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Highmark’s new Medicare advantage product in Western PA, Community Blue Medicare HMO, has resulted in the Commonwealth of PA threatening a court injunction amid claims that the plan violates a consent decree that was agreed to in July of 2014.  The consent decree requires Highmark members have access to UPMC hospitals.  The Community Blue product is a limited network product that does not include UPMC hospitals, however, Highmark has a number of premium based products which do allow access to UPMC.

Here is a link to a story from Business Journals.

Here is a link to the press release from Highmark.

Great News!  Earlier this week, we incorporated ALL summary of benefit data for all Medicare advantage plans in the United States on Medicare Quote Engine.  CMS released a slightly different format which is a little easier to read, but different than 2014’s Summary data.  Now you can compare benefits for any 2015 plans (all benefits) side by side.

More Great News!  Today, CMS released their 2015 Star Ratings and, as of this afternoon, we have incorporated ALL of the 2015 star ratings for all Medicare advantage plans and all Medicare Part D plans.

Medicare Quote Engine is a free service provided exclusively to agents of Ritter Insurance Marketing to help them select plans to meet their clients needs.  Medicare Quote Engine includes Medicare Supplement, Medicare advantage, Medicare Part D and Final Expense quotes tailored to your client.  For more information click here.

Here is the list!!

Contract Number Organization Type Organization Marketing Name Contract Name Parent Organization Rated As Highest Rating Rating
H0524 Local CCP Kaiser Permanente KAISER FOUNDATION HP, INC. Kaiser Foundation Health Plan, Inc. MA-PD Overall 5
H0630 Local CCP Kaiser Permanente KAISER FOUNDATION HP OF CO Kaiser Foundation Health Plan, Inc. MA-PD Overall 5
H1019 Local CCP CarePlus Health Plans, Inc. CAREPLUS HEALTH PLANS, INC. Humana Inc. MA-PD Overall 5
H1230 Local CCP Kaiser Permanente KAISER FOUNDATION HP, INC. Kaiser Foundation Health Plan, Inc. MA-PD Overall 5
H1651 1876 Cost Medical Associates Health Plan, Inc. MEDICAL ASSOCIATES HEALTH PLAN, INC. Medical Associates Clinic, P.C. MA-Only Part C Summary 5
H2150 1876 Cost Kaiser Permanente KAISER FNDN HP OF THE MID-ATLANTIC STS Kaiser Foundation Health Plan, Inc. MA-PD Overall 5
H5050 Local CCP Group Health Cooperative GROUP HEALTH COOPERATIVE Group Health Cooperative MA-PD Overall 5
H5262 Local CCP Gundersen Health Plan, Inc. GUNDERSEN HEALTH PLAN Gundersen Lutheran Health System Inc. MA-PD Overall 5
H5264 1876 Cost Dean Health Plan, Inc. DEAN HEALTH PLAN, INC. Dean Health Systems Inc. MA-Only Part C Summary 5
H5591 Local CCP Martin’s Point Generations Advantage MARTIN’S POINT GENERATIONS, LLC Martin’s Point Health Care, Inc. MA-PD Overall 5
H6360 1876 Cost HealthSpan HEALTHSPAN INTEGRATED CARE Catholic Health Partners MA-PD Overall 5
H9003 Local CCP Kaiser Permanente KAISER FOUNDATION HP OF THE N W Kaiser Foundation Health Plan, Inc. MA-PD Overall 5
H9047 Local CCP Providence Health Plans PROVIDENCE HEALTH PLAN Providence Health & Services MA-PD Overall 5
S1822 PDP HealthPartners National PDP HEALTHPARTNERS, INC. HealthPartners, Inc. PDP Part D Summary 5
S5743 PDP MedicareBlue Rx WELLMARK IA & SD, & BCBS MN, MT, NE, ND,& WY BCBS MN, MT, NE, ND, WY, Wellmark IA and SD PDP Part D Summary 5
S5753 PDP WPS Health Insurance WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION Wisconsin Physicians Service Ins Corporation. PDP Part D Summary 5

Below is a link to the PDF of the press release from CMS on September 30th, 2014.  Florida Healthcare Plus, Inc. was notified of the suspension of enrollment of their Contract Number H4199 by CMS.

FHP-Sanction-09_30_14(1)

The plan was hit with fines for accounting errors.  See http://www.bizjournals.com/tampabay/blog/morning-edition/2014/09/accounting-error-draws-penalty-for-florida.html

and http://health.wusf.usf.edu/post/medicare-hmo-fined-frozen

Here are the plans affected:

 

FLORIDA HEALTHCARE PLUS       Clear Skies (HMO SNP)   SNP C – HMO

FLORIDA HEALTHCARE PLUS       Day Break (HMO)           L HMO – MAPD

FLORIDA HEALTHCARE PLUS       Sunny Days (HMO SNP)  SNP D – HMO

FLORIDA HEALTHCARE PLUS       Sunrise (HMO)   L HMO – MAPD

Here is the story from Star Advertiser.  Any agents want to spend October through December in Hawaii helping these 46,000 folks find new plans??

Here is the story from the Winston-Salem Journal. 

The disenrollment for BCBSNC will impact about 49,500 Medicare beneficiaries.  There will also be significant changes to existing plans for an additional 76,500 Medicare beneficiaries with BCBSNC .  The other 34,400 with BCBSNC will only see slight changes in their plan.  The biggest impacts (disenrollment and significant plan changes) occurred with their most popular plans that were less than 4 stars.

State Farm and HCSC reached a deal to offer ACA plans in the five states where HCSC holds the BCBS licenses:  TX, IL, NM, OK and MT.  Here is the article from Forbes.

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