Dickerson Update, April 23 – 3rd Quarter Rate Updates

Aetna Announces Q3 2020 rate changes, plan updates, bonus program, and new mobile app

Aetna announced that effective July 1, 2020, the Savings Plus network will no longer be available in Fresno (RA 11) for new business. Renewing groups in RA 11 and new and renewing groups in Rating Areas 15-19 will still have this plan option available.

Aetna also released rate changes for Q2 2020. Here are the details:

HMO OAMC/PPO
Quarter +1.3% +2.5%
Annual +4.5% +5.6%

Additionally, the Attain mobile app by Aetna is now available to all medically enrolled members with a California ACA compliant plan. This mobile app is a first-of-its-kind health experience designed in collaboration with Apple that offers personalized goals, achievable actions, and big rewards. For more information on Attain, click here. There’s also an FAQ document available here.

Aetna also wants to remind brokers of their ongoing underwriting promotion and broker bonus program. Here are the details:

Relaxed Participation Promotion

  • 1-4 members enrolling: 65% participation required
  • 5+ members enrolling: 25% participation required
  • Aetna will allow one other Carrier HMO and/or PPO alongside (excludes EPO plans)
  • Participation with another carrier is not considered a valid waiver
  • Valid through December 31, 2020

2020 Broker Bonus Program 

  • 1-74 employees: $50 per enrolled employee
  • 75+ employees: $100 per enrolled employee
  • New business medical sales only
  • Valid from January 1, 2020, through December 31, 2020

To see all pertinent bonus program details, click here. For more information, please contact your Dickerson Account Executive

Anthem releases Q3 2020 rate changes

Anthem wants to remind brokers that they’ve introduced several new plans in their network! These cost-saving options include Two New Gold HMO Deductible plans offering a $500 or a $1,250 deductible option and also Two new PPO plans with just $5 copays.

Anthem also released rate changes for Q3 2020. Rate action effective July 1, 2020. Here are the details:

Quarterly Rate Change Average

PPO: 2.2%
HMO: 2.3%
Combined: 2.2%

Annual/Renewal Rate Change Average 

PPO: 5.9%
HMO: 7.4%
Combined: 6.0%

In spite of medical rate changes, Anthem is pleased to announce a rate hold for Q3 2020 renewal rates for dental, vision, life, and disability.

For more information, please contact your Dickerson Account Executive.

Blue Shield publishes Q3 2020 rate changes, hosting a COVID-19 leadership webinar

Blue Shield would like to share Q3 2020 rate changes. Here are the details:

Quarterly Rate Change Average:

PPO: .9%

HMO: .9%

Please note that rate changes can vary from region to region. For the specifics, please contact your Dickerson Account Executive.  

Additionally, on April 28, 2020 from 1:00 PM to 2:00 PM, Blue Shield will host a webinar, Blue Shield of California Update: COVID-19. During this webinar, Senior Vice President Commercial Markets Don Antonucci, Chief Operating Officer Todd Walthall, and Chief Medical Officer Terry Gilliland will be providing an update on what Blue Shield is doing as a company to address COVID-19.

Click here to RSVP!

Kaiser releases Q3 2020 rate changes

Kaiser just released Q3 2020 rate changes. 

Here are the details on average rate changes for renewals:

July 2020 0ver July 2019
Existing business NorCal SoCal
HMO metal plans (including CCSB &CalChoice)* 3.4% 3.2%
PPO metal plans 5.0%
Dental 2.0%
Child dental 0.0%
Grandfathered plans Statewide
HMO 4.0%
Dental plans 2.0%
Chiro/acupuncture rider 2.1%

Please note that rate changes vary by plan, and that the above numbers are averaged across plans.

For more information, please contact your Dickerson Account Executive.

Dickerson Individual Health Plans

Molina offering online SEP training sessions and Broker portal training sessions 

This just in: Molina is offering online training for brokers to learn the ins and outs of California SEP extensions, as well as how to maximize their online Broker portal experience.

