Posts Tagged ‘individual health insurance’

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Individual Health Insurance Reform Update January 2011

Thursday, January 27th, 2011

Last Wednesday, Jan. 19, the United States House of Representatives voted 245-189 to repeal the nation’s individual health insurance reform law, the Affordable Care Act. While a full repeal is not expected, we should see a number of congressional hearings on the topic over the next few months.

The Affordable Care Act extended to insured group health plans the non-discrimination provisions found in the Internal Revenue Code, which previously had been applicable only to self-insured group plans. Effective for Plan Years which begin after Sept. 23, 2010, non-grandfathered health insurance plans are prohibited from discriminating in favor of highly compensated employees, and a penalty is imposed of $100 per day per participant on plans that discriminate. However, in Notice 2011-1, the IRS has delayed the application of the non-discrimination provisions of the Affordable Care Act until after regulations or other administrative guidance of general applicability have been issued. Notice 2011-1 also indicates that the penalty for failure to comply with the non-discrimination provisions will also not apply until the required regulatory guidance is issued.

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Individual Health Insurance Legislative Update January

Wednesday, January 5th, 2011

The Department of Health & Human Services (HHS) has released a proposed regulation that would institute a new review process for requests by individual health insurance companies for rate increases.

The proposed rule, announced Dec. 20, 2010, would institute a new review process that may be administered by states if HHS determines that they have an “effective” rate review program, or by HHS if a state process is not considered effective. HHS expects to implement the new process by July 2011.

HHS proposes that this process become effective for rates filed or in use on or after July 1, 2011, in the individual health insurance and small group markets. This rule would not apply to grandfathered or excepted benefits.

In states that are determined to have an “effective” rate review program, HHS will defer to the state to determine whether a rate increase is unreasonable. However, the state must still report to HHS its determination – whether reasonable or unreasonable – and include a rationale for making its decision.

HHS defines an effective state review process based on the following four factors:

* Whether the state receives data and documentation from individual health insurance carriers sufficient to determine whether a rate increase is unreasonable;
* Whether the state effectively reviews the data and documentation submitted by the insurer;
* Whether the state review examines the reasonableness of the assumptions used by the issuer in developing its rate proposal and the historic data underlying those assumptions; and
* Whether the state applies a standard set forth in statute or regulations when making the determination of whether a rate increase is unreasonable.

The proposed trigger for the new review process is if an individual health insurance carrier’s “weighted average increase” is 10 percent or more for the rate filing. HHS lists what analysis must be done by states, which would include looking at reserve needs as well as the “risk-based capital status relative to national standards.”

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Individual Health Insurance Plan Tips

Wednesday, January 5th, 2011

Individual health insurance is not an easy thing to understand greatly because of the tremendous amount of health plan options that are out there.  The comparison between different companies and different types of individual health insurance plans is a challenge.  Most individuals just simply want basic private insurance.  The problem is that not everyone understands what that means.

Deductible
Individuals think that the only thing that matters in individual health insurance is the deductible.  Sure, deductibles are very important, but looking further into the plans is necessary.  For example, is a $3500 deductible plan at 20% coinsurance better than a $5000 deductible plan at 0% coinsurance?  Ask that question to the normal individual and they will say yes.  The correct answer is sometimes.  The reason is, the 3500 plan in most situations has a higher out of pocket maximum, where the 5000 plan has the lower out of pocket maximum.  Sure some individuals  have the time to go read about it and figure it out for themselves, but the average person will just simply go with the lowest deductible.

Price
The price for individual health insurance is not the most important thing.  Understanding the plan is.  If an individual health plan is a lot cheaper then all of the other compared plans there is always something wrong with it.  For example, Aetna insurance has what is called a value plan.  They are great, but you can only go see your doctor 5 times a year.  That may be fine for a lot of individuals , but what about a 50 year old.  Brokers are so important for these situations.  Aetna and most companies have this option, to spend less but also get less.  It is great, but people should know the difference.

Providers
Most individuals have a family doctor or someone in mind that they would like to see on a regular basis when purchasing individual health insurance.   The thing is most people think that their doctor will be in network no matter what, because they are purchasing a PPO plan where they can go wherever they would like to go.  The word “in- network” is very important, because it is the difference in being able to pay around $35 for a doctor’s visit or having to meet your deductible to see your regular doctor.  All the big insurance companies, Golden Rule, Aetna, Coventry, Humana, and Cigna all have a physician look up tool on their web pages.  So why not use them to your advantage.  I make sure that every one of my clients can use that free resource before they purchase an individual health insurance plan.  Imagine if a person is on vacation and they need to find a doctor fast, most people will panic. My clients will know that they can go to a computer and find an address and a number quicker than calling the back of their card.

