Health
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SAN FRANCISCO – Blue Shield of California (BSC) has withdrawn its rate filing with the California Department of Insurance and the company will not increase rates to any individual or family plan member for the remainder of the year, announced BSC chairman and CEO Bruce Bodaken on Wednesday.
The not-for-profit health plan has 340,000 individual and family plan members in California.
As a result of Wednesday's decision, Blue Shield individual policyholders will save $35 million to $40 million this year.
"Our not-for-profit mission is to provide Californians with access to quality health care at an affordable price," said Bodaken. "As long-time advocates for universal healthcare coverage, we are also deeply committed to the success of health reform. The best way to fulfill our mission and make reform work is to keep costs down. By agreeing not to raise rates this year, we are helping to make coverage more affordable for our members during tough economic times. It's a financial risk for us, but a risk that's worth taking."
"We have long acknowledged that the individual health insurance market is broken and we are pleased that the rules will change in 2014," added Bodaken. "But health reform will succeed only if we restrain the rising cost and utilization of medical services that is driving premium increases. We are dedicated to working collaboratively with providers and regulators to address that issue."
Blue Shield lost $27 million on individual health insurance coverage in 2010 and even with the now withdrawn rate increase, the company expected additional losses on this business in 2011.
In October 2010, the company filed for new individual market rates with the Department of Insurance, to be effective in March 2011.
In January, Insurance Commissioner Dave Jones asked Blue Shield to delay the filing for 60 days and the company complied. At the same time, Blue Shield submitted the rates to an independent actuarial review by David Axene, who had completed rate reviews for the Department of Insurance in 2010 and discovered errors in several filings.
Blue Shield also promised to pay refunds to its members if Axene's review found that the rates were too high. On March 1, Axene released his report, which concluded that the rates were appropriate. With Wednesday's action, however, that filing is withdrawn and the new rates will not take effect.
“I am pleased that Blue Shield announced this morning that it has decided not to move forward with the third of its three rate increases in less than a year,” said Jones.
He said for some Blue Shield policyholders, the total of these three rate increases was as much as 87 percent. The third rate increase itself was an average of 6.5 percent.
Jones said Blue Shield's decision confirms the need to give the insurance commissioner the authority to reject excessive rate hikes. “Many Californians will be surprised to learn that the Insurance Commissioner does not have the authority to reject excessive health insurance rate increases. In California, unlike in 20 other states, health insurers get to decide whether to increase health insurance rates without approval from the insurance regulator, just as Blue Shield raised rates two times and proposed to raise rates yet a third time, until today’s announcement.”
Jones is sponsoring Assembly Bill 52, authored by Assemblymember Mike Feuer, to give the Insurance Commissioner the authority to reject excessive rate hikes.
During his first week as insurance commissioner, Jones learned that Blue Shield had just notified their policyholders of a March 1st premium increase. For many policyholders that would have been their third health insurance premium increase since October 2010.
He said he immediately asked Blue Shield to delay their March 1 premium increase for 60days so that he would have the time necessary to thoroughly review their rate filing. Blue Shield initially refused his request for a 60-day delay.
“I also asked Anthem Blue Cross, Aetna and PacifiCare for 60-day delays in implementing their pending rate increases and they all agreed to the delay. Blue Shield then agreed to a 60-day delay,” he said.
Over time, the companies have provided Jones' department with much of the information requested about their proposed rate increases. It was just last week that the department received additional requested information necessary to do a thorough review of these rate increases.
The information provided by Blue Shield and other insurers about their rate filings is posted on the Department’s Web site at www.insurance.ca.gov/0250-insurers/HlthRateFilings/ .
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SACRAMENTO – On Friday California Insurance Commissioner Dave Jones and Assembly man Mike Feuer held a media conference call to highlight the critical open-enrollment period for kids’ health insurance that began on Jan. 1 and ends next Tuesday, March 1.
Jones and Feuer were joined on the call by Novato resident, Julie Walters, the parent of a child with a pre-existing condition.
During the open enrollment period, parents can sign up their children for more affordable health insurance.
