The Insurance Blog

Aetna Touch-N-Go, and the Big Picture

A couple of days ago, we reported on Aetna's apparent change of heart regarding the sale of individual medical insurance here in Ohio. Today, they're back in the news:"Aetna Inc. execs remain skeptical about how the [Obamaax] public exchanges will perform ... New and expanded private exchange programs could get off to a faster start"There are three essential differences between the Public (FFE) and Private Exchange models:First, only plans purchased......

■ While you're busy planning that end-of-summer trip to Rome or London (or Istanbul, for that matter), you should know that your health insurance works a bit differently overseas. One way to help protect yourself is with a Travel Medical plan.■ As if the ObamaTax train-wreck wasn't causing enough damage to the health care and insurance sectors, its broad "appeal" has rippled through the whole economy:"This letter was written by the three of the nation's......

As Patrick noted last week, the ObamaTax Medical Loss Ratio (MLR) provision seems to have been a wonderful gift to the health insurance industry:"So, thanks to MLR, insurance companies took in an additional $50 Billion in 2012 and paid out $800 Million less in rebates"Lest our readers think that this is an exaggeration, we learn today that at least one carrier, WellPoint, is making some serious coin off of the ObamaTax:"[N]ewly minted CEO Joseph......

Insurance as a loss leader

It's often asked how long carriers will put up with low margins and tight regulations. It's not a very attractive market to be in right now. Unless insurance isn't your primary business. If you're a hospital or health system breaking even but driving more business to your facilities would be a good deal. Making an extra couple points on insurance operations would just be gravy.Even better is having your competitors or taxpayors subsidize any loses while your hospital runs up charg......

The folks in the motor city may have Obamacare to thank for providing a way out of their financial mess.As Detroit enters the federal bankruptcy process, the city is proposing a controversial plan for paring some of the $5.7 billion it owes in retiree health costs: pushing many of those too young to qualify for Medicare out of city-run coverage and into the new insurance markets that will soon be operating under the Obama health care law.Officials......

Lucy (Peanuts fame) found working in Maryland

Lucy would be called an inflation-denier for her never-ending demand that it cost $0.05. Even today hocking life insurance she is set on five cents being the price. I have to wonder if officials in Maryland aren't giving their price setting just as little thought:"The Maryland Insurance Administration is telling some carriers that want to sell coverage through its individual exchange program to make deep cuts in their premiums. ""In the bare-bones, “bronze level” of coverage, for example, the monthly premium rates originally requested for a 25-year-old nonsmoker living in Baltimore ranged from......

Gov tries to circumvent ACA in way HHS clearly tells employers not to

How sweet this would be if not for the inevitable consequences:"Under a wrinkle that dates back to enactment of the law, members of Congress and thousands of their aides are required to get their coverage through new state-based markets known as insurance exchanges. But the law does not provide any obvious way for the federal government to continue paying its share of the premiums for the comprehensive coverage" Like any true Democrat, Rep Waxman doesn't think they should be bothered by any actual law. Representative Henry A. Waxman, a California Democrat who helped write the 2010 law, said,......

The Rate Game

Patrick's post yesterday about small group renewal rates seems to have touched a nerve, and I think it's worthwhile spending some time on the whole "early renewal" issue. The premise of early renewal is that some groups may benefit from moving their renewal dates back from (say) early 2014 to late 2013. To that end, carriers have begun offering this service to existing groups.Yesterday, Anthem sent me a list of my eligible groups, along with what they anticipate will happen to those groups' rates once community rating (and all the rest) kicks in.As with Patrick's experience, some of my groups......

January 1, 2014. Community rating, narrower age banding, guaranteed issue, and other fun parts of the law will begin on this date. In preparation, our agency has been meeting with major health insurance carriers on the impact PPACA will have on our employer sponsored plans with less than 50 employees. For my accounts the results have been staggering: 49 employer groups, 4 with decreases of 20%-30%, 4 with 0-10% increases, 20 employers with 30%......

