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

A temporary insurance policy may provide a good solution for your insurance needs until January 1st, 2015. Although temporary plans are not guaranteed to be issued to you, the underwriting process is comparatively simple and may meet your needs 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.) 

If this scenario applies to you, ask us if you want to see some options.

You can also 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.

The Covered California website is up and running at:

www.coveredca.com 

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 take our responsibility for 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

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.

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

"The medical insurance sector is complicated to navigate at the best of times and...with the whole ACA thing...it became almost impossible for me. 

Luckily, I crossed paths with Gabriel Caffrey of Caffrey Insurance Solutions and that was a fantastic break. Not only was Gabriel able to explain the tangled web of medical insurance in a manner that I was able to comprehend, but he implemented the insurance solutions for myself and my employees in such a manner that I barely had to do anything. 

It was an incredibly easy and painless process and since then, Caffrey Insurance Solutions has taken care of any and all the issues that did crop up. 

If you want medical insurance, get a broker and if you want the best, I really recommend you visit the Caffrey family!"

--Andrew Gregor, Blue Dog Construction

"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.

Fun Health Care Facts

• Like bats and dolphins, people can use echolocation to sense nearby objects through sound. Some blind people are so skilled at navigating with echolocation that they can ride mountain bikes and even play soccer.
• One more reason not to stuff yourself: Overeating temporarily diminishes your hearing.
• When you make a fist, your fingertips curl into a spiral, not a curve. 
• You are taller in the morning. During the day, as you walk around, the weight of your body compresses your cartilage, shrinking you by about a centimeter.
• Even an obese, flabby body could be worth more than $45 million if all of the usable parts were sold, according to a survey by Wired magazine, using cost estimates from US hospitals and insurance companies. And the most valuable part isn't the organs, but bone marrow, valued at $23 million (based on 1,000 grams) at $23,000 per gram.
• A snore can be almost as loud (up to 69 decibels) as a jackhammer.
• The soles of your feet contain more sweat glands and pressure-sensitive nerve endings per square inch than any other part of your body.
• When the rods and cones of your retina send an image to your brain, it's upside-down. (Your brain's visual cortex automatically rotates the image.)
• People shed about 600,000 particles of skin an hour, or 1.5 pounds a year, about the weight of an iPad.
• Over a lifetime, the average person walks about 115,000 miles-equivalent to walking around the world four times. 

What Would Gabriel Do?

1. Get an individual policy for yourself and apply for a new group plan with a different provider in a couple of months.
2. Offer to pay for private individual policies for you and your employee.
3. Decide to go uninsured for a while because it's just too complicated.
4. Protest the re-definition of the small group.
5. None of the above.

What About Group Plans?

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.

Moral of the Stories and Sad Facts of Life

Be prepared to fight. Things are not going smoothly. 

Here are some issues we have encountered with our clients:

Some medical services providers are listed in active online directories (see article above) and our clients have later learned that the providers were 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. Before scheduling visits to a provider, we strongly encourage our clients to double check with their doctor's offices.

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 some 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.

Consumers Want Broker Help with the ACA

"The Urban Institute and the Robert Wood Johnson Foundation surveyed consumers about what sources of information they used when researching PPACA health plans on the exchanges. About 84 percent of survey respondents ranked insurance agents and brokers as "very" or "somewhat" helpful, the highest ranked source. Next on the list of most helpful resources were other "forms of assistance involving a person," including navigators, community health workers and the Medicaid agency, at 77 percent.

The lowest-ranked source was call centers, with just 58 percent of respondents saying their time on the phone was very or somewhat helpful.

Nearly 80 percent of consumers surveyed said they relied on the exchange websites when researching PPACA options, but many said they supplemented that  research with information from other sources - including, of course, brokers, as well as the media, navigators, family members and friends. Just 65 percent said the websites were helpful.

According to the survey, Hispanics were more likely to use some form of direct assistance (40 percent) including call centers, navigators, and brokers and agents, compared to 31 percent of white non-Hispanics. Those aged 50-64 were also twice as likely to use direct assistance as a source of information (43 percent compared to 22 percent of those age 18-34).

Despite the troubled rollout of HealthCare.gov, more than 8 million people enrolled in a health plan through the exchanges.

Reports, including last year's AFLAC WorkForces survey, and anecdotal evidence, suggest brokers remain uneasy about PPACA, their role in the industry with the law in place, and their future because of it. But the new Urban Institute report shows consumers still need a variety of sources to help them choose coverage, most notably, brokers.

"People are using multiple sources of information to choose the plan that is right for them," said Katherine Hempstead, who leads coverage issues at the Robert Wood Johnson Foundation. "Spreading the word about enrolling in insurance coverage is important and challenging, and research into consumer patterns and preferences can help improve the process for the next open enrollment period."

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