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Showing posts with label consumers. Show all posts
Showing posts with label consumers. Show all posts
Friday, July 6, 2012
Friday, June 22, 2012
Health care insurers to dole out $1B in rebates to consumers
Health insurers will dole out a total of $1 billion in rebates to 12.8 million Americans this summer -- an average of $151 per family --as a result of the 2010 health care reform law, the government said Thursday.
The rebates announced by the Department of Health and Human Services come from a provision of the law that punishes insurers who spend too much of policyholders' premiums for boosting company profits instead of paying for their medical care.
However, it's unclear if insurers will have to issue rebates at all if the Supreme Court strikes down all of the health care law.
The court, which is reviewing the constitutionality of the Affordable Care Act, is expected to issue its ruling later this month. The court could uphold the law, overturn it partially or completely strike it down.
HHS spokesman Keith Maley said the agency was confident that the law is constitutional.
"We are focused on ensuring the benefits of the law are applied to Americans across the country, including ensuring consumers get value for their premium dollar," he said.
The rule mandated that, beginning in 2011, insurance companies would have to spend 80% to 85% of the premiums they collect on medical care instead of toward their own profits and overhead costs.
See average health insurance rebates by state
"The rule helps ensure consumers get fair value for their health care dollar," HHS Secretary Kathleen Sebelius, said in a statement.
Insurers that didn't increase that allotment to the new federal standard would have to give customers a rebate for the difference beginning in 2012.
Exchanges could survive even if health reform law dies
HHS said insurance companies that failed to meet the required "medical loss ratio" must provide a rebate for the difference to their customers no later than Aug. 1.
For families who buy their health insurance out of pocket, the average rebate is expected to be $152. In the small group insurance market, where many small businesses buy insurance for their workers, the average rebate per family is expected to be $174, the agency said.
Large companies that insure employees themselves will have to pay out an average rebate of $135 per family if they fail to meet the rule, HHS said.
HHS said consumers owed a rebate could get it as a check in the mail, a lump-sum reimbursement to the same account that they used to pay the premium if by credit card or debit card, or as a reduction in their future premiums.
3.1M young adults gained health coverage since law took effect
For affected policyholders who are insured through their employers, their companies could provide them with the check or reimbursement, or employers could apply the rebate in another manner that benefits their employees, the agency said.
View this article on CNNMoney
More From CNNMoney.com
Tuesday, June 19, 2012
Wednesday, May 16, 2012
Alliance Health Networks Acquires Medify to Strengthen Social Health Networks for Consumers and Industry Partners
Tue, May 15, 2012, 6:03 PM EDT - U.S. Markets closed
Sorry, I could not read the content fromt this page.Thursday, March 29, 2012
FAIR Health Launches Online “Medicare Compare” Tool to Help Consumers Understand Impact of Medicare-Based out-of ...
FAIR Health, the independent not-for-profit corporation dedicated to bringing transparency to healthcare costs and out-of-network reimbursement, today launched FH Medicare Compare, a free, web-based tool that will help consumers better understand their out-of-pocket medical costs if their insurers base out-of-network reimbursement on the Medicare fee schedule. The tool is available on the FH Medical Cost Lookup on the FAIR Health consumer website (www.fairhealthconsumer.org/medicalcostlookup).
A number of private health plans base out-of-network reimbursement rates on a percentage of Medicare fees. The Medicare-based reimbursement formulas, generally 110% to 140% of the fee set by Medicare, often result in reimbursement amounts that are much lower than those calculated under the traditional usual, customary, and reasonable (UCR) standards that reflect actual provider charges. The switch to Medicare-based rates confuses many consumers who are unaware of the financial implications of this method. Using a Medicare-based reimbursement method often means that consumers will have to pay a larger portion of their medical bills out of pocket when they seek out-of-network services.
