Cox News Service
Tuesday, January 31, 2006
WEST PALM BEACH, Fla. — We're going to start hearing a lot about health savings accounts. They'll be a cornerstone of the large health care section in tonight's State of the Union Address, and Congressional majority leaders support them.
So what are they, and why do we need another jagged acronym in a health insurance landscape that's already loaded with traps and trolls?
HSAs are shorthand for three things. They're high-deductible health plans. They're a cost-saving strategy popular with employers and insurers. And they're a philosophy of insurance counter to the prevailing principle of spreading financial risk through the largest possible group.
The health plans require deductibles of at least $1,050 for individuals and $2,100 for families. In exchange, they offer lower premiums and the opportunity to save tax-free for health care expenses. Employers stock the savings accounts in similar health reimbursement accounts, but only HSAs are portable from job to job.
They're a good deal for people in high enough tax brackets to benefit, who can afford to pay the deductible and fill the savings account. They're also good for people who don't spend much on health care. But spoilsports say a system with 46 million uninsured has bigger priorities than people who don't use health care.
So high-deductible plans are touted more as a cost-saving strategy. The most obvious cost savings is for employers, who shift costs they once paid as premiums into deductibles paid by employees. But long-term, proponents say, people will spend less money out of their own savings than they were spending on the insurance company's tab.
The 2004 Economic Report of the President concluded there is so much wasteful health spending because Americans have too much health insurance. High-deductible plans give us financial incentive to ask, "How much will this cost?" and "Is there a better way?" They even promise to help by arming us with new information on costs and quality.
It's true that people aren't aware enough of prices or quality. And people in high-deductible plans are more cost-conscious, a McKinsey & Company survey found last June. They're more likely to ask about cost, look for treatment alternatives and choose a less expensive treatment, although it's not clear whether the plans affect those decisions or they just attract more cost-conscious people.
It isn't because enrollees are happy with the health plans' info on costs and quality, McKinsey found. That's nowhere near adequate. Even so sophisticated a customer as former President Clinton chose a hospital with above-average death rates for his heart bypass surgery.
But although enrollees spend less money on health care, Rand Health has found they're just as likely to cut down on necessary care as unnecessary care. So while they buy generic drugs and recover from colds without seeing a doctor, they'll also stop taking the blood-pressure medicines that prevent strokes and skip the diabetic checkups that avert amputations.
Since people with chronic conditions spend about 75 percent of U.S. health care dollars, the HSA goal of less care is different from better or even cheaper care. More preventive care and behavioral education is a better way to reduce their expensive complications.
The 19 percent of Americans who do 82 percent of the spending won't even be dissuaded by high deductibles, which they'll clear anyway. They'll just be spending their own money instead of their health plans', effectively subsidizing everyone who gets tax breaks on HSAs.
The philosophical point behind HSAs is that it's wrong for the healthy to subsidize the sick, as we do now on the assumption that any of the healthy could just as easily become sick. It sees spreading risks among large groups as a form of socialism to be ended, leaving each to pay according to his or her health.
Research shows HSA enrollees are indeed healthier than average, a trend that eventually could leave sicker people sharing only each other's risks. So the policy question is: Do we want to assume the financial risks of health calamities on our own, or do we want to share them, even by paying more when we're healthy?
When politicians give us more control over our money, they're also giving us less security from financial ruin. It's a question of priorities. If you think company pensions and Social Security intrude on your right to save your own retirement money, you're going to love Washington's plans for health care.
When politicians give us more control over our money, they're also giving us less security from losing it. This has happened before. Companies are phasing out pensions in favor of employee-funded 401(k)s. HSAs would allow them to do the same with health insurance.
Tuesday, January 31, 2006
Shifting health insurance expense
BY KATIE MERX
FREE PRESS BUSINESS WRITER
Michigan could save $100 million a year if it adopted a law similar to one Maryland passed earlier this month that forces Wal-Mart to pay more for its employee health care, proponents of that legislation said.
The Maryland General Assembly approved a bill that requires employers with more than 10,000 workers to spend at least 8% of their payroll on employee health care or pay into a fund for the uninsured. The Maryland bill only affects Wal-Mart Stores Inc.
Michigan State Sen. Ray Basham, D-Taylor, introduced a similar Fair Share Health Care bill in Michigan in September. And buoyed by the success in Maryland, he's pushing anew for the Senate Committee on Commerce and Labor to take up the measure.
Basham said the proposal would save Michigan taxpayers money and result in workers receiving more generous health benefits from large employers.
In Michigan, 18 employers, including Wal-Mart, have more than 10,000 workers, said Ken Fletcher, legislative director for the AFL-CIO in Michigan.
"Of the 18 corporations in Michigan with more than 10,000 employees, four have double-digit percentages of employees on Medicaid," Fletcher said.
"They're abusing the system," Basham said.
Wal-Mart and business advocacy groups such as the Michigan Chamber of Commerce vehemently oppose such government mandates and plan to fight them. Opponents say the proposed legislation does nothing to improve health coverage for workers and is simply an effort to attack businesses that have convinced their workers not to unionize.
The AFL-CIO is helping to coordinating Fair Share Health Care actions nationwide.
Political analysts say passage of the bill in Michigan is a long shot, given the state's tough economic climate. But, they said, the state's taxpayers can expect to hear a lot of debate in the coming months about who should pay for health care as the state struggles to pay for its $2.8-billion Medicaid program and businesses buckle under the rising cost of health insurance.
Businesspeople such as Bill Largent, president of Farmington Hills consultancy the Dibaa Group, said raising the level of discussion is a good thing and he says debate over the Fair Share bill "will yield something positive."
"I fundamentally oppose mandates," Largent said. "Having said that, externalizing your costs is not a good way to do business."
Mark Mitra, who operates four Arby's roast beef restaurant franchises in Wayne and Oakland counties, said he'd like to see health care become a joint responsibility of employees, employers, government and health care systems. Mitra offers health care to his managers and his Wayne County employees. He offers the Wayne County employees a health plan because he uses the Wayne County-sponsored three-share program in which the county, employer and employee pay equal shares toward the monthly premium. He wasn't aware of a similar program that was available to his Oakland County employees.
"Unfortunately, health care in this country is becoming a luxury," said Mitra. "I believe that in a country with our rich resources, it should be accessible to everyone. ... However, mandating the amount an employer has to pay could drive many employers out of business."
But Basham, the AFL-CIO and Fair Share bill co-sponsors point out that the bill would only target the state's very largest employers. They believe it would result in lower costs for state residents and more health benefits for workers.
The bill's co-sponsors include state senate Democrats Irma Clark-Coleman, Gilda Jacobs, Samuel Thomas III, Martha Scott, Liz Brater and Hansen Clarke.
Basham argues that Wal-Mart and some other large employers skimp on health coverage, leaving taxpayers -- who fund Medicaid -- to foot the bill for their employees. Basham said that is unfair to taxpayers and large retailers who provide more generous health benefits.
Wal-Mart employs about 30,000 Michiganders. The average full-time, hourly Michigan Wal-Mart worker makes $9.87 per hour, according to Wal-Mart's Web site.
Wal-Mart, the world's largest retailer, reports that more than 615,000 of the company's 1.3 million workers are covered by Wal-Mart health plans.
Wal-Mart says it plans to challenge the Maryland law and fight passage of similar laws under consideration in more than 30 other states, including Michigan.
Wal-Mart Stores Senior Public Affairs Manager Nate Hurst said the company hopes other state legislatures will realize that the fair share health care bills are harmful to working families and drop the actions.
"These fair share health care bills do nothing to help the nation's uninsured nor control the rising cost of health care in this country," Hurst said. "They will cost jobs and hurt economic growth."
FREE PRESS BUSINESS WRITER
Michigan could save $100 million a year if it adopted a law similar to one Maryland passed earlier this month that forces Wal-Mart to pay more for its employee health care, proponents of that legislation said.
The Maryland General Assembly approved a bill that requires employers with more than 10,000 workers to spend at least 8% of their payroll on employee health care or pay into a fund for the uninsured. The Maryland bill only affects Wal-Mart Stores Inc.
Michigan State Sen. Ray Basham, D-Taylor, introduced a similar Fair Share Health Care bill in Michigan in September. And buoyed by the success in Maryland, he's pushing anew for the Senate Committee on Commerce and Labor to take up the measure.
Basham said the proposal would save Michigan taxpayers money and result in workers receiving more generous health benefits from large employers.
In Michigan, 18 employers, including Wal-Mart, have more than 10,000 workers, said Ken Fletcher, legislative director for the AFL-CIO in Michigan.
"Of the 18 corporations in Michigan with more than 10,000 employees, four have double-digit percentages of employees on Medicaid," Fletcher said.
"They're abusing the system," Basham said.
Wal-Mart and business advocacy groups such as the Michigan Chamber of Commerce vehemently oppose such government mandates and plan to fight them. Opponents say the proposed legislation does nothing to improve health coverage for workers and is simply an effort to attack businesses that have convinced their workers not to unionize.
The AFL-CIO is helping to coordinating Fair Share Health Care actions nationwide.
Political analysts say passage of the bill in Michigan is a long shot, given the state's tough economic climate. But, they said, the state's taxpayers can expect to hear a lot of debate in the coming months about who should pay for health care as the state struggles to pay for its $2.8-billion Medicaid program and businesses buckle under the rising cost of health insurance.
Businesspeople such as Bill Largent, president of Farmington Hills consultancy the Dibaa Group, said raising the level of discussion is a good thing and he says debate over the Fair Share bill "will yield something positive."
"I fundamentally oppose mandates," Largent said. "Having said that, externalizing your costs is not a good way to do business."
Mark Mitra, who operates four Arby's roast beef restaurant franchises in Wayne and Oakland counties, said he'd like to see health care become a joint responsibility of employees, employers, government and health care systems. Mitra offers health care to his managers and his Wayne County employees. He offers the Wayne County employees a health plan because he uses the Wayne County-sponsored three-share program in which the county, employer and employee pay equal shares toward the monthly premium. He wasn't aware of a similar program that was available to his Oakland County employees.
"Unfortunately, health care in this country is becoming a luxury," said Mitra. "I believe that in a country with our rich resources, it should be accessible to everyone. ... However, mandating the amount an employer has to pay could drive many employers out of business."
But Basham, the AFL-CIO and Fair Share bill co-sponsors point out that the bill would only target the state's very largest employers. They believe it would result in lower costs for state residents and more health benefits for workers.
The bill's co-sponsors include state senate Democrats Irma Clark-Coleman, Gilda Jacobs, Samuel Thomas III, Martha Scott, Liz Brater and Hansen Clarke.
