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31 Matching News Items

1.  Another Association Health Plan Success Story
InsureBlog Link to more items from this source
Feb. 13, 2020
"Rates for ACA plans require merely a list of employees, their ages, sex and marital status, and the nature and location of the business. No medical info is necessary. So groups with 3 employees on chemo and 4 on dialysis pay the exact same rate as those with relatively healthy employees.... AHP plans require medical histories, current meds and the like, and thus the process requires more effort ... But healthier groups can benefit greatly[.]"
2.  Prediction: Congress Won't Whack the Cadillac
InsureBlog Link to more items from this source
July 15, 2019
"In this installment of Congressional drama the supermajority will ... [say] that they can't kill the tax without offsetting revenues. They will again claim to be good stewards of our tax dollars and voice how much they dislike the tax. But when the dust has settled the Cadillac Tax will live."
3.  Thoughts On Risk Adjustment
InsureBlog Link to more items from this source
July 10, 2018
"[T]he Trump Administration has temporarily suspended all payments and collections of RA until the lawsuit is resolved.... [T]his is something that could have been avoided and fixed by the prior administration.... They could have issued interim rules to circumvent the problem. They could have adjusted the 2017 Notice of Benefit and Payment Parameters that were rushed through in late 2016 to mitigate the problem too. But they didn't."
4.  And the HIT Just Keeps on Coming
InsureBlog Link to more items from this source
Jan. 14, 2018
"The [Health Insurance Tax, an ACA-imposed tax on fully insured health plans,] is non-deductible, meaning for every $1.00 in taxes the insurer will need to take in $1.54 (assumes 35% corporate tax rate). For 2018, the amount this tax must generate is $14.3 billion -- meaning insurers must generate $22 billion of additional premiums to pay for it.... To offer transparency, many insurers are breaking out these taxes on renewals for consumers to see. But, for most employer plans -- where a large amount of this revenue is generated -- this tax isn't transparent to employees."
5.  A Carrier's Economist's Take on the ACA
InsureBlog Link to more items from this source
Dec. 29, 2017
"Between 2010 and the actual ACA launch, [one Blue Cross plan] spent over $100,000,000 in new spending just on compliance work and building the systems to allow us to participate. This is money that could have bought actual health care. Pre-ACA we served an individual market with the following characteristics: 125,000 people, Average age 36 years, 51% female ... Fast forward to 2017: 165,000 people, Average age 46 years old [... 30% increase; older,sicker], 58% female [... more expensive claims] ... Only 40% of policyholders keep their plan for 12 premium payments in a row."
6.  Four Reasons Why the CBO's AHCA Score Is Flawed
InsureBlog Link to more items from this source
May 28, 2017
"[1] CBO is assuming 4 million more people starting out with insurance than the actual number.... [2] AHCA's CBO score includes the potential enrollment from the 19 states that 'could' expand their Medicaid rules.... [3] While CBO doesn't actually define what constitutes insurance in the score, they insinuate that some states will cut or reduce the number of essential health benefits and cause out-of-pocket limits to rise. Suffice it to say it's amazing that they can't give us this definition yet count a few million people as uninsured because of this definition.... [4] Finally, the CBO score doesn't tell us who doesn't want to buy insurance. Without a mandate any number of people might simply say no thanks. These people aren't losing insurance, they simply don't want it."
7.  SHOP's a Flop
InsureBlog Link to more items from this source
May 17, 2017
"The SHOP Exchange was created to provide employers with less than 50 employees an easy to use process to enroll employees in group health insurance.... Turns out SHOP enrollment is extremely cumbersome, there are less plan options compared to the off exchange market, and that tax credit, well it hasn't been worthwhile for most employers. Plus it's only available for a maximum of two years.... Less than 3% of projected enrollment. That is why SHOP should be dropped."
8.  What Does 'Across State Lines' Really Mean?
InsureBlog Link to more items from this source
Apr. 12, 2017
"[A] suggestion: modify federal law to require that the coverage in any policy approved in any state, be available for purchase in every state. This would require the states abandon their monopolistic mandate regulations. It would bring the possibility of some premium relief to consumers in states that have the most mandates.... It would still allow the option of higher-coverage policies everywhere. But it would not require everyone have identical basic coverage -- as Obamacare does. It would not require any insurance company to build a new network anywhere so its policyholders could be in the service area."
9.  Don't Get Too Excited, Pinal County
InsureBlog Link to more items from this source
Sept. 8, 2016
"News broke of Blue Cross Blue Shield of Arizona remaining in the marketplace in Pinal County, Arizona late on Wednesday. Obamacare supporters will rejoice with a thunderous round of applause to the insurance company and positive vibes about how tax credits will keep costs low. But the folks in Pinal County have little to get excited about.... In their announcement to remain in the marketplace, their Senior VP of sales, strategy and marketing, Jeff Stelnik, said premiums will increase by 51%."
10.  Is Medical Mutual of Ohio Losing or Winning?
InsureBlog Link to more items from this source
Aug. 16, 2016
"Limiting network choice and limiting where to do business is bound to reduce the unhealthy risk while also eliminating providers who are unwilling to lower their reimbursement rates. Instead of Medical Mutual rolling out 45% increases to members they will send them cancellation notices.... Obamacare supporters will point to the rate reductions as a product of the law working. Never mind the fact that it is only 'working' by limiting the providers of care that are essential to the health of those Obamacare was supposed to protect the most."
