May 2014

Your Partners in Understanding Healthcare Reform
Providing Clear and Creative Health Insurance Solutions

Trustworthy. Knowledgeable. Caring.
Who knew you could get all that from an insurance broker? 


Lynn Caffrey, Principal, CA License 0557451

Gabriel Caffrey, Broker, CA License 0H66348

Agency CA License 0G80281

About Caffrey Insurance Solutions

Caffrey Insurance Solutions
Phone: 510-444-5447
Fax: 866.530.7365 
That Procedure Costs How Much?

A massive federal database of national health care costs was made public a little while back, according to an article in the Huffington Post.  

Alert! If You Are Currently Without Coverage, A Temporary Policy May Be The Answer

A temporary insurance policy may provide a good solution for your insurance needs until January 1st, 2014. Although temporary plans are not guarantee issue, the underwriting process is comparatively simple and may meet your needs well until a plan can be issued through Covered California or the private individual and family market. 

In most cases temporary medical coverage can be effective the day after you apply! (Important caveat: these plans do not cover prescription medications.) 


Ask us if you want some options if this scenario applies to you.


Or if you prefer, you can try the direct application linked here, which will assign us as your broker of record and save you some time. 


We will service any policies applied for this way.

Will You Be Eligible for a Subsidy Through Covered California Next Year? Find Out!

The Covered California website is up and running at: 

You can go online and see if your expected income will make you eligible for a subsidy, and what you might expect to pay for one of the available plans. 

This will help us aid you in deciding the best way to go when the next open enrollment window opens on November 15th. 

At any rate, remember to use us before signing up for the plan you have for next year. We are Covered California Certified Insurance Agents.

We will also be working in our customary capacity moving forward, assisting our clients with the whole process whether in Covered California or the private marketplace.

We take our responsibilities in servicing your policies very seriously and hope to continue to assist you with these new options as well. As always, our services are entirely free to you.

Best Broker in the  

East Bay

Lynn had the honor of being named Best Health Insurance Broker in the East Bay Express Best of the Bay awards. 


The review said that she was "an extremely dedicated full service health-insurance broker".  We work hard for our clients.

Review us on Yelp!

Yelp Page


Thanks to your great reviews, we have a five star rating on Yelp. If you have received good service from Caffrey Insurance Solutions over the years, please drop by and let prospective customers know about your experience. We really appreciate your time! Thank you.

How Long Will You Live?
This easy and fun calculator estimates your life expectancy.
It was developed by Northwestern Mutual Life, and it tries to predict how long you're likely to live. 


The predictions aren't going to be close if you do have a long-term health issue, but generally it works well. Barring long-term health problems, we are going to live a long time, most was into our late 80s or 90s.

2014 Group Policy Census Form Changes
We will be re-marketing all of our small group clients to see if new ACA compliant group plans are the best option available to you. 
Please fill out the linked census form and return to us at your earliest convenience so we can quote options that will continue to serve you well next year. 
As You Grow, We Grow With You

Please ask about additional services and value-added products such as HR administration and online policy management tools. 


"Lynn really helped me in dealing with a declined insurance claim by guiding me through the appeal process and communicating with the insurance provider. She offered continued support until the claim was reviewed and finally resolved. I truly believe that Caffrey Insurance Solutions' dedication in providing insurance as well as exceptional care and support to clients is invaluable."  --Current Individual Client

"Caffrey Insurance Solutions walked us through every state and step of a quite complex system, and we were successful! Without their help I do not believe we would have managed...I would refer anyone with insurance questions to Caffrey Insurance Solutions, and to Lynn Caffrey in particular."    --Alan B.

"Your expert advice is always appreciated. I literally don't know what I would do without you. You give me the most valuable gift of all: time."    --Scott Gordon 


"I'm glad there are individuals like Gabriel who can break it down so the average joe can understand the ins and outs of each plan, and make better-informed decisions."
     --Kerwin K.