Basham argues that Wal-Mart and some other large employers skimp on health coverage, leaving taxpayers -- who fund Medicaid -- to foot the bill for their employees. Basham said that is unfair to taxpayers and large retailers who provide more generous health benefits.
Wal-Mart employs about 30,000 Michiganders. The average full-time, hourly Michigan Wal-Mart worker makes $9.87 per hour, according to Wal-Mart's Web site.
Wal-Mart, the world's largest retailer, reports that more than 615,000 of the company's 1.3 million workers are covered by Wal-Mart health plans.
Wal-Mart says it plans to challenge the Maryland law and fight passage of similar laws under consideration in more than 30 other states, including Michigan.
Wal-Mart Stores Senior Public Affairs Manager Nate Hurst said the company hopes other state legislatures will realize that the fair share health care bills are harmful to working families and drop the actions.
"These fair share health care bills do nothing to help the nation's uninsured nor control the rising cost of health care in this country," Hurst said. "They will cost jobs and hurt economic growth."
J.D. Power and Associates Ranks Erie Insurance Highest in Collision Repair Satisfaction
Press release
ERIE, Pa., Jan. 30 /PRNewswire/ -- For the second consecutive year, Erie Insurance Group earned the highest ranking in the J.D. Power and Associates Collision Repair Satisfaction Study of consumers who file an auto insurance claim. Results of the fourth annual J.D. Power and Associates Collision Repair Satisfaction Study were released December 22.
The study represents the responses of 5,679 consumers who had collision repair or body work performed on their vehicles in the past 12 months. Respondents were asked to rate their satisfaction with both their insurance company and auto body repair shop. The study specifically cited ERIE's performance in repair time, accuracy of repairs, and Erie Insurance Agent and Employee contact with claimants throughout the claims process. A more detailed listing of the results by insurance provider is available at J.D. Power and Associates' Web site at www.jdpower.com.
"This notable honor demonstrates that every Erie Insurance Employee, Agent and agency employee contributes to the service provided by our frontline claims staff," says Jeff Ludrof, president and chief executive officer of Erie Insurance Group. "Information, training and tools all affect the claims service ERIE Policyholders ultimately receive in the field. Everyone directly associated with Erie Insurance -- in an agency, underwriting, processing, information technology and every area in between -- can take pride in this achievement."
ERIE, Pa., Jan. 30 /PRNewswire/ -- For the second consecutive year, Erie Insurance Group earned the highest ranking in the J.D. Power and Associates Collision Repair Satisfaction Study of consumers who file an auto insurance claim. Results of the fourth annual J.D. Power and Associates Collision Repair Satisfaction Study were released December 22.
The study represents the responses of 5,679 consumers who had collision repair or body work performed on their vehicles in the past 12 months. Respondents were asked to rate their satisfaction with both their insurance company and auto body repair shop. The study specifically cited ERIE's performance in repair time, accuracy of repairs, and Erie Insurance Agent and Employee contact with claimants throughout the claims process. A more detailed listing of the results by insurance provider is available at J.D. Power and Associates' Web site at www.jdpower.com.
"This notable honor demonstrates that every Erie Insurance Employee, Agent and agency employee contributes to the service provided by our frontline claims staff," says Jeff Ludrof, president and chief executive officer of Erie Insurance Group. "Information, training and tools all affect the claims service ERIE Policyholders ultimately receive in the field. Everyone directly associated with Erie Insurance -- in an agency, underwriting, processing, information technology and every area in between -- can take pride in this achievement."
Monday, January 30, 2006
Bredesen set to unveil uninsured health plan
By Scott Shepard
Nashville Business Journal
Updated: 7:00 p.m. ET Jan. 29, 2006
Tennessee Gov. Phil Bredesen is working on a statewide health care reform program as audacious as TennCare but that's designed to offer stripped-down medical coverage to the uninsured at a steep discount.
Bredesen so far has been quiet about the plan, even withholding it from obvious members of the General Assembly, though he and his subordinates have hinted at it during meetings with industry groups such as the Health Underwriters Association and the Memphis Medical Society.
Bredesen likely will make the program, dubbed Cover Tennessee, the centerpiece of his State-of-the-State address, tentatively scheduled for Feb. 6. The date was moved from Jan. 30 because of the legislative special session on political ethics. Should that session linger, the State of the State could be moved again to keep it out of the shadow of the ethics debates.
This is an election year and sources say Bredesen would like to make Cover Tennessee the center of his re-election campaign and the dominant subject of the legislative general session.
"I'm familiar only with some rumblings," says Sen. Mark Norris, R-Memphis. "It looks like his ploy is to set up a big dog-and-pony show. Those of us who have worked for many years to improve access in Tennessee would look more favorably at a team effort."
Norris is an attorney at Armstrong Allen in Memphis who focuses much of his practice on health care. In the General Assembly, he's often one of the key health care people.
"Where we've gotten into differences in the past is when the governor crams down (his) dream plan," he says. "It happened with (Ned) McWherter and we got TennCare. I don't want to see that happen again."
Bredesen is a native of Shortsville, N.Y. Before being elected mayor of Nashville in 1991, he made his fortune in Nashville developing managed care plans.
Cover Tennessee is patterned after Healthy New York, a program aimed at small employers and the self-employed who can not afford private insurance.
Debuting in 2000, it is a sister program to Child Health Plus and Family Health Plus, two other New York state programs designed for other, specific needs.
Its roots go back to 1995, when New York Gov. George Pataki chose to separate different pockets of the uninsured and deal with each directly. He found that most small employers would like to offer health benefits to employees, but they faced the hurdle of cost.
New York regulations have larded health plans with mandated benefits that priced many small businesses out of the market, so dealing with mandates was part of the strategy.
Enrollment has steadily grown in Healthy New York, and suddenly doubled in 2004. Last year, the program's premiums were 28 percent below the market rate for comparable small-group and individual health plans.
Bredesen last year started looking at Healthy New York as he was excising 323,000 residents from TennCare, mostly people with serious, chronic ailments who cannot qualify for other coverage. At the time, there was talk of reviving the old high-risk pool for this population.
A high-risk pool would likely be funded with an assessment on all health insurance carriers in the state, based on their market share. That money would be combined with premiums to provide coverage.
High-risk pools are invariably money losers because they attract the most expensive people in the state. The assessment is, in effect, a hidden tax on everyone with health insurance, and a high-risk pool does not address the needs of others who cannot buy coverage.
Cover Tennessee would be designed to solve both of those problems. Healthy New York started by eliminating the most expensive mandated benefits that are not life-threatening, including: outpatient alcohol and substance abuse treatment, 40 days of home health care, chiropractic, infertility treatment, and prostate screening. Most of these services are also available through nonprofit agencies.
"New York, like most states, has continued to add mandates," says Wayne Cotter, spokesman for the New York Department of Insurance. "It's very good from a public policy perspective, but it adds cost."
Mandates creep into state regulations when a group of providers lobby for their specialty to be covered. It's a no-lose proposition for politicians, who can claim credit for providing a benefit, while the burden of paying for it falls on the employer.
Companies with more than 100 lives can slip the snare of mandates by self-insuring their group and hiring a third-party administrator to shuffle the paperwork.
New York also assesses a service fee on hospital services, with the money distributed to several public health programs. In 2005, Healthy New York was subsidized from that fund at $69.2 million. Employers also gain state tax credits for signing on.
To prevent employers who already provide coverage from bailing out and joining Healthy New York, groups have to go for 12 months without coverage to be eligible.
Nashville Business Journal
Updated: 7:00 p.m. ET Jan. 29, 2006
Tennessee Gov. Phil Bredesen is working on a statewide health care reform program as audacious as TennCare but that's designed to offer stripped-down medical coverage to the uninsured at a steep discount.
Bredesen so far has been quiet about the plan, even withholding it from obvious members of the General Assembly, though he and his subordinates have hinted at it during meetings with industry groups such as the Health Underwriters Association and the Memphis Medical Society.
Bredesen likely will make the program, dubbed Cover Tennessee, the centerpiece of his State-of-the-State address, tentatively scheduled for Feb. 6. The date was moved from Jan. 30 because of the legislative special session on political ethics. Should that session linger, the State of the State could be moved again to keep it out of the shadow of the ethics debates.
This is an election year and sources say Bredesen would like to make Cover Tennessee the center of his re-election campaign and the dominant subject of the legislative general session.
"I'm familiar only with some rumblings," says Sen. Mark Norris, R-Memphis. "It looks like his ploy is to set up a big dog-and-pony show. Those of us who have worked for many years to improve access in Tennessee would look more favorably at a team effort."
Norris is an attorney at Armstrong Allen in Memphis who focuses much of his practice on health care. In the General Assembly, he's often one of the key health care people.
"Where we've gotten into differences in the past is when the governor crams down (his) dream plan," he says. "It happened with (Ned) McWherter and we got TennCare. I don't want to see that happen again."
Bredesen is a native of Shortsville, N.Y. Before being elected mayor of Nashville in 1991, he made his fortune in Nashville developing managed care plans.
Cover Tennessee is patterned after Healthy New York, a program aimed at small employers and the self-employed who can not afford private insurance.
Debuting in 2000, it is a sister program to Child Health Plus and Family Health Plus, two other New York state programs designed for other, specific needs.
Its roots go back to 1995, when New York Gov. George Pataki chose to separate different pockets of the uninsured and deal with each directly. He found that most small employers would like to offer health benefits to employees, but they faced the hurdle of cost.
New York regulations have larded health plans with mandated benefits that priced many small businesses out of the market, so dealing with mandates was part of the strategy.
Enrollment has steadily grown in Healthy New York, and suddenly doubled in 2004. Last year, the program's premiums were 28 percent below the market rate for comparable small-group and individual health plans.
Bredesen last year started looking at Healthy New York as he was excising 323,000 residents from TennCare, mostly people with serious, chronic ailments who cannot qualify for other coverage. At the time, there was talk of reviving the old high-risk pool for this population.
A high-risk pool would likely be funded with an assessment on all health insurance carriers in the state, based on their market share. That money would be combined with premiums to provide coverage.
High-risk pools are invariably money losers because they attract the most expensive people in the state. The assessment is, in effect, a hidden tax on everyone with health insurance, and a high-risk pool does not address the needs of others who cannot buy coverage.
Cover Tennessee would be designed to solve both of those problems. Healthy New York started by eliminating the most expensive mandated benefits that are not life-threatening, including: outpatient alcohol and substance abuse treatment, 40 days of home health care, chiropractic, infertility treatment, and prostate screening. Most of these services are also available through nonprofit agencies.
