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Blue Shield Of California and UCLA Medical Group are parting ways – how will it affect policy holders in Santa Monica ?

Blue Shield of California and UCLA Medical Group are parting ways and this will have affect many policyholders in Santa Monica, Pacific Palisades and Brentwood in their effort to finding affordable health insurance.

As in 2008 Blue Shield of California and UCLA Medical Group could not find agreement in their negotiations for 2012, with the result that not only HMO policy holders but starting January 2012 also PPO  Blue Shield policy holders are not able to access UCLA physicians and hospitals.  Accordingly to a Blue Shield employee the negotiations failed as UCLA demanded that contracts in the future  had to be renewed every 6 months which is causing instability for Blue Shield. The last contract length was 3 years.   Although I can understand that contract negotiations in a 6 months term are highly undesirably, but exactly the same term Blue Shield is asking from their policy holders, when they are asking to accept a 6 months rate guarantee for new applicants instead of the usual 12-months rate guarantee.

In contrast to 2008 many more policy holders are affected this time around when they cannot use the UCLA medical group. Especially with the most recent acquisition of Bay Area Medical group by the UCLA medical group many more policy holders  in Santa Monica, Brentwood and Pacific Palisades are affected by Blue Shield and UCLA separating ways.

The Ronald Reagan UCLA hospital is considered one of the top five hospitals in the country. UCLA Santa Monica Center with their brand new Orthopedic Hospital, the Resnick Neuro Psychiatric Hospital and the UCLA Mattel Children Hospital along with the UCLA Medical Centers and also the Bay Area Medical Group have given UCLA the position to be the most important health care provider in Santa Monica, Pacific Palisades, Westwood  and  Brentwood. For Blue Shield to decide not to offer UCLA services for their HMO and PPO’s policy holders had to be a very difficult decision. Until Blue Shield and UCLA will be able to find agreement, their will be only few interested applicants in Blue Shield. Many policy holders will re-evaluate to switch insurance providers so that they can visit their physician on the West Side.

My duty as an insurance agent is that my clients not only receive affordable health insurance but also have access to quality hospitals and physicians. Until Blue Shield is offering services at UCLA it will be very hard for me to recommend Blue Shield to my clients. This is a pity as I feel that there is not enough competition in the insurance market to find affordable health insurance in Santa Monica, Brentwood and Pacific Palisades.

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