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Covered CA’s Open Enrollment has now come to an end.  To qualify for special enrollment it must be triggered by a ‘qualifying life event.’

Anthem Blue Cross
Pay by Telephone855-634-3381 -- Have your Subscriber ID or Social Security number
Pay OnlineProvided on invoice
Pay by MailP.O. Box 9041, Oxnard, CA 93031-9041 -- Add Case # to payment
No Invoice Received?855-634-3381

Blue Shield of California
Pay by Telephone855-836-9705 -- Have your Subscriber ID or Social Security number
Pay Onlinehttp://service.healthplan.com/blueshieldca/binder
Pay by MailP.O. Box 60514, City of Industry, CA 91716-0514 -- Add your Certificate Number from your Invoice to payment; add your invoice stub
No Invoice Received?855-836-9705 -- Have your Social Security Number available
Chinese Community Health Plan
Pay Onlinewww.cchphmo.com/how-to-pay
Pay by Mail445 Grant Avenue, #700, San Francisco, CA 94108 -- Add your invoice stub
Pay in Person w/Check827 Pacific Avenue, San Francisco, CA 94133 -- Add your invoice stub
Pay in Person w/Cash845 Jackson Street, San Francisco, CA 94133 -- Add your invoice stub
No Invoice Received?877-224-7808
Contra Costa Health Plan
Pay by Mail or in Person595 Center Avenue #100, Martinez, CA 94553 -- Add Case # to payment
No Invoice Received?800-957-2247
Health Net
Pay by Telephone1-800-839-2172
Pay by MailP.O. Box 60515, City of Industry, CA 91716-0515 -- Add Subscriber ID to payment
No Invoice Received?888-926-4988
Register and Pay Onlinehttps://www.healthnet.com/hnsecurity/member/regForm.ndo
Kaiser Permanente
Pay by TelephoneHave Account number, invoice number, and subscriber from invoice available. Northern California - 866-475-3920 | (Spanish) 866-733-7787 Southern California - 866-450-5648 | (Spanish) 866-733-7775
Pay Onlinewww.kp.org/paypremium
Pay by MailP.O. Box 7192, Pasadena, CA 91109-7192 -- Follow the directions on your invoice
No Invoice Received?Northern California - 866-475-9320 | (Spanish) 866-733-7787 Southern California - 866-450-5648 | (Spanish) 866-733-7775
L.A. Care Health Plan
Pay by Telephone855-270-2327 (TTY/TDD 1-855-576-1620) -- Have your Case # or Social Security Number
Pay Onlinewww.lacarecovered.org/makepayment Have your Customer and Invoice Number
Pay by MailL.A. Care Covered; P.O. Box 515389, LA, CA 90051 -- Add Case # to payment
No Invoice Received?855-270-2327
Molina Healthcare Inc.
Pay by Telephone888-858-2150 -- Have your Case # or Social Security number
Pay Onlinewww.molinahealthcare.com/payment
Pay by MailP.O. Box 7010, Pasadena, CA 91109-7010 -- Add Case # to payment
No Invoice Received?888-858-2150
Sharp Health Plan
Pay by Telephone800-359-2002 -- Have your Case # or Social Security number
Pay Onlinewww.sharphealthplan.com/payment
Pay by MailP.O. Box 57248, Los Angeles, CA 90074-7248 -- Add Case # to payment
No Invoice Received?800-359-2002
Valley Health Plan
Pay by MailLos Angeles Lockbox, County of Santa Clara, PO Box 740300, Los Angeles, CA 90074-0300 -- Only taking money orders and checks - follow directions on invoice
No Invoice Received?888-421-8444
Western Health Advantage
Pay by Telephone888-442-2206 -- Have your WHA ID #, or Social Security number
Pay Onlinewww.mywha.org
Pay by MailTo the address shown on the invoice: WHA, DEPT 34668, PO Box 39000, San Francisco, CA 94139
Pay in PersonAttn: Premium Accounting, 2349 Gateway Oaks #100, Sacramento, CA 95833
No Invoice Received?888-442-2206 -- Have your WHA ID #, or Social Security number

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Recent News

Grandmothering – What is it? And who does it affect?

Governor Brown has signed into law SB 1446, the ‘grandmothering’ bill.  The bill was unopposed and passed through both Houses in the CA legislature and is in effect immediately.  Below are a few key points that outline what is now allowed under the bill:

  • The bill allows a small employer health care plan in effect on Dec. 31, 2013, and is still in effect as of the date the bill was signed (July 7th, 2014), and that does not qualify as a grandfathered health plan under the Affordable Care Act, to be renewed until Jan. 1st, 2015, and continue to be in force through Dec. 31st, 2015.
  • These plans must be amended to be in compliance with the ACA guidelines as of Jan. 1st, 2016
  • Small employer group policies must still include many ACA and state based mandated benefits such as:
    • Preventative healthcare without co-pays or deductibles
    • No lifetime caps on benefits
    • Maternity care
    • Coverage for autism
    • Elimination of gender discrimination on setting premiums
  • This bill is not a mandate and employers are not required to keep their current plans in place
  • The bill does not address rates, so premiums for these plans may increase

Health Care Costs & How to Spot Errors

Health Care is nearly a $3 trillion industry in the United States, and as many may have already experienced, the billing system can be riddled with errors.  A few statistics that illustrate this are as follows:

  • Medicare overpayments in 2013 totaled $36 billion
  • 42% of evaluation and management bills to Medicare in 2010 contained errors, costing taxpayers $6.7 billion
  • There is an 80% probability that there will be an overcharge on your hospital bill

As consumers, what can we do to protect ourselves?  First and foremost, do not be too quick to pay.  Make sure you are receiving an itemized bill rather than one final amount.  Have your explanation of benefits handy so you can compare charges and benefits.

  • Ensure that your name, address, and social security number are correct
  • Ensure all medications listed on the hospital bill are correct and that you actually took them
  • Ensure all services listed were actually conducted (ie. X-rays or blood tests)
  • After surgery, compare operating room charges which are generally by the minute.
    • If you know how long the surgery took, see if it matches, otherwise compare it to the minutes listed for anesthesia – they should be similar
  • Double check room charges for overnight stays
    • Ensure you weren’t billed for a private room if you actually shared one
  • Review the bill for duplicate charges

If you do happen to find mistakes, you may be able to simply resolve them by reporting it to your hospital and health insurance provider, otherwise setup an appointment with the hospitals billing department after you have reported the mistakes to your insurance carrier.

Blue Shield – Relaxed 25% Participation

Blue Shield has just announced that it will extend it’s relaxed participation promotion through the end of the year.  Blue Shield typically requires a 65% employee participation to enroll in it’s group products, but with groups of five or more enrolled employees they now only require 25% participation.

This limited time offer now allows employers to offer a medical plan from Blue Shield alongside another carrier’s medical plan with more lenient underwriting.  This allows smaller businesses to now competitively offer an HMO from one carrier, and a PPO from another, enhancing their employee benefit program.

You must have at least 25% of the total number of eligible employees to enroll in a Blue Shield healthcare plan with no fewer than five.  Participation in their specialty products has also been reduced to 25%, as long as Blue Shield is the sole carrier offering them in conjunction with medical, or as a standalone product.

For example: If you have 24 employees, yet 4 have a valid waiver (Medicare, Medi-Cal, military, or covered by spouse’s group coverage only) then the total number of eligible employees would be 20.  Of the 20 eligible employees, you must enroll a minimum of 25% (5 employees).