Dickerson Update, July 11 – Q4 Updates, Carrier Contract Changes, and More!

Anthem Announces Q4 Rate Changes

Anthem announced a Q4 rate change for small groups. As of 7/1/19, these rates are live and available for quoting. Anthem has also announced new plans with the Plantinum HMO 20 and the Bronze PPO 60/6000/30%. See the rates below:

Quarterly Rate Change Average:

PPO: 1.2%

HMO: 2.0%

Combined: 1.3%

Annual/Renewal Rate Change Average:

PPO: 9.5%

HMO: 11.5%

Combined: 9.8%

Anthem also has contract update news. El Camino Hospital (servicing members in the South San Francisco area) was issued a notice to terminate its Contracting Hospital Agreement. An agreement has been unable to be reached thus far and El Camino Hospital may terminate effective July 31, 2019.

Anthem has also announced that it has reached a multi-year year agreement with Adventist Health.  The fully executed amendments (which include Medicare Advantage, Professional and Ancillary Agreements) are effective August 1, 2019.

For more information, please contact your Dickerson Account Executive.

Blue Shield Announces Q4 Rates

Blue Shield recently shared fourth quarter rates. See the rates below:

Quarterly Rate Change Average:

PPO: 1.8%

HMO: 1.8%

Please note that rates vary for from -5.5% to +5.9% for PPO plans and -.9% to +4.3% for HMO plans depending on region and network.

Click here for additional details on rate changes.

Blue Shield also announced that they were unable to reach a mutual agreement on rates and terms for hospital contracts with Physicians for Healthy Hospitals PHH/KPC Hospitals System. Because of this, several hospitals will no longer be a part of Blue Shield’s network of providers effective July 1, 2019.

For more information, please contact your Dickerson Account Executive.

Choice Builder’s New Business Quoting now Available for Q4

Choice Builder announces that new business quoting is now available for 10/1/19. Additionally, there are no rate or benefit changes.

For more information, please contact your Dickerson Account Executive.

HealthNet Announces Q4 Rate Updates

HealthNet has released fourth quarter rates, which are effective from October 1, 2019 to December 31, 2019. Rates quoted are pending completion of regulatory review.

SBG Ancillary Rates

  • Dental/Vision: No rate changes at this time
  • Life: No rate changes at this time
  • Optional Chiro: No rate changes at this time

While there are no rate changes for ancillary benefits in Q4, rates will increase .7% for PPO and EnhancedCare PPO plans and 1% for HMO and HSP plans.

Rates PPO and EnhancedCare PPO HMO and HSP
Q4 2019 0.7% 1%

For more information, please contact your Dickerson Account Executive.

Oscar Announces New Broker Bonus through CaliforniaChoice

Oscar recently announced a new Small Group broker bonus program for the LA/OC area. New groups with effective dates from June 2019 through December 15th, 2019 qualify brokers for a $25, $50 or $75 per employee bonus on all groups with at least four enrolled employees. The larger the group, the greater the bonus.

Here’s how it works:

Enrolled Employees Broker Bonus
4-25 $25
26-50 $50
51-100 $75

Plus, brokers who sell their first case with Oscar of four or more employees by December 15, 2019 are eligible for an additional bonus.

Here are the details:

Enrolled Employees First Case Bonus
4-14 $250
15-100 $500

Click here for additional pertinent details.

President Trump Signs Executive Order Intended to Increase Health Care Cost Transparency

President Trump recently signed an executive order geared toward giving Americans more visibility into the cost and quality of health care services. With health care as a focal point of concern for many voters going into the 2020 election cycle, both Republicans and Democrats are advocating for increased transparency in the health care system. While the executive order itself does not immediately garner changes in the health care system, it will put into motion new federal regulations.

Hospitals and insurers have pushed back against the executive order, stating that it might destroy competition among insurers and hospital systems, and ultimately drive up prices. Representatives for the American Hospital Association and the Federation for American Hospitals have commented that the language of the executive order is a bit vague and leave room for interpretation on what transparency might look like.

To learn more, click here.

Validity of Obama health care law at issue in appeal hearing

An appeals court heard arguments Tuesday on whether Congress effectively invalidated former President Barack Obama’s entire signature health care law when it removed the tax imposed on those who chose not to buy insurance.

It is uncertain if the three-judge panel on the 5th U.S. Circuit Court of Appeals will rule on the case, as it is destined for the Supreme Court. The latter has previously reviewed the law, its coverage, and insurance protection for millions of Americans. The outcome of the ruling will affect protections for people with pre-existing conditions, Medicaid expansions for roughly 12 million people, and subsidies that help about 10 million others afford health insurance.

To read the article, click here.