Posts Tagged - ‘small group health insurance’

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State Health Insurance Commissioners To Rule on Medical Loss Ratios

Thursday, October 21st, 2010

Image: turtlemom4bacon under CC 3.0

All eyes are on Orlando today, but not because of anything Mickey Mouse has done. Rather, it is a meeting of several states’ insurance commissioners. Their topic: coming up with the rules that insurers will have to abide by post-healthcare reform.

Specifically, they are responsible for calculating minimum medical loss ratios. MLRs are also known as the percentage of premiums spent on providing health care, as opposed to profits and administrative expenses. Proponents of the limits believe that they will result in more affordable health insurance for consumers. However, some are worried that the new rules will make some niches and entire markets–such as small groups–less appealing, and that people will become uninsured as a result.

The group’s recommendations will become effective next year. Although the already-determined limits are 85% for large group plans and 80% for small groups and individuals, the commissioners will consider tax exemptions and a longer phasing-in period. Most significantly, they will help determine what counts as a medical expense. Insurers obviously want a wider definition of qualified medical costs.

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Rhode Island Health Insurance Premiums To Increase

Thursday, July 8th, 2010

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Bad news for Rhode Island health insurance consumers: the insurance commissioner just approved several premium increases.

The health insurance rate hikes, which become effective next year, are as follows:

  • Blue Cross Blue Shield of Rhode Island: 9.8% for small and large business health insurance
  • United HealthCare: 12.3% for firms with under 50 employees, and 8.4% for larger companies
  • Tufts: 11% and 10.2%, respectively

On the bright side, these rate hikes are lower than those originally requested.

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Health Insurance Company Harvard Pilgrim Agrees To Lower Rates

Monday, July 5th, 2010

Image: Guerilla Billboards

Regulators have been facing off with health insurance companies over proposed premium increases that the former consider excessive, and the latter think are necessary to continue doing business.

Apparently, compromise is possible. Harvard Pilgrim Health Care agreed to a settlement with the state of Massachusetts that limits their individual and small group health insurance rate increases. The decrease is insignificant: their initial requests ranged from 8% to 12%, while the new deal has increases of 7% to 11%.

Since earlier caps on premiums set by the state were rejected on appeal, the insurer could’ve kept fighting. However, they chose to move on instead–although they will still lose money under the agreement. Thankfully for consumers, Harvard Pilgrim (the second-largest insurance provider in the state) also agreed not to retroactively bill policyholders since April for the higher rates.

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Massachusetts Health Insurance Company Settles On Increase

Monday, June 7th, 2010

After initially asking for an 11% increase in its small group and individual health insurance rates, Neighborhood Health Plan has reached a settlement that allows them to raise those premiums by about 7%.

Neighborhood was one of six major Massachusetts health insurance companies that appealed and sued the state’s insurance commissioner when their proposals were denied in April. Now, they have bowed out of those efforts.

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Hawaii Pays Half Of Health Insurance Premiums For Small Businesses

Wednesday, May 19th, 2010

Image: JoshBerglund19 under CC 3.0

Here’s a new way to encourage job creation: pay a large part of new hires’ health insurance premiums. Hawaii is doing that, largely through funding received from the healthcare reform law.

Small business owners believe that Hawaii Premium Plus is a program that will allow them to afford hiring more workers, since they will spend less in total on group health insurance coverage. Governor Linda Lingle touts it as a strategy for reducing the state’s unemployment rate by one percent. However, some skeptics are unsure if slightly under $11 billion is sufficient funding for such a program.

For each new hire between May 1st, 2010 and April 30, 2011, the program will reimburse employers $1,680 per year. Companies with under 50 employees are eligible, though the program may be expanded if it fails to meet the cap of 6,450. It is intended to increase the number of legal residents who are both employed and have Hawaii health insurance.

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Should Hospitals Pay For Small Business Health Insurance Plans?

Monday, May 17th, 2010

For now, this is only happening in Massachusetts, but it could spread nationwide: hospitals are now required to make a one-time contribution to a fund that subsidizes the purchase of health insurance plans by small businesses. They will pay the insurers directly, and the health insurance companies will refund eligible businesses for two years.

After only one major hospital system–Partners HealthCare–agreed to contribute voluntarily, the State Senate President included a provision that forces them to pay $100 million to the fund. The amounts will be split based on the hospitals’ profit margins and the makeup of their patient populations.

According to supporters, small business health insurance premiums will drop by 2.5% as a result of the subsidy–although they acknowledge that it’s only a temporary solution. Detractors, including the Massachusetts Hospital Association, are worried that the mandatory assessments will negatively impact the finances of and quality of care from their facilities.

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Buying A Self Employed Health Insurance Plan

Wednesday, May 12th, 2010

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As a self-employed individual, buying affordable health insurance can be difficult. In 13 states, the process is more simple: you can register as a “small business of one” and buy a policy in the small group market. That market is likely to have lower rates and fewer restrictions on pre-existing conditions.

However, in most states, you’ll need to get an individual health insurance plan if you’re self employed without at least one employee. Provisions of healthcare reform that kick in by 2014 will make finding coverage easier, but for now things haven’t changed.

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