Flawed thinking on ObamaCare, giving it a shot has consequences

Reading the comments to an article in the NYT on the Obama Admin's implementation of ACA, I came across a very common response:"Corkyjon it seem to me that you speculate in the negative; the best thing that we can do for ourselves is to let Obama care play itself out. It's meant to work by getting all the uninsured to get coverage or suffer a penalty id they don't, and to offer coverage despite pre-existing conditions, Sounds good . . . will it do what's expected of the program ? that's to be seen"What I never see mentioned or discussed by these individuals is the consequences or aftereffects......

The ObamaTax Subsidy Cheat

As we noted almost 2 years ago, the ObamaTax specifically forbids folks in states with Federally-run Exchanges from receiving any subsidies (and this would include those hybrid State/Fed models, as well). Of course, a little thing like the law is of little consequence to the folks in Capital City, and so the IRS has stated unequivocally that "it determined that Congress intended for subsidies to be available in both state- and federally-run marketplaces," thus greatly expanding the scope (and, of course, the cost) of the subsidies.Now come two House committees (finally) looking into this egregious......

Need a job? Need a job with benefits?Keep looking.In order to ensure Americans understand how to access the benefits available to them when many provisions of the Affordable Care Act go online October 1, the Obama administration announced last month that it is setting up a call center that will be accessible to Americans 24 hours a day. One branch of that call center will be located in California’s Contra Costa......

We've been wondering for a while now, why - if the ObamaTax is such a grand bargain - is it necessary to advertise it so heavily, and to enlist everyone from Sheriff Andy to Michael Jordan to shout its praises from the rooftop. Not only have we received no answer, but Ms Shecantbeserious and her minions insist on doubling - nay, tripling - down.Item the first: A gorgeous, impeccably designed ObamaTax bumper sticker (to compliment the Co-Exist one......

How Much Did That Rebate Cost You?

President Obama has made another exaggerated speech regarding the insurance rebates that are being issued under PPACA. While "insurance premium savings" sounds admirable, there are a few facts we must point out to show the relative ignorance of Obamacare backers.MLR was designed to leverage insurance company profits and administrative expenses. Reality is all we have seen from MLR is an increase in profits and expenses. Here are the facts:From the US Census Bureau: for 2011 to 2012 the number of people purchasing private insurance has remained flat at roughly......

The danger of polling the masses...Employee Choice in Carriers

Journalists, a term used loosely as few actually practice the craft any more, love polls. Easy to create, easier to write stories off of, and if you put even a little thought into the questions your guaranteed to have the narrative you want to push. Which brings me to this tidbit;ebn.benefitnews.com/-Employees-want-Choose-Their-insurer-"A new survey out this week from insurance researcher HealthPocket corroborates that idea, with 65% of employee respondents saying they’d like to select their health insurance company rather than have their employer choose."I think first we need to remember who......

Less than 6 months away from full implementation of Obamacare and desperation is setting in.In an attempt to continue selling the unpopular overhaul of the best health care system in the world, Head Cheerleader Sebelius continues the search for celebrity endorsements. Having been rebuffed by pro sports she moves on to entertainers.President Obama is enrolling stars in a campaign to promote the new health insurance exchanges.Obama stopped by a private......

First, a belated Mazel Tov to William and Kate on the birth of their son, and may he enjoy a long, happy and healthy life.Would that it were so for most of their fellow Brits, who - unlike the happy royal couple - have to endure the agony that is the Much Vaunted National Health System©:"According to the Daily Express, a suite at the private Lindo Wing of London’s St. Mary’s hospital costs £6,265 per night — and this “excludes consultants’ fees .........

About 3 years ago, our own Certified Medical Office Manager (and now co-blogger) Kelley Beloff put some major holes in the Myth of the Rich Doctor:"I recently received a report stating that the average reimbursement of the average office visit code (99213) for physicians is $65.49. Yep, $65.49. That is all your physician gets for seeing you in a normal 15 minute appointment."And out of that comes his overhead, including staff salaries, office rent,......

Exchanges offer cash back bonus!