"You are different from any image I have had of an insurance broker. I simply enjoy being with you. I experience a combination of efficiency, care, honesty, commitment and flexibility. I couldn't ask for better.               --Miki Kashtan

Lynn and Gabe profile picture
To all our Clients and Friends,


We here at Caffrey Insurance Solutions have come to the end of the busiest season on record in our industry, and we are planning ahead for dealing with the next wave of open enrollments while prioritizing service of our existing group and individual clients.


If you are an existing group client with a December 1, 2014 renewal upcoming, please let us know so that we can get as far ahead of the curve as possible given that we expect to have close to one hundred groups to submit for renewal concurrently. 


It is also important for you to know that some small groups will no longer qualify for small group medical plans under the ACA, as rules governing sole proprietorships, partnerships and other shared businesses have changed as of January 1, 2014. Most frequently these are two person groups comprised of two spouses.


If you are in one of these categories and do not have at least one unrelated person on W-2 payroll, you may not recertify. In these cases we will be glad to review all options for individual and family plans.


There is no better time for us to do this particular work as it allows us to plan our time properly so you get the personalized service and attention you deserve. It also will allow time to thoroughly discuss the options, prepare any plan changes in advance and submit the paperwork before the deadline so that any plan changes you request get handled quickly and properly.


In some cases it may be advantageous to switch to new coverage before your December renewal, and we want to help you make informed decisions.

Fun Health Care Facts

An apple a day

  • A sneeze can exceed a speed of 100 miles per hour, while a cough releases a blast of air that travels at up to 60 mph.
  • Like fingerprints, everyone's tongue print is unique.  
  • We share 98.4 percent of our DNA with chimpanzees-and 70 percent with slugs.
  • About 2 billion people-about one-third of the world's population-have tuberculosis, an ancient disease that's been detected in Egyptian mummies. However, only 10 percent of people with the disease have a contagious form.
  • We're born with 300 bones, but by the time we reach adulthood, we only have 206 (because the other bones have fused together).
  • The strongest muscle in your body (relative to its weight) is the masseter, the jaw's chewing muscle, which can close the teeth with a force of up to 200 pounds on the molars.
  • The largest human cell is the female egg cell, which is about 175,000 times bigger than the smallest cell, the male sperm cell.
  • About 10 million people have the same birthday that you do.
  • Women with hourglass figures are smarter than those with round or straight bodies-and also have more intelligent kids-according to a study of 16,000 women, published in Evolution and Human Behavior.
  • 80 percent of your brain is water. What's more, the entire computing power of the human mind is fueled by just 10 watts of power.

What Would Gabriel Do?

Question Mark

Q: I have a company with 12 employees and I'm going sort of nuts administering the benefits plans, along with everything else I have to do. We've grown rapidly and it's getting out of hand. We offer a large variety of plans insurance company allows. What should I do?
  1. Outsource the benefits to a Professional Employment Organization, which costs a lot more and still would not provide hands on service.
  2. Hire someone to take over benefits internally, which would also cost you more.
  3. Hand your employees the insurance company literature and let everyone figure it out for themselves.
  4. Cancel benefits entirely and give employees a stipend to get their own coverage.
  5. None of the above.
A: None of the above.  At Caffrey Insurance Solutions, we offer more services than just finding you a great plan.  In designing the plans, we make sure there are enough choices, but not too many.
We communicate the plans to you, including providing materials that help employees make the best choices for them. We work one on one with each person as needed.  In addition, we can arrange outsourced HR services that cost no or very little money. 


As an aside, you are also not allowed to directly subsidize plans purchased on an individual basis by your staff, and there is no tax advantage to the company in terms of a write-off.

Client Spotlight

Doctor Earth Stethoscope IMage

Jenny and Tom, former group clients, left the country to travel the world. They will soon be returning to the US and wanted to make sure they had coverage upon their return.

They called our office from Vietnam and we got them set in for coverage with a few hours of back and forth emails and phone calls.

You can check out their travel blog at

What About Group Plans?

Group plans have significantly fewer restricted networks so it's good to hold on to those if you can.

New mom and pop groups are no longer eligible unless there is another W2 employee.


Owner only groups are generally not allowed, including partnerships, unless there is a W2 employee on payroll.


