Blue Shield HIPAA Plan Update

To follow up on my May 25th blog post regarding Blue Shield of California HSA 4000 plan closure for HIPAA, I wanted to post an update.

After several days of run around and legalese, I finally was able to determine that Blue Shield of California's current HIPAA portfolio is heavily weighted on DMHC (CA Dept of Managed Health Care) registered health plans (3) with only 1 CDI-registered plan (California Dept of Insurance). A normal arrangement would be 2 plans from each registration and, in the case of Blue Shield prior to 6/1, 3 DMHC and 2 CDI registered plans.

California Health & Safety Code requires an insurance company selling individual plans in California to offer two "popularly marketed health plans" to the HIPAA risk pool for each registration. Over the last several years most insurers have registered PPO plans with the Dept of Insurance (CDI) as opposed to the DMHC.

Blue Shield of California is opening a new portfolio of plans on July 1. The entire portfolio of PPO plans (Shield Secure Plus, Shield Secure, Shield Wise and Shield Savings) are registered with the DMHC in total with no new PPO plan registered with CDI. It totally took me by surprise as I can't remember the last time a carrier in California registered a PPO plan with DMHC.

So, because Blue Shield only has one remaining PPO plan registered with the CDI, that is the plan they offer in the HIPAA portfolio (Spectrum 5000).

Until such time as Blue Shield of Californa (and Life & Health) registers a second PPO plan with CDI, there will be no additional plans for HIPAA and the portfolio will consist of:

*Access+ HMO (DMHC)
*Access+ Value HMO (DMHC)
*Spectrum PPO 5500 (DMHC)
*Spectrum PPO 5000 (CDI)

Dave
www.an-insurance.com

Blue Shield CA To Reduce April Premium On DMHC Settlement

Blue Shield of California has announced to agents that they will be providing a premium reduction (March 1 increase) for those subscribers currently seeing a March 1 rate increase on their DMHC-registered health plans.

Instead of a regular premium increase reduction (say that three times fast) Blue Shield of California has agreed instead to pay the overall reduction at one time. Subscribers currently on DMHC-registered Blue Shield plans will receive a premium credit for the month of April, 2012 on average approximately 62%.

The rate increase goes into effect March 1, 2012 so those on DMHC-registered plans need to make sure and pay the full March premium. Letters regarding the April premium credit have been sent to affected subscriber.

Those on DMHC-registered plans who are currently in their initial six-month rate guarantee period will receive the premium credit the first month after the end of the rate guarantee period.

DHMC-registered plans include:

*Shield Spectrum 5500 PPO
*Access+ HMO
*Access+ Value HMO

This premium credit only applies to underwritten health plans and does not apply to HIPAA plans nor Conversion plans.

Dave
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