Wednesday, August 30, 2017

Carefirst Receives Approval for Individual Medical Plan Rate Increases

The Maryland Insurance Administration released the approved rates for CareFirst Consumer Direct medical plans on Tuesday August 29, 2017. The approved increase for the BlueChoice HMO is 34.5% and the approved increase for the BlueCross PPO plans is 49.9%. This comes on the heels of an approximate 25% rate increase last year. The new rates will go into effect beginning 1-1-18.  Expect plan changes as well.

Companies who moved to individual plans due to high cost in the group market, it may be time to move back. 



Tuesday, August 22, 2017

Evergreen Receivership Conference Call

August 22, 2017

Today we spent an hour with the Maryland Insurance Administration, Attorney for the Maryland Attorney Generals Office, Insurance Commissioner Al Redmer and spokespeople for the receivers of Evergreen Health.

Since insurance companies can't go bankrupt, they go into receivership.  The receivers will run the company with one main goal in mind, to protect the consumer.  There are not going to be any renewals with Evergreen or new business written.

Many of your employees have received letter indicating that HMO's are not covered under the Guarantee Fund.  This is correct.  However they are protected under court order and Maryland Statute.

Claims that were being processed before the Receivers took over (Around 8-1) are put on the back-burner and paid at the discretion of the Receivers. Some may never be paid.   Claims after 8-1 are given priority and paid first.  According to the Court Order, page 7, section 13, providers are not allowed to balance bill you, try to seek payment from you for claims submitted beyond your normal co-pay and/or refuse to see you.  Those that are, are violating the court order.  

Also, here are a list of FAQ's regarding the Receivership of Evergreen.

We have been in touch with each and every Evergreen client and are planning a strategy to best work with this situation that makes sense for your firm.  

As always, please feel free to contact me at 410-239-5009.