Search the News Archive

Study Says Individual Health Insurance Policy May Be More Stable Than Group Coverage

Excerpt: For workers in fair or poor health, owning individual health insurance seems to offer more security than relying on employer-sponsored small-group health coverage does.

N.Y. Insurance Co. Exec: 'Life Will Go On,' Expensively, Without Individual Mandate

"If the Supreme Court strikes down the health law, New York would be in a somewhat unique position, according to David Abernethy, a senior vice president of EmblemHealth [whose companies] insure almost 3 million people in the state. Abernethy says unlike other states, New York already requires insurers to cover all applicants, regardless of health status- that's known as 'guaranteed issue.'" [Video and transcript of interview at link.]

Aetna to Stop Selling Individual Health Insurance Policies in California

"Aetna will stop selling individual health insurance policies in California next month, just weeks after opting out of the exchange that is being established as part of the national health care reforms ... Aetna says it has about 58,000 individual enrollees in the state and expects to have about 49,000 by the end of the year. It plans to withdraw from the state at the end of the year but will continue to offer small and large group plans, as well as Medicare, dental and life insurance products."

Health Plan Service-Provider Calls Terminally Ill Patients to Discuss End-of-Life Issues

"The hope of this program ... is to build a relationship over the phone, so [the individual] might be comfortable discussing his situation and his goals. Then he'll be empowered to communicate those things with others, including his family and his doctors.... It's paid for by insurers and federal privacy rules permit this for business purposes.... And when these conversations do happen, there's can be another byproduct: reduced costs. Research is finding that when patients fully understand aggressive care, many choose less of it."

ASPPA: Don't Make 5500 Clerks Register

Excerpt: The American Society of Pension Professionals & Actuaries (ASPPA) is asking the Internal Revenue Service (IRS) to think about the red tape it is about to wrap around the support staffers who help prepare Form 5500 data.

Texas Insurance Commissioner Forbids Insurers' Provisions that Allowed Them to Interpret Policies

"Health, life and disability insurers will no longer have blanket authority to decide what their policies do and don't cover in Texas, under rules approved Monday ... The decision ... ends long-standing provisions in most health and disability plans-- called discretionary clauses-- that give insurers the right to interpret their policies and decide what benefits must be paid."

Insurers Defeat Obamacare Provision

"As of Jan. 1 ... [c]ompanies faced up to $100 per day in penalties for selling plans to people without other health insurance coverage that meets the [ACA's] minimum requirements.... U.S. District Judge Royce Lamberth sided with the insurers ... calling the government's reasoning 'counterintuitive.' He said it provided 'a recipe for eluding judicial review' in which an agency could issue a rule that puts companies out of business, not enforce it to avoid any challenges and then replace the rule with a new one that still keeps companies out of business." [Central United Life, Inc. v. Burwell, No. 14-1954 (D.D.C. Sept. 11, 2015)]

Aetna Fined for Violating Autism Coverage Law

"Aetna Life and Health Insurance will pay up to $4.5 million to settle claims they failed to cover diagnosis and treatment of autism spectrum disorders. [Missouri] Gov. Jay Nixon announced the settlement Tuesday, which includes the state's largest fine ever for insurance law violations.... In the settlement, Aetna admitted that it failed to offer autism coverage in some cases.... Aetna also admitted it violated the autism mandate in 2012 and paid a $1.5 million fine under a settlement agreement, which required it to undertake a full and complete audit to ensure compliance. Aetna admitted it did not perform the full compliance audit."

Univision Obamacare Deal Could Put WellPoint, Blues Ahead of Competitors

"WellPoint and other Blues insurers in six states including Florida have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network's Peabody-award winning health initiative, 'Salud Es Vida,' which means Health Is Life. The deals include a special plan-sponsored Univision website that will be able to connect Latinos with coverage on the online markets, or exchanges, that will serve individuals beginning in October. But it's a path that could take a detour around some competitors who are offering plans: because of a little-known rule proposed by the administration in June, customers will be able to buy their subsidized Obamacare insurance directly from the insurer."

The Tab for Public Employee Retiree Health Care Benefits Is Spiraling Out of Control

Excerpt: States pay the costs of retiree health care, which range from full coverage for life to more modest benefits, out of their annual budgets. And the tab has been spiraling out of control. In 2008, employer health insurance premiums increased by 5%, or twice the rate of inflation. 'Governments have piled up huge unfunded health care liabilities, the dimensions of which are just now being realized,' writes Lance Weiss in a report released in 2006 by Deloitte titled 'Paying for Tomorrow.' 'Estimates of unfunded liabilities associated with retiree health benefit plans represent a fiscal crisis for many states and municipalities.'