“Medicare is a government-based fee schedule that was developed for specific populations such as the elderly and the disabled. It was not designed to serve as a benchmark for the general population in the private out-of-network context FAIR Health President Robin Gelburd said. ”Many consumers are not aware of the differences between Medicare and UCR payment schedules and the cost impact on patients when their plans switch to a Medicare-based formula. Consumers can now use the Medicare Compare feature on the popular Medical Cost Lookup to understand their cost exposure if their plans use a Medicare-based reimbursement method.”
Previously, the free FH Medical Cost Lookup estimated costs for the UCR-based reimbursement method for a queried procedure. The UCR-based method remains the default, but with FH Medicare Compare, consumers can select the “Medicare-based” button to view Medicare-based reimbursement for a specific procedure and “Compare” to see Medicare- and UCR-based amounts side-by-side.
Medicare-based reimbursement:
Insurance plans using Medicare as the basis for out-of-network reimbursement multiply the fee set by Medicare for a specific medical procedure by a specified percentage to determine the maximum amount that they will reimburse for the procedure.
For example, assume that a patient visits an out-of-network doctor in Chicago, Illinois, who charges $1,700.03 for a colonoscopy with a biopsy. The patient’s insurance plan reimburses the visit based on 140% of what Medicare would normally pay for someone covered by Medicare. If the Medicare fee is $297.48 for that office visit, the plan would agree to pay up to $416.47, and the patient would be responsible for the remaining $1,283.56.
UCR-based reimbursement:
Using the same fact pattern, assume instead that the patient’s insurance plan reimburses at the 80th percentile of what the insurance company determines as UCR and the charge at such percentile is $1,700.03. If the insurer reimburses based on 70% of UCR, or $1,190.02 in this case, then the patient would be responsible for only the remaining $510.01 for that visit.
In these two examples, although the percentage of reimbursement for UCR (70%) was lower than that of Medicare (140%), the patient was responsible for a smaller portion of the $1,700.03 bill when the plan based reimbursement on a percentage of UCR, than on the Medicare fee. The new feature will allow consumers to estimate their out-of-pocket costs based on options that better reflect their specific plan provisions.
For a fuller description of the use of the Medicare fee schedule in out-of-network reimbursement, please visit www.fairhealthconsumer.org/reimbursementseries/medicare.aspx.
To use FH Medicare Compare to calculate the difference between Medicare-based and UCR-based reimbursement, visit www.fairhealthconsumer.org/medicalcostlookup.
About FAIR Health:
FAIR Health is a national independent, not-for-profit corporation whose mission is to bring transparency to healthcare costs and health insurance information through comprehensive data products and consumer resources. FAIR Health uses its database of billions of billed medical and dental services to power a free website (fairhealthconsumer.org) that enables consumers to estimate and plan their medical and dental expenditures. The website also offers clear, unbiased educational articles and videos about the healthcare insurance reimbursement system. In addition to its consumer offerings, FAIR Health licenses data products to businesses, governmental agencies, healthcare providers and researchers. With its professional staff of experts in healthcare, statistics, technology and communications, FAIR Health strives to offer accurate, consistent and timely information to all stakeholders in the healthcare system.
Thursday, February 9, 2012
Health Savings Accounts Help Consumers Save on Their Taxes and Health Care
INDIANAPOLIS--(BUSINESS WIRE)--
As 2011 W-2 forms and 1099s start arriving in mailboxes throughout the country, now is the time to remind taxpayers with health savings accounts (HSAs) that they have until April 17 to contribute to their HSAs to maximize their 2011 deductions, up to the legal limit.
For 2011, HSA contributions are tax deductible up to $3,050 for individuals and up to $6,150 for families. HSA holders who are 55 and older can deduct an additional $1,000. In 2012, tax-deductible contribution limits have been increased to $3,100 for individuals and $6,250 for families.
Health savings accounts have two components: a tax-advantaged savings account coupled with a high-deductible health insurance plan. In addition to the tax savings, a high deductible health insurance plan paired with an HSA typically costs significantly less in monthly premiums compared to more traditional health insurance while still providing quality coverage, including preventive care.