Students
Another place where individuals are getting taken advantage of are in the school plans.  Sure something is better than not having anything at all.  However, college kids aren’t reading into these policies and how much coverage they really have.  Some of these health plans only allow a person to use $50,000 at the hospital.  That’s just not enough.  Especially when you can purchase a health plan with unlimited coverage for the same price by getting individual health insurance though Easy To Insure ME.  It is very hard for people to understand why they should seek advice from a professional. This is the exact reason why they should.

Easy To Insure ME
Individual health insurance plans are similar in many ways, finding the right one is the challenge.  So when trying to find the best plan for you at the best price, seeking a professional is key. Finding a good broker is as easy as clicking the link to EasyToInsureME.com.  All you will have to do is put in your basic information in the top right hand corner of the home page, and a professional will contact you within 24 hours. It is that easy.  Easy to insure me on the web.

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Posted in aetna health insurance, cigna, coventry health care, easy to insure me, EasyToInsureME, golden rule insurance, health insurance plan, humana health insurance, individual health insurance, student health insurance | No Comments »

Individual Texas Health Insurance Providers

Friday, December 17th, 2010

In Texas health insurance, a recently released joint study by the Health and Human Services Commission (HHSC) and the Department of Insurance that examines the consequences of the state losing Medicaid funding leaves little doubt that Medicaid withdrawal would harm the state economically. It would also deprive poor, elderly and disabled people of access to health care, likely raise property taxes, rob the state of tax revenue, and lead to increases in insurance premiums. Several conservative Republicans, including Gov. Rick Perry, had broached the idea of Texas opting out of Medicaid to help solve the state’s budget gap. That is likely to change, given the report’s conclusion that Medicaid withdrawal could result in 2.6 million Texans becoming uninsured. The report also notes that the state would surrender $15 billion in federal matching funds yet continue to pay federal taxes to support other states’ Medicaid spending. The spike in the uninsured population would also swamp the state’s hospitals in billions of dollars worth of uncompensated care. On the topic of Medicaid reform, the report discusses the need for a “market-oriented” reform that would convert Medicaid funding to block grants and provide states wide latitude to spend federal money as it sees fit. That could include funneling Medicaid money into private savings accounts that individuals could use to purchase coverage from private insurers on the open market, a strategy Perry supports. The topic will likely see public debate when the State begins its legislative session in January.

HHSC has confirmed how it intends to implement its share of the 2.5 percent budget cuts ordered last week by the state’s executive and legislative leadership. The agency said it will reduce its general revenue spending by $42 million, cutting Medicaid and CHIP provider rates by 1 percent for acute care. Reimbursement rates for nursing care facilities as well as community-based care will be cut 2 percent. All of these cuts are effective February 1 and will cover the remainder of the current fiscal year. These cuts come on top of a 1 percent provider rate cut that was implemented as part of the 5 percent budget cut exercise ordered in January by the state’s leadership. Those previous cuts drew criticism from the state’s health care providers who said doctors already lose money treating Medicaid clients and that rate cuts would force providers away from offering care to the state’s most needy. HHSC spokeswoman Stephanie Goodman explained that with Medicaid taking up so much of the agency’s budget, it only made sense to look there for budget savings.

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Health Insurance Medical Loss Ratio and Exchanges

Wednesday, November 24th, 2010

The Department of Health and Human Services (HHS) has released two new sets of guidelines: the long-awaited regulations governing the Affordable Care Act provision on Medical Loss Ratio (MLR) and the first of a series of guidance and rules to aid states in complying with a health care reform law to set up insurance exchanges by 2014. The MLR regulations, which go into effect in January 2011, require that large group plans spend at least 85 percent and small group and individual health insurance plans at least 80 per cent of premiums on clinical services and activities related to quality of care. Insurers who don’t meet the standards in 2011 will be required to issue rebates for that amount in 2012. We are now evaluating the new regulations and you will be hearing more about both in the near future. Health insurance quotes

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Posted in group health insurance, health care overhaul, health care reform, health insurance exchange, health insurance quotes, health insurance reform, individual health insurance | No Comments »

Health Insurance Quotes for Children

Friday, October 15th, 2010

Health insurance companies are reluctant to offer child only health insurance policies under The Obama administration and new health law. The Affordable Care Act also know as Obama Care, states that all future plans in the individual health insurance market for children age 18 and younger cannot deny coverage to children who have pre-existing conditions.

