MEDIA RELATIONS: San Diego Union Tribune, CaliforniaChoice

Premium pain for ‘grandmothered’ health plans


By Kathy Robertson, Sacramento Business Journal

Sutter Health’s HMO poised to grow by joining small-biz insurance exchange

Sutter Health has signed a contract to offer its HMO in the private insurance exchange CaliforniaChoice as early as December.

The deal with the exchange for private-sector small employers still needs final approval by state regulators.

If approved, the move offers Sutter Health Plus a new forum to expand enrollment among small-business owners. It gives CalChoice traction to gain membership in Northern California — and it adds another plan to a private-sector competitor with Covered California.

“We want to get it done,” health plan CEO Steve Nolte said. “We think it’s a good fit for us.”A Southern California-based private exchange, CalChoice has about 12,700 employers in its program and 220,000 members.

“We believe in the Sutter model in terms of brand and we’ll help them maintain that,” said Ron Goldstein, president and CEO at Choice Administrators, which runs CalChoice. “It’s a very good fit for us. We were like them 19 years ago and know what its like to start from scratch.”

Launched in January 2014, Sutter Health Plus is available in nine counties in the Sacramento and San Joaquin valleys. The plan has applied to the state Department of Managed Health Care to expand coverage to the Bay Area in time for enrollment in 2016.

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By Bruce Shutan, Employee Benefit News

Covered California’s Small Employer Health Options Program (SHOP) is growing, but a private-sector competitor to the state-run HIX is growing even faster.

Ron Goldstein, CEO of heath exchange company: Choice Administrators at their office in Orange. ///ADDITIONAL INFO:    RonGoldstein.METRO.0424.kjs  ---  Photo by KEVIN SULLIVAN / Orange County Register  --  4/14/15 The story is about Ron Goldstein, the CEO of heath exchange company: Choice Administrators. Photographed at their company headquarters in Orange, Ca. 4/14/15

CaliforniaChoice, whose framework predated public exchanges by many years and led to their development, now has 12,070 employers in its program and 218,648 enrollees. That’s up from 11,500 employers and 150,000 members last August. In stark contrast, Covered California has 2,289 employers and 15,633 enrollees, up from 1,700 employers and 11,500 members during that same time frame.

Then again, any such comparison could be apples to oranges to a certain extent. For example, while the availability of tax credits gives SHOP exchanges a leg up over private exchanges, only a tiny percentage of small businesses are even eligible for such assistance.

“It wasn’t like getting subsidies where it was up to 400% of the federal poverty level,” says Ron Goldstein, president and CEO of Choice Administrators, which runs the private-sector small employer pool known as CalChoice for short. “It was a narrow slice of the market – a single-digit percentage in California.”

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