Savings deposited into an HSA grow tax-deferred and can be withdrawn tax-free as long as the HSA dollars are used for qualified medical expenses, which include health insurance deductibles as well as vision and dental care that are not covered by health insurance plans.
“HSAs make sound financial sense because they enable consumers to save tax-free for their current and future medical needs,” said Richard A. Collins, CEO, UnitedHealthcare’s Golden Rule Insurance Company.
According to a recent Fidelity Investments® survey, “almost seven in 10 (68 percent) of pre-retirees said the cost of medical care in retirement is one of their three biggest financial concerns.”
“Unspent HSA savings can accumulate year after year, earning interest. This helps build up a ‘medical nest egg’ that can be valuable later in life when health care needs can increase significantly,” Collins said.
To learn more about HSAs, visit www.HSAcenter.com, an interactive online resource developed by Golden Rule to educate consumers about the advantages that health savings accounts offer. Golden Rule’s expertise in the consumer-directed health care market goes back more than 20 years when the company introduced the first medical savings account (MSA), predecessor to the HSA.
About Golden Rule
A leading provider of health insurance for individuals and families for 65 years, Golden Rule has been a UnitedHealthcare company since 2003. UnitedHealthcare’s personal health and dental plans are offered in 41 states and the District of Columbia, and marketed under the UnitedHealthOne brand. For more information, consumers can call 1-800-444-8990, visit www.goldenrule.com or contact a local independent insurance broker who offers UnitedHealthOne health and dental plans.
Tuesday, January 17, 2012
Assurant Health Contracts With Aetna Signature Administrators® to Provide Consumers With Access to Expanded PPO ...
MILWAUKEE, Jan. 17, 2012 /PRNewswire/ -- Assurant Health, a leading provider of major medical, supplemental and fixed-benefit health plans for individuals, families and small employers, announces an agreement with Aetna Signature Administrators, allowing current and prospective major medical customers of Assurant Health to access the Aetna Signature Administrators national PPO network.
Beginning in March, major medical customers of Assurant Health will be able to access care from more than one million health care providers and 7,500 hospitals nationwide within the Aetna Signature Administrators PPO network. Access to this network will enhance the competitiveness of Assurant Health for individuals, families and small groups. In addition, Aetna will provide utilization and case management services to Assurant members and share risk as part of a reinsurance agreement.
"This partnership with Aetna reaffirms the commitment of Assurant Health to ensuring our customers can access high-quality, affordable health care coverage," said Adam Lamnin, president and CEO of Assurant Health. "This is great for our customers and exciting for Assurant Health as we strengthen our position as a leading provider of individual and small group major medical insurance in the United States."
The multi-year agreement provides access to all current and future Assurant Health major medical individual and small group policyholders.
"Through Aetna Signature Administrators, members can gain access to a strong nationwide network of health care providers and important medical management services," said Ralph Borzillo, President of the Aetna Signature Administrators business. "We are excited to provide these critical services to Assurant Health's members."
About Assurant Health
Assurant Health is the brand name for a family of health insurance products focused on providing a variety of affordable plan choices to consumers. The portfolio of health care products includes major medical, supplemental and fixed-benefit plans for individuals, families and small employers. Assurant Health is committed to providing access to convenient health care delivery, easy-to-understand products and value-added services that help customers better manage their health care dollars and get the most out of their coverage—ultimately seeking to protect not only financial security but also the health and well being of its customers. Assurant Health's products are underwritten and issued by John Alden Life Insurance Company, Union Security Insurance Company and Time Insurance Company, which has been in business since 1892. Headquartered in Milwaukee, Assurant Health employs approximately 2,000 employees. www.assuranthealth.com
Assurant Health is part of Assurant, a premier provider of specialized insurance products and related services in North America and select worldwide markets. Assurant, a Fortune 500 company and a member of the S&P 500, is traded on the New York Stock Exchange and has approximately $27 billion in assets and $8 billion in annual revenue. www.assurant.com
About Aetna Signature Administrators
Aetna Signature Administrators provides access to a national PPO network, medical management services and stop loss or reinsurance coverage to third party administrators and health plans.
