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May 31, 2007

Health insurance regulation proposed

An effort to regulate California's health insurance premiums like auto coverage faces a key challenge today in the state Assembly.

A bill authored by Assemblyman Dave Jones, D-Sacramento, would require state regulators to approve increases in premiums, co-payments and deductibles proposed by insurers.

Gov. Arnold Schwarzenegger's health care reform proposal would require all Californians to obtain health insurance. As part of the governor's plan to control the costs of coverage, insurers would have to spend at least 85 percent of all premium dollars on medical care.

But a number of consumer and labor groups say the governor's plan doesn't go far enough to control costs. Californians who do not receive coverage through an employer or qualify for government subsidies would be required to purchase individual insurance. Rates for such coverage have been far outpacing inflation for years.

Jones' bill faces stiff opposition from the insurance industry. It needs enough votes to move out of the Assembly Appropriations Committee to stay alive.

"This is the big showdown," said Jerry Flanagan, health care advocate for the Foundation for Taxpayer and Consumer Rights, a consumer group supporting the bill. "The insurers want to kill it ... because the cost savings are huge for California consumers and they don't want that fact to be public."

The California Association of Health Plans, which represents the state's health insurers, doesn't believe rate regulation is the right way to control costs.

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Posted by healthinsurance at 06:24 PM | Comments (0)

May 30, 2007

SoCal Doctors Post Prices Of Procedures Online

Breaking with long-held medical tradition, a Southern California physicians group has become one of the first and largest health organizations in the nation to make prices for procedures easily available to the public.

HealthCare Partners put an itemized price list on its Web site last week, with little fanfare.

"It feels like the right thing to do," said Robert Margolis, a founding physician and chief executive of the medical group.

The Torrance-based company serves more than 500,000 patients, who can now learn without asking that a flu vaccine runs $15, a chest X-ray goes for $61, and a colonoscopy costs $424.

The page can be accessed easily by clicking on "fees for basic services."

The move was spurred in part by the growth of walk-in clinics at malls and Wal Marts that provide simple medical services like vaccines and ultrasounds and make no secret of their prices.

Doctors have at times thought the practice of publicizing prices was undignified and crassly commercial, and patients with insurance often haven't cared about particular prices beyond their co-payments and premiums.

But with employers increasingly shifting more costs to workers, the numbers have begun to matter more.

"Before, if you had a $10 or $5 co-pay, it didn't hit your pocketbook," said Chris Ohman, chief executive of the California Association of Health Plans, a trade group that represents insurers. "But if now you have to pay the first $2,000, the cost of an office visit matters to you a lot more."

Some insurance companies, including Aetna Inc., have posted prices online for some regions.

HealthCare Partners hopes potential customers will appreciate their tranparency and recognize the value of a physicians group over a walk-in clinic.

"It shows them, 'This is why I'm paying more,' "said health care consultant Mary Kay Scott. "They are giving me more."

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Posted by healthinsurance at 04:11 PM | Comments (0)

May 29, 2007

California Health Care Advocates Launch Investigation of Long-Term Care Insurers' Claims-Handling Policies

The House Energy and Commerce Committee last week sent letters to long-term care insurers Conseco and Penn Treaty American to request documents as part of an investigation into the business practices of such companies, the San Francisco Chronicle reports. The committee launched the investigation in response to a March New York Times article that examined issues related to long-term insurance (Colliver, San Francisco Chronicle, 5/26).

In the article, the Times reviewed more than 400 complaints and lawsuits filed against long-term care insurers and found that some of the companies have developed practices to limit the ability of policyholders to receive claims payments (Kaiser Daily Health Policy Report, 3/26). Bonnie Burns, training and policy specialist for California Health Advocates, said, "Seven, eight, nine years later they are looking at claims and saying, 'gee whiz, is there anything on that application we can use to deny this claim,'" adding that the investigation "will shed light on practices that have been going on far too long without any regulatory response."

In a statement, Penn Treaty officials defended company business practices and said the company "sees this as an opportunity to highlight the value of long-term care insurance to America's seniors." Conseco officials in a statement said, "We agree that every long-term care policyholder deserves assurance that their claim will be handled timely and in accordance with the terms of their contract," adding that the company seeks a "thorough and fair" investigation.

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Posted by healthinsurance at 07:21 PM | Comments (0)

May 28, 2007

Health Benefits Direct to Enter California Market

Health Benefits Direct Corporation (OTCBB: HBDT), a leading innovator in the direct marketing and distribution of a wide range of health and life insurance products in the individual market, today announced that it has entered into an agreement with PacifiCare, a UnitedHealthcare company, to market a number of PacifiCare's health insurance plans for individuals and families in California.

"We are continuing to selectively and strategically expand our health insurance portal with leading providers like PacifiCare," said Alvin H. Clemens, Chairman and Chief Executive Officer. "As an advocate for individual insurance consumers, we want to line our customers up with the best, most reliable coverage offered by the most highly rated carriers. Adding PacifiCare enables us to enter the large California market with a premier offering of health insurance products."