"New York, like most states, has continued to add mandates," says Wayne Cotter, spokesman for the New York Department of Insurance. "It's very good from a public policy perspective, but it adds cost."
Mandates creep into state regulations when a group of providers lobby for their specialty to be covered. It's a no-lose proposition for politicians, who can claim credit for providing a benefit, while the burden of paying for it falls on the employer.
Companies with more than 100 lives can slip the snare of mandates by self-insuring their group and hiring a third-party administrator to shuffle the paperwork.
New York also assesses a service fee on hospital services, with the money distributed to several public health programs. In 2005, Healthy New York was subsidized from that fund at $69.2 million. Employers also gain state tax credits for signing on.
To prevent employers who already provide coverage from bailing out and joining Healthy New York, groups have to go for 12 months without coverage to be eligible.
Electric Insurance Enhances New Jersey Auto Insurance Product
Press Release
BEVERLY, Mass.--(BUSINESS WIRE)--Jan. 27, 2006--Electric Insurance Company announced today that it has enhanced its private passenger auto product and, as a result, is expanding its marketing distribution in New Jersey. Electric Insurance has been writing business in New Jersey since incorporation in 1966, serving the needs of the General Electric employee population.
"We are extremely excited about increasing our presence in New Jersey," said Mike Mucher, Vice President of Sales at Electric Insurance. "Our new product allows us to expand our channels of distribution to attract customers who recognize the value of great rates and world-class service."
Consumers can now buy Electric Insurance's auto and home products through a select group of highly professional independent agent partners who share the Company's vision and values. Providing personal assistance to consumers using local New Jersey independent agents reinforces Electric Insurance's strong commitment to customer service. The Company continues to offer its products directly to GE employees and retirees in the New Jersey area at group discounted rates.
Later in first Quarter 2006, Electric Insurance will also make its products available directly to New Jersey consumers. Access will be offered via the Company's toll-free phone number, 1-800-227-2757, and newly designed website, www.electricinsurance.com.
BEVERLY, Mass.--(BUSINESS WIRE)--Jan. 27, 2006--Electric Insurance Company announced today that it has enhanced its private passenger auto product and, as a result, is expanding its marketing distribution in New Jersey. Electric Insurance has been writing business in New Jersey since incorporation in 1966, serving the needs of the General Electric employee population.
"We are extremely excited about increasing our presence in New Jersey," said Mike Mucher, Vice President of Sales at Electric Insurance. "Our new product allows us to expand our channels of distribution to attract customers who recognize the value of great rates and world-class service."
Consumers can now buy Electric Insurance's auto and home products through a select group of highly professional independent agent partners who share the Company's vision and values. Providing personal assistance to consumers using local New Jersey independent agents reinforces Electric Insurance's strong commitment to customer service. The Company continues to offer its products directly to GE employees and retirees in the New Jersey area at group discounted rates.
Later in first Quarter 2006, Electric Insurance will also make its products available directly to New Jersey consumers. Access will be offered via the Company's toll-free phone number, 1-800-227-2757, and newly designed website, www.electricinsurance.com.
Small shops look for health insurance aid
By JOSH FLORY of the Tribune’s staff
Published Sunday, January 29, 2006
Row after row of bicycles, implements of workout equipment and athletic apparel radiate a sense of good health inside the Tryathletics store on Chapel Hill Road.
One thing is missing, though. Shop owner Steve Stonecipher-Fisher said he can’t afford to offer health insurance to the mostly college-age employees who work at his store.
A fifth-place finisher in the 1983 Boston Marathon, Stonecipher-Fisher said most employees only work at the store three to five years.
"Part of the reason they move on is I can’t offer affordable health care," he added.
State and federal lawmakers are working feverishly to address the concerns of entrepreneurs like Stonecipher-Fisher, and they’re increasingly focused on one idea in particular: encouraging small businesses to band together when buying insurance.
U.S. Sen. Jim Talent has long been an advocate of the idea and visited Tryathletics on Tuesday to stump for a federal measure that would allow small businesses to buy health insurance through national trade associations such as the Chamber of Commerce.
Missouri Gov. Matt Blunt called for "buying pools" in his recent State of the State speech, and the idea has attracted legislative proposals from both sides of the aisle.
The theory is simple:
If a business has eight employees and one of them has a serious health problem, insurance premiums for that company will probably be sky-high.
But if the company can buy insurance as part of a large association or buying pool, the impact of one employee’s sickness should have little effect on that company’s premiums.
Talent cited the example of a Farmington optometry office, where one of the employees was a breast cancer survivor. The other employees, he said, voluntarily gave up raises for several years to cover the increased health insurance costs for their colleague.
"Those are the kind of people who will go into an association health plan," he said.
At the federal level, critics have complained because the association health plans, or AHPs, favored by Talent and President George W. Bush would be regulated by the federal Department of Labor rather than by the states and would be exempt from state coverage mandates.
A Georgetown University study issued last year said that structure would "have the unintended consequence of widespread fraud threatening the coverage and financial security of millions of Americans."
But Rich Chrismer, a spokesman for Talent, countered by noting that large corporations, unions and federal employees already belong to large national pools and said this would simply extend that right to small businesses.
As for the fact that state coverage mandates wouldn’t apply, Chrismer said those mandates "are not helpful to you if you don’t have health insurance in the first place."
That’s not the only criticism. Protect Your Health Care, a coalition of AHP opponents, has argued that the cooperatives would be able to "cherry pick," or structure their plans to attract younger, healthier groups of patients.
Talent made the opposite argument Tuesday, saying small businesses that have trouble gaining coverage - possibly because of employees with a history of medical illnesses - would rush to join AHPs.
"We want people like that part of a big … pool because they can absorb those costs so much easier," he said.
In Missouri, state law prohibits businesses or individuals from joining an association that has no other purpose than providing health insurance. Some lawmakers are aiming to change that, however, including Sen. Harry Kennedy, a St. Louis Democrat.
Kennedy’s bill would allow the creation of a "small-employer purchasing alliance," in which a not-for-profit would purchase and administer insurance on behalf of groups of employers. The bill would prohibit the alliances from excluding members on the basis of health risk.
Kennedy said small businesses in his district keep raising the issue of health insurance with him.
"It’s too expensive," he said simply.
Kennedy also cited a recent project in southwest Missouri, where the state Department of Insurance indicated that it was willing to waive certain requirements for a group of manufacturers so they could band together to purchase insurance.
According to the state insurance department, the program has allowed six companies to offer insurance that previously were unable to do so.
Published Sunday, January 29, 2006
Row after row of bicycles, implements of workout equipment and athletic apparel radiate a sense of good health inside the Tryathletics store on Chapel Hill Road.
One thing is missing, though. Shop owner Steve Stonecipher-Fisher said he can’t afford to offer health insurance to the mostly college-age employees who work at his store.
A fifth-place finisher in the 1983 Boston Marathon, Stonecipher-Fisher said most employees only work at the store three to five years.
"Part of the reason they move on is I can’t offer affordable health care," he added.
State and federal lawmakers are working feverishly to address the concerns of entrepreneurs like Stonecipher-Fisher, and they’re increasingly focused on one idea in particular: encouraging small businesses to band together when buying insurance.
U.S. Sen. Jim Talent has long been an advocate of the idea and visited Tryathletics on Tuesday to stump for a federal measure that would allow small businesses to buy health insurance through national trade associations such as the Chamber of Commerce.
Missouri Gov. Matt Blunt called for "buying pools" in his recent State of the State speech, and the idea has attracted legislative proposals from both sides of the aisle.
The theory is simple:
If a business has eight employees and one of them has a serious health problem, insurance premiums for that company will probably be sky-high.
But if the company can buy insurance as part of a large association or buying pool, the impact of one employee’s sickness should have little effect on that company’s premiums.
Talent cited the example of a Farmington optometry office, where one of the employees was a breast cancer survivor. The other employees, he said, voluntarily gave up raises for several years to cover the increased health insurance costs for their colleague.
"Those are the kind of people who will go into an association health plan," he said.
At the federal level, critics have complained because the association health plans, or AHPs, favored by Talent and President George W. Bush would be regulated by the federal Department of Labor rather than by the states and would be exempt from state coverage mandates.
A Georgetown University study issued last year said that structure would "have the unintended consequence of widespread fraud threatening the coverage and financial security of millions of Americans."
But Rich Chrismer, a spokesman for Talent, countered by noting that large corporations, unions and federal employees already belong to large national pools and said this would simply extend that right to small businesses.
As for the fact that state coverage mandates wouldn’t apply, Chrismer said those mandates "are not helpful to you if you don’t have health insurance in the first place."
That’s not the only criticism. Protect Your Health Care, a coalition of AHP opponents, has argued that the cooperatives would be able to "cherry pick," or structure their plans to attract younger, healthier groups of patients.
Talent made the opposite argument Tuesday, saying small businesses that have trouble gaining coverage - possibly because of employees with a history of medical illnesses - would rush to join AHPs.
"We want people like that part of a big … pool because they can absorb those costs so much easier," he said.
In Missouri, state law prohibits businesses or individuals from joining an association that has no other purpose than providing health insurance. Some lawmakers are aiming to change that, however, including Sen. Harry Kennedy, a St. Louis Democrat.
Kennedy’s bill would allow the creation of a "small-employer purchasing alliance," in which a not-for-profit would purchase and administer insurance on behalf of groups of employers. The bill would prohibit the alliances from excluding members on the basis of health risk.
Kennedy said small businesses in his district keep raising the issue of health insurance with him.
"It’s too expensive," he said simply.
Kennedy also cited a recent project in southwest Missouri, where the state Department of Insurance indicated that it was willing to waive certain requirements for a group of manufacturers so they could band together to purchase insurance.
According to the state insurance department, the program has allowed six companies to offer insurance that previously were unable to do so.
Saturday, January 28, 2006
Arbitrary laws contributing to health-insurance crisis
Jan. 28, 2006 12:00 AM
With "Failing health: A special report," The Republic last week gave readers a valuable primer on this nation's top domestic problem. But it also may have left many readers feeling that they, too, may soon be among the uninsured.
One thing must be understood: The health care crisis in Arizona and America begins and ends on Main Street.
The latest Arizona Small-Business Conditions Report, released last month by the Research Foundation of the National Federation of Independent Business, found that 62 percent of small-business owners in the state either did not offer health care to their employees or chose not to answer the question.
Shamefully, a federal law prohibiting small-business owners from joining together across state lines to form the same large purchasing pools for health care permitted for big corporations is one of the major contributors to the crisis.
But state laws, too, have teamed up to keep millions down.
Two legislative remedies circling the Arizona Capitol would begin to help small businesses.