Thursday, January 12, 2012
Obama's health-care law is hurting insurance agents and millions of consumers
The national health-care reform law‘s unintended consequences have been well catalogued. This month marks a year since President Obama’s Affordable Care Act, sometimes called Obamacare, put into play one of its lesser known, but most damaging provisions.
If you’ve never heard of the law’s medical loss ratio (MLR) provision, you’re certainly not alone. This simple calculation has had the effect of radically reducing what health insurance agents earn. That, in turn as greatly restricted their ability to help million of Americans navigate the maze of approvals needed for medical procedures and processing claims. It has also had a devastating effect on these agents’ businesses and is disrupting the insurance market.
RELATED: Health care law's future: four scenarios
At the end of last year, state insurance commissioners took a big step to undo some of the damage done by the Patient Protection and Affordable Care Act. The National Association of Insurance Commissioners approved a resolution urging Congress to remove health insurance agents’ compensation from the law’s medical loss ratio provision. In the meantime, the association wants the Obama administration to what it can to mitigate the negative impact of the provision.
So what does that mean?
The MLR provision states that insurers must dedicate at least 80 percent of individual and small group premiums they receive to medical- or quality-improvement expenses. The figure goes up to 85 percent for large group policies. Because agents’ compensation counts against the MLR (along with such items as marketing expenses and corporate profits), many insurance companies immediately slashed commissions when the provision went into effect last January.
Insurers having to put such a high portion of the premiums collected toward these expenses meant that agents – on the frontlines of helping customers – made less and had to cut services to compensate.
OPINION: Uncle Sam's meddling in health insurance rates is wrong and will hurt consumers
A November survey by the National Association of Insurance and Financial Advisors found that 80 percent of health insurance agents saw their commissions decrease, including 52 percent whose companies cut commissions by 25 percent or more, since the health-care law went into effect last January. A report by the Government Accountability Office confirmed this, stating that “almost all of the insurers said they had decreased or planned to decrease commissions to brokers in an effort to increase their MLRs.”
If it sounds like it’s a tough time to be an insurance agent, it is. Their median annual income was less than $50,000 before the law went into effect. Many are small business owners who can no longer afford to pay their employees.
But the problem is much more serious than that. It’s getting tougher to be a consumer in the market for health insurance, too. Unlike agent compensation, premiums have not gone down. And while removing compensation from the MLR would not cause premiums to increase, there have been a slew of unintended consequences from leaving it in.
THE MONITOR'S VIEW: When the Supreme Court takes up the Obama health-care law 'mandate'
Agents do much more than sell insurance. They serve their clients, not the insurance companies, helping people when they have trouble getting surgical procedures and tests approved or claims processed. They provide corporate clients with individual enrollment assistance for their employees. They create and administer company wellness programs and often serve as the extended human resources departments for small business clients.
As agents deal with the consequences of the MLR, many are finding that the cost of servicing clients now exceeds their income. They are cutting back on services to customers and laying off support staff. Some are leaving the health insurance business altogether, effectively reducing the competition that the health-care law was supposed to foster. All of this is disrupting the marketplace.
That’s why I applaud the efforts of the National Association of Insurance Commissioners. The commissioners are well respected and have a long history of protecting consumers and ensuring the stability of the insurance market. Their opinion rightfully carries weight among decisionmakers in Washington.
ANOTHER VIEW: Barrier to better health care: Republican definition of freedom
Congress and the president certainly never intended for the law to limit consumers’ health-care choices or reduce the quality of their coverage. As President Obama has acknowledged, “Anything can be improved.” Treating agents’ compensation as a pass-through item and thereby removing it from the MLR equation would be a huge improvement and a first step toward ensuring that Americans continue to have access to the essential support and customer service that professionally trained and licensed agents provide.
Robert Miller is president of the National Association of Insurance and Financial Advisors, based in Falls Church, Va. NAIFA comprises more than 600 state and local associations representing the interests of 200,000 members and their associates nationwide.
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