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<title>Colorado Health Insurance Insider » Anthem Blue Cross</title>
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<title>HB1355 Now In Effect For All Small Groups In Colorado</title>
<link>http://www.healthinsurancecolorado.net/blog1/2009/11/05/hb1355-now-in-effect-for-all-small-groups-in-colorado/</link>
<comments>http://www.healthinsurancecolorado.net/blog1/2009/11/05/hb1355-now-in-effect-for-all-small-groups-in-colorado/#comments</comments>
<pubDate>Thu, 05 Nov 2009 17:54:16 +0000</pubDate>
<dc:creator>Louise</dc:creator>
<category><![CDATA[Anthem Blue Cross]]></category>
<category><![CDATA[Group Health]]></category>
<category><![CDATA[Health Insurance Reform]]></category>
<category><![CDATA[Individual/Family Health]]></category>
<category><![CDATA[Anthem Blue Cross Blue Shield]]></category>
<category><![CDATA[colorado]]></category>
<category><![CDATA[HB1355]]></category>
<category><![CDATA[health insurance]]></category>
<category><![CDATA[mandatory health insurance]]></category>
<category><![CDATA[premium increase limits]]></category>
<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1426</guid>
<description><![CDATA[[...] Critics are questioning why insurers keep bringing up HB1355, as the trend in national health care reform these days is towards guaranteed issue health insurance without underwriting - which is what HB 1355 was all about. But while HB1355 was beneficial to groups with unhealthy members, the majority of small groups in Colorado had a discount before HB1355 took effect. And if those groups are unable to afford their new, higher rates, they can opt to cancel their coverage - which leads to higher prices for groups that remain covered. On a national level, as far as individual health insurance is concerned, HB1355 should be considered a warning sign. Getting rid of medical underwriting is the right, and fair, thing to do. But not if people can come and go as they please in the insurance system. We've seen what the impact will be on premiums if guaranteed issue coverage takes effect without a strong mandate requiring people to carry health insurance. I think this is why insurers are still bringing up HB1355. It's impacting all small groups in Colorado now - there's no more putting it off. And significant rate hikes for healthy groups should serve as a warning for what we'll likely see in the individual market if reform passes without a way to make sure that everyone is part of the insurance pool.]]></description>
<content:encoded><![CDATA[<p>When Colorado HB1355 became law, we noted that <a href="http://www.healthinsurancecolorado.net/blog1/2008/10/06/how-hb1355-will-affect-our-colorado-clients/">for our own small group clients, it would almost universally increase premiums</a>. The new law eliminated the practice of setting small group premiums based on the overall health of a group (previously, groups could get a discount up to 25%, or a rate increase of up to 10%, compared with base rates). HB1355 took effect for policies starting or renewing on or after January 1 2009, but businesses were able to keep their discount for part of this year if their policy renewed before the end of the year last year. Last fall, Anthem Blue Cross Blue Shield allowed small businesses to move up their renewal dates in order to keep their discounts for another year, which most of our Anthem clients opted to do. But now those plans are up for renewal again, and <a href="http://www.denverpost.com/news/ci_13716161">there is no way to avoid the premium increases for groups of generally healthy employees</a>.</p>
<p>Insurance carriers in Colorado were strongly opposed to HB1355. The majority of small businesses in Colorado were receiving a discount on premiums based on health status, which HB1355 forbids. Insurers knew that businesses that were already struggling to pay premiums at a reduced rate might decide to forgo health insurance for their employees after the discount was eliminated. This is especially true for the most healthy groups, whose members can find health insurance within the medically underwritten (and less expensive) individual market. Of course the removal of healthy groups from the pool of insureds only serves to drive premiums even higher for the sicker groups who remain insured under the group plans. It’s true that groups can no longer be rated higher than the base rate because of the specific health of the group, but the base rate can – and likely will – continue to rise.</p>