In addition to PacifiCare, Health Benefits Direct's major medical insurance carriers include UnitedHealthcare's Golden Rule Insurance Company, Aetna, Humana, Time Insurance Company (marketed as Assurant Health), and UniCare (a Wellpoint company). The company offers life insurance through Fidelity Life and AIG American General (an AIG company). Indemnity, short-term major medical, and critical illness insurance is offered through various additional partners.

About Health Benefits Direct Corporation

Health Benefits Direct Corporation is an insurance agency that operates an interactive online marketplace and contact centers enabling consumers to shop for, compare, and purchase health and life insurance and related products for individuals and families. Health Benefits Direct's sales platform combines its proprietary, integrated online technology and dialing application to connect consumers who express an interest in purchasing health or life insurance or related products with its knowledgeable, licensed agents housed in one of its contact center locations. www.insuremyhealth.com

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Posted by healthinsurance at 09:23 PM | Comments (0)

May 21, 2007

Advantages of single-payer plans

America's health care system is broken. While attempts at reforming it have stalled due to the ideological differences between the two major political parties, the number of Americans without health insurance has risen steadily to the point where we now have 47 million people, approximately one-sixth of the population, uninsured.

Several states have begun to propose various plans to increase the number of people covered by insurance. The most recent of these proposals have come from Massachusetts and California. While developing a patchwork of coverage across every state might have a certain appeal for proponents of states' rights, access to at least a minimum level of health care ought to be a right of every citizen of the richest country in the world, and it is a problem that ought to be tackled at the federal level.

Under the current system, the United States spends the equivalent of $6,280 for every American each year on health care -- twice the average spent by other OECD countries. In spite of that, it is the only rich country that does not guarantee universal health coverage.

One plan that proposes to provide universal coverage is the Single Payer National Health Insurance plan. This is a system where a single public or quasi-public entity is responsible for health financing while delivery of services remains private. While the primary benefit of this plan is that it provides for universal coverage, there are several other ancillary benefits.

Since the main purpose of such a plan is delivering needed health care, it tends to be more about the patient and less about maximizing profits for the insurance companies. So individuals would have the ability to go to the doctor or hospital of their choice.

Got insurance? Click here for your free California health insurance quote now!

Posted by healthinsurance at 02:56 PM | Comments (0)

May 16, 2007

Small Businesses Struggle To Afford Employer Health Insurance

American Public Media's "Marketplace" on Monday examined how small businesses are dealing with rapidly rising employee health insurance costs. "Marketplace" profiled Lincoln Precision Machining, a Massachusetts company with about 20 employees that has seen health insurance premiums for each worker increase from $460 per month in 1999 to nearly $1,500 per month today. The company used to pay the entire premium but now requires workers to pay about $300 per month.

John Arensmeyer, head of the Small Business Majority, said, "Many times, entrepreneurs can't get health insurance because they're too high a risk," adding, "If you run a small business and you can get rated just based on yourself or a few other employees, you may be out of luck finding affordable insurance at all." Arensmeyer also said that small businesses need a system that guarantees access to affordable health insurance.

Gary Claxton, vice president of the Kaiser Family Foundation and director of the Kaiser Family Foundation Health Care Marketplace Project, said there is national momentum towards broad-based health plans like initiatives in Massachusetts and California, adding that there "be some business opposition, because most of the proposals that we see do require businesses to do something" (Ryssdal, "Marketplace," American Public Media, 5/14).

Californians, click here for your free health insurance quote now!

Posted by healthinsurance at 05:11 PM | Comments (0)

May 14, 2007

Blue Cross to stop retroactive insurance cancellations

Blue Cross of California — under scrutiny for retroactively canceling health insurance policies leaving patients with unpaid medical bills — has agreed to a class-action settlement that would sharply alter its practice and could set a precedent for other insurers.

At issue is an infrequently used, but longstanding industry practice: Canceling coverage after patients make costly claims, if insurers find mistakes or omissions on application forms completed by policyholders. The practice, called "rescission," affects people who buy their own insurance, not those covered under group plans, such as job-based coverage.

The proposed settlement, which must be approved by the courts, comes amid increased scrutiny of the practice, particularly in California. State regulators there are reviewing many insurers and have issued fines against two: Blue Cross, which is a subsidiary of WellPoint; and Kaiser Permanente.

In the proposed settlement, presented in Los Angeles County Superior Court on Friday, Blue Cross agreed not to retroactively cancel coverage unless policyholders "intentionally misrepresented" information on their applications.

In March, the California Department of Managed Health Care fined Blue Cross $1 million, saying a review of 90 canceled policies found that the insurer had failed to conduct thorough pre-enrollment investigations on 39 of them and found none in which the insurer had proven the applicant was intentionally deceptive. Blue Cross is contesting that fine.

Click here for your free California health insurance quote!

