Pros and Cons
of Health Care Reform Blog

Jul 18

Covered CA participating insurance companies announced

Posted by Dina Collins on Thursday, July 18, 2013

Covered CA announced in May the insurance companies participating in the individual exchange, called Covered CA. In the greater Sacramento area those four companies will be Blue Shield, Anthem Blue Cross, Kaiser and Western Health Advantage. Health Net is offered in other counties. Health Net is participating in certain counties but not Sacramento. Aetna has decided to no longer offer individual coverage in CA for new subscribers and January 2014 for current. Cigna and UnitedHealthcare have chosen not to participate at least initially. Will they prove wise or foolish? The media and government spokespersons are jubilant that the individual rates aren’t as high as some were predicting. Yes, that is good news and we can take a slight breath but the rates are still increasing by up to 25% (depending on age and county and health status). These are the numbers Covered CA released. How did they arrive at the numbers? Are they a fair representation? We won’t know until we can begin quoting October 1st.

For those qualifying for the Advanced Premium Tax Credits (APTC’s) and subsidies, yes, rates will look very good compared to now. Those who’s incomes are within 138% and 250% ($15,856 to $28,725 of income if family size is one) of federal poverty level will qualify for tax credits to help offset the premiums AND subsidies to help offset some of the copays an deductibles. Those whose incomes are within 250%-400% ($28,725 to $45,960 of income if family size is one) of federal poverty level will qualify for tax credits to help offset the premium but not the subsidies. For those who are currently uninsurable or get approved with really high rates, yes probably more affordable. For those above 400% of federal poverty level and healthy and young, definitely not more affordable.