Archive for the ‘UPMC health insurance’ Category

Pennsylvania Health Insurers Offer Low Cost Non-Compliant Plans Through 2017

Sunday, April 27th, 2014

Pennsylvania is one of nine states that is giving health insurance customers a break before forcing them to adhere to Affordable Care Act guidelines.  According to the Pittsburgh Business Times’ Kris B. Mamula, Highmark health insurance is the latest company offering renewals that don’t meet all of the new insurance mandates.  In “Highmark prepares new renewal plan health insurance,” we learn that Highmark is following in the footsteps of UPMC Health Plan with their new renewal options.  UPMC was the first company in western Pennsylvania to offer these non-compliant health insurance plan renewals that are lower cost.  They started offering these plans four months ago.  Highmark Inc. will be offering new renewal plans to employers who provide health insurance coverage.  The options will be available during both the July and December enrollment periods.

Plans were introduced during an insurance broker meeting last week.  Although minor details were not yet given to the public, Highmark is calling the plans “grandmothered plans”.  These lower cost plan options do not meet the requirements of the Affordable Care Act.  Insurance companies in Pennsylvania and eight other states have a three-year window where they can continue to offer their existing health insurance plans without penalty.  They will have to meet the Affordable Care Act guidelines in 2017, but the added three years gives employers some time to plan out their course of action.  More details are expected to be released by Highmark soon.

When UPMC started offering their lower cost plans, premium increases were between 0 and 48%.  Plans that incorporate the mandated coverage from the ACA had premium increases 100% and greater.  Insurance brokers who were at the recent meeting said that Highmark will be offering more flexibility with their non-compliant health insurance renewal plans.  Highmark is also likely to see a large increase in sales of their Community Blue plans, which limit the network of providers available.  It’s good news to employers and others who will benefit from the three year reprieve given in Pennsylvania and eight other states.  But eventually they will all have to meet the new guidelines put into place by the Affordable Care Act.  They will save money and have added time to determine their best plan options starting in 2017.  But in other states, health insurance companies will already be settled into their new health plans and insurers in these nine states will have to play catch up.

Highmark Hopes to Rival UPMC’s Health System

Wednesday, November 14th, 2012

Highmark, Pennsylvania’s largest health insurance company, is hoping to rival the hospital system of UPMC some day.  They have been looking to merge with West Penn Allegheny since earlier this year, but the deal soured recently.  According to Alex Nixon of The Pittsburgh-Tribune Review, leaders of both companies have been ordered by a judge to keep working on the deal, at least until the contract expires next May.  In “Highmark, West Penn Allegheny Meet to Resurrect Merger,” Nixon says that the companies put out a joint statement saying that they will work once again on the $475 million deal.

There are multiple issues that the company leaders are working through, most which pertain to the finances of West Penn.  West Penn is the second largest hospital system in the region, but is losing money and operating with a critical financial crisis.  Their pensions are underfunded by $280 million, so Highmark suggested that the federal Pension Benefit Guaranty Corp. take them over.  Bondholders are owed $750 million and Highmark is requesting that number be reduced to $400 million before the companies join forces.  William Penn’s operations lost $112.5 million during the fiscal year ending this June 30.

Highmark made these financial requests during an injunction hearing.  A judge allowed Highmark an injunction preventing West Penn from talking with other interested parties until May.  West Penn said that they had the right to talk with others because Highmark wanted them to go through bankruptcy because of the bond and pension debt.  They believed that Highmark had broken their contract with that request.  But now the two sides will be working together again and trying to secure a formal deal for West Penn’s five hospital health care system.  Acquiring the system is part of a $1 billion plan Highmark has to compete with UPMC.


Democrats vs. Republicans: What Changes Will UPMC Health Insurance & Others Have to Make?

Sunday, November 28th, 2010

In light of this month’s elections that increased the Republican strength in the Senate and saw them take over the House, there may be some tweaking of the health care bill.  In “Sen. Reid says willing to tweak healthcare law” from numerous  contributors on Reuters, U.S. Senate Majority Leader Harry Reid stresses that the tweaking will not ‘denigrate’ the health care law and that he intends to extend tax cuts to the middle class that were put in place by President George W. Bush.  He will not push to extend the tax cuts to the wealthy, however.  Due to strong opposition from Republicans, Reid and other Democrats will compare health insurance changes enacted by the reform and update the bill with Democrats and Republicans working together.

