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 California Removes HIPAA 4000 HSA PPO

One of the more popular HIPAA guaranteed-issue plans over the last couple of years has been the HSA-compatible Spectrum Savings PPO 4000 with Blue Shield of California (Life & Health).

With the previously blogged closure of the majority of Blue Shield's PPO health plans (July Plan Closure Blog), including the 4000 Savings PPO, the plan has also been removed from the offerings for HIPAA.

As of today, it is my understanding that Blue Shield does not intend to replace the 4000 HSA PPO plan in the HIPAA portfolio and has no intention of offering any HSA-compatible PPO plan for HIPAA-eligible individuals & families. I was told that until and unless I hear otherwise, the HIPAA portfolio available from Blue Shield will be as follows:

*Access+ HMO
*Access+ Value HMO
*Spectrum PPO 5000
*Spectrum PPO 5500

These are also the four remaining underwritten individual & family plans that are not being closed to new enrollments July 1.

Both Blues (Blue Cross of California (Anthem) and Blue Shield of California) are excellent PPO carries with large networks in California. The loss of the only HSA-compatible PPO plan by either Blue for HIPAA enrollees is a bit sad. There are many who need to enroll in HIPAA that would benefit from both the lower annual out-of-pocket and the combined Rx and medical expenses.

Should Blue Shield provide information on any new HIPAA plans I will post here on the blog.

Dave
www.an-insurance.com