Posts Tagged ‘premiums’
Tuesday, January 24th, 2012
Anthem Blue Cross policyholders who remained on grandfathered plans (those administered by the Department of Managed Health Care rather than the Department of Insurance) faced an unexpected surprise. Along with increased premiums, their plan benefits changed as well. Co pays, deductibles, and out of pocket maximum amounts all increased as a result of these changes. Anthem said this was a necessary move to keep up with increasing health costs, but policyholders had enough, and Consumer Watchdog stepped in. The lawsuit that has been filed states that Anthem used “bait and switch” tactics, leaving “consumers are left with no certainty about what they will have to pay and what coverage they’ll receive.” Many customers who had met their deductible earlier in the year were surprised to receive bills from their providers stating that they had not yet reached their portion of medical expenses, though the patient was under the impression they had.
The lawsuit serves to protect the 100,000 policyholders who have experienced what they feel is a misrepresentation of plan coverage. Company spokespeople from Anthem state that there is no violation of state laws and regulators were made fully aware of the proposed plan changes. Consumer Watchdog stated that even though these state regulators were aware of the plan changes, they in no way received a stamp of approval to move ahead with them. Per Jerry Flanagan, staff attorney at Consumer Watchdog, “Basically, higher deductibles mean you’re paying more for less health care. It’s a change to the essential definition of a plan.”
While it is understandable that changes need to be made to policies from time to time, it is important that these changes be presented in a clear and concise manner. This will help to avoid confusion and allow members to make necessary adjustments ahead of time.
Permanent link to this post (300 words, estimated 1:12 mins reading time)
Tags: deductibles, health insurance, individual health, premiums
Posted in Federal, General, Laws, Resources, State, Tools | No Comments »
Thursday, December 8th, 2011
In an effort to give consumers more knowledge when it comes to premium rate increases, the Department of Health and Human Services can now require that all insurance carriers file their rate increases online via a government website -http://companyprofiles.healthcare.gov. As of September 1, 2011 insurers who plan on raising their rates 10% or more must not only provide the rate detail, but the reasons justifying the need for such an increase. This information will now be made available to consumers, allowing them to not only be made aware of premium changes, but also allow them an option to add their questions, concerns, and comments – giving them a voice where previously they felt powerless to fight against the insurance companies. It also allows them to make more educated decisions when choosing to purchase a policy with a company, or move to another more competitive carrier. During a time when most Americans are struggling while big corporations continue to reap in big profits, holding them to some accountability is a big relief.
Tags: health care costs, health insurance, premiums
Posted in Federal, General, Government Run Health Plan, Laws, Resources, State, Tools | No Comments »
Thursday, November 10th, 2011
A surprising number of employees make vital errors during their company’s open enrollment process, often resulting in unexpected out of pocket costs. By not understanding deductibles, coinsurance, or premiums amounts responsible out their own pockets, many find out too late that they have made an error and must wait until their next anniversary date to make a change. Some of the most common mistakes are not knowing what benefits they have, not clearly understanding costs for the coverage chosen (for themselves and their dependents), and not taking advantage of pre-tax premiums and/or flexible spending plans, and not electing ancillary benefits (i.e. dental and vision), all by not taking advantage of face to face interaction prior to enrolling or renewing their benefits.
As your agency, we will assist you in every step of your open enrollment process, whether you are the employer or employee. We will walk you through the plan options, explain out of pocket exposure, and break down your monthly portions for you and your family members before you enroll, ensuring that you are on the best plan for your needs. Our enrollment meetings are not only a great way to get to get to know us, it also guarantees your complete understanding of your company’s benefits.
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Tags: deductibles, group health, health plan, health savings accounts, premiums
Posted in Employees, Employers, Group | No Comments »
Tuesday, September 13th, 2011
Health care administration under the Affordable Care Act is tricky enough, but none more so than in California. Currently there are two options for the golden state – either consolidating into one regulatory agency or combining between two agencies, the California Department of Insurance (CDI) and Department of Managed Health Care (DMHC), to properly maintain a system that will ensure consumer protection. Those supporting consolidation believe that the fewer hands in the pot will avoid confusion and conflicting interpretations of federal laws. Oversight between two entities can also result in added government and administrative burdens, and difficulty in monitoring what is being purchased and sold in the marketplace.
This is a preview of
Health Insurance Regulation in California Under Health Care Reform
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Tags: group health, health care costs, health care reform, premiums, Universal Health Care
Posted in Federal, General, Government Run Health Plan, Group, Laws, Resources | No Comments »
Wednesday, April 27th, 2011
Even though a privately hired actuary deemed Blue Shield proposed rate hikes as “reasonable”, continued pressure from clients and state officials helped to convince the carrier to cancel their May 1st increase. Though citing a projected loss in the millions, consumers are looking at saving close to $40 million in premiums, which bring much needed relief after the two rate increases within six months – one in October and another January 1, 2011. Blue Shield of California’s CEO released a statement to include “…By agreeing not to raise rates this year, we are helping to make coverage more affordable for our members during tough economic times. It’s a financial risk for us, but a risk that’s worth taking.”
