Dickerson Update, January 13 – Anthem, Blue Shield Announce Q2 Rate Changes

Hot off the Press: Anthem Q2 2020 Rate Changes
and New Underwriting Promotions

Anthem released approved rate changes for Q2.
Here are the details: 

Quarterly Rate Change Average:
PPO: 0.9%
HMO: 0.9%
Combined: 0.9%

Annual/Renewal Rate Change Average:
PPO: 5.2%
HMO: 6.9%
Combined: 5.4%

Additionally, Anthem announced underwriting promotions that will make it easier for you to sell this year! Here’s how the promotions will work:

Relaxed Participation

1-4 enrolling: 65% participation
5+ enrolling: 25% participation
The same participation rules apply for Dental and Vision coverage with a minimum of 2 enrolled.

Valid Waivers

Individual coverage both on and off the Exchange will be accepted as a valid waiver. Valid waivers also include employees waiving due to Medicare, Medi-Cal or military, or being covered as a dependent on a spouse’s or parent’s employer sponsored group plan.

No DE9C

A DE9C is not required for groups with 6+ subscribers and Specialty. Groups with prior coverage must submit prior carrier bill. This promotion excludes virgin groups.
These promotions are valid for groups with effective dates through 6/15/20.

For more information, please contact your Dickerson Account Executive.

Blue Shield’s Q2 Rate Changes and Underwriting Promotions

Blue Shield is pleased to announce that their Q2 2020 rate action is a statewide average of 0.0%. Rate actions are the same across all plans and rating regions since Q2 2020 rates are the same as Q1 2020 rates due to the Q2 rate pass. Here are the details:

Quarterly Rate Change Average:
PPO: 0.0%
HMO: 0.0%
Combined: 0.0%

Blue Shield is also extending its relaxed participation requirements for Small Group to 12/31/20. Please see below for more information:

Trio HMO Plans
Blue Shield is waiving participation requirements for Trio-only groups with 1-100 employees.

Relaxed Participation Requirements
• Effective dates of 1/1/16 through 12/31/20
• New medical and specialty small business clients with off-exchange plans
• 25% of eligible employees enroll in a Blue Shield plan with no fewer than 5
• One carrier may be written alongside Blue Shield

For all pertinent details, click here.

Governor Newsom’s Proposed Budget Includes Medi-Cal Expansion for Undocumented Seniors


California’s Governor Newsom unveiled his proposed budget for the 2020 through 2021 fiscal year, with homelessness, education, climate action, consumer protection, and health care as focal priorities. This initial budget proposal indicates the start of a long negotiation process between the Governor and State Legislators.

Governor Newsom’s budget includes a $700 million increase in funding for Medi-Cal. His budget would allow undocumented seniors to enroll in Medi-Cal if they meet income requirements. This has the potential to build upon Medi-Cal’s recent expansion to undocumented young adults. Additionally, this proposal also seeks to create a state-owned generic drug label in California.

To read the full story, click here.