Archive for April, 2010

Insurance Freeze From Fallon Health Insurance & Other MA Insurers

Wednesday, April 28th, 2010
Governor Deval Patrick

Governor Deval Patrick

The Wall Street Journal article “The Massachusetts Insurance Blackout” explains the fallout from Governor Deval Patrick’s price controls on insurance premiums.  Insurers are not selling small business and individual premiums because they say that the Governor’s rate cap will force them into huge losses.  This small-group market consists of 800,000 Massachusetts residents, many of whom will have to go without health care.  Fallon health insurance, Blue Cross Blue Shield, and Tufts Health Plan are three of the largest four insurers in the state.  All of them had operating losses in 2009 and say that this premium freeze will force another $100 million in losses this year.  All of the major health insurers in Massachusetts operate as non-profits and some are having their solvency threatened by this rate cap.

Governor Patrick says that this is his response to the greed that health insurance companies have shown.  The Boston superior court has heard an emergency case and is expected to make a decision soon.  State officials, however, are demanding the insurance companies go back to selling their policies at last years premiums.  The state’s Attorney General believes that the cost of health care in general is to blame for Massachusetts having the highest premiums in the nation.  He says that if you compare health insurance costs to the cost of the actual health care, the industry is not abusing its customers.  This debate in Massachusetts between political power for candidates and health care will likely happen all across the United States because of President Obama’s so-called ObamaCare.

Tax Credit and Aultcare Make Health Insurance Coverage Easier

Saturday, April 24th, 2010

IRSIt can feel nearly impossible for small businesses to offer health coverage to their employees.  A special tax credit new in 2010 can help small businesses and tax-exempt organizations provide health insurance, according to “New for 2010 – Tax credit helps small employers provide health insurance coverage,” from The Gilmer Mirror out of Dallas.  The credit is included in the health care reform act, the Patient Protection and Affordable Care Act.  The credit aims to help small businesses obtain or maintain health insurance coverage from companies like Aultcare and is aimed towards those employers who pay at least half of their employee’s single coverage cost.  The IRS Commissioner urges small businesses and tax-exempt organizations to see if they qualify for this tax break because it is already in effect.

The current maximum credit is 35% of the premiums paid by small businesses in 2010 and 25% of the premiums paid by tax-exempt organizations that are eligible employers.  The maximum credits increase in 2014 to 50% for small businesses and 35% for tax-exempt employers.  The small and tax exempt employers can obtain coverage from Mercy Health Plans or any other insurance provider.  This credit targets small businesses and organizations employing workers with low to moderate income levels.  Typically they have to employ less than 25 full time equivalent workers earning less than $50,000 per year on average.  The maximum tax credits go to businesses employing fewer than 10 full time equivalent workers, earning less than $25,000 on average.  The general business credit can be redeemed starting in 2011 and the IRS is sending out postcard notifications to businesses that may be eligible.

UPMC Health Insurance Plan will Host ‘We Can!’ Event

Tuesday, April 20th, 2010

kids soccerUPMC health insurance plan is going to host a training event to teach community leaders from its surrounding region about the We Can! program.  The workshop will take place on April 27-28 at the Marriott City Center Hotel in Pittsburgh, according to UPMC press release “UPMC Health Plan to Host We Can! Regional Training Event.”  The We Can! program stands for ‘Ways to Enhance Children’s Activity & Nutrition’.  It was started by the National Institutes of Health (NIH), which is part of the U.S. Department of Health and Human Services.  This nationwide movement of both families and communities to promote a healthy weight for children aged 8-13 is crucial right now.  We Can! entails reducing television, gaming, and computer time; eating healthier foods in appropriate quantities; and increasing kids’ physical activity.

The program will be run by representatives from the NIH.  They’ll teach community leaders about helping the children through their parents, teachers, and other members of the community.  Local Pittsburgh organizations that have already run successful We Can! programs will also speak at the event to help new communities start their own programs.  Compare health insurance companies’ community outreach and UPMC definitely is tops in their industry helping the community.  As a co-sponsor with Subway restaurants, UPMC hopes this We Can! training event will help combat childhood obesity in their community.  The NIH and UPMC health insurance plan hope that parks and recreation departments, schools and after-school programs, hospitals and other health care systems, churches, public health departments, and anyone else dealing with kids will come learn about the We Can! program.

California Hospitals: Compare Health Insurance Rising Costs

Sunday, April 18th, 2010

In “California’s higher hospital costs add to health insurance hikes,” Bobby Caina Calvan and Phillip Reese of The Sacramento Bee try to compare health insurance costs and the reasons they keep rising.  While the general public and even the government can be quick to blame insurance companies for everything, the authors’ research showed that hospitals collected $25 billion from health insurance companies from September 2008 to October 2009.  Since 2005, that number increased by over one-third.  A lot of the charges to insurance companies, which flow directly to consumers, come from expenses like hospital expansions, new technology, and services for the uninsured.  It was found that some hospitals actually charged more than double what the service provided actually cost.

Insurers like Golden Rule Health Insurance are essentially held hostage by the charges from hospitals yet take most of the blame for increasing premiums to consumers.  Hospitals in California are required to report the amount they spend on caring for insured patients, the amount they charge insurance companies, and the amount that they actually collect.  The hospitals reported a 53% increase from the amount they spent on care to the amount they charged.  Unfortunately, hospitals are in their own predicament with costs which is why they have to pass them along somewhere.  Government mandates to make hospital improvements, provide care to uninsured Americans and illegal aliens, and reimbursements for Medicare and Medi-Cal that are less than cost force that money to be made up for somewhere.  Unfortunately for consumers, these cost increases for insurance companies usually lead to increased premiums.