11.  Justice Department Calls Flag on the Play
InsureBlog Link to more items from this source
Aug. 2, 2016
"DC thinks they can control the behavior of individuals and business by regulation and intimidation. The DOJ believes they can preserve what little competition left in the health insurance market by blocking mergers.... If the DOJ prohibits the merger [the insurers] will simply withdraw from the market leaving only 3 major health insurance carriers in the 2017 game. Which is precisely what the merger was intended to do. Remove weaker players from the game and leave the stronger ones in play."
12.  Suspend. Delay. Postpone. Repeat.
InsureBlog Link to more items from this source
Dec. 28, 2015
"By postponing the Cadillac Tax from 2018 to 2020, pausing the Medical Device Tax for 2017 and 2018, and also pausing the Health Insurance Tax for 2017 the federal government is reducing revenues to fund Obamacare by $32.1 Billion.... The total cost over ten years of eliminating these three taxes will decrease Obamacare revenues by $331,900,000,000. This makes up more than half of the revenues Obamacare is supposed to generate over that same time period."
13.  The Flip Side of Halbig
InsureBlog Link to more items from this source
May 30, 2015
"[If] getting rid of the subsidies renders coverage 'unaffordable' (an ACA 'term of art), then the penalty no longer applies, thus saving consumers even more money. In fact, the 'study finds that 11.1 million people will be free of the individual mandate, and more than a quarter million businesses will be liberated from the employer mandate' if the plaintiff prevails[.]"
14.  Employer Sponsored Insurance: Behind the Little Tree Is Obamacare's Forest
InsureBlog Link to more items from this source
Apr. 28, 2015
"[T]he most important question asked when discussing public views on Obamacare: 'Would you say the health care law has directly helped you and your family, directly hurt you and your family, or has it not had a direct impact?' It's not who has been helped (19%) or hurt (22%) by the law. It's the significant majority of respondents -- 56%!!! -- who have felt no direct impact. It's not a coincidence that the respondent percentage is almost identical to those with employer insurance."
15.  Counting Down the ObamaTax
InsureBlog Link to more items from this source
Jan. 19, 2015
" 'TurboTax, an online tax service, estimated that the average penalty for lacking health insurance in 2014 will be $301.' On the one hand, that's a lot more than $95, but on the other, it's likely less than one month's premium, especially for folks who don't qualify for a subsidy."
16.  Testing the SHOP in Ohio: Not as 'Easy as Buying a Plane Ticket'
InsureBlog Link to more items from this source
Oct. 30, 2014
"Ohio is one of five states with early access to the Small Business Health Options Program (SHOP).... [The web site] asked us to begin entering information for each employee. We could either do that or download an excel document and populate it into the system.... The spreadsheet has 20 columns to complete for each employee. Each dependent has an additional 8 columns to complete. You must provide date of birth, social security number, date of hire, address, employee code, and a preferred method of contact for each employee and their dependents.... Without knowing the rates and benefits it doesn't make sense to waste productivity gathering all of the data. Instead we will wait until the insurance companies are allowed to quote the plans directly. When will that be? I'm not sure but I'll bet it won't be until after next Tuesday."
17.  AT&T Cancels Retiree Health Insurance
InsureBlog Link to more items from this source
Oct. 15, 2014
"The existing retiree plan will be replaced with an HRA (health reimbursement arrangement) for qualified purchases only.... The HRA money is currently $2700 for the retiree plus an additional $1500 for their qualified spouse.... AT&T literature indicates future contributions are not guaranteed. There are strings attached to the money."
18.  U.K.'s Lower Per-Person Health Costs May Not Indicate That Single-Payer Provides Effective Cost Control
InsureBlog Link to more items from this source
Aug. 17, 2014
"UK's cost reached our 1994 level in 2014; and so UK's cost may well reach what ours is today, in 2034. This interpretation also suggests the UK is not retarding the growth of medical cost any more successfully than the US. The US is simply the leading indicator for cost growth over time. This interpretation also suggests the higher US point-in-time costs arise from other factors."
19.  Actuarial Value, Cost Sharing Limits, and Indexing Are at Odds with Lower Costs, Better Benefits, and Additional Consumer Protections
InsureBlog Link to more items from this source
Aug. 11, 2014
"Every year CMS updates a calculator that determines if an insurance plan meets the strict requirements of what Obama considers 'good' insurance.... Over time, plans that have a very low out-of-pocket will no longer be offered because good insurance doesn't equal 'Obamacare good' insurance. These tiers aren't designed to change, so as time goes on the health insurance plans people like, even the Obamacare compliant ones sold today, will no longer be available. Think about that for a moment: Obamacare increases your out-of-pocket maximums and calls that 'better' insurance."
20.  Four Reasons Why Automatic Health Insurance Renewal Isn't Going to Work
InsureBlog Link to more items from this source
June 29, 2014
"[1] Due to strict actuarial value parameters and changing limits on certain benefits the plans offered in 2014 may have to be cancelled in 2015.... [2] Each plan will have different premiums than last year. New companies to the market will add their plans.... [3] Changes in income or life status result in varying subsidies.... [4] Everyone's situation changes."
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