
Measles
Mumps
Rubella

Immunizations for Children:

Hepatitis A & B
Rotavirus
Meningococcal Polysaccharide
Rubella
Mumps
Measles
Polio
HPA (Human Papilloma Virus)
Pneumonia
Flu Shot (Infuenza)
Chicken Pox (Varicella)
Dipheria, Tetanus, Pertussis

Most Carriers that offer Preventive Care coverage will give their member the option to use these services once a year during their annual physical by their In-Network Physician.

Please let me know if you have any questions or would like info on which plans or carriers give you 100% coverage when it comes to Preventive Care.

Politi Insurance Agents & Brokers
http://www.health-insurancecalifornia.com
818-709-8442

Follow us on Twitter:
http://www.twitter.com/lesleypoliti

A new plan has come out for individuals by Anthem Blue Cross called the Premier Plans. There are a number of different plans to choose from and in this blog I will review them.

The Premier plan has a higher premium then the Smart Sense plan I talked about in a previous blog but does have different coverages. One of the main differences is with the Premier plan is the member has unlimited office visits before the deductible is met, for both primary at $30 and specialist at $50. With the Smart Sense plans a member gets 3 office visits at $30 before the deductible is met.

Most of the newer plans that Carriers offer do waive a members deductible for preventative care (please see below), but the Premier also does waive a members office visit co-pays, which is unlimited.

Annual Physical-$30
Routine Mammogram, Pap and PSA tests-$30 copay
Well Child/Baby Care (through age 6)-$30 copay
Your deductible is only waived for members after 6 months.

Anthem Blue Cross Premier Plan PPO comes in a number of different deductibles, to let the member choose what is right for them. They go fro $1,000 to $6,000 with out of pockets maximums ranging from $5,500 to $10,500.

Most Anthem Blue Cross PPO plans have 30% co-pays for services when In-Network with a PPO policy. The Premier Policy for In-Network services is a 25% Co-Pay, this would include X-Rays, Lab work, Anesthesia, Surgeon etc. All In-Network In and Out-Patient services and Emergency Rooms. A member would pay 25% after their deductible is met.

All Anthem Blue Cross Premier plan does come with $15 Generic drug coverage with no deductible. If a member was to use a Formulary Brand or Non Formulary Brand drug the member would first need to meet a $500 drug deductible. After the RX deductible is met it would cost $40 for Formulary Brand and $60 for Non-Formulary.

Many more changes to come to Health Insurance Reform but below are a few of the most important changes happening in 2010. Please let me know if you have any questions regarding the changes in policies and coverages that will be happening.

Effective in 2010

Lifetime Max:

No longer will their be any Lifetime limits on Health Insurance Plans benefits coverage

Health Insurance Rates:

Federal review of all Health Insurance Carriers Premiums and their rates to the public.

Dependent Coverage

Raises the age of a dependent coverage for adult children to be able to stay on their parents plan until age 26.

Eliminates Pre-Existing Condition exclusions:

Eliminates exclusions for anyone with a condition due to domestic violence to be declined for a Health Insurance Policy.

Surgery for Children:

Mandates coverage of reconstructive surgery for children with developmental or congenital deformities. This coverage will now be covered by the Insurance Carrier.

Rebates for Medicare:

A rebate of $250 will be given out to Medicare beneficiaries who reach the part D “donut hole”.

Emergency Services:

A new Mandate of coverage for emergency services at in-network level regardless of provider. Can go to any provider in or out of network in an emergency situation.

Info for Small Employers:

Tax Credits:

Tax credits would apply to small employers with fewer then 25 employees and average annual wages of less then $40,000 that purchase health insurance for their employees.

There will also be Grants for Small Employer-based wellness programs.

If you have any questions or comments please let me know.

Free Health Insurance Quotes:

www.health-insurancecalifornia.com

877-707-9898

Follow on Twitter:

www.twitter.com/lesleypoliti

Today, Monday October 5th is the first day that the Swine Flu Vaccine will be given out. The vaccine will be given to healthcare works in Indiana and Tennessee.

The first batch will be given as a nasal spray from AstraZeneca. The vaccines will come in at about 20 million doses a week. Hopefully there will be enough to keep most of the US Swine Flu free.

Make sure to take look into your Health Insurance Plan and see if you get your preventive care free.

For Free Health Insurance Quotes or Questions please give us a call, 818-709-8442

Http://www.health-insurancecalifornia.com

Follow us on Twitter:
http://www.twitter.com/lesleypoliti

Check me out! Please leave a comment, rating and become my friend!

http://bit.ly/1yMd3s