Archive for July, 2014

Massachusetts Consumers Receive 2nd Highest Health Insurance Refunds in the U.S.

Thursday, July 24th, 2014

You could be one of the millions of Americans getting a refund from your health insurance company soon.  The Affordable Care Act has a law called the 80/20 rule, where insurance companies have to spend at least 80% of total premium costs on medical care or improving the quality of health care for consumers.  In The Boston Globe’s “Health Insurance Companies Refund $15B to Mass. Consumers,” Chelsea Rice talks about the refunds going out and the companies who will be paying them.  The U.S. Department of Health & Human Services released this data showing that Massachusetts consumers will be getting the second highest amount of refunds in the United States.  The total refund amount for the U.S. is $332 million, which will pay around $80 a family those those receiving refunds.  Florida health insurance companies will be paying the most refunds with $41.5 million owed.  Massachusetts residents will be paid out $15 million, which amounts to $133 per family getting a refund.

Almost all of Massachusetts’ residents have health insurance, most through their employer, but 1/4 of them still struggle with the burden of high health insurance costs.  The ACA’s 80/20 rule brings transparency and competition to the health insurance marketplace.  It also offers greater value to consumers in their health insurance plans.  Large group plans have to follow an 80/15 rule.  Insurance companies operate more efficiently when they are following this rule by cutting out unnecessary expenses.  They have been able to lower premiums throughout the U.S. by $3.8 billion.  Companies who do not follow the 80/20 rule during their fiscal year have to refund the excess they spent to consumers in their health insurance plan.  Those receiving refunds will get them by August 1 either by check, a discount in next years premium, an account reimbursement or a direct reimbursement through their company.

In Massachusetts, more than 208,000 consumers will be receiving an average refund of $133 per family.  This new 80/20 rule has made quite a shift in the amount of upfront value that consumers receive from their health insurance plans.  The biggest shift by far has been in the individual health insurance market.  Back in 2011, the HHS found that 61% of consumers in the individual market received upfront value from their plans.  Just two years later, 81% of people are receiving upfront value from their individual health insurance plans.  Ten health insurance companies in Massachusetts will be sending out refunds, including Fallon Community Health Plan, Neighborhood Health Plan Inc. and Tufts Associated HMO.  If you are one of the Americans receiving a refund from your health insurance company, look for that in the next week.

5 New Entrants to Indiana’s Health Insurance Exchange

Sunday, July 20th, 2014

Residents of Indiana are getting some new health insurance choices in the state’s health insurance exchange.  According to The Courier-Journal’s “Indiana health insurance market to see changes,” Maureen Groppe says that five additional companies will be selling plans in the state exchange this year.  There are currently four companies offering plan choices in Indiana.  Out of the 16 states that make their information public, Indiana has the most new entrants.  There will be some rate changes by the four companies who are already selling in Indiana’s exchange.  The highest change is a 96% increase and the lowest change is an 11% decrease in plan costs.  More choices mean that Indiana residents who already have health plans could get rates that are significantly lower than their current plan rates.

More than 130,000 Indiana residents purchase health insurance outside of an employer program or Medicare.  It’s possible that number could double next year as more uninsured Americans seek health insurance plans through the government exchanges and individual companies to comply with the individual mandate.  CareSource is one of the new companies to Indiana’s exchange and plans to offer very low, competitive rates.  Their rates are so low in fact, that the state regulators questioned the insurance company’s filing.  Premium prices will not be set in stone until just before the November 15 open enrollment period.  But the state filings help the market get a feel for what is going to happen in the fall.

Overall health care costs are increasing by 5.4%.  Insurance companies have to justify increases in premiums that are much more than the increasing cost for health care.  Some insurance companies face a greater amount of claims than others.  Indiana is changing the way that their disabled residents qualify for Medicaid, so close to 7,000 people with higher medical expenses will be entering the individual health insurance market next year.  Since these Affordable Care Act rules are fairly new, insurance companies are still trying to maneuver this health insurance market where they cannot deny coverage to people with preexisting conditions.  Companies are seeking rate increases and also lowering premium costs based on regions in the state and the tier level of different plans.  It will take a few years for health insurance companies to determine exactly what premium changes need to be made based on what happens each year with costs and new members.

You Could Lose Your Health Insurance When Your Parent Dies

Sunday, July 13th, 2014

The last thing you are worried about when a parent dies is what will happen to your health insurance coverage.  But unfortunately for many young people, they also lose their health insurance coverage when their spouse dies.  This also holds true for spouses, including those with young children.  In the U.S. News & World Report Health article “What to Do When You Lose Your Health Insurance,” Geoff Williams offers up options for those who lose their health insurance unexpectedly.  The article gives the example of a 30-year old woman who lost her health insurance coverage when her father passed away in April.  She has ulcerative collitis, a bowel disease that could cause serious complications without her medication and doctor visits.  She found out that she had lost her health insurance when she tried to fill a prescription and her insurance was declined.  It cost her $200 out of pocket just to buy the four pills that she needs for one day.

It’s not common for a 30 year old to have health insurance coverage under her Dad’s plan, so the woman in the example was lucky to have such a perk.  In this particular instance, her Dad had carried individual health insurance with his carrier for so long that they allowed him to keep his daughter on his plan to age 31.  She would have had to search for health insurance soon anyways, so she was likely already researching her options.  If you don’t have health insurance coverage, you can shop for it at any time.  The Health Insurance Marketplace open enrollment period is from November 15 to February 15, but the government dates aren’t necessarily written in stone.  You can apply for a health insurance plan at any time when you have had a life change that took away your health insurance.  You can also apply for health insurance with an individual health insurance company at any time during the year.  Most companies have open enrollment periods similar to the government, but for a shorter period of time.  You can make changes to your plan during that time, unless you have a life changing event some other time during the year.

Life changing events include death, the birth of a child, marriage, divorce, a change of income, relocation, or the sudden loss of health insurance.  If any of these events happen to you, the government gives you a 60 day grace period to obtain health insurance in the exchange.  You can get health insurance quotes from multiple companies here.  You can also use an agent that works for one health insurance company or a broker that shops the health insurance marketplace for you.  The last option is similar to shopping the market for health insurance with comparehealthrates.com.  Medicaid and the Children’s Health Insurance Program are available to those with low income.  COBRA is a health insurance option for people who have just lost their jobs, and therefore their health insurance coverage.  If your parent dies and you lose your health insurance, there are options for you to find health insurance coverage.  The woman in the article was able to get her insurance plan extended until August 1 so that her daily medication is covered, so she had a couple months to search for her own health insurance plan.