[…] If the government can tell the health insurance carriers that no more than 15 – 20% of premium dollars can be spent on administrative expenses, including profits, why can’t similar guidelines be enacted for the pharmaceutical industry? Perhaps then we wouldn’t need to worry as much about who is going to pay the cost of prescription drugs for seniors. And maybe individual health insurance policies could start covering prescriptions with basic copays again.
Anthem Blue Cross
Anyone looking to compare plans with 2011 rates can start with Anthem BCBS, Assurant, and Rocky Mountain Health Plans (get quotes here). These will include maternity coverage. More coming this week….
The House Committee on Energy and Commerce released a memorandum this week detailing the practices of the four largest private health insurance carriers (Aetna, Humana, UnitedHealth Group and Wellpoint) regarding maternity coverage on individual policies. For anyone who is familiar with the individual health insurance market, the details of the memo will come as no surprise. But since the majority of Americans are covered by group health insurance plans that cover maternity just like any other claim, the details of how maternity coverage works in the individual market may be eye-opening for a lot of people. […]
[…] So far, none of the carriers who had backed out of the child-only market have commented on whether the open enrollment periods might make them change their minds, but AHIP (America’s Health Insurance Plans) has said that they are continuing to work with regulators to try to find solutions that would make the child-only market feasible for insurers in the future.
We mentioned last week that the Colorado Division of Insurance had not yet approved rates past 9/23 for several carriers, and unfortunately, that is still the situation. For carriers that allow any effective date, quotes can still be generated for 9/22, but carriers that only allow 1st and 15th of the month effective dates are unable to quote new policies now (and have been since 9/15) if their rates have not been approved. This is causing a bit of a traffic jam for people who are searching for a new individual health insurance policy right now. […]
I spent some time on the Healthcare.gov website this morning, and found some great resources that could be particularly helpful for people with pre-existing conditions who are unable to obtain coverage in the individual market. The website was set up in conjunction with the PPACA and was designed to help people navigate the myriad of health insurance options available, along with the changes that will happen over the next few years as the provisions of the PPACA go into effect. […]
Many plans with most carriers still haven’t gotten the rates approved past 9/23. These plans with carriers like Anthem BCBS can still be quoted with effective dates of 9/22 and before.
Carriers like Cigna only have 1st and 15th of the month effective date options. Therefore, rates and plans are not being quoted at all until the DOI approves their rates. Hopefully any moment.
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[…] Colorado will get $1 million to use for more extensive review of future rate increases, and the Division of Insurance has proposed hiring more analysts and actuaries to examine the data that is filed each year by the insurance carriers. The rate proposals will get more scrutiny, which is a good protective measure for consumers. But insureds could still see hefty rate increases thanks to the ever-increasing cost of health care. […]
[…] We still have several months left in 2009 for regulators and insurance companies to work out the details, and I’m sure we’ll know more by the end of the year. When you combine this with the new Colorado law banning gender rating on health insurance policies, and the myriad of reforms coming from the federal government, I’d say that health insurance regulators in Denver are going to have their hands full for a while.
[…] The problem is that health insurance companies are paying for care with premium dollars collected from insureds, and as costs go up, so do premiums. Until we shift our attitude to a “less is more” mentality, we’re going to continue to see an increase in the cost of care, and subsequently in the cost of health insurance. But it’s not just about money. Articles like Maggie’s should give us a reason to question excessive screening and testing, simply from a standpoint of having a better quality of life. The fact that it could drive down health care costs is a bonus.
[…] As I noted last month, while Anthem’s rate increase for 2010 was a big one, their premiums are still very much in line with premiums currently being charged by other individual health insurance carriers in Colorado. My guess is that de Percin’s take on this is probably correct: “… it is outrageous but it’s probably not a case of gouging.”
Three of the nation’s top health insurance carriers – Wellpoint, United Healthcare, and Humana – have announced that they will automatically keep young adults under the age of 26 on their parents’ policies between now and September 23, when the health care reform legislation guarantees this option for all everyone under the age of 26. […]
[…] But these numbers would seem to indicate that while Anthem’s rate increase may have been large, it seems to be in line with what other carriers are charging in Colorado. For the little test I conducted, Anthem’s premium was the second-lowest I found, and the only one with a lower premium had an additional thousand dollars in out of pocket exposure.
[…] I will be interested to see more on the Wellpoint story as the rate increases are investigated this spring, but I imagine that it’s not a simple problem or one that has a simple solution. It’s true that Wellpoint is in business to make money. But a dramatic, highly publicized rate increase is bad for business, and it’s hard to explain it away as a company simply trying to raise profits.
[…] If people know that they won’t be penalized for pre-existing conditions and that health insurance companies will have to accept everyone, a penalty that is just a tiny fraction of the cost of coverage might be the preferred option for a lot of people. And without a large pool of healthy insureds, I just don’t see a way that premiums won’t increase significantly. I’m keeping an open mind, but I’m skeptical that we’ll be able to provide all of the proposed consumer benefits with such a lax enforcement of mandatory health insurance.
[…] People who buy their own health insurance must pay the whole bill, every month. When it’s time for their rate increase, there’s no employer shouldering part of the burden. The option to continue or drop coverage is there every month when it’s time to pay the premium… and if it comes to a decision between the rent or the health insurance, it’s easy to understand how a healthy person might opt to go uninsured.
[…] But setting a flat dollar amount above which a plan will be taxed seems ill-advised. It doesn’t really do a good job of weeding out health insurance plans that truly have too many bells and whistles, and it wrongly penalizes people who live in areas where health care costs are higher than average, or companies with a disproportionate number of older workers.
[…] In Colorado, a similar law took effect last week, requiring health insurance companies to cover various preventive care at the level of the policy co-insurance. It will be interesting to see how this law impacts both premium and health in Colorado over the next few years. Will more people seek out preventive care? Will we be healthier as a result? Will our health insurance premiums increase even more than they already do? We’ll have to wait and see.
[…] I’m not opposed to the idea of health insurance companies that could operate on a national basis, allowing people to keep their health insurance if they move to another state. But such a plan would have to be overseen by federal guidelines. Simply opening things up to allowing health insurance companies to base themselves in any state they choose, operate under that state’s laws, and sell health insurance in all states, would take us to the lowest common denominator in terms of consumer protections.
[…] When it came to the mandate, however, things got a little stickier. I believe that lawmakers understood that allowing people to purchase health insurance without medical underwriting, while also allowing them to choose whether or not to obtain coverage, would amount to much higher premiums for the people who choose to have coverage. Initially they drafted a reasonably strong mandate, but caved in to criticism and weakened the mandate to the point where the fine for not carrying health insurance will only amount to a fraction of the cost of buying a policy […]
[…] 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.
[…] 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. […]
[…] 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.
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 […]
Much has been said about the merits of preventive medicine. It’s been a major talking point for politicians on both sides of the aisle throughout the health care reform debate. Whatever reform measures end up being enacted, there is likely to be an enhanced focus on screening tests. […] But does preventive medicine really help? […]