Exchanges in DC just got a little more attractive, around 2-3% or a free trip to your sunny local of choice that is.http://www.benefitspro.com/2013/07/23/credit-cards-causing-headaches-for-exchanges"The exchange managers would consider taking SHOP premiums via credit card and debit card in 2015, if interest in that option appears strong."If you had the option to pay your insurance premiums with credit card and receive cash back or points to use, what smart business owner wouldn't jump all over that? It is sort of ironic with government's push to squeeze every penny possible out of administrative......

A month ago (to the day!) we noted that Aetna had suspended sales of its individual major medical products here in the Buckeye State.This just arrived in my email inbox:"We are pleased to announce that effective immediately, you may quote and sell new business for Aetna Advantage Plans for Individuals, Families and the Self-Employed in Ohio.As a reminder, as of June 24 any Ohio applications that had already been submitted were processed by our underwriting......

Wednesday WroundUp

■ The future is a lot closer than you might think. We know that Star Trek presaged cell phones, tablets and holograms; now we may actually get tricorders, too:■ If you're not regularly reading Avik Roy's Apothecary, you're missing a lot. Here's a sample:- The NY Times Tries — And Fails — To Protect Obamacare From Health Insurance ‘Rate Shock’- The Devastating Obamacare Tax On Low Income Workers At Large Firms- Labor Unions: Obamacare Will ‘Shatter’ Our Health Benefits, Cause ‘Nightmare Scenarios’Lots more at Avik's place.■ FoIB Holly R sends us this interesting item on life insurance and single......

Cavalcade of Risk #188: Tech & Mech edition

Nina Kallen presents this week's round-up of risky posts, with an emphasis on "their technical and detailed nature." Have you ever wondered about health insurance in China? How about how to overcome pre-existing conditions when applying for insurance? All this - and more! - at this week's C......

Exchange Security Breach.....who pays?

There have been a lot of discussions this past week or two on the potential of ID theft in the exchanges. While people getting their ID stolen is bad, as a business owner my bigger fear would be losing my business because the exchanges allowed someone's ID to get stolen.When I trade protected info with other firms we have Business Associate Agreements (BAA) and other written contracts that protect me if they fail to protect the data I provide them. If they screw up I would still get sued, which is just as bad or worse than actually losing, but hopefully would have some recourse. Cover my cost......

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Obamacare - Is Your Identity Safe?

This fall you will have an opportunity to buy your very own Obamacare health insurance policy. A plan designed by the same folks that gave us the bridge to nowhere and bailed out the auto industry, saving Detroit from financial ruin."Are you 100 percent finished establishing appropriate privacy protections?" Rep. Scott DesJarlais asked skeptically, with reference to the GAO report."No, we are not,"CNBCHow secure is the Obamacare system?"I would say with regards to privacy and security we're probably about 80 percent,"As they say, close enough for government work.Millions of Americans will be asked......

Here's a thought: what if they gave an Exchange and nobody came?That's the premise behind a group calling itself the Citizens' Council for Health Freedom, which has rolled out a campaign to dissuade folks from buying plans on the public Exchanges. CCHF offers four rationales:1.No private insurance – Obamacare is “Medicaid for the middle class” – or as CBO director Douglas Holtz-Eakin calls exchange coverage: “a second Medicaid program.”2.No privacy......

"House Republicans received a boost from Democrats on Wednesday during votes to delay ObamaCare’s individual and employer mandates ... Twenty-two Democrats joined Republicans in a vote to delay the individual mandate"This in response to the Obamastration's unilateral suspension of the (Evil) Employer Mandate a few weeks ago. The premise seems to be "if employers are off the hook, why shouldn't individuals be off it, as well?"Which may well be "fair,"......

Monday Morning ObamaTax News

■ Late last month, the 10th Circuit Court of Appeals gave Hobby Lobby a temporary reprieve from the birth control convenience item mandate. Last Friday, "U.S. District Judge Joe Heaton ... stayed the case until Oct. 1 to give the federal government time to consider filing an appeal with the U.S. Supreme Court." So for now, at least, the owners of Hobby Lobby can enjoy their 1st Amendment rights (until SCOTUS rules it a tax, one supposes).■ FoIB Holly R alerts us that Anthem Blue Cross will not be participating in the California small business health insurance Exchange:"The company said it still......