As a result of President Obama’s federal health care reform plan and AB 2244 by Feuer, children with pre-existing conditions cannot be denied coverage – they also cannot be charged rates that are more than double the rates of healthy kids.
Parents of healthy children without insurance should also sign their kids up during this period; kids who don’t sign up during open enrollment periods may be subject to a 20 percent surcharge on their insurance rates for a full year.
“One of the most important changes that federal health care reform has initiated is allowing for children with pre-existing conditions to attain health coverage,” Commissioner Jones said. “This initial open enrollment window is critical and there are only a few days left before it closes, so parents should take full advantage of it by signing their children up for coverage.”
“Under my new law, kids can receive the health care they need, even if they have a pre-existing condition,” Feuer said. “But it's crucial that parents act during this open enrollment period by signing up their children for health insurance. If they don't act by March 1, covering their kids could be much more expensive.”
Feuer authored legislation, AB 2244, that helps to implement this component of federal health care reform in California.
The new law, which has been in effect since January 1, gives California children access to affordable care and a healthy future by ensuring that certain children cannot be denied coverage or priced out of the market.
It also prohibits insurers that sell individual market policies in California from refusing to sell or renew coverage to children with pre-existing conditions – it also bans insurers from the individual market for five years if they do not sell policies to children.
“Parents need to take this opportunity seriously and enroll their kids immediately, because this is a unique chance to make sure children – especially children with pre-existing conditions – have health coverage at very affordable rates they may not be able to find later on,” Julie Walters said. “Even though my daughter does have health coverage, if anything should happen to that coverage through job loss or other circumstances, it is a tremendous relief to know that she cannot be denied coverage, even with her pre-existing condition.”
For more information, parents are encouraged to check the web site of the California Department of Insurance (CDI) at www.insurance.ca.gov, where they can find fact sheets on how to insure their children. Parents can also call CDI’s consumer hotline at 1-800-927-HELP or the state health insurance hotline at 1-888-466-2219 with any questions or concerns.
Another important resource is http://finder.healthcare.gov/ (or www.cuidadodesalud.gov for Spanish speakers), a Web site created to assist consumers in navigating their options under the Affordable Care Act.
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NORTH COAST, Calif. – Everyone should learn to save lives, regardless of the ability to pay. That’s the motivation behind CPR Saturday, the annual free training presented by the American Red Cross, serving Sonoma, Mendocino and Lake Counties on Saturday, March 12.
Eleven counties from Mendocino to Palo Alto will host the event on the same day.
Participants who successfully complete the class, including hands-on and written testing, receive adult CPR certification from the Red Cross. The certificate is good for two years.
In Sonoma County, adult cardiopulmonary resuscitation (CPR) classes in English will be offered at the Sebastopol Veterans Building, 282 S. High St., starting every hour on the hour from 8 a.m. until 2 p.m.
The Red Cross is offering Adult and Child CPR for the last session beginning at 2 p.m. There also will be two classes in Spanish, at 8 a.m. and noon.
In Mendocino County, CPR Saturday will take place at the Alex Rorabaugh Center at 1640 S. State St. in Ukiah.
Lake County will be hosting CPR Saturday at the Lakeport Fire Station, 445 N. Main St. in
Lakeport. Times for classes in Ukiah and Lakeport are still being arranged.
Interested participants in those counties can go to www.arcsm.org or call 707-577-7603 for updated information.
The Red Cross offers CPR Saturday at no charge to help remove any barriers to those with lower incomes, people who have never taken CPR previously, and those who speak Spanish.
There is no upper or lower age limit for participants. In order to receive a certificate, all attendees
must be able to pass a written exam as well as the physical skills test, which includes kneeling on the floor and having enough upper body strength to compress the manikins' chests repeatedly.
Those who cannot kneel can still take the class, but they will not be able to be certified, as kneeling ability is essential for performing CPR in a wide variety of settings.
Participants in Sonoma County must pre-register for this event via email, telephone, or online by writing
They should be prepared to provide complete information (name, address, phone, time of class they prefer) when they call. Participants in Mendocino and Lake Counties can go to www.arcsm.org or call 707-577-7603 for updated registration information and class times.
