Archive for October, 2010

McDonalds to Compare Health Insurance Waivers

Saturday, October 30th, 2010

McDonalds and other retailers hope that the U.S. Department of Health and Human Services will grant them a waiver to continue offering the same “mini-med” insurance plans.  The plans do not comply with the new health care reform law, but President Obama has stated that his administration is working with McDonalds and other companies so that their employees are not negatively impacted.  “Mini-med” plans offer limited benefits to hourly workers, of which McDonalds employs over 30,000.  It’s affordable for both the employee and the company and offers employees prescription drug coverage, preventative care, and both inpatient and outpatient care.  Compare health insurance costs and McDonalds and other retailers pay far less in administrative costs when they offer “mini-med” plans.

The stipulation in the health care reform bill stating that 85% of the premium costs that companies collect must go directly to paying medical costs rather than administrative costs is the problem for McDonalds.  Because of their high turnover and fairly low payouts of claims relative to other costs, they spend more than 15% of collected premiums on administrative costs.  The “mini-med” plans offered by McDonalds also have annual and yearly benefit caps on coverage which could be eliminated in the new health care reform.  McDonalds is looking for other health insurance options, possibly from Assurant Health or another insurer, in case they are not able to get a waiver from the government.  Obviously having McDonalds’ hourly employees lose their group health insurance is not a side effect of the reform that the government anticipated, so hopefully something can get worked out soon.

Blue Cross Blue Shield Issuing Refunds

Friday, October 29th, 2010

The new health law that went into effect on March 23 is causing Blue Cross Blue Shield of North Carolina to dole out $156 million in refunds to its customers.  USA Today’s article by Alison Young, “Blue Cross to refund $156 million in N.C.,” speculates that other insurers in other states may be doing the same.  North Carolina’s health insurance regulators have been looking into its insurers’ practices deeply since the government’s new health care law in March and found that their insurers need to make some changes.

Blue Cross Blue Shield of North Carolina recently requested approval to increase the rates they charge their customers.  It was determined that the company was building up reserves in order to finance claims that it will need to pay in 2014 and beyond, when many more changes to the health care law will go into effect.  If you compare health insurance today to what it will look like in 2014, there will be many differences.

As a result of this inquiry, 215,000 individual policyholders in North Carolina will be getting refunds by the end of this year.  The reserves system was not put into place for group plans so they are not effected by this refund.  Average policyholders can expect to receive around $690 each.  Reserves were collected in the beginning of a policy being issued to help keep the premium costs even throughout the life of the plan, but the new health care law doesn’t allow insurance to work that way.  The U.S. Department of Health and Human Services is looking into whether this is a larger issue that needs to be addressed nationally.

Cigna & Other Insurers Defend Changes

Thursday, October 28th, 2010

Some insurers who previously offered child-only insurance policies no longer plan to offer such policies now that President Obama’s health care reform bill requires children with pre-existing conditions to be covered as well.  This information comes from The Washington Post’s “Some insurers to halt new child-only policies” by N.C. Aizenman.  Cigna health insurance, WellPoint, and CoventryOne are three companies under fire from advocacy groups for making these changes.  Customers who already have child-only policies will be able to maintain those and children with pre-existing conditions will not have a problem being included in new family policies.

Health Care for America Now’s Ethan Rome says that it is immoral and appalling for these large companies to take away one of the consumer’s most anticipated changes from the health care bill.  The insurers who have decided to drop their child-only plans say that so many companies either don’t offer them or have taken them away that to keep the plan offerings would not allow them to remain competitive.  They argue that they couldn’t offer their customers the value they previously had and that their company could be compromised.

The Department of Health and Human Services is disappointed because insurance trade group America’s Health Insurance Plans supported the law and said that insurers would comply in a letter last March.  AHIP points out that children with pre-existing conditions will still be covered under family plans and worries that parents would wait until their children were extremely sick to purchase child-only plans if the option were there.  In 2014 when all Americans will be required to maintain health insurance and adults with pre-existing conditions will always be covered as well, everything may be shaken up again.  Poor children with pre-existing conditions have Medicaid and CHIP to cover them and those children who are not poor can get coverage through high-risk health insurance pools.  Some states even have laws that will prevent insurers from halting sales of new child-only plans.

