Posts Tagged - ‘group health insurance’

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Mini-Med Health Care Policies Under Senate Investigation

Wednesday, December 1st, 2010

Mini-medical plans are controversial. On the one hand, they provide some coverage for emergency care, and in many cases are better than nothing. On the other hand, they often come with extremely low annual benefit payout limits that make them nearly useless if a person needs major medical treatment.

Mini-meds are typically offered by low-wage companies, and administered by major health insurance plan providers like Cigna and Aetna. A Senate committee is currently investigating the issue; the probe has been expanded from McDonald’s to other employers. The issue is that although policyholders are usually saddled with high medical bills, the plans are sometimes promoted as full-fledged comprehensive health care.

Although the healthcare reform law bans annual and lifetime limits, dozens of mini-med providers have been granted exceptions from that provision. Mini-meds are also subject to a lower medical loss ratio, which determines the percentage of premiums that must be spent on medical care.

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Stay Vigilant With Your Health Insurance Benefits

Monday, October 25th, 2010

Image: Mike Sansone under CC 3.0

If you have generous health insurance benefits provided by your employer, you may not think about it that often. For the most part, you choose the most affordable health insurance option that fits your needs during the open enrollment period and then run on autopilot.

Unfortunately, it seems that sticking your head in the sand isn’t good enough. Teachers in several school districts in New Jersey were recently uninsured for several months. A clerical error meant that although premiums were taken out of their paychecks, premiums were not paid to the insurers for four months.

Teachers in Newark still haven’t had their coverage restored. However, Paterson teachers are luckier–all covered expenses that occurred during that period will be paid for, and their coverage was reinstated.

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Boeing’s Health Insurance Plans Becoming Less Attractive To Employees

Wednesday, October 20th, 2010

Image: X-Ray Delta One under CC 3.0

In order to combat continually rising health care costs, many companies are changing their benefits packages to transfer more of the expense onto employees. Boeing is no different.

According to human resources senior VP Rick Stephens, co-payments, co-insurance percentages, and deductibles will go up next year. One of their health insurance plans will have its co-insurance percentages soar to 20% from 10% in 2012. About 90,000 employees will be affected.

Union employees are exempt, because they have their own negotiated contract. Many are speculating that the healthcare reform law has something to do with it, which the aircraft manufacturer denies.

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Is Your Health Insurance Plan Being Dropped?

Monday, September 20th, 2010

Image: TheAlias under CC 3.0

If you’re insured through Excellus Blue Cross Blue Shield or MVP Health Care, you may be caught in the middle of their shrinking their product lines. Like any business, they want to eliminate unpopular products–but is this an end run around a new New York health insurance law that forbids insurers from dropping entire products as a sneaky way of canceling the coverage of people with serious pre-existing conditions and high medical claims?

The insurers defend their actions as normal business practice, adding that a relatively small percentage of customers use the plans slated to be eliminated. Just 605 policyholders will be affected, most of them either group health insurance plans based on a company’s claim history or community-rated individual health insurance priced with a large pool. Those whose health insurance plan will be discontinued will be offered an alternative, though it remains to be seen if the terms are as appealing.

Excellus plans slated to be canceled will expire on January 1st, while MVP plans (which have rolling enrollment schedules) will be discontinued on October 1st or November 1st, depending on the product. The state’s Ian’s Law will take effect early next year.

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Census: Percentage of Americans With Health Insurance Plan Dropped

Friday, September 17th, 2010

Image: Michigan Municipal League (MML) under CC 3.0

Since the Census Bureau began tracking the percentage of Americans who are insured in 1987, last year showed the lowest rate on record. 253.6 million reported having a health insurance plan in 2009, which doesn’t seem so bad until you find out that 255.1 million were insured last year.

The recession is largely to blame, because it caused hundreds of thousands of employees to lose jobs with health benefits. Supporters of healthcare reform will likely use this statistic as an argument for the necessity of the Obama administration’s legislation.

At the same time, Medicaid enrollment rose, along with the poverty rate.

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Employer-Based Health Insurance Plans Providing Less Care for More Money

Friday, September 3rd, 2010

Image: RangerRick under CC 3.0

When employees look at their health insurance plans today, they see more responsibility (and cost) on their end with fewer benefits. That’s according to a new survey from the Kaiser Family Foundation.

In a struggling economy, companies look for different methods of saving money. One of them is shifting the cost of health coverage to employees. Unfortunately, workers must pay for those costs with the same or even smaller (for those who have taken pay cuts) incomes! Wages have not grown with the cost of health insurance for several decades now.

The average employee is paying 14% more for health care in 2010.

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Inflation of Health Insurance Plans Continued in 2009

Thursday, August 26th, 2010
health insurance plans
Image: Paolo Camera under CC 3.0

2009 had the American economy in the throes of recession. Inflation was very low, while the Federal Reserve cut the interest rate to almost zero. So why did the cost of health insurance plans continue to rise?

To be exact, United Benefit Advisors found that health insurance rates increased by an average of 7.3% for employers. That’s almost three times the inflation in general consumer prices.

Insurers tend to blame an increase in medical expenses. Meanwhile, companies are using consumer-directed health plans to pass more of the cost of group health insurance coverage onto their employees.

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Co-Payments Vs. Co-Insurance

Monday, July 12th, 2010

Image: db*Photography under CC 3.0

When trying to find affordable health insurance, it can be difficult to find the right policy. One of the most confusing aspects is the out-of-pocket cost you are expected to pay, above and beyond the monthly premium.

Most health coverage options include co-payments, co-insurance, or both. What’s the difference?

  • Co-insurance is a percentage of the fee charged for an item or service. For example, if you have a 30% co-insurance percentage under your policy and a doctor normally charges $100 per visit, you will be responsible for paying $30 upfront. In many cases, this is the more expensive option. However, it is becoming more common among group health insurance plans, due to employers trying to reduce their cost burden.
  • On the other hand, co-payments are a fixed amount. If your insurance company specifies a $15 co-payment for prescription medications, that is the amount you’ll pay the pharmacy each time you fill the prescription–regardless of how much the medicine actually costs. Sometimes, insurers have multiple tiers of co-payments: depending on the type of medication, doctor visit, or hospitalization, the copayment will be higher or lower.
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Your Health Coverage Can Be Canceled for One Penny

Friday, July 9th, 2010


Image: stevendepolo under CC 3.0

In order for your coverage to remain secure, it is essential to pay every single penny of your health insurance premium–literally.

A woman with cancer lost her job, but got COBRA to continue her group health insurance benefits. Last year’s stimulus package gave her a 35% subsidy to help cover the cost. However, her insurance company never sent her the reduced bill.

Therefore, she calculated the smaller amount herself and sent in the premium. Unfortunately, the insurer’s calculations didn’t agree: they said her payment should be one cent higher. As a result, they canceled her plan entirely for nonpayment! She was unable to send a check for $0.01 because she was in the hospital undergoing chemotherapy at the time.

The good news is that they eventually overturned their decision and reinstated her coverage.

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