The Insurance Blog

E(HR)xtravaganza

So the other day, I'm corresponding with the practice manager of one of my physician group clients. This particular PM is extremely professional and knowledgeable, to the point that I rarely hear from her unless I instigate the conversation. I had emailed her regarding the upcoming ObamaTax compliance issue we wrote about earlier this week.I really just wanted to know if she had any questions, or would like to meet for a mid-year plan review. She......

■ HHS Secretary Shecantbeserious sure loves her slushies. No, not that kind, this kind:"A little-noticed part of [the ObamaTax] channels some $12.5 billion into a vaguely defined “Prevention and Public Health Fund" ... the department can spend the money as it sees fit and without going through the congressional appropriations process. The sums involved are vast. By 2022, the department will be able to spend $2 billion per year at its sole discretion.......

No, not those Exchanges. These Exchanges:"Students at [University of Illinois Chicago] covered by the school’s health insurance will have an added benefit come the fall: sex change surgery."We've long dismissed student health plans as poor values, but we never expected this turn of events.One presumes that Ms Shecantbeserious is eying this development with a gleam in her eye.......

[Scroll down for updates] Paul Krugman, economist, may know economic theory but his knowledge and understanding of health care and health insurance put him in the same class with Ezra Klein.Guys, don't give up your day job.In some states, like California, insurers reject applicants with past medical problems. In others, like New York, insurers can’t reject applicants, and must offer similar coverage regardless of personal medical history (“community......

PCIP. Great idea. Complete flop when it closed early due to lack of funds. How can that be? DC printing presses on strike?Now we find out that ERRP (Early Retiree Reinsurance Program) ran out of gas too.PPACA drafters created the ERRP system, to encourage employers to keep health plans for retirees ages 55 to 64 in place. Congress provided $5 billion in funding for early retiree health plan subsidies. ERRP managers were supposed to use $300......

Record numbers of individuals on Medicaid as the count grows past 72 million. With over 48 million on Medicare and 320 million living in the US that translates into almost 40% of the population is not paying for health insurance (or is paying very little).The 72,600,000 enrolled in Medicaid in the United States in 2012 was more than the 65,630,692 people who lived in France last year, according to data published by the Census Bureau, or the 63,047,162......

As we've long documented, one of the (intended?) effects of the ObamaTax is a looming physician shortage. But perhaps some clarification is needed: the shortage is most likely to hit the insured and/or less wealthy demographic first.Why is that, you ask?Well:"Dr. Michael Ciampi [has] ... stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health......

There has been much discussion about affordability in the insurance exchanges. From huge potential rate increases to lower than current rates being proposed under Covered California, the range of costs vary significantly.So it came as a surprise last week when news broke that California's program was showing lower than projected premiums. Ezra Klein called it "Very Good News for Obamacare." Major news networks cited the release telling......

Cavalcade of Risk #184: Post-Memorial Day Risk-a-thon

Jeff Rose hosts this week's small - but powerful! - roundup of risk-related posts. From fast-food to k-rations, you'll run little risk of being disappointed.Thanks, Jeff!......

Thanks to alert IB reader Peter K, we have two new items to add to our Much Vaunted National Health System© database. Last month, we noted that "[MVNHS©] doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds;" this was one side of the coin. It only gets worse, though, when one considers the other side of it:"Patients undergoing planned operations on the NHS are far......

■ First up, via email, United Healthcare lets us know that its "Early Warning Report forecasts the states, legal entities and group sizes ... that are currently eligible to be issued MLR premium rebates by [UHC] associated with the 2012 calendar year. Any owed rebates will be paid in July ... There are 21 states and two territories in which UnitedHealthcare does not currently anticipate paying any rebates associated with group business"Don't spend......

Much like doctors and lawyers carry malpractice insurance, licensed insurance agents carry Errors and Omissions (E&O) coverage. This type of liability policy protects policyholders (clients) if/when the agent screws up, causing financial loss.Now come the Navigators. In addition to having to pass no background checks or graduate high school, these folks will also not be required to carry any kind of E&O coverage. Which is actually a good......

