It\’s now been over a year since health reform or Obamacare was passed and there have definitely been some changes with more to follow. Let\’s take a quick look at the more consequential changes we\’ve seen so far and look at what can be expected. We\’ll keep it strictly politics free and just look at impacts to California health insurance shoppers and policy holders.

One of the big changes that we like is the PCIP or Pre-existing Condition Insurance Plan. PCIP, as it\’s know, provides a high risk pool at the Federal level. The pricing is pretty competitive and you can qualify without underwriting. They require a letter of denial from a carrier at the maximum and there\’s talk about just needing a letter from your doctor saying you will likely be declined or a letter from a carrier saying that you will likely be declined. From dealing with PCIP clients every day, it\’s best to just apply for individual/family insurance and get the declination letter back. The main issue with PCIP is that you need to have been uninsured for 6 months in order to qualify. This is fine for people who have been without insurance for a period of time but poses an issue for someone exhausting Cobra, losing coverage, or moving to California (which is the typical situation). As a California health insurance agent with your client\’s best interest, it\’s hard to recommend going without coverage for even 6 months. MRMIP does not have the 6 month requirement although it can have waiting periods so you need to check with the State\’s site. Make sure not to lose a Cobra option if available while exploring these other options.

Underage dependents on family or group plans. Another element of the health reform bill that we like allows dependents to remain on parent\’s California health insurance until age 26 regardless of student status. This is great for families where the dependent child might not qualify for individual coverage due to health or where there\’s a flat family rate for any number of children in which case, the family rate will stay the same with the addition of the new dependent. By now, all dependents should probably be on the family plan where it\’s financially advantageous to them. We can help look at your situation to see which way works best.

Guaranteed issue for children. This addition has been a bit rocky but we now have the rules from all the California health insurance carriers on how they\’re treat them. For the most part, children up to age 18 will be guaranteed issue for individual coverage but the rates can increase based on health. Each carrier has different ways of interpreting the laws in terms of what rates they can charge but the guaranteed issue availability is welcomed. Of course, the premiums have increased as a result.

Maternity health insurance in California. This is tricky. We have lost most of our California health plans that cover maternity in the last 6 months. There\’s only one plan right now (either Shield $5500 or $5000 whichever is less expensive) that makes any sense at all. The Blue Cross of California plans are much more expensive for comparable coverage. You can split policies so that the female adult has a maternity plan and the other family members are non-maternity plans to get the best rate.

Preventative coverage is covered at 100% now (in-network and on newer plans after 9/23/2010). This is quite a big perk although the rates have increased as a result so make sure to take advantage of these benefits since you\’re paying for them.

Those are some of the big changes that we actually deal with on a daily basis resulting from health reform in the California health insurance market. There\’s definitely more to come and we\’ll address these as they actually roll out. Please let us know if you have any questions going forward. We\’re happy to help.

Dennis Jarvis is a licensed California health insurance broker with extensive knowledge of the Individual and Small Group health market in California.

Dennis Jarvis is a licensed California health insurance broker with extensive knowledge of the Individual and Small Group health market in California. More information can be found at http://www.calhealth.net

Author Bio: Dennis Jarvis is a licensed California health insurance broker with extensive knowledge of the Individual and Small Group health market in California.

Category: Finances
Keywords: california health insurance, california health quote,individual california health insurance quote