House Bill 2698 would lift the heavy yoke of state mandates on health-insurance plans off of the backs of small businesses and allow greater consumer choice. Mandates are requirements by states on health insurers to add various procedures to their basic plans before they can be legally sold.
The more mandates, the higher the cost of health insurance. Each new mandate hurts the chances for a small business to buy medical coverage for its employees. Idaho requires only 13 mandates on health insurers, the fewest in the nation; Minnesota, with the most, has 60 requirements; Arizona has 28, according to the Council for Affordable Health Insurance.
House Bill 2177 would provide a health-insurance coupon for workers who are uninsured and earning a low wage and for small businesses with between two and 25 employees. The coupon would be worth up to 50 percent of the annual health care premium cost and be capped at $1,000 for individuals and $3,000 for families annually.
Neither piece of legislation is a panacea for the health care crisis, but each would be an immediate fillip to firms unable to afford health benefits.
But if truth be told, much of the health care crisis is due to a wait-until-it-gets-even-worse competition between ideologues who either want total, European-style socialization of medicine on one side or total employer removal from health care on the other side.
Whichever side you happen to gravitate to, millions of people should not have to suffer in the meantime.
With "Failing health: A special report," The Republic last week gave readers a valuable primer on this nation's top domestic problem. But it also may have left many readers feeling that they, too, may soon be among the uninsured.
One thing must be understood: The health care crisis in Arizona and America begins and ends on Main Street.
The latest Arizona Small-Business Conditions Report, released last month by the Research Foundation of the National Federation of Independent Business, found that 62 percent of small-business owners in the state either did not offer health care to their employees or chose not to answer the question.
Shamefully, a federal law prohibiting small-business owners from joining together across state lines to form the same large purchasing pools for health care permitted for big corporations is one of the major contributors to the crisis.
But state laws, too, have teamed up to keep millions down.
Two legislative remedies circling the Arizona Capitol would begin to help small businesses.
House Bill 2698 would lift the heavy yoke of state mandates on health-insurance plans off of the backs of small businesses and allow greater consumer choice. Mandates are requirements by states on health insurers to add various procedures to their basic plans before they can be legally sold.
The more mandates, the higher the cost of health insurance. Each new mandate hurts the chances for a small business to buy medical coverage for its employees. Idaho requires only 13 mandates on health insurers, the fewest in the nation; Minnesota, with the most, has 60 requirements; Arizona has 28, according to the Council for Affordable Health Insurance.
House Bill 2177 would provide a health-insurance coupon for workers who are uninsured and earning a low wage and for small businesses with between two and 25 employees. The coupon would be worth up to 50 percent of the annual health care premium cost and be capped at $1,000 for individuals and $3,000 for families annually.
Neither piece of legislation is a panacea for the health care crisis, but each would be an immediate fillip to firms unable to afford health benefits.
But if truth be told, much of the health care crisis is due to a wait-until-it-gets-even-worse competition between ideologues who either want total, European-style socialization of medicine on one side or total employer removal from health care on the other side.
Whichever side you happen to gravitate to, millions of people should not have to suffer in the meantime.
Friday, January 27, 2006
US life insurance companies to post in-line Q4 results
NEW YORK, January 25 (newratings.com) – Analysts at UBS believe that US life insurance companies would post in-line results for 4Q05.
In a research note published this morning, the analysts mention that US life insurance companies are likely to have benefited during Q4 from the y/y sales growth in the VA and MF industry, driven by robust demand for no-lapse products. US life insurance companies are, however, likely to have witnessed unfavourable mortality trends during the quarter, the analysts say. UBS prefers the stocks of BVPS and AMP at present.
In a research note published this morning, the analysts mention that US life insurance companies are likely to have benefited during Q4 from the y/y sales growth in the VA and MF industry, driven by robust demand for no-lapse products. US life insurance companies are, however, likely to have witnessed unfavourable mortality trends during the quarter, the analysts say. UBS prefers the stocks of BVPS and AMP at present.
Auto and Homeowners Insurance Available Through AAA Hawaii
Press Release
HONOLULU--(BUSINESS WIRE)--Jan. 26, 2006--AAA Hawaii's affiliated insurer has received approval by the state insurance division to offer automobile and homeowners insurance to qualified members.
"We appreciate the approval and work by Insurance Commissioner Jeffrey P. Schmidt and his staff," said AAA Hawaii Regional Manager Richard Velazquez. "We look forward to providing members with these quality insurance products that will add value to being a AAA member."
Numerous discounts on auto insurance may be available, such as multiple vehicles, safe driver, multiple policies, and others, said AAA Hawaii Insurance Manager Quyen Le.
Homeowners insurance on a primary residence is also provided through AAA Hawaii. Discounts are extended for smoke alarms and fire extinguishers, burglar alarms, newer homes, multiple policies and more, said Le. In addition, loss assessment coverage, personal property replacement coverage and extended replacement cost coverage is available, she added.
"We're selling insurance to our members using local agents who share the AAA Hawaii commitment to quality service," she added. "These new insurance products will add even more value to being a AAA Hawaii member," Le said.
For a free insurance quote on Oahu, call AAA Hawaii at 808-593-2221. Those from neighboring islands can call for a free quote at 1-800-736-2886. Free quotes also can be obtained by clicking on aaa.com or visiting the AAA Hawaii office at 1130 N. Nimitz Highway.
Insurance payment plans are available and electronic payment is also available through an automatic premium payment called AAAuto Pay.
These insurance products are provided by AAA Hawaii's affiliated insurer, the Interinsurance Exchange of the Automobile Club, rated A+ Superior for financial stability by A.M. Best, the respected insurance industry analyst.
HONOLULU--(BUSINESS WIRE)--Jan. 26, 2006--AAA Hawaii's affiliated insurer has received approval by the state insurance division to offer automobile and homeowners insurance to qualified members.
"We appreciate the approval and work by Insurance Commissioner Jeffrey P. Schmidt and his staff," said AAA Hawaii Regional Manager Richard Velazquez. "We look forward to providing members with these quality insurance products that will add value to being a AAA member."
Numerous discounts on auto insurance may be available, such as multiple vehicles, safe driver, multiple policies, and others, said AAA Hawaii Insurance Manager Quyen Le.
Homeowners insurance on a primary residence is also provided through AAA Hawaii. Discounts are extended for smoke alarms and fire extinguishers, burglar alarms, newer homes, multiple policies and more, said Le. In addition, loss assessment coverage, personal property replacement coverage and extended replacement cost coverage is available, she added.
"We're selling insurance to our members using local agents who share the AAA Hawaii commitment to quality service," she added. "These new insurance products will add even more value to being a AAA Hawaii member," Le said.
For a free insurance quote on Oahu, call AAA Hawaii at 808-593-2221. Those from neighboring islands can call for a free quote at 1-800-736-2886. Free quotes also can be obtained by clicking on aaa.com or visiting the AAA Hawaii office at 1130 N. Nimitz Highway.
Insurance payment plans are available and electronic payment is also available through an automatic premium payment called AAAuto Pay.
These insurance products are provided by AAA Hawaii's affiliated insurer, the Interinsurance Exchange of the Automobile Club, rated A+ Superior for financial stability by A.M. Best, the respected insurance industry analyst.
Health Insurance perk should be canceled
What Indiana House Speaker Brian Bosma did a few days ago was welcome and good. And what Indiana Senate President Pro Tem Robert Garton is considering is promising.
But it's not enough.
Bosma ordered the end of free lifetime health insurance for current and future House members, their spouses, ex-spouses and minor children. According to news reports, Garton is considering doing the same thing in the Senate.
The perk was included in a 2002 bill, and it covered members of the General Assembly and their families once they retire, so long as they had at least six years of service. Under Bosma's order, no House members who serve beyond Nov. 7, 2006, may get the package. Nineteen House members who retired after the new benefit was added would still be allowed to get it as well as current members, who have at least six years of service, if they don't seek re-election, according to news reports.
Hoosiers should not have to count on orders from the House speaker and the Senate president pro tem. Those orders can be changed easily.
The whole plan, including the enrollment authority granted the speaker and president pro tem, should be repealed. That is why House Bill 1309 should be brought out of committee and passed by both the House and the Senate.
The whole issue caught people's attention when state Auditor Connie Nass said the plan was expected to cost the state $306,000 a year by 2008.
Given the state's financial condition and especially the problems with Medicare funding, there shouldn't be much discussion.
That's in addition to the embarrassment factor. Considering the financial demands health insurance places on so many constituents, as well as those constituents who can't even afford it, legislators should, in theory, at least, be ashamed to sign up.
Some might argue that the free health insurance was an incentive to get people to consider public service. Maybe, but members of the General Assembly should not be treated differently than other state employees, and this isn't available to all of them. (And before someone gets a bright idea, it shouldn't be made available to all state employees, either.)
No one enjoys paying higher health insurance premiums. But taxpayers should not be saddled with another government cost that easily can be avoided.
The perk was ridiculous when it became law in 2002, and nothing has changed that. HB 1309 should become law, and the health insurance perk should become history.
But it's not enough.
Bosma ordered the end of free lifetime health insurance for current and future House members, their spouses, ex-spouses and minor children. According to news reports, Garton is considering doing the same thing in the Senate.
The perk was included in a 2002 bill, and it covered members of the General Assembly and their families once they retire, so long as they had at least six years of service. Under Bosma's order, no House members who serve beyond Nov. 7, 2006, may get the package. Nineteen House members who retired after the new benefit was added would still be allowed to get it as well as current members, who have at least six years of service, if they don't seek re-election, according to news reports.
Hoosiers should not have to count on orders from the House speaker and the Senate president pro tem. Those orders can be changed easily.
The whole plan, including the enrollment authority granted the speaker and president pro tem, should be repealed. That is why House Bill 1309 should be brought out of committee and passed by both the House and the Senate.
The whole issue caught people's attention when state Auditor Connie Nass said the plan was expected to cost the state $306,000 a year by 2008.
Given the state's financial condition and especially the problems with Medicare funding, there shouldn't be much discussion.
That's in addition to the embarrassment factor. Considering the financial demands health insurance places on so many constituents, as well as those constituents who can't even afford it, legislators should, in theory, at least, be ashamed to sign up.
Some might argue that the free health insurance was an incentive to get people to consider public service. Maybe, but members of the General Assembly should not be treated differently than other state employees, and this isn't available to all of them. (And before someone gets a bright idea, it shouldn't be made available to all state employees, either.)
No one enjoys paying higher health insurance premiums. But taxpayers should not be saddled with another government cost that easily can be avoided.
The perk was ridiculous when it became law in 2002, and nothing has changed that. HB 1309 should become law, and the health insurance perk should become history.
