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Blue Shield canceled it’s latest rate increase–is that good?

03-19-2011by Colleen King


This past week, after much controversy, Blue Shield of California canceled it’s rate increase set for May. It was supposed to be in March, they were asked to delay it 60 days by the insurance commissioner, which they did. So after already having two rate increases since October of last year, Blue Shield canceled this current rate increase and has said no more ‘rate actions’ through the end of the year. Click here for the details.


Basically, it appears that one reason this was able to happen was expenditures for health care services late 2010 were less than anticipated. SO, does that mean everything’s okay?


Not sure; what if expenditures exceed what is expected? Conventional thinking is that when times are tough, people skip care that is not essential. This is either because they have no insurance or their insurance puts more of the initial costs on the member. That’s how you keep insurance premiums down, especially when you hear about rate increases like these.


I’m concerned about what happens next year, wondering if rates will fly up to a ridiculous level. Carriers are being expected to do things and cover services in ways not previously experienced, and don’t know how to price for it, so they shoot rates up. And it’s not just Blue Shield, it’s happening with all the carriers.


So to all of you who said to me ‘hey, I thought health care reform was supposed to drop rates,’ I told you it wasn’t going to happen any time soon. Believe me, I’m sorry I was right!

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Category: Uncategorized


Prescription drugs and the high cost of health insurance–related?

03-01-2011by Colleen King

Okay, so it’s one reason that insurance premiums are so high, but it’s a big one.


On AOL today there was an article about several drugs that will be coming off patent–big name drugs like Lipitor. Drug companies, in order to recoup their ‘research and development’ costs have exclusive rights to a drug they develop for several years. Read here for more. And check out the BILLIONS in sales each of these generates!


Is your drug on this list? Well, if you take Lipitor, Protonix, Zyprexa, Concerta or several others, over the next 2-3 years you’ll see a drop in costs. If you don’t have health insurance, one thing that I’ve told my clients to do is check at Costco. You don’t have to be a member for prescription purchases necessarily. They have a ‘price checker’ on their site that I refer to often. Prices can vary by location, and the pricing here is based on buying from Costco.com. Check your local Costco to see what the cost actually is. The one in Northridge near me is usually pretty close.


Point is, to bring down the cost of health care in general and insurance too, you have to be a saavy consumer. Many studies show that people spend more time researching an auto or TV purchase that things related to their health care. Enough of ‘buyer beware,’ time make smart choices. You can start with your drug purchases.

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Category: Uncategorized


What do I do about a ‘child only’ health insurance policy in California?

01-24-2011by Colleen King


When health care reform was voted in last year, one of the first items that when into effect September 23, 2010 was the guarantee issue of plans to kids under age 19 without regard to pre-existing conditions. Problem with that was that insurance carriers had no idea what the liability was going to be so instead of risking a big financial hit, several opted not to write ‘child only’ policies since obviously, the most likely people to try to get coverage were those who had medical needs.

Well, the California Legislature passed a bill requiring carriers who wanted to sell in the Individual plan market in California has to participate in an ‘open enrollment’ period for kids under age 19. This all came about fairly late, there are things still to be determined but in a nutshell, here are the basics:

Open enrollment is January 1 to March 1. If you miss this time period, there is also the month of the child’s birthday.

These parameters may change in the future. These time frames do not apply to having kids on your family’s insurance plan. There are a few other circumstances so call me if you have questions.

So if you need coverage for your kids, or if you have friends with kids, please share this information with them. Call me, call your agent if you have one other than me, just get the ball rolling because time is limited!
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Category: Uncategorized


Health care reform compliance, and the IRS is going to be the monitor?

01-14-2011by Colleen King

I came across an article recently published by USA Today that reminded me of the big wake up call we have coming in 2014 when the bulk of the health care reform measures go into effect. Check out this article by Sandra Block, “IRS lack clout to enforce mandatory health insurance.”

This article lists estimates of needing 16,000+ IRS agents to enforce this eventually. The Congressional Budget Office is estimating the cost at $5-10 billion to administer this. And that’s just the start.

My concern along with other agents in California is the price tag on all the changes. Even though people aren’t happy with rates in LA and Ventura counties, you are definitely paying less than places like Massachussettes, New York and New Jersey. And now that you are looking at eventually subsidizing people, not excluding for pre-existing conditions, rates will soar. But the IRS can’t apparently enforce these new provisions in the law.

For example–30 year old male in New York City, hospital only plan would run $176/month. No deductible, but no coverage for office visits, most outpatient care or prescriptions. Which is more of what a 30 year old would need. You could get something comparable in the SFV area for $78-99/month, but there would be a deductible.

The same 30 year old, wanting a more comprehensive plan, opts for a $2000 deductible, $30 office visits, 80/20 coverage, sounds great right? Are you willing to pay $529.06/month for that? That’s a real figure for the 10009 zip code. I can find $2500 deductible, 70/30 plans with three office visits per year with generic and brand coverage for $111/month here in the Los Angeles area.

So you might want to look for coverage now, while it’s affordable in California. No one really knows what will happen once all this starts to kick in. Pretty scary!

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What? The plan for ‘uninsurables’ is filling up? What now?

01-01-2011by Colleen King

Geez, now this is a drag–the Pre-existing Condition Insurance Plan (PCIP) which was supposed to be such a panacea for the uninsurable apparently was too popular–in 2 months, the program might be stopping enrollment because, get this–the claim costs were 3 times higher than anticipated. Big surprise! You have to realize that when you offer ...read more