Archive for January, 2013

Connecticut’s Insurance Exchange A Model for Other States

Wednesday, January 30th, 2013

Connecticut is looking to be an example for the other states in the U.S. with their health insurance exchange.  The federally mandated exchanges are supposed to make it easier for uninsured Americans to find health insurance in an affordable way.  They will primarily be online and will offer an array of plans, most of which will be subsidized by the government for those needing help with the cost.  Connecticut’s exchange will have four different coverage tiers, which are bronze, silver, gold, and platinum.  The Exchange’s Board of Directors just approved new criteria that is specific and will remain consistent across the different plans.  This criteria will enhance the transparency of the benefits and coverage and will make it easy to compare the overall value consumers will receive.

According to a press release from the Connecticut Health Insurance Exchange, each plan will offer comprehensive insurance coverage and include preventative care in consumers’ premium payments.  Many different people and agencies had a hand in developing the new criteria, which has three main goals.  The first is simplicity, both for consumers’ understanding and for administration.  Next, they strive to be completely focused on the consumer.  They will offer the basic health care that consumers need for the lowest possible price.  Lastly, the Exchange will put a strong emphasis on primary care so that people are taking an active approach to consistently maintain their health.

Nine different carriers have already showed interest in joining Connecticut’s health insurance exchange when it starts offering plans October 13 of this year.  Each insurer will have to offer a standard plan design in each tier, but can also offer another of their own to encourage competition and new ideas.  In addition to the four above mentioned tiers, three more silver plans will be available to lower income families.  The Connecticut Insurance Department will approve all of the plans once the insurance carriers iron out the details of what they will offer consumers.  All plans will be certified by the Exchange.  Look for Connecticut’s health insurance exchange to be up and running this October.

Rewards & Penalties for Health Care Choices

Wednesday, January 23rd, 2013

Well, this sounds like a fantastic idea to me.  Some experts in the health insurance industry have suggested making health insurance more like car insurance.  The better you take care of yourself, the cheaper your health insurance rates will be.  It certainly gives people incentives to drive the speed limit and avoid accidents when their car insurance rates will increase if they don’t follow the rules.  It makes sense that getting a discount for being healthy would push Americans to exercise more, eat healthier, and avoid unnecessary doctors visits, all while keeping their yearly check-ups for health maintenance.  The Marketwatch article by Jen Wieczner asks “Should health insurance be like car insurance?”  I think that it should.

Both employers and health insurance companies have been pushing Americans to make lower cost health decisions for awhile now.  They recommend seeking urgent care help before more expensive emergency room visits and may even recommend a gym membership to stay healthy.  A lot of times the consumers don’t save any money when they make these healthy or low-cost decisions though.  Insurance companies and employers might save money, but there is little to no incentive to the consumer if they aren’t seeing any of this savings.

The results for companies who have already started either rewarding those who help lower costs or penalizing those with higher health risks are pretty astounding.  IBM gives employees $300 rebates each year if they are members of nutrition and fitness programs.  From 2005 to 2007, this alone helped the company save $190 million in health care costs.  The employees at IBM spend 60% less on health care than the average in the industry.  Almost 40% of companies offering health insurance charged more in premiums or deductibles to those who are considered unhealthy, including smokers, obesity related illnesses, and those with high cholesterol.  On the other end, 80% of companies says they will offer some type of financial incentive for their employees who demonstrate healthy behavior.

JetBlue is offering great cash back incentives for employees who take charge of their health, in essence saving both the company and the employees money.  A lot of companies are actually saving money on health care costs by getting rid of the copays for generic drugs, second opinions, and also for preventative care.  Companies are stressing that they don’t want individuals and families to stop going to doctors to save money, they want them to take charge of their health and make good decisions about when to be seen.  So far, that seems like the best way to lower overall costs for companies and individuals.  Experts say that paying employees a percentage of what they save would be a good goal for the future.  If they need a CT scan and choose to get it at an outpatient facility rather than a hospital, they could save thousands of dollars for the company.  Getting a percentage of that in their pocket or towards their HSA is great incentive to be financially responsible when it comes to health care spending.

Mississippi’s Health Insurance Exchange Controversy

Thursday, January 17th, 2013

There has been a battle in Mississippi over implementing President Obama’s health insurance exchange.  By 2014, states have to either run their own health insurance exchange or the government will run one for them.  Most of the leaders in Mississippi are Republican, so it was definitely strange to see a battle between two Republicans over this issue.  Mike Chaney, the state’s Insurance Commissioner, was challenged by Governor Phil Bryant because he doesn’t agree with the health insurance exchanges at all.  Bryant is worried that implementing a health insurance exchange is going to allow the federal government a way to force states to expand Medicaid.  Governor Bryant and other Republican Governors are very against this.

Attorney General Jim Hood ruled in favor of the Insurance Commissioner, who now will be able to implement and run Mississippi’s health insurance exchange.  According to the Insurance Journal article “Mississippi AG: State Insurance Chief Has Health Exchange Authority,” Chaney’s office has already been working on plans for their exchange for months.  Some conservatives in Mississippi feel that the Republican Chaney is promoting the health insurance exchanges and in turn, big government by his willingness to create an exchange.  But he says it is just the opposite.  He believes that if the state does not create its own exchange and lets the federal government run Mississippi’s exchange, they will be much more likely to expand Medicaid and make other decisions that the Governor is opposed to.

The Mississippi Insurance Department has already submitted their exchange information to the federal Department of Health and Human Services.  The HHS had yet to approve the submittal because of the battle between Chaney and Gov. Bryant.  Now that Chaney has the legal authority to manage the health insurance exchange, Mississippi will wait for federal approval.  A Governor spokesperson hinted that Bryant is not going to let this battle end anytime soon, although it might be in the best interest of his state to just go with the flow of the new healthcare laws.

Buying Health Insurance From a Storefront

Sunday, January 6th, 2013

I must say that I’m really intrigued by the concept of store fronts where they sell health insurance.  According to The San Francisco Chronicle’s “Health care coverage sold in stores,” Alex Nussbaum says that UnitedHealth Group is one of the driving forces behind this change in the industry.  As the largest medical insurer in the United States, UnitedHealth Group is trying out this retail plan in anticipation of the health care changes taking place in 2014.  When the individual health insurance mandate goes into effect, there could be 85 million people comparing plans as they shop in public and private health insurance exchanges.  Those Americans account for nearly $600 billion in spending power.

UnitedHealth has already opened 8 retail health insurance stores in the U.S., mostly for helping current customers now, but hopefully to bring new business in as well.  Their storefront locations are located from New York to Los Angeles.  The company has also made 16 mall locations throughout the central U.S. permanent retail shops.  Opening retail storefronts is a way for health insurance companies to get their name out there and let potential customers know how much help they can offer when they can walk in just as they do to their bank.

Highmark, Inc. of Pennsylvania has already opened 9 storefronts, while Blue Cross Blue Shield of Florida has 11 places for customers to get health insurance information.  Experts point out that these retail stores have to provide valuable services to their customers and potential customers in order to gain any significant business from the storefronts.  They can’t just be a marketing tool; they have to add value and really help consumers.  Answer questions that no one else can, give discounts not available elsewhere, and really help consumers figure out how the new health care laws affect them and their health insurance.  But many people appreciate all of the extras offered in addition to information.  Some storefronts offer blood pressure and other health checks or are attached to medical care facilities.  Others have translators for many languages and toys to keep children occupied while parents get information on anything from healthy eating to health insurance quotes.  Next time you are walking down the street and see a health insurance storefront, you may want to stop in and check it out.