Thursday, January 26, 2006
Auto insurance drives reforms
Colorado drivers might see higher auto-insurance premiums and other policy changes under a package of bills being considered by lawmakers in response to complaints about shortcomings since the state eliminated its no-fault system.
One frustrated lawmaker even plans on introducing legislation to make the insurance commissioner a statewide-elected position instead of one appointed by the governor.
Coloradans need "somebody who sits in that office and has an independent opinion not based on the agenda of any elected official," said Rep. Dorothy Butcher, D-Pueblo, who plans to sponsor the bill.
Colorado Insurance Commissioner David Rivera said, "We do answer directly to the consumers, everyday."
Another bill, scheduled for a vote today in the Senate Health and Human Services Committee, would require drivers to carry emergency medical coverage to pay for trauma treatment after a car accident.
Senate Bill 19 supporters, such as hospitals and ambulance services, say the change is needed to ensure they are paid quickly. Since the state switched to a tort system several years ago, emergency-care providers say they have not been paid promptly or as much - forcing cuts in service.
But insurance companies, which oppose the bill, argue mandatory coverage could cost consumers hundreds of dollars more a year.
The bill highlights the highly contentious and politicized debate in the legislature over how to handle car insurance.
In 2003, the state switched from no-fault - in which car-accident injuries were paid for no matter who caused the accident - to a tort system, in which the at-fault driver pays the damages.
Determining who caused an accident takes time, and the lag between the accident and when first responders get paid is hurting their ability to provide service, several organizations testified last week during a legislative hearing.
Carole Walker of the Rocky Mountain Insurance Information Association said the bill would force consumers, who may already be covered under their health insurance, to pay for duplicative coverage.
"Funding trauma is a national problem, and we were trying to make that up on the backs of drivers," she said.
But Rep. Morgan Carroll, D-Aurora, who is sponsoring the bill in the House, said consumers should not have to pay more in premiums to ensure emergency-care providers get paid.
Sen. Bob Hagedorn, D-Aurora, said Wednesday that he expects to offer an amendment to the bill today. It would replace the $25 emissions-test surcharge motorists pay every two years on their vehicle registration with a $10 annual fee to cover the cost of first responders.
Last summer, legislators recommended a package of bills to address other car-insurance concerns, including legislation that would create a consumer insurance board and require companies to offer medical-payments coverage and clearly explain their coverage.
Carroll said the changes are piecemeal. Long term, the state needs an elected insurance commissioner and should toughen its regulations on rate hikes, she said. She said she plans on trying to reform how the state approves rates next year.
One frustrated lawmaker even plans on introducing legislation to make the insurance commissioner a statewide-elected position instead of one appointed by the governor.
Coloradans need "somebody who sits in that office and has an independent opinion not based on the agenda of any elected official," said Rep. Dorothy Butcher, D-Pueblo, who plans to sponsor the bill.
Colorado Insurance Commissioner David Rivera said, "We do answer directly to the consumers, everyday."
Another bill, scheduled for a vote today in the Senate Health and Human Services Committee, would require drivers to carry emergency medical coverage to pay for trauma treatment after a car accident.
Senate Bill 19 supporters, such as hospitals and ambulance services, say the change is needed to ensure they are paid quickly. Since the state switched to a tort system several years ago, emergency-care providers say they have not been paid promptly or as much - forcing cuts in service.
But insurance companies, which oppose the bill, argue mandatory coverage could cost consumers hundreds of dollars more a year.
The bill highlights the highly contentious and politicized debate in the legislature over how to handle car insurance.
In 2003, the state switched from no-fault - in which car-accident injuries were paid for no matter who caused the accident - to a tort system, in which the at-fault driver pays the damages.
Determining who caused an accident takes time, and the lag between the accident and when first responders get paid is hurting their ability to provide service, several organizations testified last week during a legislative hearing.
Carole Walker of the Rocky Mountain Insurance Information Association said the bill would force consumers, who may already be covered under their health insurance, to pay for duplicative coverage.
"Funding trauma is a national problem, and we were trying to make that up on the backs of drivers," she said.
But Rep. Morgan Carroll, D-Aurora, who is sponsoring the bill in the House, said consumers should not have to pay more in premiums to ensure emergency-care providers get paid.
Sen. Bob Hagedorn, D-Aurora, said Wednesday that he expects to offer an amendment to the bill today. It would replace the $25 emissions-test surcharge motorists pay every two years on their vehicle registration with a $10 annual fee to cover the cost of first responders.
Last summer, legislators recommended a package of bills to address other car-insurance concerns, including legislation that would create a consumer insurance board and require companies to offer medical-payments coverage and clearly explain their coverage.
Carroll said the changes are piecemeal. Long term, the state needs an elected insurance commissioner and should toughen its regulations on rate hikes, she said. She said she plans on trying to reform how the state approves rates next year.
New insurance provider to be chosen - Campus
From BGnews.com
Two companies are in the running for next year's mandatory student health care plan
The competition is down to two health insurance companies, as to which will be named next year's provider for uninsured students.
Either the current provider, Chickering, or a new option, Student Resources, will become the University's student health insurance provider next year.
When the Health Services Advisory Committee chooses a which provider to recommend to the president's office on Friday, the decision will impact all undergraduate students on campus. That's because all students will be required to show they have health insurance before registering for classes.
If a student has no health insurance, or if their insurance doesn't meet a list of yet to be determined standards; the student will be required to buy a plan through the University.
The current plan from Chickering costs students $1,350, and includes abortion coverage, dental and vision coverage.
Both insurance companies have price estimates for a similar version of this plan.
Chickering would drop their price to $1,190 if chosen as the provider for a mandatory plan.
Student Resources has offered a rate at $1,242 for a comparable plan.
All of the these new price estimates are taken from a document that student committee member Maria Khoury gave members of Undergraduate Student Government at their meeting on Monday.
Student Health Services Director Dr. Glenn Egelman pushed for a required insurance plan last spring. Now Egelman and the committee are pushing both companies for a better, cheaper insurance plan for students.
Egelman said that the committee will bargain with both companies to increase prescription coverage from the current $2,000 per year limit to $3,000 per year for drugs.
Chickering would raise their quote to $1,217 for the increased drug coverage; a difference of $27.
Student Resources would up their price to $1,265, which is a $23 difference.
The committee is also considering adding coverage for birth control. If the committee decides to include the pill in the new plan, Chickering would raise it's price by $9, and Student Resources would charge $23 more.
But cost isn't the only factor the committee is considering when comparing the two companies. Customer service is also an important part of the decision.
"There has been a drop in customer service complaints from students," Egelman said, since Chickering has been the provider.
Egelman credits fewer complaints with Chickering's team of insurance representatives that deal exclusively with the University. Having representatives who respond to complaints from University students - and no one else - could mean faster service, Egelman said.
"And that is a real plus, and that means a lot to the committee," he said.
But even Chickering's customer service record hasn't totally convinced the committee to stick with the current provider of student health insurance, Egelman said.
"When you look at the overall proposals of each of the two companies, there are red flags in each of them, so the committee is hashing through each of them," he said.
Another issue to consider is the fact that Student Resources is going through an ownership change.
"Generally from the students I spoke with, a lot told me to stick with Chickering because of the stability of the company," Khoury said.
Two companies are in the running for next year's mandatory student health care plan
The competition is down to two health insurance companies, as to which will be named next year's provider for uninsured students.
Either the current provider, Chickering, or a new option, Student Resources, will become the University's student health insurance provider next year.
When the Health Services Advisory Committee chooses a which provider to recommend to the president's office on Friday, the decision will impact all undergraduate students on campus. That's because all students will be required to show they have health insurance before registering for classes.
If a student has no health insurance, or if their insurance doesn't meet a list of yet to be determined standards; the student will be required to buy a plan through the University.
The current plan from Chickering costs students $1,350, and includes abortion coverage, dental and vision coverage.
Both insurance companies have price estimates for a similar version of this plan.
Chickering would drop their price to $1,190 if chosen as the provider for a mandatory plan.
Student Resources has offered a rate at $1,242 for a comparable plan.
All of the these new price estimates are taken from a document that student committee member Maria Khoury gave members of Undergraduate Student Government at their meeting on Monday.
Student Health Services Director Dr. Glenn Egelman pushed for a required insurance plan last spring. Now Egelman and the committee are pushing both companies for a better, cheaper insurance plan for students.
Egelman said that the committee will bargain with both companies to increase prescription coverage from the current $2,000 per year limit to $3,000 per year for drugs.
Chickering would raise their quote to $1,217 for the increased drug coverage; a difference of $27.
Student Resources would up their price to $1,265, which is a $23 difference.
The committee is also considering adding coverage for birth control. If the committee decides to include the pill in the new plan, Chickering would raise it's price by $9, and Student Resources would charge $23 more.
But cost isn't the only factor the committee is considering when comparing the two companies. Customer service is also an important part of the decision.
"There has been a drop in customer service complaints from students," Egelman said, since Chickering has been the provider.
Egelman credits fewer complaints with Chickering's team of insurance representatives that deal exclusively with the University. Having representatives who respond to complaints from University students - and no one else - could mean faster service, Egelman said.
"And that is a real plus, and that means a lot to the committee," he said.
But even Chickering's customer service record hasn't totally convinced the committee to stick with the current provider of student health insurance, Egelman said.
"When you look at the overall proposals of each of the two companies, there are red flags in each of them, so the committee is hashing through each of them," he said.
Another issue to consider is the fact that Student Resources is going through an ownership change.
"Generally from the students I spoke with, a lot told me to stick with Chickering because of the stability of the company," Khoury said.
Wednesday, January 25, 2006
cheap auto insurance for more CA counties
State Insurance Commissioner John Garamendi will expand California's low-cost automobile insurance program to eight additional counties, including Stanislaus and San Joaquin, later this year.
Monday, Garamendi announced plans to include Stanislaus, San Joaquin, Sacramento, Imperial, Kern, Contra Costa, San Mateo and Santa Clara counties in the program. Once in effect, the program will allow qualified drivers to get staterequired liability coverage for less than $400 a year.
A pilot program was created in 1999 in Los Angeles and San Francisco counties. Last year, the Legislature approved expanding the program by passing Senate Bill 20, written by Sen. Martha Escutia, D-Whittier. The bill expanded the program to Alameda, Fresno, Orange, Riverside, San Bernardino and San Diego counties as of April 1. It also authorizes the insurance commissioner to introduce the program in other counties.
The California Automobile Assigned Risk Plan administers the policy. Government funding does not subsidize or pay for the insurance, said Byron Tucker, communications director for the Department of Insurance.
