Dickerson Update, October 10 – Updates from Anthem, Blue Shield, CalCPA, Health Net, and More!

Anthem Incentivizes You with Its Q4 Bonus Programs

Exclusively for Q4, Anthem is offering these bonus programs!

Effective 10/1/19 to 1/15/20, Anthem will pay $50 per member for all 10+ subscriber groups. Previously, Anthem announced a broker bonus program for its ACE Agents with a 7% commission on 10+ groups. Please note that ACE Agents are not eligible for this Bonus unless they want to forgo the 7% Commission program and elect to take the $50 Per Member Bonus.

Additionally, dental and life sales are also eligible for a bonus. This program is effective from 10/1/19 to 1/1/20.

Here are the details:

  • $100.00 per small group dental sold case with 10 to 50 enrolled employees
  • $200.00 per small group dental sold case with 51 to 100 enrolled employees
  • $50.00 per small group life sold case with 10 to 50 enrolled employees
  • $100.00 per small group life sold case with 51 to 100 enrolled employees

Payout will occur in April 2020.

For more information, please contact your Dickerson Account Executive.

Blue Shield Announces Addition to Trio Providers in Inland Empire

Effective October 1, 2019, Riverside Physician Network (RPN) will be in the Trio list of providers in the Inland Empire. This new addition impacts all Trio plans across commercial lines of business including Core, Premier, Small Business, Individual, and Family plans.

As you may or may not know, PrimeCare Riverside acquired RPN. For now, search results on Find a Doctor and the Trio Census Tool will show RPN as a provider. However, beginning January 1, 2020, RPN will officially be a part of PrimeCare Riverside on all Blue Shield systems and will no longer listed as RPN, but instead as a part of PrimeCare.

For more information, please contact your Dickerson Account Executive.

CalCPA Shares Changes to 2020 Plans alongside 2019 Plan Comparison Sheet

CalCPA shared changes to 2020 plans, which primarily pertain to deductibles, out-of-pocket-costs, and drug co-pays. The most marked change is the removal of office limitations before the deductible on most of the PPO Plans.

Click here for more on 2020 plan changes, and here for a 2019 plan comparison sheet.

For more information, please contact your Dickerson Account Executive.

Health Net Announces Rate Change Update, New Plans and More 

Health Net has announced that it is mailing out an important reminder about a Centers for Medicare & Medicaid Services (CMS) notice, regarding pharmacy plan creditable coverage, to employers groups that they must present to their employees by October 15, 2019.  

Pharmacy Plan Creditable Coverage Notification Employer groups who provide prescription drug coverage through a group-sponsored health plan have to notify Medicare-eligible employees of the creditability status of their pharmacy plan.

For more information on CMS Model Beneficiary Creditable Coverage, please click here and see the employer section of the CMS website.

Health Net is also replacing some plans with similar new plans for 2020 selling.  Here’s a list of the plans that were updated:

The carrier is closing these Health Net Life Insurance Company insurance plans:

  • Silver 70 Value PPO 1700/30 + Child Dental Alt (including CCSB plan)
  • Silver 70 HDHP PPO 1350/40 + Child Dental Alt (including CCSB plan)
  • EnhancedCare Silver 70 Value PPO 1700/30 + Child Dental Alt
  • EnhancedCare Silver 70 HDHP PPO 1350/40 + Child Dental Alt (including CCSB plan)

The following plans below will be closing and new plan options will be offered:

  • CommunityCare HMO Gold $5
  • CommunityCare HMO Silver $20
  • CommunityCare HMO Bronze $45

Plan closure letters will be mailed to employer groups and members impacted by these changes. Letters will mail on a monthly basis at least 90 days prior to the impacted group’s renewal date. January 2020 employer group and member letters will mail by October 1, 2019. 

Finally, due to required regulatory changes, Health Net has updated its previously released first quarter 2020 SBG Medical Rates, and SBG Medical Portfolio plans, have been updated. Please also note the updated HMO and HSP rate comparisons.

The new rates and new plans are effective 1/1/2020 – 3/21/20. See below for new rates:

Rates

PPO and EnhancedCare PPO

HMO and HSP

Q4 2019

0.7%

1%

Q1 2020

3.6%

4.6%

Dental and Vision: See new rates for 2020 here

Life: No rate changes at this time

Optional Chiro: No rate changes at this time

For more information about Health Net, please contact your Dickerson Account Executive.

New Executive Order for Medicare Packs Potential Rise in Patients’ Costs

Medicare provisions, especially Part A, could be significantly affected as a result of an executive order issued last week by President Trump.  The proposed changes could affect parts of the program by making it easer for beneficiaries and doctors to opt out. While it might make it simpler to find a doctor who takes new Medicare patients, it could lead to higher costs for seniors and potentially expose some to surprise medical bills. The latter being a problem that Medicare has traditionally protected consumers from.

The order also seeks to ease rules that affect beneficiaries who want to opt out of the hospital portion of Medicare, known as Part A.

To read the article, click here.

 

California Expands Access to HIV Prevention Drugs

Under a new law that Governor Newsom signed Monday, October 7 2019, California will allow consumers to obtain HIV prevention medication without a prescription. Senate Bill 159 allows pharmacists to provide pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis, known as (PEP), similarly to how they can dispense birth control and emergency contraceptives.

Studies show that PrEP dramatically reduce the probability of getting infected by HIV, while PEP drastically reduces post-exposure transmission. Proponents of the bill state that it will remove barriers for individuals who need these medications, and also reduce the number of HIV transmissions.

To read the full story, click here.