The new group plans are similar to the individual plans being marketed but there are other choices as well and many have lower out of pocket maximums, in addition to much better access to services and the usual tax advantages of small group coverage.


Check Out Our Video on Youtube!
Caffrey Insurance Solutions, Inc. Video
Caffrey Insurance Solutions, Inc. Video


Moral of the Stories and Sad Facts of Life

Solutions -- Not Problems

Be prepared to fight. Things are not going smoothly. 


Here are some issues we have encountered with our clients:


Providers are listed in active directories and our clients later learn they are not actually on the plan. In some cases this has to do with contracts not being finalized before the directories go live online, in other cases directories are simply listing plans in error. As yet, we do not know how to avoid this situation but we strongly encourage our clients to double check with their doctor's offices before scheduling visits to confirm plan coverage.


There are certain covered hospitals that are not listed on the plans, and in many cases going to an in-network hospital doesn't mean most of the physicians there are in-network. For example, Anthem Blue Cross of CA says that they have Alta Bates and Summit Hospitals but not most of the doctors affiliated with them.


Blue Shield has been rejecting claims, saying that in-network providers are not in the network.


Blue Shield has been rejecting some preventive care claims. (These do have to be done in network to be covered.) 


For more information on what constitutes Preventive Care, please take a look here.


Premium billing is still very messed up and it is difficult to get help over the phone. But for the moment at least, that's how it has to be done.

Covered CA and Individual Plan Enrollment Summary

Lynn Caffrey In the aftermath of the full-scale roll out of the Affordable Care Act, we wanted to let you know how the enrollment numbers have turned out. 


As of recent estimates, more than 1.4 million Californians have signed up for coverage through Covered California. Many more have signed up for unsubsidized coverage directly from major carriers as well, and almost 2 million low-income Californians are now enrolled in Medi-Cal. 


According to the Los Angeles Times, Covered California Certified Agents were responsible for facilitating approximately 40% of all enrollments through Covered California.


Although enrollment for coverage through the exchange is closed for now (except in cases of qualifying life events), it's still possible to apply for Medi-Cal at any time if your income is low enough. We can help with these enrollments, although we recommend dealing with Medi-Cal specialists for detailed assistance with these programs.


For an overview, please review these resources from the Los Angeles Times:


Finding Your Medical Providers

For Your New Coverage

It is crucial that you check for your providers. The lists are not as complete as before and you may not find your doctors. Note that where plans say they are EPO's, you must stay in network.  


Due to overwhelming demands on our time we are not able to research every doctor on your lists but here are the resources required to do so:


Anthem Blue Cross PPO

Blue Shield of CA (EPO in Alameda County, PPO elsewhere)

Kaiser Permanente (HMO)

Health Net of CA (PPO, not available in Alameda County)

Chinese Community Health Plan (HMO, San Francisco County)

Western Health Advantage (HMO)


Also, dependents who live outside of California or the reach of the new EPO networks cannot be covered except for emergencies. If you have children attending college out of state, the student health plan on their campus may be their best coverage option.

Covered California Verification Requirements

You may have noticed that your Covered California account is still listed as conditionally approved. If that's the case, your policy will still be active as of the requested effective date, but Covered California wants some verification on your eligibility. 


The most common requests are for identity and income verification. You can address these missing documents by logging in to your account and clicking the "Manage Verifications" link in the box on the bottom right.

About Caffrey Insurance Solutions 

Caffrey Insurance Solutions is a family business employee benefits brokerage firm that provides insurance expertise for small companies (fewer than 50 employees) and individuals seeking individual or family coverage. We also provide Medicare assistance.  

Caffrey Insurance works with you to find the best insurance benefits that provide the best value, tailored to the unique needs of your company.

California License Information
Lynn Caffrey: 0557451
Gabriel Caffrey: 0H66348
Caffrey Insurance Solutions, Inc.: 0G80281

Caffrey Insurance Solutions, Inc.
405 14th Street, Suite 711
Oakland, CA 94612
Phone: 510-444-5447