To qualify, a driver must be 19 or older and have no more than one at-fault accident or one point taken away for a moving violation in the past three years. Income must not exceed 250 percent of the poverty line — $23,275 for a single driver or $47,125 for a family of four. The value of the vehicle must be less than $20,000.
Monday, Garamendi announced plans to include Stanislaus, San Joaquin, Sacramento, Imperial, Kern, Contra Costa, San Mateo and Santa Clara counties in the program. Once in effect, the program will allow qualified drivers to get staterequired liability coverage for less than $400 a year.
A pilot program was created in 1999 in Los Angeles and San Francisco counties. Last year, the Legislature approved expanding the program by passing Senate Bill 20, written by Sen. Martha Escutia, D-Whittier. The bill expanded the program to Alameda, Fresno, Orange, Riverside, San Bernardino and San Diego counties as of April 1. It also authorizes the insurance commissioner to introduce the program in other counties.
The California Automobile Assigned Risk Plan administers the policy. Government funding does not subsidize or pay for the insurance, said Byron Tucker, communications director for the Department of Insurance.
To qualify, a driver must be 19 or older and have no more than one at-fault accident or one point taken away for a moving violation in the past three years. Income must not exceed 250 percent of the poverty line — $23,275 for a single driver or $47,125 for a family of four. The value of the vehicle must be less than $20,000.
Democrats vow to reverse insurance victory
By ANDREW TAYLOR
ASSOCIATED PRESS WRITER
WASHINGTON -- Democrats promised Tuesday to introduce legislation to reverse concessions made to the health insurance industry in a budget bill, claiming GOP lawmakers changed the bill behind closed doors.
Sen. Hillary Clinton, D-N.Y., and Rep. John Dingell, D-Mich., said Republicans had caved in to powerful health insurance companies during talks on the five-year, $40 billion budget cut - at the expense of Medicare and Medicaid beneficiaries.
At issue is an obscure provision in the budget bill - slated for a final House vote next week - aimed at keeping health insurance plans participating in the Medicare program from obtaining inflated payments from the government. Such payments come when doctors and insurance companies perform a service but exaggerate the extent of the care when billing the government.
More broadly, Medicare's private insurance plans reap large profits because they tend to cover healthier, less costly-to-treat patients than those participating in Medicare's traditional fee-for-service system while receiving comparable payments.
The Senate version of the budget bill would have cut $26 billion in payments to managed care health plans over the next decade by cracking down on the practice, known as "upcoding" in government argot. The House-passed bill also curbed the overpayments, but only between 2008-2010.
The final version of the Medicare provision largely mirrored the House language, costing insurance companies just $4 billion over 10 years, according to estimates by the nonpartisan Congressional Budget Office.
What is more, Democrats say, the GOP-drafted provision takes away the government's ability to address the overpayments under its own regulatory authority - giving the managed care plans a better deal than they would have if Congress hadn't tried to rein them in at all.
That prompted Democrats to accuse Republicans of surrendering to the insurance industry as senior lawmakers and staff crafted the final bill behind closed doors. While Medicare's private plans won concessions, poor and disabled people covered by Medicaid were hit by benefit cuts and new fees.
"I am astounded that they wish to move forward with this budget bill in the House - where it is so plain that working families' health care has been sacrificed to protect industry's excess profit from the Medicare program," Dingell said.
Senate Finance Committee Chairman Charles Grassley, R-Iowa, defended the outcome of last month's negotiations.
"I appreciate the interest in fixing a 'giveaway' to insurance companies," Grassley said. But he argued that the bill "cuts Medicare payments to insurance companies by $6.5 billion over five years. Even more important, it rescinds the policy leading to those extra Medicare payments."
A senior GOP aide to the Senate Finance Committee involved in the negotiations said Republicans disagree with CBO's analysis of the provision. The aide, speaking on condition of anonymity, said Medicare's overseers at the Health and Human Services Department would retain authority to address the overpayments problem.
Insurance providers said there is no documented proof of overpayment abuses.
"There's no study to suggest this is taking place," said Karen Ignagni, president of America's Health Insurance Plans. She added that private insurers participating in Medicare absorbed 75 percent of the cuts generated by the bill even though they cover only 12 percentage of Medicare patients.
ASSOCIATED PRESS WRITER
WASHINGTON -- Democrats promised Tuesday to introduce legislation to reverse concessions made to the health insurance industry in a budget bill, claiming GOP lawmakers changed the bill behind closed doors.
Sen. Hillary Clinton, D-N.Y., and Rep. John Dingell, D-Mich., said Republicans had caved in to powerful health insurance companies during talks on the five-year, $40 billion budget cut - at the expense of Medicare and Medicaid beneficiaries.
At issue is an obscure provision in the budget bill - slated for a final House vote next week - aimed at keeping health insurance plans participating in the Medicare program from obtaining inflated payments from the government. Such payments come when doctors and insurance companies perform a service but exaggerate the extent of the care when billing the government.
More broadly, Medicare's private insurance plans reap large profits because they tend to cover healthier, less costly-to-treat patients than those participating in Medicare's traditional fee-for-service system while receiving comparable payments.
The Senate version of the budget bill would have cut $26 billion in payments to managed care health plans over the next decade by cracking down on the practice, known as "upcoding" in government argot. The House-passed bill also curbed the overpayments, but only between 2008-2010.
The final version of the Medicare provision largely mirrored the House language, costing insurance companies just $4 billion over 10 years, according to estimates by the nonpartisan Congressional Budget Office.
What is more, Democrats say, the GOP-drafted provision takes away the government's ability to address the overpayments under its own regulatory authority - giving the managed care plans a better deal than they would have if Congress hadn't tried to rein them in at all.
That prompted Democrats to accuse Republicans of surrendering to the insurance industry as senior lawmakers and staff crafted the final bill behind closed doors. While Medicare's private plans won concessions, poor and disabled people covered by Medicaid were hit by benefit cuts and new fees.
"I am astounded that they wish to move forward with this budget bill in the House - where it is so plain that working families' health care has been sacrificed to protect industry's excess profit from the Medicare program," Dingell said.
Senate Finance Committee Chairman Charles Grassley, R-Iowa, defended the outcome of last month's negotiations.
"I appreciate the interest in fixing a 'giveaway' to insurance companies," Grassley said. But he argued that the bill "cuts Medicare payments to insurance companies by $6.5 billion over five years. Even more important, it rescinds the policy leading to those extra Medicare payments."
A senior GOP aide to the Senate Finance Committee involved in the negotiations said Republicans disagree with CBO's analysis of the provision. The aide, speaking on condition of anonymity, said Medicare's overseers at the Health and Human Services Department would retain authority to address the overpayments problem.
Insurance providers said there is no documented proof of overpayment abuses.
"There's no study to suggest this is taking place," said Karen Ignagni, president of America's Health Insurance Plans. She added that private insurers participating in Medicare absorbed 75 percent of the cuts generated by the bill even though they cover only 12 percentage of Medicare patients.
Tuesday, January 24, 2006
Safe, low-income drivers may get an auto insurance boost
Joe Goldeen
Record Staff Writer
Published Tuesday, Jan 24, 2006
STOCKTON - San Joaquin was added to a list Monday of eight counties targeted for expansion of the California Low Cost Automobile Insurance Program, which provides eligible low-income good drivers with state-required liability coverage for less than $400 a year.
A town-hall meeting conducted by state Insurance Commissioner John Garamendi will be held next Tuesday to gauge the community's interest in the program.
With enough support, the low-cost insurance program could be rolled out in San Joaquin County as soon as June 1, a department spokeswoman said.
To be eligible, a driver must have no more than one at-fault accident or one point for a moving violation in the past three years and have gross annual income no higher than 250 percent of the federal poverty level. Examples include up to $23,275 for a single motorist or $47,125 for a four-person household. The vehicle being insured may not be valued at more than $20,000.
The state's low-cost auto insurance plan was introduced in 1999 as a pilot program in San Francisco and Los Angeles counties, where annual premiums are $314 and $347 respectively. While it's possible to purchase private insurance for about $400 annually in San Joaquin County, the qualifications - such as the ZIP code in which you live - make it far more difficult to obtain low-cost insurance than under the state's program.
Garamendi was given the authority under recent legislation - Senate Bill 20 - to launch the program throughout the state upon his determination of need in each county.
"Every day, more than 3million motorists travel California's roads without auto insurance. This is clearly a recipe for disaster. This program is an affordable option for qualified low-income drivers. Why risk driving without insurance when you can afford it?" Garamendi said.
SB20 specifically expanded the program to Alameda, Fresno, Orange, Riverside, San Bernardino and San Diego counties effective April 1. On Monday, Garamendi targeted Contra Costa, Imperial, Kern, Sacramento, San Mateo, Santa Clara, San Joaquin and Stanislaus counties for possible expansion of the program, for a total of 16 counties statewide.
"Based on a review by my department, I have initially determined the necessity to expand this program to these eight counties this year. I plan to hold town-hall meetings in each of these communities to directly gauge their insurance needs," Garamendi said.
The eight additional counties are being considered based on the number of uninsured motorists and low-income residents. The community meetings will help Garamendi determine where the need is greatest, the spokeswoman said.
Once a county is selected, it will go through a rate-setting process to determine the monthly premium.
The California Low Cost Automobile Insurance Program was created to provide low-income good drivers with access to affordable automobile liability insurance. The program's policies are issued by private insurance companies licensed by the state, and the program is administered by the California Automobile Assigned Risk Plan; it is not subsidized or otherwise supported by government funding.
Record Staff Writer
Published Tuesday, Jan 24, 2006
STOCKTON - San Joaquin was added to a list Monday of eight counties targeted for expansion of the California Low Cost Automobile Insurance Program, which provides eligible low-income good drivers with state-required liability coverage for less than $400 a year.
A town-hall meeting conducted by state Insurance Commissioner John Garamendi will be held next Tuesday to gauge the community's interest in the program.
With enough support, the low-cost insurance program could be rolled out in San Joaquin County as soon as June 1, a department spokeswoman said.
To be eligible, a driver must have no more than one at-fault accident or one point for a moving violation in the past three years and have gross annual income no higher than 250 percent of the federal poverty level. Examples include up to $23,275 for a single motorist or $47,125 for a four-person household. The vehicle being insured may not be valued at more than $20,000.
The state's low-cost auto insurance plan was introduced in 1999 as a pilot program in San Francisco and Los Angeles counties, where annual premiums are $314 and $347 respectively. While it's possible to purchase private insurance for about $400 annually in San Joaquin County, the qualifications - such as the ZIP code in which you live - make it far more difficult to obtain low-cost insurance than under the state's program.
