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Covered California Daily News

  • Covered California Announces Rates for 2015; Rigorous Negotiations with Health Insurance Companies Keep Rate Increases Low and Choices Robust
    Strong Enrollment for 2014 Prompts Balanced Risk Pool and Competition Between Health Plans; Average Statewide Rate Increase Kept to 4.2 Percent

    SACRAMENTO, Calif. — The vast majority of Covered California consumers will see low increases in their health insurance premiums for 2015, and many consumers will see no increase or even a decrease. The statewide weighted average*  came in at 4.2 percent, with some plans offering weighted average rates that are 8.5 percent lower than current pricing.

    “This is good news for Californians and an example of how Covered California and the Affordable Care Act are working to make health insurance affordable,” said Covered California Executive Director Peter V. Lee. “As we move into our second open enrollment and first renewal for many Californians, we are glad to see consumers have a real choice, with affordable options in all regions.”

    Covered California’s role as an “active purchaser” brought in low rate increases while maintaining high quality. Covered California’s team of negotiators actively engaged in vigorous back-and-forth with insurance companies to keep increases at a minimum, deliver networks of doctors and hospitals that meet consumers’ needs and give them meaningful choice when shopping for the plan that is the best fit.

    “Health care is regional, it’s local, and it’s personal. This means that the costs and options for each consumer in California are different,” Lee said. “The ‘average’ rate going up only 4.2 percent means that for some it will go up more and for some less, but all consumers now have the ability to shop. Consumers are not locked in to one plan; they can stay with their plan or change and can often find a lower-priced option.”

    Covered California has selected 10 health insurance companies to be in the state health exchange in 2015. All 10 health insurance companies were in the exchange for 2014 and submitted bids to return to the exchange for 2015 coverage. The portfolio reflects a wide mix of large nonprofit and commercial leaders in the individual health insurance market, along with Medi-Cal and regional plans.

    Covered California selected the following health insurance companies for the 2015 exchange:

    • Anthem Blue Cross of California.
    • Blue Shield of California.
    • Chinese Community Health Plan.
    •  Health Net.
    • Kaiser Permanente.
    • L.A. Care Health Plan.
    • Molina Healthcare.
    • Sharp Health Plan.
    • Valley Health Plan.
    • Western Health Advantage.

    The rates submitted by the selected companies are tentative and subject to an independent reasonability review by the state’s regulators, with the California Department of Managed Health Care reviewing the rates of nine carriers and the California Department of Insurance reviewing the rates of one.

    Additionally, 90 percent of consumers currently enrolled in health insurance plans through Covered California are receiving federal subsidies to help reduce their overall costs. In most areas of the state, the amount of subsidy that individuals receive will either increase or remain very close to 2014 subsidy amounts. This means that for many consumers, any increase in premium will be offset by an increase in subsidy.

    All insurers submitted bids for products that include children’s dental plans, making it convenient and affordable for families to get dental care for their children.

    In response to customer feedback, some health insurance plans will offer expanded provider networks so that Californians can choose from a wider selection of doctors.

    The participating companies offer networks designed to meet the needs of consumers. In many cases health plans added doctors and hospitals to existing networks, in addition to providing essential health benefits such as prescription drug coverage and hospital stays. These benefits are identical for both consumers purchasing coverage through Covered California and consumers purchasing on the individual market outside the exchange.

    Because of the Affordable Care Act, all health insurance companies in the individual market now offer guaranteed issue; no one is denied coverage because of a pre-existing condition. Consumers can select plans without worrying about gimmicks and gotchas that previously plagued the commercial market. Additionally, the law’s limits on out-of-pocket spending are helping Californians avoid financial ruin due to medical costs.
    Consumers can now use the 2015 Shop and Compare Tool on the Covered California website, at www.CoveredCA.com/shopandcompare/#calculator, to look at plans and products in their area and to get a preliminary estimate of costs and premium assistance.

    For more details on the plans in specific pricing regions, visit www.CoveredCA.com/PDFs/CC-health-plans-booklet-2015.pdf.

    The current list of insurers is for comprehensive individual health policies only. Covered California will later announce adult and family dental options available through Covered California, along with health insurance options for small businesses.


    About Covered California
    Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

    Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information on Covered California, please visit www.CoveredCA.com.

    *The weighted average is a blended rate that considers both the increase or decrease in rate and the number of consumers who will receive that rate change.