Reid stressed that they do not plan to undo the changes made that will help protect Americans from the insurance industry that he and others believe was bankrupting them.  While Republicans in the House want the entire bill to be repealed, Reid hopes that they instead will work in a partisan way to satisfy both sides.  He also stressed that he had hoped Republicans would work with the Democrats while drafting the bill instead of fighting against it.  Insurers like UPMC health insurance await the results of these talks to see what health care reform changes they will ultimately be making.

Tax cuts from President Bush will expire on January 1 of next year, so Democrats also have to figure out who will get an extension on those tax cuts.  The majority of Democrats want to extend the cuts to families with an income below $250,000 and individuals with an income below $200,000, but Republicans and a small segment of Democrats want to maintain tax cuts for everyone.  While working together seems to be the ideal solution to any problem, that is easier said than done for Democrats and Republicans.

UPMC Health Insurance For Retirees Abroad

Tuesday, September 28th, 2010

earthFor those looking to retire abroad, it may be difficult to find health insurance but it surely isn’t impossible.  “How to Find Retiree Health Insurance Abroad” by Kathleen Peddicord of U.S. News & World Report discusses this issue.  It’s possible that you will even find health insurance for better prices overseas than you could in the U.S. from reputable companies like UPMC health insurance.  Just as it is in the U.S., it is crucial that you understand your policy, all the details of your coverage, your deductibles and your premiums.  Especially if you are moving to a country speaking a language other than English, you need to make sure you know all the fine print.

Even within a country, all of the plan details and costs can vary significantly when you start to compare health insurance.  Some insurance carriers only accept applicants up until a certain age so that is important to research before deciding to move away for retirement.  You can get a comprehensive insurance policy in the Dominican Republic for under $90 a month as a 60-year old man.  In Uruguay, you can get top notch hospital-based coverage for $50 per month, but it can only be used at that hospital and is not technically health insurance since you can’t use it elsewhere.

Prepaid medical center programs are your best bet in countries like Ecuador.  Humana is one of the leading insurers in Ecuador offering this program, where a 75-year old man can get basic coverage for less than $90 per month.  In Ireland, there are insurance plans that even cover you out of the country for as low as $60 per month.  Malaysia has long been known as one of the  most affordable places to get health care that is excellent.  Many of their medical staff speak English and trained in Western countries.  You can find plans under $20 a month for a 50-year old man.  Regardless of the location you desire to retire, don’t forget to research your health insurance options before moving out of the U.S.

Highmark’s New iPhone App

Sunday, August 29th, 2010

phoneHighmark health insurance and A.D.A.M. have come out with a new iPhone application called Health@Hand.  A.D.A.M. provides health information and innovative solutions for benefits technology in the health industry.  They partnered with Highmark to launch this application which will be available to all members of Highmark through the online iTunes store.  Health plan members can now get a wealth of information right from their iPhones including articles, information on first aid, discounts on services, and local provider and facility information.

The Pennsylvania-based health insurance company’s Health@Hand was based off of their member’s specific plan and provider information.  It is possible that other Pennsylvania-based health insurers like UPMC health insurance could come out with similar plans through A.D.A.M. in the future.  Current Highmark plan members can use the GPS in their phone to locate specific doctors, specialties and facilities near them.  They can even get a map of the location and connect directly to the office via their phone.  Another unique option members have is the availability of information by simply touching a specific body part.  Members can even change the gender or age for specific information.  The product can also be downloaded by non-Highmark members through A.D.A.M. and iTunes.

UPMC Health Insurance Could Suffer From Reform

Friday, July 30th, 2010

kill the billWhile the health care reform bill passed by President Obama means well, the state of Massachusetts has already tried something similar without much success.  According to The Washington Post article “As Massachusetts health ‘reform’ goes, so could Obamacare,” columnist Robert J. Samuelson doesn’t believe that Obama’s plans will do much to solve the health care crisis.  By putting caps on premium increases for companies like UPMC health insurance and other small and large insurers, it could easily put them out of business or into bankruptcy.

Massachusetts started by expanding the state-subsidized insurance coverage, but failed to get health care costs under control or make sure that people’s overall health actually is improving from this policy.  Currently, the federal government plan has begun the same way.  Most individuals in Massachusetts are required to compare health insurance coverage and purchase some form.  Middle class families earning too much to qualify for Medicaid but with incomes less than three times above the poverty level receive state subsidies.  Insurance coverage has increased from 87.5% of the (non-elderly) population in 2006 to 95.2% in 2009.