Brokers who sign up for one of the 2020 CA Molina Marketplace Online SEP Training sessions can expect to learn about the following topics:

  • SEP resources and tips
  • Molina Marketplace member benefits
  • Provider networks and hospitals
  • Coronavirus updates
  • State SEP extensions and deadlines

The SEP Training will occur on the following dates. Click on any of the dates to register:

Molina’s Online Broker Portal Training will show brokers how to:

  • Access BoB
  • Identify which members are in grace period
  • Submit commission reconciliation requests
  • Update E&O and license renewals online

The Online Broker Portal Training will occur on the following dates. Click on any of the dates to register:

For more information on selling Molina, or to find out how you can get appointed, please contact Sally Saracay at sally@dickerson-group.com or (323) 805-2901.

Oscar extends benefits for COVID-19 treatment services.

Oscar understands that testing positive for COVID-19 is hard enough, so they’ve decided to make member access to treatment more attainable and affordable during these trying times.

Oscar is now offering the following regarding services in the treatment of COVID-19:

  • Waiving cost-sharing for the treatment of COVID-19 delivered by in-network providers for its Individual and Small Group members through May 31, 2020.
  • No cost-sharing for treatment at out-of-network facilities if the member obtains pre-authorization.
  • If follow-up care is required at an out-of-network facility or hospital, contact your local Oscar representative as soon as possible.

For exceptions regarding prior authorizations, click here.

Please note that if any of your Oscar clients have paid for COVID-19 treatment services with normal cost-sharing, they may be eligible for a possible claim adjustment. To inquire about a claim adjustment, contact Oscar’s Concierge team through your online account, the Oscar app, or by calling Oscar’s Concierge team at 1-855-672-2755 for assistance.

In addition to the above-mentioned services, Oscar Health is offering the following related services for the treatment of COVID-19:

  • Waiving cost-sharing for COVID-19 screening at both in-network and out-of-network. This also includes the cost of the visit and the test itself.
  • Waiving cost-sharing for all COVID-19 care delivered through telemedicine through May 10th.
  • Temporary elimination of early limited refills on most prescription drugs at all in-network pharmacies.
  • Extension of prior authorizations for any previously-approved requests.

To ensure that members receive the most up-to-date information on a timely basis, Oscar Health is conducting outreach to their members who have already tested positive for COVID-19 to check in on their recovery progress, as well as inform them of updated policies.

For more information, please contact your local Dickerson Account Executive.

Industry News

CalSavers extends registration deadline for large employers

CalSavers, California’s new retirement savings program available to California workers whose employers don’t offer a workplace retirement plan, self-employed individuals, and others who want to save extra, is extending their registration deadline. Because of the unprecedented challenges employers are facing due to COVID-19, CalSavers is allowing employers with more than 100 employers to register until September 30, 2020 (from June 30, 2020).

To learn more about CalSavers and read the announcement in full, click here.

California becomes first state to recommend some COVID-19 testing for asymptomatic individuals

California is now the first state to recommend COVID-19 testing for asymptomatic individuals working or living in high-risk environments such as nursing homes and prisons. According to the public health department, this points to an increased availability of testing and a greater capacity to run more procedures at labs. The limited availability of and ability to administer tests has proven to be an issue for individuals wanting to determine if the mild symptoms they’re exhibiting are related to COVID-19. This has also made it difficult for public health officials to obtain a more accurate picture of just how widespread COVID-19 is.

While scaling up the availability of supplies and systems for COVID-19 has come with many challenges and there’s still more work to be done, experts are optimistic that California’s relaxing of requirements for testing points to the first step in establishing a widespread testing program.

Click here for the full story.

Southern governors form a COVID-19 coalition to re-open the region’s economy; public health experts saying it could be the “perfect storm” for a coronavirus outbreak

Republican governors in the southeast region have formed a coalition to reopen the region’s economy. Despite an inadequate amount of testing in this regions to find out how rapidly the virus is spreading, governors in the South would like to begin reopening businesses. Experts fear that in doing so, it could create a “perfect storm” where the virus can start to spread rapidly. The coalition includes governors from Florida, Georgia, South Carolina, Tennessee, Alabama, and Mississippi, where social distancing measures were suggested and there has been a lack of testing. Records also show this part of the country has underfunded health systems, high obesity rates, and other illnesses which only increases the likelihood of a coronavirus outbreak. Despite expert opinions that state reopening the economy should happen in phases, the coalition is pushing forward.

Click here for more details.