Tags: health care costs, health insurance, premiums
Posted in Family, Individual, Tools | No Comments »
Friday, March 4th, 2011
Employers are constantly searching for ways to bring down the cost for group health insurance premiums. While the answer used to be “switch to an H.M.O”, this is no longer the case. While H.M.O. plans used to offer much lower premiums because patients were limited in where they could go for care, the rates for such plans have increased at such a steady pace, many of them have surpassed the PPO options in terms of monthly rates. The average increase for an H.M.O. in 2011 was 9.8%, the highest increase in five years.
Tags: group health, health care costs, HMO plan, premiums
Posted in Employees, Employers, Group, Individual, Resources, Tools | No Comments »
Thursday, July 8th, 2010
Startling news shows that one in five California residents (under the age of 65) have a “pre-existing” condition, which could render them ineligible for coverage, or offered premiums at inflated rates. Though health care reform promises all Americans coverage by 2014, this still leaves many without the coverage they need for years. What is considered a pre-existing condition? Pretty much anything you have been treated for, or are currently under treatment for prior to applying for coverage. While not all conditions will result in your denial for coverage, it can result in an increase in the monthly premiums from 20% – 100% higher. If you had a lapse in coverage, but are approved for coverage on a new plan, there may be a waiting period of 6 months before anything relating to your pre-existing condition will be covered by your insurance plan. The good news is as of September of this year, children under the age of 19 cannot be denied coverage due to their pre-existing conditions.
This is a preview of
Pre-existing Conditions and California Residents
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Tags: health insurance, individual health, pre-existing, premiums, underwriting
Posted in Individual | No Comments »
Monday, January 18th, 2010
Worries grow as those Californians who have been receiving assistance with their COBRA premiums are faced with losing financial assistance. As federal stimulus money dwindles, the 65% of premium formerly covered by this subsidy will expire, leaving many to make a tough choice – pay the premiums or go without coverage. COBRA (the Consolidated Omnibus Budget Reconciliation Act) was passed in 1985, allowing involuntarily terminated employees to keep their current health plan, and take over the payments for their monthly premiums. However, after many years and skyrocketing health care inflation, many people are finding that their COBRA premiums are exceeding their unemployment benefits.
If reports are correct in showing that 40% of newly employed people applied for the COBRA subsidy, these numbers can mean that the number of uninsured people will rise along with the lack of federal support. There are some plans in the works, however, which may bring some much needed relief:
HR 3930 would extend the period of eligibility through June 2010, increase the maximum duration of the subsidy to 15 months and end all subsidies at the end of December 2010.
S 2730 by includes the same provisions as the House bill and would also increase the federal subsidy from 65% of the premium to 75%, as well as expand eligibility to include employed people who lose health coverage because of involuntary reduction of hours.
COBRA Subsidy Laws are changing all the time. We will try and bring you the most updated information as we can. In the meantime, there are many websites to help you keep up with the changes. We are also happy to answer any questions you have!
Permanent link to this post (280 words, estimated 1:07 mins reading time)
Tags: COBRA, group health, health care costs, premiums
Posted in Employees, Employers, Federal, Group, Laws, Resources | No Comments »
Thursday, December 24th, 2009
Important news for our Blue Shield of California clients who are currently on individual and family plans. If you miss a payment, and exceed your grace period, they will no longer reinstate you after January 1, 2010. In these cases you will have to reapply for coverage and be subject to medical review once again. You are not guaranteed approval, even though you were a recent member.
We will make every effort to give you updates if you show late on payments. Not only will we send you email reminders, Blue Shield will also send you late payment notices via mail. Make sure to send in your premium, or contact us to set up monthly automatic payments via credit card or checking account to avoid cancellation.
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Tags: health insurance, premiums, underwriting
Posted in Family, Individual, Resources, Tools | No Comments »
Monday, November 2nd, 2009
The federal economic stimulus package which covers 65% of the cost of COBRA premiums is set to end as of December 2009. This reduction was designed to assist those who had an involuntary termination of employment and were eligible for COBRA during the period of September 1, 2008 through December 31, 2009. Though the subsidy is set to end after a period of 9 months, this does not mean you are going to lose your coverage. Instead, you will now be covering the entire cost for the remainder of your 18 months, or longer if your coverage is eligible for extension. The subsidy will end prior to the 9 months in the case of eligibility for coverage under a new group plan, eligibility for Medicare, or in the case of non-payment of the remainder of the COBRA premiums.
Let us help you find alternate coverage before your COBRA expires. There are many options for you and your family, and we are happy to help you determine whether a new plan is the best route, or to stay on COBRA for the remainder of your eligibility period. It is our pleasure to help you determine the best choice for your health insurance coverage.
Permanent link to this post (203 words, estimated 49 secs reading time)
Tags: COBRA, health insurance, premiums
Posted in Employees, Employers, Federal, Group, Laws, Resources | No Comments »
