Posts Tagged - ‘health insurance companies’

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Sebelius Urges Employers to Implement Group Health Insurance Earlier

Friday, May 28th, 2010

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The deadline for large group health insurance plans to expand coverage to the adult children of employees until the age of 26 is September 23rd. However, the actual date depends on when the new plan year begins, which can be as late as January 1st of next year for many companies.

Secretary of Health and Human Services Kathleen Sebelius is encouraging employers to enact this element of healthcare reform earlier than required. Doing so will be especially helpful to recent college graduates, who would otherwise be uninsured.

Will businesses comply? On the one hand, the demographic in question is generally healthy, so total costs shouldn’t rise all that much. On the other hand, premiums may increase. One study found that 16% are planning to expand their health benefits to this group.

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Are Health Insurance Company Mergers Good Or Bad?

Thursday, April 29th, 2010

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Corporate mergers are a fact of life. In recent years, more of them have occurred in the health insurance industry. The healthcare reform law may end up forcing more of them to merge or go out of business.

How do these mergers affect consumers? On the positive side, they allow firms to band together and negotiate lower rates from providers due to their combined policyholder base. However, they decrease the amount of competition and the choices of affordable health insurance available.

The latter is especially dangerous when the major health insurance plan providers in a state merge, leaving residents with few options. Antitrust law could be used to challenge the mergers, but it rarely has been. There are ups and downs, besides.

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Lobbyists Still Fight Over Health Insurance Reform

Monday, April 19th, 2010

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Most people believe that lobbyists for various interest groups have already had their say once legislation passes. You’d think so, but that’s not the case for affordable health insurance reform.

The main reason for the continued push for favorable enforcement is that the Department of Health and Human Services is currently formalizing regulations. Lobbyists are trying to influence the agency in order to get implementation that is more favorable to their side.

Health insurance companies, in particular, have a significant interest in how this plays out:

  • They want specific definitions of who is eligible to participate in the state health insurance exchanges. Obviously, they would appreciate eligibility to be as limited as possible.
  • In addition, insurers want clear information regarding the legal documents that must be given to consumers. They would probably prefer less paperwork, but HHS may require clearer wording.
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Are Health Insurance Companies Hypocrites?

Friday, April 16th, 2010

Image: Valerie Everett under CC 3.0

Most health insurance companies are ramping up their promotion of wellness campaigns. Their strategy involves reducing the cost of claims–and therefore the price of premiums–by improving the health of policyholders. Many of these programs involve weight loss and improvements in diet.

Strangely, it has been found that many insurers are major stockholders in fast food corporations! In total, they own about $2 billion worth of stock in McDonalds, Burger King, KFC, and Taco Bell; as well as other similar restaurants. These companies have been blamed for their role in America’s obesity epidemic. Insurers may also profit twice, because they have been able to charge higher rates to those who have overindulged in fast food and harmed their health–although healthcare reform will minimize that incentive, beginning in 2014.

Researchers at the Harvard Medical School believe that providers of individual, group, and family health insurance should use their clout as significant shareholders to push those chains to provide a wider selection of healthier products and offer smaller portion sizes.

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Is Health Insurance Plan Reform Truly Socialist?

Friday, April 16th, 2010

Image: Mike Licht under CC 3.0

One of the primary objections to the Obama administration’s health insurance reform is that it is a socialist takeover of a significant part of the American economy. While that is a legitimate concern, actual card-carrying socialists disagree.

According to Socialist Party USA co-chair Billy Wharton, the legislation that passed is far from socialist. Instead, it’s more of a “corporate restructuring”; it gives private sector health insurers millions of new customers with relatively little incentive to radically change their system. He considers the law as something that was written by private health insurance plan companies for their benefit.

What would real socialists have preferred? They would have liked a national single-payer system with a government-run public option. Tea party skeptics say that regardless of the fact that President Obama isn’t extreme enough for the far-left fringe, he is nevertheless promoting socialist policies.

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Group Health Takes A Hit: Humana Latest To Announce Job Cuts

Wednesday, February 17th, 2010

Little more than a month after Philly-based Aetna announced it would lay off an additional 1,250 workers after it issued a similar pink slip notice to 900 employees last November, Humana announced today it would be cutting 2,500 people from its payrolls after losing 11 percent of its enrollments in group health plans. The layoffs amount to about 5 percent of its workforce.

In making the announcement, Aetna president and CEO Michael McCallister said, “This regrettable but necessary reduction in our work force is a direct result of Humana’s need to align the size of our company with that of our membership.”