Anthem Blue Cross Blue Shield Rates Increase: Yes or No?

Tuesday, April 13th, 2010

In the Medical News Today article “Health Insurance Customers in California, Mass. Await Decisions About Premium Increases,” they discuss insurance customers’ hopes that their premiums will not be going up.  Anthem Blue Cross Blue Shield, the largest for-profit health insurer in California, has plans to increase health insurance premiums by as much as 39% in California and Massachusetts.  After announcing the plans, there was an uproar from the the public citizens who purchase individual health insurance from Anthem Blue Cross.  Because of the public outrage, California insurance commissioner Steve Poizner appointed outside actuary Axene Health Partners to evaluate the company’s spending practices.

While Anthem is probably none too thrilled with this process, they have no choice but to wait.  May 1 is the date that Anthem agreed to wait for after a two month stall of their rate hikes.  Many of the company’s 800,000 individual policyholders will see their premiums increase if Axene Health Partners’ report shows no misconduct on the books of Anthem Blue Cross.  The report should be available and a determination made in approximately two weeks.  Until that time, individual insurance policyholders with Anthem Blue Cross Blue Shield wait on baited breath to see if their health care costs are going to skyrocket.

Cobra Remains: Compare Health Insurance Bill

Friday, April 9th, 2010

cobraAmericans who were worried about the recent health care reform bill eliminating Cobra coverage can rest assured that will not happen, according to The New York Times article “Health Law Preserves Cobra Plan” by Walecia Konrad.  The government-mandated Cobra program is meant to bridge insurance you have lost with new insurance coverage.  Compare health insurance under Cobra and it basically continues insurance coverage from a job you were either laid off from or left to find another job.  Cobra lasts for 18 months and you have to pay the premiums your old employer was paying for you as well as what you were previously paying in most cases.  The health care reform bill that just passed basically makes no changes to Cobra, but for people that couldn’t afford Cobra or had yet to find another job after the 18 month coverage expired, some other aspects of the new law should help them.

A government subsidy covering 65% of laid-off workers’ Cobra coverage  expired at the end of March which puts many unemployed families in a predicament where they will go from paying around $385/month to $1,100/month for their coverage.  For families like that who may no longer be able to afford Cobra coverage and those whose Cobra has expired, they have to look into the independent insurance market at companies like Assurant Health for coverage.  Anyone who was previously insured under Cobra cannot be denied coverage by individual insurance companies based on a preexisting condition, so make sure to shop around well before your 18 months expires to find health coverage.  Some other options to look into if you are uninsured are getting onto your parents insurance up to age 26 and obtaining coverage under the new state run high-risk insurance pools.  But even without a subsidy, Cobra may be the best way to continue your previous insurance after a job loss.

Coming Soon: Compare Health Insurance Pools

Tuesday, April 6th, 2010

861559957_1d2a7ccdd0_mStates need to decide whether or not they are going to participate in President Obama’s new high-risk health care pools, according to the Chicago Sun-Times article “High-risk health insurance pools set to begin in June.”  Monifa Thomas’ article explains that not all states will even participate, but they have to make their decision within 90 days of the health bill signing on March 23.  Compare health insurance in some states and you find that these high-risk insurance pools already exist in 35 states, although some of their rules will surely change.  These high-risk insurance pools are for people who can’t get other, affordable insurance coverage because of pre-existing conditions.  They are temporary until 2014, when insurance exchanges where consumers can shop for heath insurance will replace the pools.

While federal health officials are unsure how much premiums will cost in these new pools or how many people will now have coverage that didn’t, they are confident that the pools will help many of the uninsured.  Consumers will only have to pay premiums that are 35% of the program cost, compared to Illinois’ current program where consumers pay 2/3 of the cost in premiums.  For six months, certain pre-existing conditions cannot be excluded from coverage.  Most states that already have high-risk pools in place will most likely transition those consumers into the new federal high-risk pools, although that will take time.  Whether you have an easier time getting affordable coverage from companies like Fallon Health Plans or state run high-risk insurance pools, the general idea of the health care reform is for more Americans to be insured.  States opting out of running their own pools will have the Department of Health and Human Services run one for them.

Compare Health Insurance for Women After Health Care Reform

Saturday, April 3rd, 2010

According to “Health Law Cuts the Cost of Being a Woman” by Denise Grady of the New York Times, health insurance companies can no longer treat women as a liability.  House Speaker Nancy Pelosi and other women in government are advocating for women’s health by ensuring that being a woman is not considered a pre-existing condition.  The new health care bill forbids all health insurance companies, like UPMC, from sex discrimination.  In the past, companies took advantage of women with unfair health care and health insurance policies towards them.

Companies who sell individual insurance policies, usually bought by people who have lost jobs or other group coverage plans, had been charging women more than men for the same health insurance coverage.  Many plans did not even include maternity care.  Insurance companies argued that women use doctors more than men.  The National Women’s Law Center found that men who smoked were actually being charged less than women who did not.  Even group plans when you compare health insurance were affected.  Although sex discrimination laws didn’t allow the excess costs to be passed down to female employees, smaller business and those heavy in female employees have been forced to make sacrifices including discontinuing coverage in some cases.

Gender rating is now outlawed and maternity coverage has to be included as an “essential health benefit” like heart attacks and cancer.  Women should no longer have to be concerned about getting fair treatment in the health care industry from companies like Golden Rule Insurance.  There are people who worry that insurance companies will be able to find ways around the new laws to protect themselves from financial costs, but the Law Center’s co-president doesn’t currently see any loopholes and is confident that the health care bill will better protect women.