Benefits Pro for Free?

We have a pop-up giveaway today: the first five readers who email Naama Pozniak at naama@rightplan.com will receive a code for FREE admission to the upcoming BenefitsPro Broker Expo in San Diego August 16-18! Email now if you’re interested! Check out the Expo agenda here. Registration info here.

HEALTH

Study Ranks Health Systems of $ Countries

Sometimes you have to deliver bad news…Today it’s results from Mirror, Mirror 2021, the Commonwealth Fund’s latest international rankings of health care systems of high-income countries. In a nutshell:

Unique in measuring and comparing patient and clinician experiences across nations, Mirror, Mirror 2021 shows that in the U.S., an individual’s chance of getting good health care depends to a large extent on income — more so than in any other wealthy country. The U.S., which spends the most per person on health care, has ranked last in every edition of the report since 2004. And the U.S. has fallen even further behind on certain measures, especially health outcomes linked to primary care access and equity in care delivery.

Read the whole report because there are lots of fascinating details in there.  Plus informed opinion about what the U.S. could learn from other nations to improve health care for all Americans.

Insurers Push Back on ACA Proposals

The Centers for Medicare & Medicaid posted its Notice of Benefit and Payment Parameters recently.  While the Biden Administration sees the proposals as a step forward in health equity, not everyone agree. Fierce Health reports that insurers are pushing back on proposals to extend ACA open enrollment and more:

Several insurers and advocacy groups commented on the proposals outlined in the Centers for Medicare & Medicaid Services’ Notice of Benefit and Payment Parameters, which outlines ACA marketplace exchange regulations for the 2022 coverage year. Insurers worried that extending the open enrollment period could lead to adverse selection and raise premiums for consumers.

Get more details here. Remember that these are merely proposals. We’ll keep you posted.

LARGE GROUP

Kaiser Announces New ‘Virtual First’ Plan

Kaiser Permanente announced that it will be offering a new health plan, Virtual Complete, to large employer groups everywhere Kaiser coverage is available except Hawaii starting January 1, 2022. The new plan is called a “virtual first” health care option.  It primarily steers members to no-cost telehealth services and saves the in-person care for when they truly need it.  From Kaiser:

Virtual Complete also offers a range of both copay and deductible options for members, including unlimited $0 video visits, telephone appointments, and secure messaging. The plan typically has a limit of 3 in-person office visits per year at a predictable copay. After 3 in-person visits in a year, additional visits will be subject to the deductible.

Lab tests and generic prescriptions also will have a copay and will not be subject to the deductible. Plan members will not be required to get a doctor referral or have a virtual visit before getting in-person primary or mental health care. Preventive office visits will not count toward the member’s in-person office visit limit. The plan also covers in-person emergency care and urgent care, with no referral needed.

This seems like a really interesting innovation! No doubt other providers will follow with similar plans. More info about Virtual Complete can be found here.

VISION

Vision Pros & Aetna Not Seeing Eye to Eye

The California Academy of Eye Physicians and Surgeons (CAEPS), the state’s professional organization representing ophthalmologists in the state, is extremely unhappy with Aetna’s recent change in policy with cataract surgery and care.  The health insurer is now requiring precertification for all cataract surgeries. CAEPS and other state and national groups have asked Aetna to immediately withdraw the program. The groups say Aetna published no updated policy documents and provided limited prior education before implementation last month. They claims the changes are causing chaos at doctors’ offices and places where surgery is performed.

SENIOR SUMMITS

Virtual Event Coming Up!

The California State Medicare Expo will be virtual August 26-27. Register here. The theme is “Unmasking Medicare.”

See You at Pechanga

The Senior Summit groups (IEAHU, OCAHU and SDAHU) will be hosting their 9th Annual event August 31st-September 2 LIVE at Pechanga Resort Casino. Register now for 2021 Senior Summit: Chart Your Course & Navigate into the Future. Cal Broker will be their celebrating its 40th anniversary issue.

DCAHU Summit is Back

Desert Cities Association of Healthcare Underwriters have announced they are back for their in-person medicare conference on September 16! The event will take place 9am-3:30pm a the Villa Portofino Clubhouse in Palm Desert. Lots of CE, networking, prizes and more! Register here.

LIFE

LifeSecure Launches Products

LifeSecure Insurance Company announced a strategic partnership with iptiQ by launching simplified issue final expense and term life insurance products. Available since Aug. 1, the two products mark LifeSecure’s first expansion into the life market. The final expense and term life insurance products are both underwritten by iptiQ’s insurance carrier, Lumico Life Insurance Company. Both products will be available in Washington D.C. and in all states except New York. The final expense insurance product will not be available in Montana. Certain benefit riders will not be available in California, according to the company. More info here.

EDITORIAL COVERAGE

Cal Broker Surveys
California Broker magazine does a series of editorial surveys in which thought leaders and providers get to share wisdom and info with readers. Our survey lead Thora Madden is currently putting together the Small Group and the Large Group Health surveys. If you represent a provider or if you have questions about your company being included in this survey, please reach out to Thora directly: Thora@calbrokermag.com.