Medicare: Compare Health Insurance Changes

Sunday, October 24th, 2010

2011 will mark a year of many changes for Medicare beneficiaries.  “Medicare changes set for 2011″ in California’s Times-Standard summarizes the information shared from The Area 1 Agency on Aging.  The Agency’s Health Insurance Counseling and Advocacy Program (HICAP) offers free services in two Northern California counties related to Medicare counseling, assistance, and notification of changes.  They help Medicare beneficiaries compare health insurance changes so that they know what to expect and change in the coming year.

Beneficiaries will now be eligible for an annual wellness exam each year without having to pay co-pays or deductibles.  This begins one year after their initial Medicare exam.  For those who reach the donut hole, or the gap in prescription drug coverage, they will pay about half as much for name brand medications and even pay a bit less for generic drugs.  These discounts will last all the way through 2019.

People looking to remove themselves from a Medicare Advantage Plan and enroll in traditional Medicare will have a new enrollment period lasting from Jan. 1 through Feb. 15.  There will also be a new enrollment period for those wanting to join a prescription drug plan.  The HICAP encourages people to call them early and inquire about all the changes occurring with Medicare Advantage and prescription drug plans because they expect to be busy.  Enrollment begins Nov. 15 and lasts through Dec. 31.

If they don’t make changes or additions during this year’s enrollment period, the dates will change for 2011 open enrollment.  That will begin Oct. 15 and last through Dec. 7.  At that time, beneficiaries can either change or join Medicare Advantage or Prescription Drug Plans.  Whether you are insured through a smaller insurer like Aultcare health insurance or a larger company providing your Medicare benefits, it is important to know all of your options and any upcoming changes that could affect your benefits.

Highmark Collaborates with Blue Cross Blue Shield

Monday, October 18th, 2010

Blue Cross Blue Shield of Delaware (BCBSD) is now working closely with Highmark Inc. of Pennsylvania.  According to Blue Cross Blue Shield’s press release “Blue Cross Blue Shield of Delaware Announces Affiliation Agreement with Highmark Inc.,” this business relationship will strengthen the cost-effectiveness of the two companies.  It will also allow Blue Cross Blue Shield to bring Delaware residents some new products and services.

BCBSD has been working for four years on new corporate planning techniques to save money while remaining a competitive and leading force in the local marketplace.  By working closely with Highmark, BCBSD will remain a non-profit organization while enhancing their operations in a cost effective way.  As it has gotten harder for small, independent companies to stay competitive because of cost increases in the medical field, affiliations like this will probably become more common.

Once the Delaware Department of Insurance finishes their approval process, the two companies will be able to work together on investments towards new systems and other business capabilities.  Compare health insurance costs and they will be better positioned to keep customers happy by sharing investment expenses and capital requirements.  They will reduce administrative costs by sharing not only costs but current capabilities and systems that the other may not have.

Humana Gets Good News About Medicare

Sunday, October 10th, 2010

humanaAccording to “Humana wins Medicare approval for 2011 plans” from Business First of Lousiville, the U.S. Securities and Exchange Commission just reported that Humana Inc. has Medicare approval for 2011.  They will be able to offer Medicare Advantage and prescription drug plans for the next policy year, keeping up with any federal Medicare changes.

Humana will offer prescription drug plans across all of America as well as in Puerto Rico.  They are also joining forces with Wal-Mart Stores Inc. to co-brand a prescription drug plan in the U.S.  HMO plans will be available in 26 states and Puerto Rico, local PPO plans in 39 states and Puerto Rico, and regional PPO plans in 23 states belonging to Medicare Advantage regions.  Full-network and partial-network Private Fee-for-Service (PFFS) plans will be offered in 34 and 28 states, respectively.  In two states, non-network PFFS plans will be offered.