<p>Critics are questioning why insurers keep bringing up HB1355, as the trend in national health care reform these days is towards guaranteed issue health insurance without underwriting – which is what HB 1355 was all about. But while HB1355 was beneficial to groups with unhealthy members, the majority of small groups in Colorado had a discount before HB1355 took effect. And if those groups are unable to afford their new, higher rates, they can opt to cancel their coverage – which leads to higher prices for groups that remain covered. On a national level, as far as individual health insurance is concerned, HB1355 should be considered a warning sign. Getting rid of medical underwriting is the right, and fair, thing to do. But not if people can come and go as they please in the insurance system. <a href="http://www.healthinsurancecolorado.net/blog1/2009/10/25/how-current-reform-proposals-would-impact-colorado-premiums/">We’ve seen what the impact will be on premiums</a> if guaranteed issue coverage takes effect without a strong mandate requiring people to carry health insurance. I think this is why insurers are still bringing up HB1355. It’s impacting all small groups in Colorado now – there’s no more putting it off. And significant rate hikes for healthy groups should serve as a warning for what we’ll likely see in the individual market if reform passes without a way to make sure that everyone is part of the insurance pool.</p>
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<item>
<title>How Current Reform Proposals Would Impact Colorado Premiums</title>
<link>http://www.healthinsurancecolorado.net/blog1/2009/10/25/how-current-reform-proposals-would-impact-colorado-premiums/</link>
<comments>http://www.healthinsurancecolorado.net/blog1/2009/10/25/how-current-reform-proposals-would-impact-colorado-premiums/#comments</comments>
<pubDate>Sun, 25 Oct 2009 19:10:05 +0000</pubDate>
<dc:creator>Louise</dc:creator>
<category><![CDATA[Anthem Blue Cross]]></category>
<category><![CDATA[Health Insurance Reform]]></category>
<category><![CDATA[Individual/Family Health]]></category>
<category><![CDATA[Anthem Blue Cross Blue Shield]]></category>
<category><![CDATA[colorado]]></category>
<category><![CDATA[health insurance]]></category>
<category><![CDATA[mandatory health insurance]]></category>
<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1385</guid>
<description><![CDATA[[...] Wellpoint actuaries have crunched the numbers and come up with their best estimates as to how premiums would be impacted in the 14 states where Wellpoint operates. Colorado is one of those states, and for the first time we're able to see a detailed analysis of what would likely happen to premiums for people here. [...]]]></description>
<content:encoded><![CDATA[<p>From the beginning of the health care reform debate, cost has been the primary issue. Plenty of focus has been aimed at how to control health care costs (which nobody seems to have figured out yet), along with CBO estimates of what each piece of proposed legislation would cost taxpayers. But we haven’t seen much in the way of determining how the proposed legislation would impact health insurance premiums. We know that in states where health insurance is guaranteed issue but coverage is not mandatory, premiums on individual policies are far higher than in states like Colorado, where policies are underwritten. But what would happen to premiums in states that use medical underwriting (all but five states) if the current versions of health care reform become law?</p>
<p>Wellpoint actuaries – the people who are responsible for setting premiums – have crunched the numbers and come up with their best estimates as to how premiums would be impacted in the <a href="http://wellpoint.com/newsroom/stats_facts.asp">14 states where Wellpoint operates</a>. Colorado is one of those states, and for the first time we’re able to see a <a href="http://wellpoint.com/pdf/Colorado%20Premium%20Impacts%20Analysis.pdf">detailed analysis of what would likely happen to premiums for people here</a>, both the old and the young, the sick and the healthy. All health insurance providers operating in Colorado have to follow the same rules as far as state mandates and regulations, and they all have to compete with each other. So it’s reasonable to assume that the data is also indicative of what would happen to premiums on policies offered by most of the health insurance carriers in Colorado.</p>
<p>With the current proposed legislation, it looks like we would see a huge premium increase for young, healthy people in the individual market in Colorado (about 140%). For average age policyholders in average health, premiums would likely increase by 52%. Older, sicker individuals would get a break though, and would see a premium decrease of about 22%.</p>
<p>The bulk of the increase in premiums stems from the fact that the requirement that everyone carry health insurance has been <a href="http://www.healthinsurancecolorado.net/blog1/2009/10/06/mandate-an-important-part-of-reform-efforts/">greatly eroded</a> over the last several weeks. If the penalty for not having health insurance is dramatically less than the cost of coverage, it makes sense that healthy people who are trying to save money might opt for the penalty instead of the premiums. And if health insurance is guaranteed issue anyway, why wouldn’t they? If they started to feel sick, they could sign up for health insurance at that point, knowing that their pre-existing conditions would be covered. The obvious result would be ever-increasing loss ratios for health insurance companies, followed by even higher premiums to try to make up the difference. Higher premiums would mean more healthy people – who otherwise would still like to have health insurance coverage – being forced to drop their policies. There is no possible way that guaranteed issue health insurance is sustainable unless <em>everyone</em> is required to be in the health insurance system.</p>
