Blue Shield and Sutter Health sign 3 year contract

Sutter Health and Blue Shield of California have come to an agreement on a three year renewal of their provider contact through Dec. 31st, 2019.  The contract is for all coverage – Individual, Group, Medi-Cal, and Medicare.  Keep in mind that not all providers or facilities are available to all plans, so please double check with www.sutterhealth.org and www.blueshieldca.com for in-network specifics.  Sutter Health participates in Blue Shield’s PPO plan through Covered CA, but please check for specifics on each respective...
Should you take advantage of latest Obamacare delay?

Should you take advantage of latest Obamacare delay?

Federal officials announced last Wednesday that Americans can keep health insurance plans that fail to meet the standards of the Affordable Care Act for another two years.  This latest delay allows insurers to renew the old plans as late as October 1, 2016, meaning customers who renew then would be covered for most of 2017.  The option will only be available to people who renewed plans at the end of 2013. New subscribers will not be able to enroll in these plans. Those who are satisfied with their current coverage may take comfort in knowing they can put off shopping for health insurance for a few more years however, this does not necessarily mean that they will be getting a better “deal”.  The old policies were canceled initially because they didn’t meet the higher standards set by the health reform law, which requires that all plans cover maternity care, prescription drugs and mental health, among other benefits. Many people who decide to keep their old plans may find out that they would have to pay higher rates to keep the same coverage.  Even if rates are unchanged, some subscribers may find they need better coverage, since the plans being extended may not cover hospital stays, prescription drugs or other services. Having an educated broker to turn to for guidance in these changing times is proving to be a more valuable commodity than ever. Contact Bedrosian & Associates if you would like a free review of your current medical insurance plan versus the medical insurance plans...

Blue Shield of CA Updates – Network, Renewals and Technology

Expanded PPO Contract with Hoag Hospital, Orange County We have signed a new contract with Hoag Hospital in Orange County. Beginning March 1, 2014, Hoag Hospital’s Newport Beach and Irvine locations will now participate in Blue Shield of California’s Exclusive PPO Network for Individual and Family Plan products. Hoag Hospital has been a participating provider of Blue Shield’s network since 1984. Consumers who buy the new 2014 Individual and Family PPO Plans directly from Blue Shield of California or Covered California will now have expanded access to care at Hoag’s Orange County facilities. This new contract DOES NOT change Hoag’s previous arrangement with Blue Shield. April Renewal Bills Delayed for Small Business Customers Small Business customers renewing in April will receive their April bill the week of March 17, 2014 – one week later than all other non-renewing Small Business customers. The delay is due to the continuing transition of customers to our newly enhanced eligibility and billing system. Here are five things to know about this delay: The bill delay does not impact members’ access to care and coverage won’t lapse because of it. This delay will help ensure your clients receive accurate bills. Non-renewing Small Business clients will be mailed their bills on schedule the week of March 10, 2014. The one-week delay only applies to Small Business customers with April renewals. There is a 30-day payment grace period from the time bills are mailed. Commissions will be paid upon receipt and allocation of customer payment. Service and Technology Updates New automated phone account management Our new, easy-to-access telephone feature for IFP customers is already starting to...

What is Considered Preventive Care?

                                If you have a new health insurance plan or insurance policy beginning January 1, 2014 or after the following preventive services must be covered without your having to pay a copayment or co-insurance or meet your deductible. This applies only when these services are delivered by a network provider.  When making an appointment with your provider for preventive services, it is always good practice to tell them that your visit will be for preventive services as outlined in your health plan.   15 Covered Preventive Services for Adults Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked Alcohol Misuse screening and counseling Aspirin use for men and women of certain ages Blood Pressure screening for all adults Cholesterol screening for adults of certain ages or at higher risk Colorectal Cancer screening for adults over 50 Depression screening for adults Type 2 Diabetes screening for adults with high blood pressure Diet counseling for adults at higher risk for chronic disease HIV screening for all adults at higher risk Immunization vaccines for adults–doses, recommended ages, and recommended populations vary: Hepatitis A Hepatitis B Herpes Zoster Human Papillomavirus Influenza (Flu Shot) Measles, Mumps, Rubella Meningococcal Pneumococcal Tetanus, Diphtheria, Pertussis Varicella Learn more about immunizations and see the latest vaccine schedules. Obesity screening and counseling for all adults Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk Tobacco Use screening for all adults and cessation interventions for tobacco users Syphilis screening for all adults at higher risk 22 Covered Preventive Services for Women, Including Pregnant Women Anemia screening on a routine basis for...

5 Things to Know About Deductibles in The Exchange

Having health insurance can lower your costs even when you have to pay out of pocket to meet your deductible. Insurance companies negotiate their rates with providers and you’ll pay that discounted rate. People without insurance pay, on average, twice as much for care. A health insurance deductible is different from other types of deductibles. Unlike auto, renters, or homeowners insurance, where you don’t get services until you pay your deductible, many health insurance plans provide some benefits before you meet the deductible. All medical plans cover preventive care. Screenings, immunizations, and other preventive services are covered without requiring you to pay your deductible. Many health insurance plans also cover other benefits like doctor visits and prescription drugs even if you haven’t met your deductible. In 2014, there usually is a $6,350 maximum for individual out-of-pocket costs for in-network services. The maximum for families is $12,700. Even if you choose a high deductible catastrophic plan, your out-of-pocket costs should not exceed this limit. Over 70% of Marketplace plans have deductibles under $3,000. When you choose a health insurance plan, it’s important to understand what your insurance company covers without requiring you to pay your deductible. Then you can decide whether you want a plan with lower monthly premiums and a higher deductible, or one with a higher monthly premium and a lower...