More than 100 volunteers and instructors will help throughout the day. Kelsey Abbott, a student at Santa Rosa Junior College, is coordinating the event for the second year in a row.
Classes include a video followed by practice on manikins and finally, a written exam. The entire process takes approximately three hours.
Kaiser Permanente is, once again, a major sponsor to the event. Red Cross has also received in-kind support from the Sonoma County Regional Parks and Petaluma Auto Dealerships. Local businesses such as Clover Stornetta, Round Table Pizza of Sebastopol and Sierra Springs Water have generously donated food and beverages for the volunteers who will be working the event.
The CPR Saturday event held in Sonoma, Mendocino and Lake Counties costs more than $9,000 to produce.
American Red Cross offers CPR classes throughout the year in both Sonoma and Mendocino Counties. However, CPR Saturday is the only time CPR certification is offered for free.
The usual cost for these classes is $50.
American Red Cross is a neutral, humanitarian organization that provides relief to victims of disasters, and prepares people to prevent and respond to emergencies.
Like all Red Cross chapters, the local chapter is self-sustaining and is funded by local contributions. All
assistance to disaster victims and to members of the armed forces provided by the chapter is free and made possible by voluntary donations of time and money by the people of Sonoma, Mendocino and Lake Counties.
Donations can be made at www.arcsm.org, www.redcross.org, via mail to American Red Cross, 5297 Aero Drive, Santa Rosa, CA 95403, or by phone at 707-577-7627 (Sonoma and Lake Counties), 707-463-0112 (Mendocino County).
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The Department of Health and Human Services (HHS) is announcing a new interactive map at www.HealthCare.gov/consumerhelp to make sure that consumers know how to contact their state Consumer Assistance Program.
“With www.HealthCare.gov, we are putting the resources of the Affordable Care Act at the fingertips of consumers all across the country – and the new map is an important part of that effort,” said HHS Secretary Kathleen Sebelius. “Consumers no longer have to wonder where to turn when they have questions about their health insurance.”
The interactive Consumer Assistance Map at www.HealthCare.gov/consumerhelp went live in early February as states around the country and U.S. territories are using federal grant dollars to establish or strengthen consumer assistance programs.
California is one of 40 states or territories receiving grant funds.
Consumer Assistance Programs, run by state governments, sometimes in partnership with local nonprofit organizations, have trained caseworkers that can help consumers enroll in a health insurance plan or policy, or file a complaint or appeal with their insurer.
They can also help consumers learn about the new insurance resources and reforms under the Affordable Care Act.
Consumer Assistance Programs will also help explain the new consumer protections and options that will become available as additional parts of the health care law take effect in 2014.
In addition to helping consumers on an individual basis, the Consumer Assistance Program in California will be tracking complaints to help identify potential trends in the health insurance market. Regulators can use this information to ensure that insurers are playing by the rules and consumers are receiving all their rights and protections under the law.
The interactive Consumer Assistance Program map is one of the ways the Affordable Care Act is bringing more openness to the health insurance market.
The Web site, www.HealthCare.gov, includes information about the Affordable Care Act, a timeline of implementation and other resources. The Web site also includes the health insurance finder at www.finder.HealthCare.gov, a first-of-its-kind Web site to bring information and links to health insurance plans into one place and make it easy for consumers to learn about and compare their insurance choices.
“Consumers across the country have new options and protections under the Affordable Care Act,” said Secretary Sebelius. “These tools will help empower consumers to get the health care and health coverage they and their families need.”
The Department of Managed Health Care, in partnership with the Office of the Patient Advocate in California was awarded $3.4 million in October 2010 to perform the following activities:
Develop and promote a coordinated consumer-friendly website and corresponding toll-free number that consumers can call with questions about health care coverage, and to receive assistance with the filing of complaints and appeals.
Conduct a statewide media campaign, in partnership with consumer organizations, to educate consumers about their rights and responsibilities and to provide assistance with enrollment in group health plans or health insurance coverage.
Evaluate the effectiveness of the initiatives, and collect, track and quantify consumer problems and inquiries for reporting to state and federal policymakers.
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