CA Small Group 2017 Network Comparisons

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Presentation transcript:

CA Small Group 2017 Network Comparisons

PCP/Specialist Counts by County PCP/Specialist Counts by County CA SBG: Full Network HMO vs. WholeCare HMO Northern California Rating Region PCP/Specialist Counts by County Full WholeCare WholeCare % of Full HMO 1 Nevada 214 121 57% 2 Marin 546 268 49% Napa 296 80 27% Solano 412 157 38% Sonoma 764 431 56% 3 El Dorado 250 184 74% Placer 777 169 22% Sacramento 3,054 899 29% Yolo 371 134 36% 4 San Francisco 3,878 1,246 32% 5 Contra Costa 1,815 1,090 60% 6 Alameda 2,681 1,096 41% 7 Santa Clara 2,332 1,085 47% 8 San Mateo 364 34% 9 Santa Cruz 556 237 43% 10 Merced 270 139 51% San Joaquin 795 470 59% Stanislaus 856 356 42% Tulare 629 450 72% 11 Fresno 1,187 797 67% Kings 192 116 Madera 158 54 12 Santa Barbara 700 375 54% Ventura 1,331 909 68% 14 Kern 1,118 844 75% Southern California Rating Region PCP/Specialist Counts by County Full WholeCare WholeCare % of Full HMO 15/16 Los Angeles 15,702 9,743 62% 17 Riverside 3,214 1,980 San Bernardino 2,630 1,824 69% 18 Orange 7,297 4,334 59% 19 San Diego 6,320 4,462 71% Note: Provider counts are an approximate and are subject to change without notice.

CA SBG: SmartCare HMO vs. Full Network & WholeCare SmartCare HMO Service Area Rating Region PCP/Specialist Counts by County Full Network WholeCare SmartCare SmartCare % of Full HMO SmartCare % of WholeCare 7 Santa Clara 2,332 1,085 656 28% 60% 9 Santa Cruz 556 237 238 43% 100% 15/16 Los Angeles 15,702 9,743 7,725 49% 79% 17 Riverside 3,214 1,980 1,090 34% 55% San Bernardino 2,630 1,824 1,388 53% 76% 18 Orange 7,297 4,334 2,368 32% 19 San Diego 6,320 4,462 2,055 33% 46% Note (1): Full Network HMO and WholeCare HMO are available in NorCal regions outside of the SmartCare HMO service area. Note (2): Provider counts are an approximate and are subject to change without notice.

PCP/Specialist Counts by County PCP/Specialist Counts by County CA SBG: PPO vs. EPO/HSP Northern California Rating Region PCP/Specialist Counts by County PPO EPO/HSP EPO/HSP % of PPO 1 Nevada 253 168 66% 2 Marin 555 371 67% Napa 320 198 62% Solano 444 45% Sonoma 940 359 38% 3 El Dorado 314 203 65% Placer 837 338 40% Sacramento 3,128 1,135 36% Yolo 391 189 48% 4 San Francisco 3,874 553 14% 5 Contra Costa 1,928 1,227 64% 6 Alameda 3,005 1,348 7 Santa Clara 5,659 4,196 74% 8 San Mateo 1,402 836 60% 9 Santa Cruz 700 293 42% 10 Merced 300 246 82% San Joaquin 927 484 52% Stanislaus 894 50% Tulare 661 478 72% 11 Fresno 1,510 1,371 91% Kings 217 166 76% Madera 348 242 70% 12 Santa Barbara 929 707 Ventura 1,817 1,404 77% 14 Kern 1,122 760 68% Southern California Rating Region PCP/Specialist Counts by County PPO EPO/HSP EPO/HSP % of PPO 15/16 Los Angeles 18,729 11,863 63% 17 Riverside 3,210 2,202 69% San Bernardino 3,582 2,381 66% 18 Orange 8,371 5,063 60% 19 San Diego 7,765 2,731 35% Note: Provider counts are an approximate and are subject to change without notice.

Std/Alt AV Segment Exchange Network Regions Std Plan. 89.72% SBG/CCSB Yes PPO 1 - 19 Gold 80 PPO 0/35 0/30 + Child Dental 80.86% Silver 70 PPO 1500/45 2000/45 + Child Dental 71.56% Bronze 60 PPO 6000/70 6300/75 + Child Dental 61.90% Health Net Bronze 60 HSA PPO 4750/15 Alternate PPO Bronze HSA Alt 61.94% SBG Only No NEW! PPO Gold Value 78.81% NEW! PPO Silver Value 68.60% Gold 80 EPO 1000/20 1300/20 + Child Dental Alt 79.74% PureCare One 1 - 12, 14 - 19 Silver 70 EPO 1800/30 2000/20 + Child Dental Alt 71.33% Health Net Platinum 90 HSP 0/20 0/15 SBG PureCare 1 - 12, 14 - 19 Health Net Gold 80 HSP 0/35 0/30 Health Net Silver 70 HSP 1500/45 2000/45 Health Net Bronze 60 HSP 6000/70 6300/75 Plan WholeCare HMO Platinum $10 90.88% WholeCare 1 - 12, 14 - 19 WholeCare HMO Platinum $20 88.22% WholeCare HMO Gold $30 82.00% WholeCare HMO Gold $40 80.82% WholeCare HMO Gold $50 78.37% Salud HMO y Mas Platinum $10 Salud Salud HMO y Mas Platinum $20 Salud HMO y Mas Gold $30 Salud HMO y Mas Gold $40 Salud HMO y Mas Gold $50 SmartCare HMO Platinum $10 SmartCare 7, 9, SmartCare HMO Platinum $20 15 - 19 SmartCare HMO Gold $30   SmartCare HMO Gold $40 SmartCare HMO Gold $50 Full Network HMO Platinum $10 Full Network HMO Full Network HMO Platinum $20 14 – 19 Full Network HMO Gold $30 Full Network HMO Gold $40 Full Network HMO Gold $50 CommunityCare HMO Silver $20 71.94% CommunityCare 15, 16, 18 CommunityCare HMO Gold $5 81.05%

Thank You