Humana said most of the cuts would come from attrition, outsourcing some of its business functions and not filling open positions, but told investors it expects to ramp up operations in Medicare and its mail-order pharmacy unit; both of which posted stronger financial results. For the quarter ending December, 2009, Humana posted a 44 percent profit, mostly attributed to growth in its Medicare business.

The move comes at a pivotal time for group health insurance companies, as leading economists and Wall Street analysts report that the U.S. economy is starting to show signs of job growth while Congress is scrapping its health care reform initiatives and starting over. Industry observers expect the U.S. government to introduce changes to the health insurance industry that would, in effect, make it more affordable for individuals to purchase individual and family health insurance policies directly from carriers and brokers. If passed, the change is likely to put an even larger financial dent in the group health insurance market.

Insurers that issue work-based health insurance plans have struggled over the past year to increase revenues, as the economic recession continues to wipe away jobs from the private sector. In addition to the job cuts at Humana and Aetna, other health insurance companies that specialize in group plans; such as CIGNA and Wellpoint, have eliminated more than 1,000 jobs in the past year. President Obama recently announced new banking and grant programs aimed at small business owners in hopes of staging a revival in the national job market.

Anthem Blue Cross of California, among other health insurance plans administered by Wellpoint, announced today it would cancel its previously announced investor conference that had been scheduled next Tuesday so it could prepare for a Congressional hearing prompted after the company said it would hike insurance premiums by 38 percent in May.

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Health Insurance Web Searches Spike, Says ComShare

Tuesday, February 16th, 2010

If there ever was a proof-positive sign the economy and its lingering layoffs are driving people to find their own health insurance plans, this is a big one.

ComScore, the people who measure all-things-online (working behind the iron curtains at Google, Yahoo! and other search engines) just released a study of online health insurance activity in 2009. The study found that nearly 24 million Americans visited a health insurance company Web site during the fourth quarter of 2009, representing 10 percent of the total U.S. online population.

Aetna led the pack of health insurance companies that attracted the most traffic with nearly 5 million visitors during October, November and December of 2009, followed by Blue Cross Blue Shield sites with 4.1 million visitors (17.4 percent penetration). Kaiser Permanente clocked in with 3.1 million; UnitedHealthcare snatched 2.2 million visitors; CIGNA got 2.6 million and Wellpoint sites attracted a combined count of 2.2 million homepage hits.

All things considered, the Web is growing as the primary source of information people turn to first about everything. Internet searching has grown to 175 million per hour, according to comScore stats. In December 2009 alone, there were 131 billion Internet searches conducted around the globe. Health insurance companies comprise a small piece of the whole Internet search world, but significant nonetheless.

“Consumers are increasingly turning to the Internet as one of their first destinations to research health insurance, whether it is gathering information to evaluate options or seeking answers to questions concerning their current provider,” said comScore director Susan Engleson in a press release accompanying the stats. “Having a strong online presence serves as both a gateway to consumers as well as an important branding opportunity for health insurance organizations.”

A Stanford University study following some 66,000 Americans and their use of the Internet for individual health insurance found very similar results. An excerpt of “Consumers’ Use of the Internet for Health Insurance” reveals greater opportunities for health insurance companies to attract more traffic to their Web sites:

“Analysis of Internet applications for consumer health has focused on the extent to which people use the Internet for information about health and healthcare. The role of the Internet in the relationship between consumers and health plans has received considerably less attention. Nevertheless, the potential impact of Internet applications in this area is large. Health insurance is a complex and information-intensive product, requiring extensive coordination among consumers, patients, insurers, and providers. In theory, consumers, purchasers, and health plans could benefit substantially from technological innovation that either improved the ability of consumers to obtain information about the types of health insurance available to them or reduced the cost or increased the quality of health insurance products.”

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Outcomes Driven Medicine: UnitedHealthcare Speeds Ahead

Wednesday, February 10th, 2010
The buzz in health care for hospitals and health insurance companies these days is outcomes- and evidence-based medicine. If the deepest cost-cutting proposals of health care reform on the table in D.C. come  to pass, doctors, hospitals and essentially any company that delivers direct medical care services could eventually be held to a set of standards set by companies who compile results of controlled research studies about patient protocols and disease management practices that deliver the best possible physical outcome.

Under this system, if a doctor doesn’t follow the protocols, medical health insurance companies don’t pay the bill.

UnitedHealthcare became the first major health carrier to announce its intent to dollect data from doctors and share it amongst all their contracted providers. Beginning today, United’s Oncology Care Analysis is aggregating data from more than 2,600 oncologists and 8,600 patients diagnosed with breast, colon or lung cancer. After the data is analyzed against an alliance of 21 participating U.S. cancer centers, known as the National Comprehensive Cancer Network (NCNN), it’s distributed to United’s network providers as a soft mandate at this point in time, to follow the recommendations when treating patients with similar medical demographics.

