Covered California releases New Health Reform Benefit Plans

Standard Benefit Plan Designs

The California Health Benefit Exchange on 3/22/2013 at 3:30 pm has filled an Emergency Notice Publication Regulation Submission outlining the benefits that will be your Health Insurance plans effective January 1st 2014.

Take note

Everyone in California currently on Individual Plans, that are not Grandfathered, will only be able to purchase one of these 12 health insurance plans effective January 1st 2014. Your carrier will no longer be allowed to leave you on a non-Grandfathered plan.

12 Different Plan Options

There will be 12 different plan designs to choose from. You will have approximately 4 carriers to choose from in the exchange. As we currently understand, the following carriers will be offered California wide; Anthem, Blue Shield, Untied Healthcare and Kaiser. In Sacramento, Solano, Napa and Sonoma counties we also expect to have Western Health Advantage as an additional option. While the number and exact carriers that will be offered in the exchange has not been determined, the above listed carriers are expected to be offered.

Catastrophic Coverage

Catastrophic Coverage is only available to individuals under the age of 30. The reason for this exception is the exchange needs younger people to pay premiums for Health Insurance instead of a fine to support membership for individuals older than 30 years old.

While the actual premiums for these plans have not been released, we do expect to have rates for each of the 12 different plan designs in July or August of 2013, so people can start enrolling onto coverage plans in the initial open enrollment period that will run from October 1st 2013 to March 1st 2014.

All Health insurance plans will be required to cover these

Essential Health Benefits:

• Ambulatory Patient Care
• Emergency Service
• Hospitalization
• Maternity and Newborn Care
• Mental Health and Substance Abuse Disorder Treatment
• Prescription Drugs
• Rehabilitation and Habilitation Services and Devices
• Lab Services
• Preventive and Wellness Services and Chronic Disease Support;
• Pediatric Services, including Dental and Vision Care.

Standard Benefit Plan Designs - FINAL