It’s hard to tell whether there has been any improvement in health since many uninsured people were young and healthy.  It will likely take many years to determine that.  But emergency rooms are still full, workers are taking home less pay because of their insurance costs, and less money is being spent on schools, police, prisons, roads, and more because of the increase in health care spending.  While ideas have come about to help decrease overall health care costs and spending, such as per-patient fees combining doctors to make treatments higher quality rather than quantity, nothing has had enough of a blueprint to actually be tried.  There is a dangerous possibility that this unchecked spending on healthcare will increase taxes and budget deficits and hardly show any health gains.

UPMC Health Insurance Stores

Thursday, June 3rd, 2010

retail storeHighmark health insurance currently operates two retail health insurance stores in Pennsylvania.  They are the only company to offer such a service in the state and because of the stores’ success they’ll be opening four new Highmark Direct locations.  The current stores in Pittsburgh and Mechanicsburg have been operating just over a year and have seen tremendous success.  Highmark Inc.’s President and CEO says that the goal of these retail locations is to help Pennsylvania residents get the health insurance information that they need in order to make informed decisions about their care.  With the success of Highmark’s retail stores, it is possible that other Pennsylvania insurers like UPMC Health Insurance might take interest in offering similar services to their clients.

All of Highmark’s new stores are slated to open this year.  Their locations will be in Monroeville, Robinson Township, South Hills, and Harrisburg.  Customers have been requesting more one-on-one service from companies for years; Highmark is meeting this request with their retail stores aimed at explaining the health insurance options that are available and helping customers decide what will be best for them.  Highmark sells individual plans, senior plans, and small business plans to customers located in their service area.  They also sell dental care through their subsidiary iDental.  This innovative way to sell health insurance may catch on in surrounding states.  Ohio’s Aultcare could be the next company opening retail stores to help their customers get one-on-one health insurance service.

Doctors Get Pay for Performance: Will UPMC Health Insurance Be Next On Board?

Monday, May 17th, 2010

philadelphiaThere’s an interesting concept coming out of Philadelphia where doctors are being rewarded for helping to improve your health.  In “Philadelphia Insurer To Implement Pay-for-Performance Model” from The Philadelphia Inquirer, the plan is detailed.  Independence Blue Cross is Philadelphia’s biggest health insurer.   Their newest program is a pay-for-performance model where doctors will get paid more as their patients’ health improves.  They want to reward those primary care physicians who are offering higher quality care at a lower cost.  These are the doctors who use “patient-centered medical homes” which give patients better access, follow guidelines for treatment, educate people to manage their own health, and easily prescribe needed medications.

With Philadelphia’s largest health insurer implementing this new plan, maybe other Pennsylvania insurers like UPMC health insurance will follow with similar programs.  Doctors are happy with this new plan because their primary and preventative medical care will be strengthened as will the way they finance it.  Many doctors are worried that the increased administrative burden will be high though and they hope the plan will help to pay for that.  According to Independence, patients’ health has already improved.  The diabetics seeing doctors in the program improved their blood sugar levels and even their blood pressure by nearly twenty-five percent.

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.

Fallon Health Insurance: Health-Care Bill Timeline

Friday, March 26th, 2010

calendarThe passing of the health-care bill on Sunday will bring about changes in the industry for individuals and companies like Fallon Health Insurance.  In The Washington Post’s article “When does the health-care bill go into effect,” the newspaper summarizes the timetable.  The first change should happen within the year, offering a rebate of $250 for Medicare recipients whose initial prescription drug coverage has run out.  Within 90 days, people who were denied insurance based on preexisting conditions will have access to high-risk pools.  Changes that will come about for insurance companies within 6 months include a requirement for children to remain on their parents’ policies until age 26 if they desire and the banning of insurance companies imposing lifetime coverage caps, denying coverage when people get sick, and denying children with preexisting conditions coverage.

By 2011, individual and small group insurance plans like UPMC Health Insurance are required to use 80% of premium money towards medical services while large group plans must use 85%.  The Medicare payroll tax will be increased and expanded by 2013.  Families who earn 400% or less of poverty level income will receive subsidies to buy health insurance by 2014.  Also that year, most employers will have to provide insurance coverage or will receive penalties and most Americans will have the same stipulation for obtaining health coverage.  High-end insurance policies will have an excise tax of 40% imposed in 2018.  And by 2019, health insurance will cover 32 million more people than it does today.