<p>The penalty for opting to not carry health insurance is currently proposed to start at $200/year in 2014, and would gradually increase to $750/year in 2017. This is not even close to what health insurance actually costs, which means that people who are healthy might very well choose to pay the penalty rather than buy health insurance.  Another problem with the proposed method for enforcing the mandate is that is would work via the tax system. That leaves millions of Americans – those who don’t file taxes, or who have no tax liability – outside of the mandate-enforcement system. If we truly want to make sure that all Americans are insured, we need to have a better way of enforcing the mandate. We need penalties that are approximately equal to the cost of premiums, an enforcement system that is more broad than the IRS (perhaps a combination of schools, the DMV, hospitals and clinics, and any government office), and increased subsidies for lower income families.</p>
<p>Health insurance for everyone, regardless of pre-existing conditions, is possible. But it’s not possible if the system is essentially set up to encourage only unhealthy people to buy health insurance. Insurance works by spreading risk. We need to make sure that young, healthy people are paying into the insurance pool in order to offset the claims made by older, sicker individuals. Without a strong, widely enforced mandate, guaranteed issue health insurance isn’t a sustainable proposal.</p>
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</item>
<item>
<title>The Impact Of Medical Underwriting On Premiums</title>
<link>http://www.healthinsurancecolorado.net/blog1/2009/09/11/the-impact-of-medical-underwriting-on-premiums/</link>
<comments>http://www.healthinsurancecolorado.net/blog1/2009/09/11/the-impact-of-medical-underwriting-on-premiums/#comments</comments>
<pubDate>Fri, 11 Sep 2009 20:05:12 +0000</pubDate>
<dc:creator>Louise</dc:creator>
<category><![CDATA[Anthem Blue Cross]]></category>
<category><![CDATA[HSA]]></category>
<category><![CDATA[Health Insurance Reform]]></category>
<category><![CDATA[Humana]]></category>
<category><![CDATA[Individual/Family Health]]></category>
<category><![CDATA[Anthem Blue Cross Blue Shield]]></category>
<category><![CDATA[colorado]]></category>
<category><![CDATA[HB1355]]></category>
<category><![CDATA[health insurance]]></category>
<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1321</guid>
<description><![CDATA[[...] Many proponents of a shift away from medical underwriting want to require everyone to carry health insurance. That would help spread the cost of care across a larger population, and would likely help to contain the price increase that we would see if medical underwriting were to cease. But my guess is that we would still see a rather dramatic increase in premiums.]]></description>
<content:encoded><![CDATA[<p>The issue of pre-existing conditions and medical underwriting in the individual health insurance market has been a major point of contention in the health care reform debate this year. <a href="http://insureblog.blogspot.com/2009/09/on-risk-insurance-and-intellectual.html">Hank Stern of InsureBlog has weighed in on the topic</a>, and it’s an issue that I think deserves another look. Hank points out that in the small group market, health insurers are required (for the most part) to accept all applicants without much in the way of medical underwriting. People who haven’t had continuous coverage will have waiting periods applied to pre-existing conditions, but they can’t be declined completely, and once the waiting period is over, even the pre-existing conditions are covered. Here in Colorado, small groups used to be subject to some underwriting in order to determine the premium – groups could qualify for up to a 25% discount or a 10% price increase based on the overall health of the members. <a href="http://www.healthinsurancecolorado.net/blog1/2008/10/06/how-hb1355-will-affect-our-colorado-clients/">But that disappeared with HB 1355</a>.</p>
<p>The individual market is different. Medical underwriting is part of the application process, and applicants can be declined, offered coverage at a higher price, or offered coverage with pre-existing condition exclusions. The trade off is that the policies are less expensive than they would be in the group market.</p>