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Received a sample notice that will (when finalized) have to be sent from employers to their employees later this summer. If you're interested, click here to download it. It's 3 pages, and pretty scary.Scary, Henry?Well, here's the thing. The employer will need to complete this form, and attest that, for example, his group plan meets the "minimum value standard." That is, that "the plan's share of the total allowed benefit costs covered by the plan......

According to Georgia Health News citizens of the Peach State will have 7 (but in reality only 6) carriers to pick from when the 2014 Obamacare exchange, uh, marketplace rolls out this fall.Aetna, Alliant, Blue Cross and Blue Shield of Georgia, Coventry, Humana, Kaiser Foundation Health Plan, and Peach State will offer a range of plans for individuals in Georgia as part of the Affordable Care Act’s exchange, or “marketplace,” which will debut in 2014.Aetna......

These days it seems like everyone is a financial expert and wants to cast stones at people or companies they believe are "excessively wealthy" or "unjustly profitable".The latest group is, of all people, a nurses association, that claims that hospitals are now the villains raking in obscene profits.The nurses' research found what appear to be staggering statistics: U.S. hospitals charge on average $331 dollars for every $100 of their total costs,......

As we reported almost 8 years ago, in our exclusive interview with its Medical Director Dr Dexter Campinha-Bacote, Aetna has long been in the forefront of health care transparency.Now, our good friend David Williams blogs that the carrier has "won an Award of Distinction for its short videos designed to help members comprehend and use their benefits."David offers some great reasons why he approves of this development, and singles out Aetna's......

Nice to see the legacy media catching up with us:"[S]ome unions leaders have grown frustrated and angry about what they say are unexpected consequences of the [ObamaTax] ... The problem lies in the unique multiemployer health plans that cover unionized workers ... union plans were already more costly to run than traditional single-employer health plans. The [ObamaTax] has added to that cost"Gee, who could have seen that coming?Oh, yeah.And it's not......

Last week, we noted that the IRS was knee-deep into building the enforcement mechanisms for the ObamaTax. But just how deep are they really?This deep:"The Internal Revenue Service ... has created eight offices and special "teams" to handle the chore, way more than initially revealed."And just how "special" are those teams? Here's 1000 words on them: [Click graphic to embigg......

Hospital Claim of the Day

Received an audit back on behalf of a client. When we can our plans only pay Hospitals their cost plus a 12% profit margin or Medicare plus 20%, which ever is greater. A member went to a new Spine Surgery Center and the bill was $8,300. Medicare + 20% was $620.28. Billed Charges are 1300% increase of Medicare allowable.Luckily this new facility was out of Network so we don't have a PPO telling us we have to pay inflated prices. Even a 50% discount, top side for this market, would have been over a $4,000 bi......

Cavalcade of Risk #184: Call for submissions

Jeff Rose hosts next week's Cav. Entries are due by Monday (the 27th).To submit your risk-related post, just click here to email it.You'll need to provide:■ Your post's url and title■ Your blog's url and name■ Your name and email■ A (brief) summary of the postPLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like). And please only submit if you are willing to link back to the carnival if your submission is accept......

Obama Skinny Plan Irony

Prior to ObamaCare a few million people had these not-quite-insurance insurance mini med policies. The administration and pro-reform crowd decided people who purchased these plans needed protection from themselves and set out to wipe them away. Some of these forsaken plans had limits only in the tens of thousands. They might only pay a few hundred dollars per day for hospitalization or surgery.The requirement that plans have no limits, annual or lifetime when fully implemented would see these plans die a deserved death.These helpless souls had much to look forward to under Obamacare, why they......

Health Wonk Review: Cereally? Edition

Brad Wright offers up a clever, lighthearted and (his word) sardonic take on the Health Wonk Review. From Einstein to Beckham, angels and bell curves, you're sure to find something to amuse, enlighten and/or enrage you.Kudos, Br......

The editors of InsureBlog are pleased to add Insurance Library to our all star blogroll.I am very familiar with the originators of Insurance Library and know how much they give back to the public in the form of educational blogs and forums. Insurance Library is a new site but is rapidly growing their visitor count on a daily basis.Consumers can review questions and answers on over 3,000 topics ranging from auto insurance to homeowners, life insurance,......

