HealthNet Filling Insurance Void for Small Businesses

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Pacific Health Advantage’s announcement in August that it would discontinue offering health insurance coverage by the end of the year was a blow to 6,200 small businesses in the state. They relied on the San Francisco-based non-profit purchasing pool to offer a richer choice of coverage to their employees than they otherwise could afford.


The purchasing pool, backed by the a coalition of major California employers known as the Pacific Business Group on Health, cited the dwindling number of health plans willing to participate as its reason. Now HealthNet of California, one of the few remaining plans in the program, saw a business opportunity and last week launched a program that aims to retain some of the flexibility that employers had under PacAdvantage.


Called Hn Options, the program lowers previous participation requirements to enable small businesses to offer Health Net policies alongside another health carrier’s policies. Employers still must have 75 percent of employees enrolled in some health plan to qualify for group coverage, but can count all of its plans toward the total.


Businesses that enroll a minimum of five employees in HealthNet get access to 10 plans, and five additional plans if they sign up 10 employees.


Douglas King, HealthNet’s general segment manager of individual and small business plans, said the change came in response to requests from insurance brokers, in addition to the realization that it was missing business opportunities by making it harder for small employers to quality for its plans.


“It was a matter of listening to the market,” King said. “Our brokers were saying that many of their clients wanted more flexibility in how they wrote their plans. It also fits well with trying to find a home for the employers who had been in PacAdvantage.”


HealthNet did revise terms of some of its plans to make the economics add up. Health insurers generally prefer to have as large a pool of members as possible at each employer because it lessens their risk of taking on too a high percentage of ailing workers.



Corporate L.A. Backs Hospital


When you have a $950 million hospital to open by this time next year, every $5 million you can toss into the construction kitty is welcome. That realization, not to mention the opportunity to show off the Italian travertine-covered walls of an I.M. Pei-designed health facility, led UCLA to dedicate the proceeds from last week’s Millennium Ball gala to its new Ronald Reagan UCLA Medical Center.


Dozens of chief executives and chairmen of Los Angeles’ largest companies, including event co-chairman and Paramount Pictures Corp. Chief Executive Brad Grey plus the usual array of public officials and Hollywood stars noshed and networked in the future hospital lobby before heading to a huge tent on the grounds for dinner and entertainment.


Walt Disney Co. Chief Executive Robert Iger, a longtime supporter of health causes, was guest of honor at this year’s event, which in most years is a fund-raiser for the university’s David Geffen School of Medicine.


Other business leaders on the guest list included philanthropist Eli Broad, Occidental Petroleum Corp. Chief Executive Ray Irani, TCW Group Inc. Chairman Robert Day, DreamWorks Animation SKG Inc. Chief Executive Jeffrey Katzenberg, Saban Capital Group Chief Executive Haim Saban, and Walt Disney Studios Chairman Richard Cook.


The $5 million raised at the Oct. 5 event set a gala record. “It’s reflective of the tremendous support that the community has offered to UCLA and our health care system for a long time,” said Dr. David Callender, associate vice chancellor and chief executive of the UCLA Hospital System.


The new medical center, which meets tougher state hospital seismic standards, will replace a 1950’s era facility damaged in the 1994 Northridge earthquake.


UCLA also is taking the opportunity to upgrade its Santa Monica hospital campus, the first phase of which is expected to open around the same time as the Westwood medical center. The cost to build and equip both facilities is expected to total $1.3 billion, Callender said, which has come from federal funds, loans and private donors.



Docs Lauded


Twelve Los Angeles County physician groups were recognized last week by the Integrated Healthcare Association’s Pay for Performance program, which ranked the groups on the quality of their preventive care and chronic care management, patient satisfaction, and use of information technology to support patient management and care.


Seven major health plans Aetna Healthcare of California, Blue Cross of California, Blue Shield of California, CIGNA HealthCare of California, Health Net of California, PacifiCare of California, and Western Health Advantage participate in the association’s initiative by rewarding participating physicians with incentive payments.


Honorees included HealthCare Partners Medical Group, UCLA Medical Group, Cedars-Sinai Medical Group, and Facey Medical Foundation. The remaining six were from Kaiser Permanente’s Southern California Permanente Medical Group practices in Los Angeles, West Los Angeles, Baldwin Park and Bellflower, Panorama, South Bay/Harbor City and Woodland Hills. A Kaiser spokesman said it was the first time it had entered the competition and that the practices at all 12 of its Southern California medical centers had made the cut.


Integrated Healthcare reported across-the-board improvements last year by physician groups on its evidence-based clinical care measures. Compared to 2004, for example, physician groups reported that they screened about 60,000 more women for cervical cancer, tested nearly 12,000 more individuals for diabetes, and administered approximately 30,000 more childhood immunizations.



Staff reporter Deborah Crowe can be reached at (323) 549-5255, ext. 232, or at

[email protected]

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