Archive for January, 2014

Many Target Employees Now Searching for Health Insurance

Tuesday, January 28th, 2014

Part-time employees working at Target stores are searching for new health insurance policies right now.  As of April 1, Target’s part-timers are no longer eligible for the company’s health insurance plan.  This information comes from Bloomberg’s Alex Wayne in the article “Target to Drop Health Insurance for Part-Time Workers.”  They are following in the footsteps of Trader Joe’s, Home Depot, and other large retailers in the U.S.  Last year, the company had more than 361,000 workers.  They would not specify how many of those workers are part-time, which means that they work fewer than 30 hours a week.  But Target did say that only 10% of their part-time employees actually opted to take the health insurance offered to them.  This could be because they are students on their parents’ plans, have a spouse with health insurance, or forgo having insurance altogether.

Target is making these changes because of President Obama’s U.S. Patient Protection and Affordable Care Act.  Companies with more than 50 employees must offer health insurance plans to their full-time workers or they will be penalized.  Most Americans will also be penalized if they are not insured.  But Target insists that their part-time workers will be better off searching for their own health insurance plans.  If they qualify for a government subsidy, they can buy a plan from a health insurance exchange and pay less than they would with Target’s plan, according to the company.  This allows both the employee and the company to save money.  It’s not apparent how many of these Target workers will qualify for a subsidy though.  Those who don’t qualify might end up paying more for their health insurance than they did with Target.  If you are looking for a cheap health insurance plan, you can receive affordable quotes here.

Employees shopping in the health insurance exchanges have until the end of March to meet the open enrollment deadline.  This lines up with the end date of Target’s insurance plan for their part-time workers.  Target insists that people will not have their hours cut just so that the company no longer has to offer them health insurance plans.  They say that this will only apply to those who are already part-time, but only the employees will know if this holds true.  If it’s true that only 10% of their part-timers opted for company health insurance anyways, this change may not make a large impact overall.  But with the company withholding figures on the number of part-time workers and those close to the cusp of 30 hours, I’m not sure how many people truly will be affected by this health insurance change.

If Aetna Leaves the Exchanges, Others Likely to Follow

Thursday, January 23rd, 2014

With all of the ruckus over the Affordable Care Act, there is one aspect that we haven’t considered yet in this blog.  Health insurance companies might start backing out of the exchanges if things don’t go as planned with enrollment.  So far, not enough young and healthy people have purchased insurance through the exchanges.  This puts the entire plan out of balance because young people help to keep the costs down for everyone involved, including the insurance companies.  According to CNBC’s Matthew Belvedere, “Aetna could be forced out of Obamacare: CEO.”  Aetna’s CEO, Mark Bertolini, worries that the age of enrollment and Medicare changes could force his company out of the health insurance exchanges.  They have to publish their health insurance rates in the exchange for 2015 by May of this year.  As of now, they don’t have enough information to decide whether they will have double digit gains, smaller gains, or have to leave the program altogether.

According to Aetna’s CEO, the majority of people who have bought health insurance in an exchange already had individual health insurance.  They just switched to an exchange to save money because of the available federal subsidies.  Right now, 11% of the people buying in exchanges were fully uninsured before the Affordable Care Act.  That statistic isn’t promising to support the claims that this act would help insure nearly all Americans in an affordable way.  Mr. Bertolini says that the exchanges need more choices in them.  More insurance companies need to offer plans in the exchanges in order for them to actually function like the marketplace they were supposed to.  This will bring more Americans into the exchanges to search for health insurance.  This could also bring more younger, healthier people into the exchanges.  These young Americans help keep rates down for everyone.  Plans from the Afforable Care Act only make up 3% of Aetna’s revenue, so they aren’t concerned about it making or breaking them.  It seems to me that the process is more of a headache to Aetna as it stands now.  Aetna’s CEO forecasts a large number of people using exchanges over the next 6 years, but says the majority of those will be in private exchanges rather than public.