"ObamaCare is ... demoralizing doctors, distracting providers toward bureaucracy and away from patient care. It is disrupting quality and access, and damaging health."Says whom?Says Dr Charles Willey, "CEO of Innovare Health Advocates in St. Louis, a medical group employing five physicians and five nurse practitioners in five offices."Dr Willey is suing the Feds to try to derail the "train wreck," focusing on the IRS's unique and powerful role in......

The Grease Fire Spreads [UPDATED]

First HHS "suspended" enrollment into PCIP because of insufficient funding. Now comes word that HHS will be cutting payments to providers who treat those in PCIP. From the New York Times:Under a new policy issued by Kathleen Sebelius, the secretary of health and human services, “health care facilities and providers will get paid less” for providing the same services to patients in the federal program, known as the Pre-Existing Condition Insurance Plan.The article further stated:Federal health officials said the alternatives were worse. If the program runs out of money, they......

Well, some good news for Beaver State residents who may be shopping for health insurance this fall. Unlike so many other states, carriers seem to be supportive of Oregon's Exchange:"The Oregon Insurance Division has posted individual and small-group rate proposals for 2014 ... rate proposals from a total of 16 conventional carriers and two new CO-OP plans for the exchange and non-exchange markets."Oregon is one of the minority of states that has......

Need Obamacare insurance? No problem. Click or call the exchange in your state using your Obama-phone. Complete the 20+ page Obama-application for financial assistance. Once approved you pick an Obama-plan and then in just 12 easy payments you will be the proud owner of your new Obamacare health insurance plan.But wait.Paying for it (even after financial assistance) may be a challenge for some.For ordinary Americans deemed unbankable, those......

Offered without comment:MetLife removes alien status from capt......

We've already noted that carriers seem to be actively avoiding the Exchanges due to go online in the next few months. Of course, that's for the individual market - the small group market must be doing gangbusters, though, right?Right?Turns out, maybe not:"The California Health Benefit Exchange has put out a call for general agents ... to recruit, train, supervise and support the retail agents that help the small employers that sign up for the......

Small Businesses are Exempt from PPACA?

A couple of weeks ago The Hill reported that 48% of small business owners believe that PPACA will hurt their business. In the article there is a quote from President Obama about the impact this will have on small business. He said: "Some small businesses are being told their costs are going to go up, even though they're exempted from the law" or stand to benefit from it.I am a small business owner working within a large insurance agency. I have two employees and I provide benefits including medical insurance. Under our arrangement I currently pay 100% of the premiums.......

As the Exchange Countdown Clock slowly - inexorably - winds down, our attention turns to the eternal question: "what's next?"Ostensibly, folks who plan on buying their new health insurance from one of the public Exchanges will turn to one of those new-fangled "Navigators" for help. After all, these folks are new to the insurance purchasing process, and need highly trained folks brimming with integrity and advanced insurance knowledge.Or maybe not:"At......

The Insurance Blog

E(HR)xtravaganza

Late Morning LinkFest

Student Health Exchanges

Obamacare Train Wreck - Krugman Weighs In [UPDATED]

ERRP . . . Obamacare Indigestion

Free Health Insurance Numbers Grow

ObamaTax: Another Nail

California's Sneaky Little Trick

Cavalcade of Risk #184: Post-Memorial Day Risk-a-thon

MVNHS© Back in the News

Tuesday Afternoon LinkFest

E & Ooops

Coming Soon - Obamacare Wait Times

ObamaTax Compliance heads' up

Obamacare | GSU Prof. Bill Custer Whiffs It

Excessive Hospital Profits

Outstanding Carrier Trick

About that Union Label

What could possibly go wrong - An Update

Hospital Claim of the Day

Cavalcade of Risk #184: Call for submissions

Obama Skinny Plan Irony

Health Wonk Review: Cereally? Edition

Insurance Library

Doctor's orders

The Grease Fire Spreads [UPDATED]

On the Oregon ObamaTrail

Just 12 Easy Payments

Unexpected Insurance Headlines

Help Wanted

Small Businesses are Exempt from PPACA?

Dumber and Dumberer

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