  • Covered California Announces Director of Plan Management and Chief Financial Officer Appointments
    SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee announced the appointments of Anne E. Price as director of the Plan Management Division and James D. Lombard as chief financial officer.



    Price recently joined Covered California from Blue Shield of California. She has more than 20 years of financial and management experience in the health care industry, including commercial insurance, Medicare and Medicaid. At Blue Shield, she was director of finance and strategic partnerships with the California Public Employees’ Retirement System. She reports to Yolanda Richardson, chief deputy executive director for strategy, marketing and product development.

    “Anne brings extensive experience in financial modeling, innovative product development, and contract negotiations with health plans, hospitals, medical groups and large employer groups,” said Lee. “She will be a huge asset to our agency going forward.” The annual salary for her position is $180,000.

    Lombard has 20 years of public finance experience, including budgeting and policy analysis, administration and program operations. He most recently was chief administrative officer in the California State Controller’s Office, where he supervised human resources, budgets, accounting, facilities and information technology. He will start his new job in the coming weeks. He will report to Susannah C. Johnsrud, chief deputy executive director of operations.

    “Jim’s strong fiscal background and knowledge of the organization and functions of state and local government are just what we need as a fairly new agency,” Lee said. “We’re glad to have him on our team.” The annual salary for the chief financial officer is $160,485.

    About Covered California
    Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

    Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information on Covered California, please visit www.CoveredCA.com.
  • Covered California Announces Promotion and New Appointment to Senior Leadership Team
    Richardson Helped Lead New Health Insurance Exchange Through Its Historic First Enrollment Success; Johnsrud Brings Strong Financial Skills to Agency

    SACRAMENTO, Calif. — Covered California Executive Director Peter V. Lee has announced the appointments of Yolanda R. Richardson as chief deputy executive director of strategy, marketing and product development; and Susannah C. Johnsrud as the new chief deputy executive director of operations.


    In her new role, Richardson is responsible for developing and implementing the agency’s strategic approach to product development, marketing and sales to ensure Covered California is well-positioned to retain its strong customer base and continue its rapid growth by providing a solid value proposition for individuals and small businesses.

    “Yolanda Richardson has not only done a stellar job in getting us more than up and running; she also brings to Covered California deep experience in private health plan operations,” Lee said. “She embodies the Covered California spirit of listening, learning and adjusting.”

    Richardson joined Covered California in April 2012 as deputy chief operations officer, playing an instrumental leadership role in setting up the new exchange’s operations. She provided executive-level leadership over the direction of day-to-day operations for the agency. She also provided leadership over the design and management of internal control systems, organizational structure, all business operations and human resources. The salary for Richardson’s new position with Covered California is $210,000.

    Johnsrud most recently served as director of the Financial Information System for California (the FI$Cal Project), which is integrating financial management for the state of California. Previously, she was chief operating officer of the governor’s office, providing counsel on fiscal, human resources, information technology and other issues statewide.

    She also has served as chief administrative officer and chief financial officer for the state Department of Justice. The salary for her position with Covered California is $190,000.

    “Sue Johnsrud has a wealth of experience in information technology, operations, human resources and complex financial management,” Lee said. “She comes to us with a great background and perspective to help us as we continue to grow and mature as an organization.

    “Covered California has a big mission, big aspirations and a big job. With the team we are building — including Yolanda, Sue and our entire staff — we are positioned well to manage the challenges that lie ahead.”

    About Covered California
    Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

    Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information on Covered California, please visit www.CoveredCA.com.
  • Covered California Accepting Applications for $16.9 Million in Grants for New Enrollment and Education Program
    ‘Navigators’ Will Inform and Help Consumers Enroll in Quality, Affordable Health Insurance Plans

    SACRAMENTO, Calif. — Covered California™ has announced its intent to award up to $16.9 million in grants for the launch of its Navigator Program, the next phase in the agency’s outreach, education and enrollment efforts.



    Covered California will award grants to educate consumers about Covered California health insurance plans and about how to obtain financial assistance to help pay for them. Navigator activities will also include informing consumers about the benefits of obtaining health care coverage, motivating consumers to act, helping consumers to shop for and compare plans, and assisting consumers in enrollment and renewals.

    The goal of the Navigator Program is to enroll more than 130,000 subsidy-eligible consumers during the second open-enrollment period: Nov. 15, 2014, to Feb. 15, 2015. Navigators also will help current enrollees renew their health insurance coverage.