Do you like your doctor? Does he or she take the time to listen, like Dr. Marcus Welby? Or maybe they can overcome all odds like Dr. Mike Quinn. Perhaps you are swayed by their rugged good looks like Dr. Doug Ross of ER fame.Enough dreaming. Back to reality.Does this sound familiar?If you have insurance that you like, then you will be able to keep that insurance. If you've got a doctor that you like, you will be able to keep your doctor. Nobody......

Fees, Glorious Fees (continued)

As Nate reported earlier this week, the ObamaTax Patient-Centered Outcomes Research Institute (PCORI) fees taxes are due this month.Despite the conventional wisdom (and official line) that carriers pay the fee for fully insured plans, we know that's not the case. They simply pass them along to their customers (policyholders). Self-insured plans already understand this, because the employer (plan sponsor) has to pay the fee directly.For plan years ending last October through this September, the fee is $1 per covered life; for plan years ending this coming October through September of '14, they......

Behold, the ObamaTax, simplified: [Hat Tip: Heritage]Meantime, FoIB David Adams reports that Blue Grass State health insurance premiums are set to rise a modest amount.And by "modest" he means upwards of 80%.Hu......

To our own Bob Vineyard, runner up in this year's National Underwriter Industry Elite Awards (for Industry Awareness):Congratulations, Bo......

Cavalcade of Risk #188: Call for submissions

Nina Kallen hosts next week's Cav. Entries are due by Monday (the 22nd).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......

This is beginning to sound like one of those jokes. The ones that ask "How many Democrats does it take to implement a health insurance plan?".Equifax Workforce Solutions has been tapped to verify incomes of people who apply for federal subsidies to buy health insuranceEquifax — a company used by mortgage lenders, social service agencies and others — will verify income and employment.St Louis TodayRemember the old days when all that was......

Do you think the NSA spy system on your private life is bad. Get a load of this. 700 pages of the 2,700-page Obamacare law were a rewrite of IRS code, according to expert testimony at the Minnesota legislature, giving the IRS 47 new tax provisions to administer and essentially establishing the IRS as a police force for implementing and imposing Obamacare.CCH FreedomWhat kind of information you ask?"The system will contain personally identifiable......

Did you ever wonder how your Obamacare premiums will be paid if you have a subsidy? I didn't think so.Well here is something to chew on.Once a consumer signs up for coverage, someone has to feed the enrollment data into a carrier data store and an exchange data store. The state must determine whether the consumer will get tax subsidy benefits and other types of help.The carrier must tell everyone whether the consumer actually sends in the first payment......

Well, this is hardly a surprise:"Any organisation that is treated as being beyond reproach is bound in time to become flabby ... When I pointed out that the NHS fared badly by most international comparisons three years ago, my since-deceased mother was harassed by Left-wing journalists"No, the "journalists" didn't kill his mum, but they'd certainly like to kill any dissension, as would the folks at the top of the MVNHS© food chain:"[O]f course, this......

ObamaTax Exchange Setup Running at Peak Efficiency

Well, peak government efficiency:"Two U.S. government officials warned on Wednesday that the launch of new state healthcare exchanges could potentially be delayed"No kidding?Why is that, do you suppose?Oh:"[A]n auditor with the Treasury Inspector General for Tax Administration, an Internal Revenue Service agency that monitors performance, said testing the systems needed to implement the exchanges "will be difficult to complete" by the October 1 start date."I bet.Not a big deal though, right Mr Taxman?Well...."The lack of adequate testing could result in significant delays and errors in accepting......

ObamaTax stormin'

It ain't sci-......

The old saying, ignorance is bliss, is alive and well in Obamacare-land. Here we are, over 3 years after the bill was signed into law and less than 6 months away from (almost) full implementation (less 20 or so provisions that have been delayed or dropped) and it seems the bulk of the public is blissfully ignorant about Obamacare.Spotted on a popular social network . . .I had a not so nice surprise today when I went to pick up a prescription......

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