Insurers Will Now Offer Better Mental Health & Addiction Coverage

Saturday, January 11th, 2014

There is some great news for Americans struggling with mental health or addiction who were having problems with their insurance coverage.  Insurance plans offered in the federal and state run health insurance exchanges are required to offer coverage for mental health care and addiction treatment under the 10 essential benefit requirements.  This information comes from The New York Times article “Understanding New Rules That Widen Mental Health Coverage,” by Ann Carrns. This coverage expansion is welcome news to millions of Americans who have been suffering with seemingly no hope for help.  Whether they couldn’t find an insurance plan that offered mental health coverage or the benefits were not the same as medical coverage, they will now have help.

Inclusion in the 10 essential health benefits is not the only change affecting mental health and addiction treatment.  Back in 2008, the Mental Health Parity and Addiction Equity Act worked to make mental health coverage the same as coverage for physical health ailments.  While they have had a long road, parity rules will finally take effect in July of this year.  Most health insurance companies will have to follow these rules in their individual and family insurance plans starting next January.  When insurance companies offer mental health coverage, they will not be able to charge higher deductibles or co-pays for these visits than they do for medical visits.  They also cannot limit the number of mental health visits allowed in a more restrictive way than they do for medical visits.

Some insurance companies already follow the parity rules, but how they comply with them will now be detailed by the government.  They can’t limit the geographical region for mental health coverage if they don’t limit it for medical coverage.  Insurance companies cannot make it more difficult to get pre-approval for inpatient mental health treatments than they do for inpatient medical care.  They also have to make it clear to consumers what criteria they are using to determine their ruling.  This is good news for consumers who have been struggling to get mental health care because the insurance coverage was less adequate than their medical coverage.

It’s important to note, however, than it won’t necessarily be easier to get mental health treatment because of one big factor.  Around half of psychiatrists do not accept private health insurance as payment, mostly because their reimbursement has been terrible in the past.  Since these new rules are going in effect, it is possible that more office based psychiatrists will accept private insurance in the next few years.  Be an advocate for yourself and make sure that you know the laws and rules that apply to mental health and addiction coverage.  If you are having a hard time with your insurance company or can’t find a therapist who will accept your plan, there are free services to help you locate one.

How Children’s Health Insurance Differs From Adults

Tuesday, January 7th, 2014

The new health insurance laws affect children differently than adults.  U.S. News & World Report’s article “How Obamacare Affects Children” discussed the differences so that parents know what to expect.  Kimberly Leonard got information from the Urban Institute, Georgetown University’s Center for Children and Families, First Focus and the American Academy of Pediatrics for this list of how children’s insurance will be different from adults.  First of all, children did not have to wait to shop for health insurance in the new health insurance exchanges.  They were already eligible through Medicaid and the Children’s Health Insurance Program (CHIP).  This program has been available to uninsured children at either no cost or a very low cost.  This federally or state run program drastically lowered the number of uninsured children to a number that is still a record low.  But even though the number of uninsured children is at a record low, one in ten kids in the United States was uninsured before the Affordable Care Act took effect.

Now that millions of parents will be getting health insurance because of the Affordable Care Act, many of the 7.6 million uninsured children will also get health insurance coverage.  Parents may be shopping in the health insurance exchanges or comparing health insurance from companies so that they will not be penalized for not having coverage.  Some parents whose children qualify for public health insurance plans might be better suited signing their kids up for that then adding them to their new private health insurance plan.  Compare the benefits and costs and make sure that your child’s current pediatrician is covered if you want to stay with them.

The biggest news for children under the Affordable Care Act is the large amount of services that private health insurance plans must offer, many of them for free.  There are 26 preventative services that are now covered without the payment of a copay, deductible, or co-insurance.  Kids with pre-existing conditions can no longer be denied health insurance coverage because of their disability or health issue.  There are also 10 Essential Health Benefits services that have to be covered by private plans and health insurance exchange plans.  These include vision and dental coverage for kids, emergency services and more.  Kids over the age of 19 don’t have to be covered with vision and dental, so consider that when shopping plans.  One of the biggest benefits to parents and older children was the inclusion of kids under their parents’ insurance until the age of 26.  Some young adults aren’t offered health insurance at their first jobs, so being able to maintain coverage through their parents is the only way for them to have health insurance.  This list includes many of the ways that health insurance for children is different than insurance for adults and the added benefits that kids can receive.