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Covered California Releases List of Plans and Rates for 2014

This morning Covered California released a summary of the plans, benefits and premiums that it will be offering to individuals in 2014. Enrollment begins October 1, and coverage begins January 1, 2014.

Thirteen plans will offer benefits in the state’s 19 regions. The plans include the biggest statewide plans, such as Kaiser Permanente, Anthem Blue Cross, Blue Shield and Health Net. They also include significant local plans, such as Chinese Community Health Plan in the Bay Area, Sharp in San Diego, Molina in Southern California and Western Health Advantage in the Sacramento region. Local public plans in Alameda, Contra Costa, Los Angeles, Santa Clara and Ventura are also participating.

The covered benefits include ambulatory care, emergencies, hospitalizations, maternity, prescriptions, behavioral health, lab services, rehabilitation, prevention and pediatric services.

Covered California’s brochure lists the monthly premiums for catastrophic coverage for a 25 year old, and for all four levels of coverage for a 21 year old and a 40 year old. These vary by region. For example, the lowest cost catastrophic coverage for a 25 year old in Los Angeles is $142 a month, while the lowest cost bronze coverage is $154 a month for a 25 year old in Los Angeles. In San Francisco by comparison, the premiums are about $20 a month higher.

The rates in Southern Los Angeles County:

 

The brochure also displays how much an individual aged 21 and an individual aged 40 would pay as their share of premiums for bronze and silver plans, both statewide and in each individual region. An individual with income under 150% of FPL selecting the most affordable bronze plans would pay no premium; the tax credit would pay the entire premium to the plan selected by the individual. An individual with income under 150% of FPL selecting the most affordable silver plans would pay about $40 per month; the tax credit would pay the rest of the premium.

 

The brochure also lists the copays and deductibles for all types of plans and demonstrates the impact of the refundable tax credits in reducing the burden of copays on low and moderate income individuals. Thus for example, the full copay for a primary care visit in the silver plan is $45, while the copay for an individual with income up to 150% of FPL (about $16,000) is $3 per visit and $3 per generic drug, and the copay for an individual with income up to 200% of FPL (about $22,000) is $15 per visit and $5 per generic drug prescription. The federal tax credit would pay the plans for the difference.

 

Covered California has negotiated premiums for individuals in 2014 that are, for the most part, equal or lower than the equivalent 2013 premiums for small employers. In Los Angeles, premiums are between 22 and 29% lower than the comparable small employer premiums for 2013.

For the full Covered California brochure with plan and rate information, click on this link.

 

Prepared by Lucien Wulsin, ITUP

Date: 5/23/13

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