United is billing the reports as a way to help improve the quality of cancer care by showing how well a particular patient is complying with their medications or sharing inromation about procedures performed by other specialists. At this point, the medical sata sharing initiative will be limited to United’s cancer patient group — which accounts for $2.5 billion of United’s annual spending.

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Anthem Blue Cross Hikes Rates By A Third In California

Tuesday, February 9th, 2010
One of California’s biggest health insurance carriers, Anthem Blue Cross, will increase  its individual health insurance premiums by nearly 40 percent starting next month.

The announcement came within hours of the Obama Administration’s call for Congressional Republicans and members of his own party to meet at the White House for a televised summit on moving forward with health care reform. President Obama appeared to use the announcement as political proof that health care reform is “essential,” while his Secretary of Health and Human Services denounced the insurance carrier in a statement later in the say.

“As we continue the health insurance reform debate in Washington, this announcement reminds us that too many Americans can be left with unaffordable insurance each time the rates of rules change in the private market,” said Sebelius. “It’s clear that we need health insurance reform that will give American families the secure, affordable coverage they need.”

Meanwhile back in Anthem’s home state, California Insurance Commissioner Steve Poizner publicly scathed the company and urged individuals looking for affordable health insurance plans to compare rates with other carriers. Poizner said he was “Alarmed” by the larger-than-expected rate increase and said his department would examine Anthem’s actions in the coming days.

Health insurance is regulated in the individual states where they are sold. In Calfornia, state law requires that health insurance companies spend at least 70 percent of every dollar earned from their premiums on medical care. Poizner said he has hired an outside actuary to review Anthem’s increase “to ensure they are complying with this state law. If we find that their rates are excessive, I will use the full power of my office to being these rates down.”

Complicating Anthem’s justification for the increase, its parent company, Wellpoint Inc. announced it had earned $2.7 billion during the previous business quarter. Neither Anthem nor Wellpoint made a public statement to the news media about its rate plan at the time this story was published.

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Insurance Without Borders: Will Buying Health Plans Across State Lines Help?

Monday, February 8th, 2010

With health care legislation on perpetual pause in Congress, Republicans are proposing some new ideas for getting the deal done. From hybrid health insurance exchanges to mandates requiring everyone to be covered, the debate has shifted to what is likely to close the debate and get a bill on the President’s desk: allowing Americans to buy health coverage across state lines.

Currently, people can buy health policies only from health insurance companies licensed by the states in which they live. This is why you find, for instance, Blue Cross and Blue Shield plans that are essentially privatized entities incorporated and sold exclusively in the states in which they are sold. Auto and home insurers have used this same approach for years.

Remember when Allstate and its Good Neighbor competitor dropped coverage on houses in hurricane-prone Florida and other coastal states? Insurance companies can cut bait in states where they have a subsidiary company underwriting their policies. Allstate wasn’t writing your policy, Mr. Homeowner. It was Allstate Floridian – a separate, but equally capitalized company that was set up to take cover when floods rolled in.
The Republican idea of buying health insurance across state lines has been altered a bit, but it is incorporated into the Democrats’ House and Senate bills, and expected to be the centrepiece of any health care legislation that wins final passage.

Congressional Republicans have proposed the concept in the past and Sen. John McCain, R-Ariz., embraced it as part of his 2008 presidential campaign. Advocates — including some insurers and small business groups — say it would give the more than 17 million Americans who buy individual coverage a greater choice of plans and the possibility of lower prices.

But critics, including the National Association of Insurance Commissioners say the provision would erode state government consumer protections, leave policyholders with inadequate coverage and could actually lead to higher premiums for some people. On the flip-side, allowing people to buy health insurance from any company regardless of where they call home would encourage competition for your business. That usually leads to lower prices and, in effect, more affordable health insurance for all.

Regardless of what Congress decides to do about health care reform, there are options readily available. Insurance companies report an increase in short term health insurance which in essence, provide guaranteed coverage for major medical expenses for a pre-determined amount of time. With the rise in unemployment and prospects of new job growth ever-stagnant, we can expect to see short term medical plans grow in popularity and affordability.

No matter how you slice it, insurance by its very nature is risk. Risk breeds fear. Fear breads inaction.
Critics say that selling insurance across state lines might not save much money, and point to a 2005 CBO report that says: “if only those benefit mandates imposed by the states with the lowest-cost mandates were in effect in all states, the price of individual health insurance would be reduced by about 5 percent, on average.”
But when you consider the cost of a major medical insurance plan for a chronically ill individual can approach an average of $400 per month, that 5 percent “on average” is money in the bank.

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