Some insurers decided to stop quoting and writing new business in the child-only market because of concerns that parents would not quote and enroll children until they get sick. Insurers can charge higher rates for children, which is not prohibited by the Affordable Care Act but is permitted by state law.

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Posted in buying individual health insurance, children, health care overhaul, health care reform, health insurance quotes, individual health insurance | No Comments »

Losing Cobra or Group health insurance coverage?

Thursday, September 2nd, 2010

Are you going to be losing your cobra or group health insurance coverage?

Many people today are losing their cobra coverage as the government extensions and subsidies are finally going away. To make things worse, with the new health care reform laws, employers are cutting coverage benefits as well. Some employers are even erasing the group health plans completely.

All in all this may be a benefit to you. Individual health insurance is affordable and anyone can apply for coverage. The best part is that if you have serious pre existing conditions and cannot be approved on a health plan that you can get a guaranteed issue plan.  The plan is guaranteed to offer you health insurance coverage if you have had creditable group or cobra coverage in the past 63 days. So take a look at the health insurance quotes and see which plan is going to be best for you and your family.

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Health Insurance Reform May Update

Tuesday, May 4th, 2010

While the underlying cost of health insurance services remains an under-reported issue, there are signs that this may be changing. The California legislature, for example, is beginning to turn its attention to rising hospital and provider costs, and not just the rising cost of premiums. Just in time, the U.S. Justice Department announced last week that California’s largest health care purchasers can proceed with an extensive study of the costs of care at more than 300 hospitals statewide. The California Hospital Association tried to block the project claiming antitrust concerns, but the Justice Department rejected the claim. Only by addressing costs throughout the health care system will the nation begin to slow the overall cost of health care and truly deliver on the promise of health care reform. Transparency remains a very important part of the equation.

Federal
In January, the U.S. Supreme Court ruled in the Citizens United case that the First Amendment protects the right of corporations, as citizens, to spend corporate funds on political advertising advocating the election or defeat of a particular candidate. In an effort to stave off an anticipated onslaught of corporate money infusion in this year’s elections, the Democratic majority introduced legislation last week to curb any such corporate activity. The core component of the legislation would require corporations (and unions) in the name of transparency to disclose their spending on political advertisement. This legislation is very likely to be a key subject of debate for the rest of the legislative year as Democrats seek to rally consumers and other groups in favor of the bill, and Republicans use the measure as a rallying cry against what they view as an infringement on the First Amendment.  It is not at all clear, at this stage, whether this bill has legs or whether corporations will even take advantage of the Supreme Court’s ruling. What is clear is that the issue will further drive a wedge between the two parties.

In response to WellPoint’s proposed rate increase in the California individual health insurance market in January (now rescinded), Senator Dianne Feinstein (D-CA) had proposed legislation to establish a Federal Rate Authority to both review “potentially unreasonable” increases in health insurance rates (in conjunction with the states) and to endow the federal government with new regulatory powers with respect to the Authority’s findings. Although this provision was not included in health care reform, Senator Feinstein now is poised to offer her bill as an amendment to other legislation moving through the Senate — starting with the financial regulatory reform measure currently before the Senate. The Feinstein proposal would further erode the traditional role of the states with respect to insurance matters and was opposed by Aetna and the insurance industry. Aetna will oppose this new tactic as well.

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Individual Health Insurance Fine 4 Million Will Pay

Friday, April 23rd, 2010

An expected four million people in the U.S can be fined for failing to buy individual health insurance by the year 2016. This is when when the health care overhaul law will be in full force. According, to the CBO forecast on Thursday.

United States citizens must buy health insurance and abide by the individual health insurance mandate set forth in the landmark legislation passed by Congress last month. If citizens do not comply they will face fines. People without coverage can be fined up to two and a half percent of their personal income.

The Congressional Budegt Office also forecasted that the government will collect close to $4 billion annually from these penalties between the years 2017 and 2019.

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Aetna Health Insurance Maryland Changes 2010

Wednesday, April 21st, 2010

Aetna is implementing a rate action for Aetna health insurance plans for individual, family, and the self employed in Maryland health insurance.

The new rates are effective July 1, 2010

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