California health insurance
-
California Group health insurance
-
Kaiser Group Health Coverage
Kaiser Group health insurance in California
Kaiser
is one of the largest (if not the largest)
health insurers in the California small group
market. It is unique and quite different from
the other health insurance carriers such as
Anthem Blue Cross, Blue Shield, Health Net, and
Pacificare in many ways.
Kaiser dominates certain areas of California
so let's take a look at the pro's and con's of
insuring your employees with Kaiser group
health.
First, a quick introduction.
A quick introduction to Kaiser in California
Kaiser dates back to the depression and is
quite unique in California.
Traditionally, it has been an HMO provider
but is different from the other California
carriers in that it employs the actual doctors
and owns the hospitals. The other carriers
contract with individual medical groups and
hospitals to provide HMO coverage to their
enrollees. With Kaiser, the insurer is also the
provider.
There are pro's and con's to this type of
delivery.
For one, people may be concerned about
financial concerns affecting medical decisions.
To some extent, this is an issue relating to
HMO's in general and not specific to Kaiser but
with Kaiser, the proximity of insurance carrier
and provider might further the concern. Again,
HMO's by their design have this concern as even
independent medical groups and doctors are paid
a fixed amount per enrollee.
The medical group then must balance care
options with a fixed budget in order for the HMO
relationship to remain viable.
Kaiser locations and Small Group coverage
The other major difference with Kaiser is
that they own the actual hospitals and medical
facilities.
This affects where Kaiser is available.
The facilities tend to be in more populous
areas which is true also for most HMO's. You
need a larger population to support the HMO
model. If you live outside a Kaiser area, you
may not be able to take advantage of their HMO
plan benefits. This can be an issue for
California companies that have employees in
different areas and especially employees outside
the State altogether.
A new twist on this is the roll-out of
Kaiser's PPO plans. They have contracted with a
nationwide network to provide PPO benefits as
part of their suite of plans.
Kaiser is traditionally, not thought of as a
PPO carrier, and the PPO rates are typically
higher than carriers such as Blue Cross which
have a long track record with PPO
Why Kaiser small group remains popular
There are three main reasons that Kaiser is a
dominant carrier in the California health
insurance landscape.
1. Cost. This is the biggest driver as
Kaiser is very difficult to beat cost-wise. It's
rare to find cheaper California health plan
alternatives for equivalent benefits on the
market...either HMO or PPO.
If cost is the main concern for an employer,
Kaiser is an option to look at.
2. Ease of Use. If choosing your own
doctor is not an issue, some people like the
feel of Kaiser.
When you go to a Kaiser facility, the process
can be pretty smooth as all the needed
information lies within one "umbrella". Your
medical history and information is available
throughout the system.
3. Day to day medical. Kaiser is great
for your basic health care needs with a focus on
prevention. Maternities can be handled very
well. The only issue (as with all HMO's) is when
you have something more exotic health-wise.
You may want to go to a particular specialist
who concentrates on your ailment. Within an HMO
type of plan, this might not be an option. For
the majority of medical services, however,
Kaiser can be very cost-effective and
user-friendly.
Kaiser Wrap
There is an option called the "Kaiser Wrap"
where you can split employees between Kaiser
plans and those of another carrier such as
Anthem Blue Cross.
There are certain eligibility requirements in
terms of numbers of employees on each plan but
this allows those that like Kaiser to go there,
and those that do not, to choose another
carrier.
Kaiser will continue to be a strong carrier
going forward in the California small group
health insurance market.
HMO's in general have been under pressure as
their rates have increased at a quicker clip
than less-rich plans but Kaiser is probably the
best at cost-containment and efficiency to help
offset this premium pressure going forward.
Again, there is absolutely no cost to you for
our services. Call 800-320-6269 Today!