<p>Jay and I have an HSA-qualified policy for our family. It has a $5000 deductible (one deductible for all three of us together). Other than a small amount of preventive care, nothing is covered before the deductible is met, so our coverage only comes into play if we have a relatively large claim. But it only costs $288/month for our family. It also allows us to put pre-tax money into an HSA and save up for the possibility of having to meet our deductible one day (or for retirement, if we don’t end up needing the money for medical expenses).</p>
<p>Jay and I are both full-time employees of our corporation, and could thus qualify as a group of two with any small group carrier in the state. For comparison’s sake, I got a quote for us for an Anthem Blue Cross Blue Shield HSA-qualified policy. Jay and I would each have our own policy as a group of two, with our son added to one of the policies. I found an HSA qualified small group policy that would cost $578/month for our group. But the deductibles would end up being a total of $15,000 for our family on that policy. The policy would be twice as expensive as what we have now, and the out of pocket exposure would be three times as much as what we have now. And that’s a quote from a very competitive carrier.</p>
<p>Incidentally, if all three of us had medical conditions that allowed us to qualify for <a href="www.covercolorado.org">Cover Colorado</a>, we could pay a total of $550/month for three separate HSA qualified policies, each with a $2000 deductible. This is another example of guaranteed issue coverage, and the increased price when compared with our current policy reflects the added cost that comes when health insurance picks up the tab for pre-existing conditions.</p>
<p>That’s what happens when policies have to be guaranteed issue (and include state mandated coverage like maternity on all policies). Of course, the current small group market doesn’t include any sort of mandate requiring groups to purchase health insurance. Proponents of a shift away from medical underwriting on individual health insurance policies also tend to back a measure that would require everyone to carry health insurance. That would help spread the cost of care across a larger population, and would likely help to contain the price increase that we would see if medical underwriting were to cease. But my guess is that we would still see a rather dramatic increase in premiums. This highlights the importance of getting to the root of the issue of health care costs, and how to contain them at source. Health insurance pays the costs, and unless we can lower those costs, it’s unlikely that we’ll be able to lower the cost of health insurance.</p>
<p>I found Hank’s post in the <a href="http://ozrisk.net/2009/09/10/cavalcade-of-risk-87-risk-perceptions/">Cavalcade of Risk</a>, hosted down under this week by Andrew at Oz Risk.</p>
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<slash:comments>2</slash:comments>
</item>
<item>
<title>Complaint Ratios Updated With 2008 Data</title>
<link>http://www.healthinsurancecolorado.net/blog1/2009/08/25/complaint-ratios-updated-with-2008-data/</link>
<comments>http://www.healthinsurancecolorado.net/blog1/2009/08/25/complaint-ratios-updated-with-2008-data/#comments</comments>
<pubDate>Wed, 26 Aug 2009 03:34:48 +0000</pubDate>
<dc:creator>Jay</dc:creator>
<category><![CDATA[Aetna]]></category>
<category><![CDATA[Anthem Blue Cross]]></category>
<category><![CDATA[Humana]]></category>
<category><![CDATA[Insurance Companies]]></category>
<category><![CDATA[Kaiser Permanente]]></category>
<category><![CDATA[Rocky Mountain]]></category>
<category><![CDATA[United Healthcare]]></category>
<category><![CDATA[Anthem Blue Cross Blue Shield]]></category>
<category><![CDATA[Cigna]]></category>
<category><![CDATA[colorado]]></category>
<category><![CDATA[health insurance]]></category>
<guid isPermaLink="false">http://www.healthinsurancecolorado.net/blog1/?p=1286</guid>
<description><![CDATA[The Colorado Division of Insurance has finished compiling and organizing the data for 2008. Visit the Colorado Health Insurance Company Complaint Ratio Comparison page to see the updated complaint, revenue, and market share statistics from the division of insurance along with the A.M. Best Rating information we’ve added [...]]]></description>
<content:encoded><![CDATA[<p>The Colorado Division of Insurance has finished compiling and organizing the data for 2008. Visit the <a href="http://www.healthinsurancecolorado.net/complaint-ratio.html">Colorado Health Insurance Company Complaint Ratio Comparison page</a> to see the updated complaint, revenue, and market share statistics from the division of insurance along with the A.M. Best Rating information we’ve added alongside. We hope this makes it easier for you to shop for health insurance in Colorado, but you can always <a href="http://www.healthinsurancecolorado.net/blog1/contact-us/">contact us</a> for our <a href="http://www.healthinsurancecolorado.net/colorado-broker.html">expert assistance at no cost</a>!</p>
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