Garamendi was given the authority under recent legislation - Senate Bill 20 - to launch the program throughout the state upon his determination of need in each county.
"Every day, more than 3million motorists travel California's roads without auto insurance. This is clearly a recipe for disaster. This program is an affordable option for qualified low-income drivers. Why risk driving without insurance when you can afford it?" Garamendi said.
SB20 specifically expanded the program to Alameda, Fresno, Orange, Riverside, San Bernardino and San Diego counties effective April 1. On Monday, Garamendi targeted Contra Costa, Imperial, Kern, Sacramento, San Mateo, Santa Clara, San Joaquin and Stanislaus counties for possible expansion of the program, for a total of 16 counties statewide.
"Based on a review by my department, I have initially determined the necessity to expand this program to these eight counties this year. I plan to hold town-hall meetings in each of these communities to directly gauge their insurance needs," Garamendi said.
The eight additional counties are being considered based on the number of uninsured motorists and low-income residents. The community meetings will help Garamendi determine where the need is greatest, the spokeswoman said.
Once a county is selected, it will go through a rate-setting process to determine the monthly premium.
The California Low Cost Automobile Insurance Program was created to provide low-income good drivers with access to affordable automobile liability insurance. The program's policies are issued by private insurance companies licensed by the state, and the program is administered by the California Automobile Assigned Risk Plan; it is not subsidized or otherwise supported by government funding.
OPM Ousts Postmasters Benefit Plan From Health Insurance Program
From The Washington Post
By Stephen Barr
Tuesday, January 24, 2006; Page B02
The Postmasters Benefit Plan has been dropped from the federal employee health insurance program, the Office of Personnel Management announced yesterday.
In a two-paragraph statement, OPM said the Postmasters plan "will no longer participate" in the Federal Employees Health Benefits Program. Last month, OPM launched an inquiry into the Postmasters plan because of concerns about its solvency and its handling of insurance claims.
OPM said steps are underway to move Postmasters enrollees into Blue Cross and Blue Shield's standard option. Postmasters enrollees who don't want the Blue Cross plan will have an opportunity to choose another, OPM said.
Postmasters was one of the smaller insurance carriers in the federal program, covering about 7,950 enrollees. It was a nationwide fee-for-service plan geared to postal employees. Nonpostal employees who enrolled in the plan paid a $45 fee to become associate members of the sponsor. The plan's most successful years were probably in the mid-1980s, when it had about 80,000 members.
Steve D. LeNoir , president of the National League of Postmasters, which sponsors the plan, said: "We are going to meet all of our claims obligations. No members will be left with any bills. We will take care of our members, and I apologize for any inconvenience that has been caused."
OPM officials have been monitoring the plan closely in recent years, and a recent audit by the OPM inspector general reported that Postmasters suffered operating losses from 1997 through 2001.
In early December, OPM essentially put the plan on probation, faulting it for failure to comply with OPM directives, failure to adjudicate claims in a timely and accurate manner and failure to ensure that the plan paid or denied claims properly.
Over the last month, LeNoir met with OPM officials several times in an effort to keep the plan in the federal program for at least another year. Although the league undertook changes to address OPM's concerns, it was not able to show that $10 million being held in a reserve could be quickly converted into cash or marketable assets, said David M. Ermer , an attorney for the league.
Medicure Plus Inc., the plan's manager, had set aside the $10 million and agreed to make it available to pay claims and benefits if the Postmasters plan was unable to meet its obligations. The guarantee was made as part of a contract agreement with the league.
But the OPM inspector general, in a report last month, contended that the league's contract with Medicure had not been approved by OPM. As a result, the inspector general said, the federal benefits program was inappropriately charged about $6.4 million for the contract from 2000 to 2003.
The inspector general also said it found "numerous expenses that were either explicitly unallowable or did not benefit the federal program." The audit report listed Medicure payments that went to family members, a Democratic campaign committee, a university and a kennel.
Medicure's chief executive, Thomas J. Ernst , said the audit wrongly included "private money" from records that were mistakenly provided to OPM for the inquiry. "We never charged a dime to the federal contract," he said.
He said Medicure had saved the Postmasters plan several million dollars through renegotiation of contracts for prescription drugs and preferred provider organizations and other services.
But the inspector general's report said, "We believe that Medicure paid these unallowable and/or unreasonable expenses using the funds from the monthly management fees that were charged to" the federal program.
By Stephen Barr
Tuesday, January 24, 2006; Page B02
The Postmasters Benefit Plan has been dropped from the federal employee health insurance program, the Office of Personnel Management announced yesterday.
In a two-paragraph statement, OPM said the Postmasters plan "will no longer participate" in the Federal Employees Health Benefits Program. Last month, OPM launched an inquiry into the Postmasters plan because of concerns about its solvency and its handling of insurance claims.
OPM said steps are underway to move Postmasters enrollees into Blue Cross and Blue Shield's standard option. Postmasters enrollees who don't want the Blue Cross plan will have an opportunity to choose another, OPM said.
Postmasters was one of the smaller insurance carriers in the federal program, covering about 7,950 enrollees. It was a nationwide fee-for-service plan geared to postal employees. Nonpostal employees who enrolled in the plan paid a $45 fee to become associate members of the sponsor. The plan's most successful years were probably in the mid-1980s, when it had about 80,000 members.
Steve D. LeNoir , president of the National League of Postmasters, which sponsors the plan, said: "We are going to meet all of our claims obligations. No members will be left with any bills. We will take care of our members, and I apologize for any inconvenience that has been caused."
OPM officials have been monitoring the plan closely in recent years, and a recent audit by the OPM inspector general reported that Postmasters suffered operating losses from 1997 through 2001.
In early December, OPM essentially put the plan on probation, faulting it for failure to comply with OPM directives, failure to adjudicate claims in a timely and accurate manner and failure to ensure that the plan paid or denied claims properly.
Over the last month, LeNoir met with OPM officials several times in an effort to keep the plan in the federal program for at least another year. Although the league undertook changes to address OPM's concerns, it was not able to show that $10 million being held in a reserve could be quickly converted into cash or marketable assets, said David M. Ermer , an attorney for the league.
Medicure Plus Inc., the plan's manager, had set aside the $10 million and agreed to make it available to pay claims and benefits if the Postmasters plan was unable to meet its obligations. The guarantee was made as part of a contract agreement with the league.
But the OPM inspector general, in a report last month, contended that the league's contract with Medicure had not been approved by OPM. As a result, the inspector general said, the federal benefits program was inappropriately charged about $6.4 million for the contract from 2000 to 2003.
The inspector general also said it found "numerous expenses that were either explicitly unallowable or did not benefit the federal program." The audit report listed Medicure payments that went to family members, a Democratic campaign committee, a university and a kennel.
Medicure's chief executive, Thomas J. Ernst , said the audit wrongly included "private money" from records that were mistakenly provided to OPM for the inquiry. "We never charged a dime to the federal contract," he said.
He said Medicure had saved the Postmasters plan several million dollars through renegotiation of contracts for prescription drugs and preferred provider organizations and other services.
But the inspector general's report said, "We believe that Medicure paid these unallowable and/or unreasonable expenses using the funds from the monthly management fees that were charged to" the federal program.
Monday, January 23, 2006
Montana Inks Small Business Health Insurance Contract
From Insurance Journal
January 23, 2006
Montana sealed a deal with the state's largest health insurer Thursday to offer affordable group coverage to small businesses that enroll in a new insurance pool.
The pool is part of a $13 million state program called "Insure Montana" and is designed to help Montanans who lack health insurance. One in five state residents do not have coverage, and about half of that population works for a small business, State Auditor John Morrison said.
"It's bad for their health and bad for everyone's pocketbooks," he said.
Blue Cross Blue Shield of Montana inked a contract with the state to provide two health policies and dental coverage through the insurance pool, which helps businesses qualify for lower premiums through mass buying power.
The plans are "designed to be affordable for Montana families while at the same time providing excellent benefits," Blue Cross Blue Shield CEO Sherry Cladouhos said.
In recent months, more than 1,000 small businesses have applied to participate. The program is offered on a first-come, first-served based as money is available. Initial funding will cover participation by about 900 businesses.
The program has two parts.
The first is a state income-tax credit, $100 to $125 per employee per month, offered to small businesses that already provide health insurance to employees. Several hundred businesses will be authorized to take part, starting this year.
Small businesses that do not offer health insurance can buy it from the health insurance pool. The state will offer premium subsidies to businesses and their workers who get insurance through the pool.
Subsidies will be $102 a month for employee-only coverage, $175 for an employee and spouse and $490 for an employee and a family with two children.
"Reducing the number of uninsured Montanans has been my top priority since I took office in 2001," Morrison said. "It is very gratifying to see the wheels put into motion. Coverage will now be a reality for hundreds of previous uninsured Montanans."
Kate Wilson, chairwoman of the Insure Montana Governing Board, said she sees the need for such a program every day at Cooperative Health Center, a Helena facility that she heads. It offers basic medical and dental care primarily to people lacking other access to such services.
About 70 percent of the center's clients have no insurance, and many people need financial help to get their own health coverage, Wilson said.
"There's no way an individual can afford to buy a good health insurance product," she said.
The 2005 Legislature approved the program. It is financed by increased state tobacco taxes that voters approved in 2004. Initiative 149 directed that part of the higher taxes pay for tax credits to subsidize health insurance for small businesses.
January 23, 2006
Montana sealed a deal with the state's largest health insurer Thursday to offer affordable group coverage to small businesses that enroll in a new insurance pool.
The pool is part of a $13 million state program called "Insure Montana" and is designed to help Montanans who lack health insurance. One in five state residents do not have coverage, and about half of that population works for a small business, State Auditor John Morrison said.
"It's bad for their health and bad for everyone's pocketbooks," he said.
Blue Cross Blue Shield of Montana inked a contract with the state to provide two health policies and dental coverage through the insurance pool, which helps businesses qualify for lower premiums through mass buying power.
The plans are "designed to be affordable for Montana families while at the same time providing excellent benefits," Blue Cross Blue Shield CEO Sherry Cladouhos said.
In recent months, more than 1,000 small businesses have applied to participate. The program is offered on a first-come, first-served based as money is available. Initial funding will cover participation by about 900 businesses.
The program has two parts.
The first is a state income-tax credit, $100 to $125 per employee per month, offered to small businesses that already provide health insurance to employees. Several hundred businesses will be authorized to take part, starting this year.
Small businesses that do not offer health insurance can buy it from the health insurance pool. The state will offer premium subsidies to businesses and their workers who get insurance through the pool.
