DHCS Allows Brokers to Market Cal MediConnect Plans

Despite opposition from California Health Advocates and other advocates statewide, California’s Department of Heath Care Services (DHCS) recently approved a new pilot that will allow brokers to market Cal MediConnect plans to dual eligibles as of January 1, 2019. This new pilot overturns a longtime ban on brokers which prevented them from marketing Cal Mediconnect plans for fear of exposing consumers to potentially harmful broker misconduct and disruptions in care. While DHCS has noted that existing marketing guidelines from the Centers for Medicare and Medicaid Services will apply, how that will play out specifically is not yet known. This new policy to introduce brokers is inconsistent with consumer experience on the ground, and the whole stakeholder engagement process during the proposal review was woefully inadequate.

California Health Advocates and other advocates will keep am eye on the new pilot to make sure that dual eligibles are able to make informed enrollment decisions and are not improperly enrolled in plans that will cause disruption. If you come across suspected agent misconduct, please report it to our California Senior Medicare Patrol (SMP) at 1-855-613-7080.