Compare The Major California Health Insurance Carriers

Five Critical Criteria used to compare California carriers.

1. Health Plan pricing in the market. Ultimately, benefits need to be priced well relative to other similar plans on the market. Also, the plans have to make sense financially in today's world of ever-increasing cost. Some large multi-line carriers like Principle offer extremely rich benefits that have completely priced themselves out of the market. There's a "sweet spot" where plan design meets the consumer's budget and that has to be a given when choosing a plan. Interestingly enough, this pricing value is driven by a carriers ability to do well in the following other areas so let's take a look at them. More information on the major carriers in the California market.

2. Extensive provider network for HMO and PPO. A carrier needs to have as many doctors and hospital in all major areas participate in their HMO and PPO networks. The more the better. This is especially true for PPO plans which is the direction the market is ultimately heading as costs escalate. This is primarily a function of how many subscribers the carrier can bring to the bargaining table with medical and hospital groups. If a carrier covers a significant number of people in a given area, the doctors and hospitals of that area need to contract with the carrier. Also, the carrier can negotiate rates better which is essentially the foundation for PPO plans. PPO's are big group discounts essentially. Here, bigger is better. You can find more information on how the California health networks work.

3. Flexibility and Scope of plan design. The carrier must also offer a full range of plan options: both rich and value HMO options; a full range of PPO plans from rich copay plans to hybrid lower priced plans; Health Savings Account or HSA compatible plans and strictly catastrophic lower-priced plans. No one's needs are the same. The carrier should be able to provide for both sides of the spectrum. A key direction in the market today is towards the segmentation of maternity and non-maternity benefit plans on the Individual/Family market. This is a critical consideration or any enrollee who may need maternity coverage in the future. Health Net currently only has one plan with maternity benefits in their PPO portfolio. On the group side, it has been more a move towards higher deductibles and in some instances, generic drug coverage only. The Generic only benefit is more and more prevalent on the Individual/Family side. We feel strongly at http://CalHealth.netthat Brand name prescription is important as more exotic medical conditions can require new drugs that run 10's of thousands of dollars.

4. Ease of Use. One more time... EASE OF USE. The carrier has to be easy to deal with. This is critical for the day-to-day management of your policy (which we help with) and more importantly, the claims-processing side. Technology is increasingly figuring here. Which carriers have made the investment in the Information systems to facilitate both the membership and claims side. We deal with all the carriers day-in and day-out... common sense and practicality are essential in the carrier you choose.

5. Pricing Stability. Over the past decade, California health insurance costs have increased significantly. Barring major changes, it will likely continue as Americans use more and more health care. The ability to mitigate this increase is primarily a function of a carrier's management of the above four items. Are they designing and pricing correctly for the market to encourage future rate stability? Can they negotiate well with the medical groups and large hospital chains in the California health market? Do they offer options for carriers to reduce benefits (and cost) and still feel well protected? Have they invested in making their business effective from and IT perspective? These are all important questions that directly your future rates and results as a function of the health carrier's management.

California health insurance Carrier by Carrier listing in descending order based on our experience

Blue Cross of California

Blue Cross is owned by Wellpoint, which is probably the dominant carrier nationwide in terms of stability and progressive plan design. They are known as Anthem Blue Cross Blue Shield or Unicare in most other States. They have been the ones to beat in the California health market.

1. Plan Pricing - they are consistently priced in the top 1-2 for comparable plans.

2. Network - For PPO plans, they probably the most extensive network with providers in all counties. Over 70K providers and 400 hospitals State-wide plus access to the Blue Card network for family members or employees in other States.

3. Flexibility - On the Small Group side, they started the Employee Elect program which is still the most flexible and easiest to use. They even apply choice to the dental plans as well. They have 4 HMO plans, 5 HSA plans, and 12 PPO plans plus a suite called BeneFit for low cost plans. On the individual side, they consistently bring out new plans from the Right Plan 40 no-deductible PPO plan to the new Tonik health plan suite that the other carriers invariably try to copy 6-12 months later.

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