Posted by healthinsurance at 05:02 PM | Comments (0)

May 11, 2007

Blue Cross and Canceled Policyholders Agree to Settlement

A major class action settlement has been reached with Blue Cross of California, a Wellpoint subsidiary, concerning the cancellation of health insurance policies that occur after a claim for pre-authorized medical treatment. From now on, Blue Cross has agreed that it will not retroactively cancel insureds' health insurance policies unless the insured "intentionally misrepresented" information on the insurance application. "This will stop the practice of canceling health insurance policies for honest mistakes, inadvertent errors, or other inconsistencies that often appear on health insurance applications," said William Shernoff of the Claremont law firm of Shernoff, Bidart & Darras, who represents a class of approximately 6,000 Blue Cross policyholders.

The settlement also includes a new individual health insurance application that is designed to minimize mistakes and new procedures to be followed at Blue Cross that will assure customers that cancellation of insurance policies will only take place upon a finding of "willful misrepresentation." Additionally, Shernoff said, "Even if a cancellation occurs upon such a finding, the insured will still have a right to appeal that decision to either the Department of Insurance or the Department of Managed Health Care."

Shernoff praised the Department of Managed Health Care and the Department of Insurance for becoming involved in the negotiations leading up to the settlement saying they "gave tremendous input and support to help this settlement become a reality." Both the Department of Managed Health Care and the Department of Insurance had representatives involved in the lengthy mediation process, presided over by former California Supreme Court Justice Edward Panelli.

"In addition to the new procedures that Blue Cross will put in place in the future to end most cancellations, the settlement also provides remedies for approximately 6,000 Blue Cross insureds that have already been cancelled under such circumstances," said Shernoff who called the settlement "a major breakthrough." "Blue Cross should be credited for recognizing this problem and their willingness to fix it." Shernoff said, "It will be interesting to see if other health insurance companies like Blue Shield, Health Net and others will follow suit."

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Posted by healthinsurance at 02:29 PM | Comments (0)

May 09, 2007

Big companies are backing health reform

Not so long ago, we remember a bright-eyed pair of Clintons arguing for universal health care. Bill Clinton took his wife's plan before Congress, where "HillaryCare" was received about as well as the waiting list for a liver transplant.

Corporate America shunned the proposed reforms, which would have required companies to offer insurance to all employees by working with heavily regulated health maintenance organizations (HMOs). Without support from Democrats, the plan died in the ambulance on the way to the hospital.

Putting HillaryCare on ice might have made sense in the days when insurance premiums weren't the burden on business they are today, and individuals could buy plans at relatively reasonable rates without fear of being dropped the moment they sneezed.

Or maybe the Clintons were ahead of their time back in 1993 and could have staved off the mess health care is now in. We'll never know.

These days, Sacramento is looking at another proposal - we'll call it "ArnieCare" - that could cover the 6 million uninsured Californians by requiring businesses, doctors and hospitals to pay into a fund that would give bare bones, or catastrophic, coverage to everyone.

Arnold Schwarzenegger's ambitious proposal is becoming increasingly attractive to the two strange bedfellows - Democrats and businesses - he needs to push his reforms through the Legislature.

Thirty-six of the state's largest employers - General Mills, Kroger, PepsiCo, Safeway and Wrigley among them - began a formal political campaign Monday in favor of Schwarzenegger's proposals. A surprising number of health and insurance companies, such as Aetna, Blue Shield of California and PacificCare, are on board as well.

Californians, click here for you free health insurance quote now!

Posted by healthinsurance at 05:25 PM | Comments (0)

May 07, 2007

Require all residents to have health insurance

In the state of Maryland where there is Medicare, Medicaid and employer coverage (Prince George’s unemployment rate of 4.5 percent), we should not have a massive problem with uninsured patients. A solution to the health care crisis in Prince George’s County and elsewhere in Maryland is to require all residents of Maryland to have health care insurance.

Currently Maine, Massachusetts and California have passed legislation to require residents to have health insurance through state sponsored health plans or employment plans. This will bring the populace closer to universal health care coverage.

Benefits of this plan are that Marylanders will have coverage, and hospitals will receive payment through the plans.

Click here for your free California health insurance qoute!

Posted by healthinsurance at 12:17 AM | Comments (0)

May 02, 2007

The wise investment of insuring children

SMALL CHANGES, as any parent knows, can make a big difference in the lives of young children.

When Sheila Miguel, a single mother in Sun Valley, had no health insurance, her 7-year-old daughter, Chelsea, received only sporadic treatment for her asthma, usually in an emergency room after she suffered an attack. Chelsea almost never saw the same doctor twice. When her medication ran out, the family often could obtain more only by returning to the emergency room. Mostly, Sheila tried to make do on her own.

"She would have asthma attacks and I would just treat it at home, … and as a mother, it is pretty stressful," Sheila said.

But since last winter, Chelsea has received health insurance through the "Healthy Kids" plan offered by the Children's Health Initiative of Los Angeles, a public-private partnership that covers about 40,000 otherwise uninsured children across the county.

Chelsea, a second-grader, now receives regular treatment from a doctor in a mobile asthma clinic that visits the small, welcoming health center attached to the Charles MacLay Middle School in Pacoima. She misses school much less often and plays more easily with her friends when she's there. And her mother sleeps better at night.

Californians, get your free individual and family health insurance quote now!

Posted by healthinsurance at 05:18 PM | Comments (0)