    Covered California is seeking proposals from grant applicants that have statewide and regional reach or scope. Covered California seeks organizations with experience providing outreach to California’s diverse populations and proven success enrolling consumers in health care programs.

    Upward of 135 organizations could receive grants, which will be based on recipients enrolling a predetermined number of consumers. Grants will cover the period of Oct. 1, 2014, through June 30, 2015.

    The grant application deadline is July 28, 2014. Awards will be made starting Aug. 27, 2014. Covered California reserves the right to award grants in phases.

    Organizations will be selected through a competitive grant application process. Applications will be evaluated based on the best overall value and most effective enrollment strategies. Grant applicants must comply with the Enrollment Assistance Program regulations. Interested organizations are encouraged to carefully review the application information and view a webinar that explains the application process on Covered California’s stakeholder website, at http://hbex.CoveredCA.com/navigator-program/.

    About Covered California
    Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

    Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information on Covered California, please visit www.CoveredCA.com.

  • Covered California's Executive Director: We're Open for Business
    “We’re open for business and enrolling thousands of Californians every day.” That’s what I say when people ask what Covered California is doing now that our historic first open-enrollment period has come to an end. We need you to get the message out that Covered California is still very “open for business.”

    By the end of March, 1.4 million people had embraced this new era of health care and selected a Covered California health insurance plan, with many more signing up for Medi-Cal through our website and with the help of thousands across the state. Today the opportunity to get covered still exists for many Californians, and we’re doing everything we can to let people know.

    Covered California's special enrollment period is open for those 
    with life-changing events, if you are eligible for Medi-Cal and,
    for a limited time, if you are on COBRA
    If you, a friend or a neighbor has had a major change of circumstance — whether it’s the joyful moment marked by getting married, the day a child is born, or the challenge you face when you lose your health care coverage because you’ve changed jobs — you can still sign up for a quality, affordable health care to protect yourself and your family. You would still be potentially eligible for financial help to reduce your costs, and you couldn’t be turned away by an insurance company. In addition, if you are eligible for Medi-Cal, you can enroll year round.

    During our “special-enrollment period,” from April to November, you can sign up for coverage as long as you do so within 60 days of the qualifying life event. The most common reasons that make someone eligible are:

    • You lose your health care coverage because you’ve lost or changed jobs.
    • You get married or enter a domestic partnership.
    • You have a baby, adopt a child or place a child in adoption or in a foster home.
    • You move and gain access to new Covered California health insurance plans that were not available where you previously lived.
    • You become a citizen, national or lawfully present individual.

    We know that these moments happen in the lives of thousands of Californians every day, and our special enrollment is a chance for these people to get the protection and peace of mind that they deserve. And the good news is that thousands are signing up every day.

    For a limited time, a special-enrollment period is also open to Californians who are covered through COBRA (the Consolidated Omnibus Budget Reconciliation Act). For more than three decades, COBRA coverage has allowed people who lost their employer-sponsored health care coverage to keep their plan, if they paid the full cost plus a 2 percent administrative fee. We estimate that about 300,000 Californians have insurance through COBRA or CalCOBRA (the state program that extends the post-work coverage option for an additional 18 months).

    For many people on COBRA, plans in Covered California could be better options, thanks to the good rates we negotiated for consumers and thanks to the possibility of federal financial assistance and cost-sharing reductions that are available only through health exchanges like Covered California. This financial help could save Californians on COBRA hundreds of dollars a month and thousands of dollars a year. And many Californians can get a better deal even without a financial subsidy.

    The special-enrollment period for COBRA beneficiaries ends on July 15. For more information, visit www.CoveredCA.com/faqs/cobra.

    Special enrollment for those with life-changing events will be available to all eligible Californians until open enrollment resumes in the fall. For more information, visit www.CoveredCA.com/coverage-basics/special-enrollment. And remember: When in doubt, tell your friends to apply. They may be eligible for Medi-Cal and not realize it.

    If you qualify for any of these opportunities, you can apply at the Covered California website and click on the “Special Enrollment” button. You can also contact one of our Certified Enrollment Counselors or Certified Insurance Agents, or you can call Covered California at (800) 300-1506.

    We’re hard at work planning for the next open-enrollment period, but with your help we will continue to make California a better place to live for thousands of families. Thanks for helping us get the word out.