November 15 will start the enrollment period for the 2011 Medicare plans.  Humana reported fewer commercial segment customers from 2008 to 2009, mostly because of high unemployment causing large numbers of uninsured Americans.  They also saw a decrease in medical members between the two years.  Their specialty-benefit membership increased however.  Medicare Advantage plan membership increased, while the prescription drug plan membership decreased.  Humana’s net income and revenue increased from 2008 to 2009.

Blue Cross Blue Shield Helps Small Businesses

Thursday, October 7th, 2010

Blue Cross Blue Shield announced on it’s website that Independence Blue Cross in Philadelphia has 25 new health insurance plans that will really help small businesses with 2 to 50 employees.  The press release, “Independence Blue Cross Unveils New Health Plan Options for Small Businesses,” describes the Blue Solutions plans that became available on October 1.  Blue Solutions are available as HSA plans, or Health Savings Accounts, copay, and deductible plans.  All of them have prescription drug coverage included as well.  Many people who did not previously have access to HSAs will now, which is crucial as these types of insurance plans skyrocket in popularity.

HSAs are a great way for employers and employees to receive quality health care in an affordable way.  Either or both make contributions to this account that pays for health expenses.  Since consumers are paying for the health care needs until meeting their deductible HSAs are having a positive effect with people living healthier lifestyles and taking control over their health.  There are many tax advantages when you compare health insurance with an HSA.  Employers consider contributions business expenses for tax purposes and employees reduce their taxable income by contributing to the account.  Any interest earned is free of taxes when used for qualifying expenses and reimbursed medical expenses that qualify are also tax free.

The Blue Solutions plans comply with all of the recent health care reform changes that are taking place currently and into the future.  They also have a wide array of options within the plans such as choosing HMO, PPO, High-Deductible and other plans.  Employers and employees have the option for any type of coverage they desire, depending on how much they are willing and able to spend.  Promoting healthier lifestyles is important to Blue Cross Blue Shield so they have added Healthy Lifestyles components like gym membership reimbursement and help to cover the expense of quitting smoking.  There is a Blue Solutions plan available to meet anyone’s needs.

Medicare Advantage Changes Will Effect UPMC

Friday, October 1st, 2010

There could be some drastic changes to Medicare Advantage plans after everything is said and done with the Health Care Reform Act of 2010.  According to Texas’ The Daily Tribune author Marcia Davis-Seale, “Obamacare could shut out Medicare Advantage.”  While it seems unlikely that Medicare Advantage plans will go away altogether, the number of Medicare participants enrolled in such plans is estimated to go from 24% of participants down to 14% of them.  Compare health insurance costs related to Medicare Advantage and as the government subsidizes less for insurance companies, doctors, and hospitals, they likely will not be accepting as many Medicare Advantage plans. As many of 50% of current plan participants may have to switch to traditional Medicare.

Currently about a quarter of Medicare recipients have Medicare Advantage plans, accounting for around 10 million seniors.  The plans are alternatives to Medicare and offer a combination of Medicare plans along with extra benefits like dental and vision coverage and even gym memberships.  Since the plans are heavily subsidized by the government, these extras rarely effect plan holders with extra costs.  It costs the government between 13 and 20% more to fund Medicare Advantage plans than traditional Medicare plans.  As the government cuts back the amount it is spending on these costly plans over the next ten years, insurance companies may be more likely to drop the plans.  Insurers also have to comply with the new rule that they spend 85 cents of every dollar on actual medical care for their customers so that may be a cost cutting factor as well.

Everyone on Medicare will continue to receive the same benefits they have always been guaranteed.  The extra $1000 spent per Medicare Advantage recipient has been passed along to all Medicare policy holders over the years.  Now that the government is working to “level the playing field” in regards to Medicare it remains to be seen what insurance companies like UPMC will do.  Gym memberships and other perks will likely be cut by many, but seniors don’t have to worry about losing basic Medicare benefits like hospital and doctor care.  It will continue to be a balancing act for all of those involved to maintain seniors’ health care needs, keep Medicare fiscally afloat, and pay an adequate amount to private health insurers going into the future.