Subsidies will be $102 a month for employee-only coverage, $175 for an employee and spouse and $490 for an employee and a family with two children.
"Reducing the number of uninsured Montanans has been my top priority since I took office in 2001," Morrison said. "It is very gratifying to see the wheels put into motion. Coverage will now be a reality for hundreds of previous uninsured Montanans."
Kate Wilson, chairwoman of the Insure Montana Governing Board, said she sees the need for such a program every day at Cooperative Health Center, a Helena facility that she heads. It offers basic medical and dental care primarily to people lacking other access to such services.
About 70 percent of the center's clients have no insurance, and many people need financial help to get their own health coverage, Wilson said.
"There's no way an individual can afford to buy a good health insurance product," she said.
The 2005 Legislature approved the program. It is financed by increased state tobacco taxes that voters approved in 2004. Initiative 149 directed that part of the higher taxes pay for tax credits to subsidize health insurance for small businesses.
South Carolina cracks down on insurance fraud
From Greenville Online
By Julie Howle
STAFF WRITER
It could be a false claim, an overstatement of damages and injuries from an accident or not reporting accurate medical history when applying for health insurance.
But whatever the form, insurance fraud is one reason South Carolinians are seeing a larger portion of their paychecks go to rising insurance costs, said Trey Walker, a spokesman for the State Attorney General's Office, where the budget has been boosted to chase offenders.
Walker said that as insurance companies lose money because of fraud, the cost is passed on to the consumer. He said the average American household pays about $1,000 a year in out-of-pocket costs as a result of insurance fraud.
The office sees cases every day, he said, like the Travelers Rest man who pleaded guilty to insurance fraud recently and got a five-year suspended sentence and three years' probation in a case where prosecutors said he claimed the same damage to his pickup truck twice. He was ordered to pay restitution of $3,899.72 to State Farm Insurance Co.
James Quiggle, a spokesman for the Coalition Against Insurance Fraud, said there is $80 billion in insurance fraud each year nationally.
He said insurance fraud can range from people underreporting the number of miles they drive on their auto policy to staging an accident and having passengers pretend to be injured to collect insurance.
And there's always an influx of fraud after disasters as well, whether it is a flood, ice storm or hurricane, he said.
"People will always swoop in and try to profit from a natural disaster," Quiggle said.
Fraud doesn't just hit insurance companies, according to the Coalition Against Insurance Fraud. People can lose their life savings because of insurance investment schemes, pointing to swindlers who sell nonexistent health policies or other insurance plans, the group said.
The state Attorney General's Office has been prosecuting insurance fraud by statute since the mid-'90s, and the office has a division devoted solely to insurance fraud prosecution, Walker said.
Walker said that initially in the mid-'90s the office had two prosecutors and two State Law Enforcement Division agents dedicated to prosecuting insurance fraud across the state.
But with budget cuts, the office shrank to only one prosecutor and two SLED agents, he said, which led to a tremendous backlog that the offices are still working through today.
Walker said the Legislature acted to provide an additional $400,000 a year to the Attorney General's Office to hire insurance fraud prosecutors, starting in fiscal year 2005-2006.
In July 2005, the office hired four more prosecutors and now has five prosecutors devoted to insurance fraud cases.
Walker said in the first quarter of the 2005 fiscal year, the office had a 250 percent increase in the number of insurance fraud cases it handled and closed compared to the first quarter of the 2004 fiscal year.
More tax money is going to the state Attorney General's Office to pursue insurance fraud cases. It's a crime that contributes to higher insurance costs, and prosecution could diminish the extent of the problem.
By Julie Howle
STAFF WRITER
It could be a false claim, an overstatement of damages and injuries from an accident or not reporting accurate medical history when applying for health insurance.
But whatever the form, insurance fraud is one reason South Carolinians are seeing a larger portion of their paychecks go to rising insurance costs, said Trey Walker, a spokesman for the State Attorney General's Office, where the budget has been boosted to chase offenders.
Walker said that as insurance companies lose money because of fraud, the cost is passed on to the consumer. He said the average American household pays about $1,000 a year in out-of-pocket costs as a result of insurance fraud.
The office sees cases every day, he said, like the Travelers Rest man who pleaded guilty to insurance fraud recently and got a five-year suspended sentence and three years' probation in a case where prosecutors said he claimed the same damage to his pickup truck twice. He was ordered to pay restitution of $3,899.72 to State Farm Insurance Co.
James Quiggle, a spokesman for the Coalition Against Insurance Fraud, said there is $80 billion in insurance fraud each year nationally.
He said insurance fraud can range from people underreporting the number of miles they drive on their auto policy to staging an accident and having passengers pretend to be injured to collect insurance.
And there's always an influx of fraud after disasters as well, whether it is a flood, ice storm or hurricane, he said.
"People will always swoop in and try to profit from a natural disaster," Quiggle said.
Fraud doesn't just hit insurance companies, according to the Coalition Against Insurance Fraud. People can lose their life savings because of insurance investment schemes, pointing to swindlers who sell nonexistent health policies or other insurance plans, the group said.
The state Attorney General's Office has been prosecuting insurance fraud by statute since the mid-'90s, and the office has a division devoted solely to insurance fraud prosecution, Walker said.
Walker said that initially in the mid-'90s the office had two prosecutors and two State Law Enforcement Division agents dedicated to prosecuting insurance fraud across the state.
But with budget cuts, the office shrank to only one prosecutor and two SLED agents, he said, which led to a tremendous backlog that the offices are still working through today.
Walker said the Legislature acted to provide an additional $400,000 a year to the Attorney General's Office to hire insurance fraud prosecutors, starting in fiscal year 2005-2006.
In July 2005, the office hired four more prosecutors and now has five prosecutors devoted to insurance fraud cases.
Walker said in the first quarter of the 2005 fiscal year, the office had a 250 percent increase in the number of insurance fraud cases it handled and closed compared to the first quarter of the 2004 fiscal year.
More tax money is going to the state Attorney General's Office to pursue insurance fraud cases. It's a crime that contributes to higher insurance costs, and prosecution could diminish the extent of the problem.
Michigan Governor Plans to Help Those Without Health Insurance
Governor Granholm's state of the state address is scheduled for this Wednesday. A spokesperson for the governor says it will include a proposal to help residents without health insurance. The one-billion dollar plan, if passed, will provide health insurance to half of the people in the state currently without coverage. It's designed to alleviate some of the strain that the uninsured place on businesses and the economy. Funding for her proposal will come from the state and federal government.
Claritas Insurance Audit Shows Baby Boomers Are Embracing Health Savings Accounts
Press Release
Overall, Enrollment in HSAs Is Also Growing, But at a Measured Pace
SAN DIEGO, CA--(MARKET WIRE)--Jan 23, 2006 -- While less than five percent of U.S. consumers have a health savings account (HSA), Baby Boomers, by contrast, are embracing the product in comparatively high numbers. In fact, according to recent findings from the 2005 Insurance Audit™, 56 percent of householders with an HSA are between the ages of 40-60 years old.
By comparison, just under 35 percent of the respondent households with an HSA are under 40 years old. Overall, 4.4 percent of the entire survey household sample of 35,000 said they had a group HSA, but the numbers are expected to continue moving upward as HSAs are increasingly offered on a broader scale through corporate group plans.
2005 Respondent Households with HSA: Age Categories:
http://www.claritasmarketing.com/press/health/
ADVERTISEMENT
The Insurance Audit survey, which is administered by Integras, Claritas' advanced analytical services division, is designed to generate a national representative sample of United States households' insurance behavior. Data includes the following insurance categories: automobile, residential, life, health and insurance attitudes.
"HSAs provide consumers an excellent way to obtain affordable health insurance and a way to save on overall medical expenses, as well as future medical expenses," said Integras Consultant Noel Schoonover. "The ability of baby boomers to begin saving now for their health expenses during retirement will also save Medicare money in the future and help ensure Medicare's future financial vitality," he added.
Other notable findings included:
-- Nearly 40 percent of households with an HSA are concerned about their
long-term care needs compared to 32.1 percent of the total households
surveyed.
-- Nearly 45 percent of households with HSAs are concerned about earning
an income if they become disabled compared to 33.1 percent of all
households surveyed.
-- Over 50 percent of households with an HSA are concerned about
outliving their retirement savings compared to 44.2 percent of the total
households surveyed.
Overall, Enrollment in HSAs Is Also Growing, But at a Measured Pace
SAN DIEGO, CA--(MARKET WIRE)--Jan 23, 2006 -- While less than five percent of U.S. consumers have a health savings account (HSA), Baby Boomers, by contrast, are embracing the product in comparatively high numbers. In fact, according to recent findings from the 2005 Insurance Audit™, 56 percent of householders with an HSA are between the ages of 40-60 years old.
By comparison, just under 35 percent of the respondent households with an HSA are under 40 years old. Overall, 4.4 percent of the entire survey household sample of 35,000 said they had a group HSA, but the numbers are expected to continue moving upward as HSAs are increasingly offered on a broader scale through corporate group plans.
2005 Respondent Households with HSA: Age Categories:
http://www.claritasmarketing.com/press/health/
ADVERTISEMENT
The Insurance Audit survey, which is administered by Integras, Claritas' advanced analytical services division, is designed to generate a national representative sample of United States households' insurance behavior. Data includes the following insurance categories: automobile, residential, life, health and insurance attitudes.
"HSAs provide consumers an excellent way to obtain affordable health insurance and a way to save on overall medical expenses, as well as future medical expenses," said Integras Consultant Noel Schoonover. "The ability of baby boomers to begin saving now for their health expenses during retirement will also save Medicare money in the future and help ensure Medicare's future financial vitality," he added.
Other notable findings included:
-- Nearly 40 percent of households with an HSA are concerned about their
long-term care needs compared to 32.1 percent of the total households
surveyed.
-- Nearly 45 percent of households with HSAs are concerned about earning
an income if they become disabled compared to 33.1 percent of all
households surveyed.
-- Over 50 percent of households with an HSA are concerned about
outliving their retirement savings compared to 44.2 percent of the total
households surveyed.
Sunday, January 22, 2006
44% in area without health insurance
Jake Rollow
El Paso Times
Sunday, January 22, 2006
El Paso health experts said local Hispanics and low- income earners suffer drastic shortages in health coverage and access to medical care, echoing a recent national study.
Hispanics had worse access to health services 88 percent of the time compared with non-Hispanic whites, according to the National Healthcare Disparities Report released this month. People earning low incomes faced worse access in 100 percent of the time when compared with wealthier U.S. residents.
And in El Paso, the access gap may be even wider because of the region's uninsured and undocumented populations, said Robert Anders, co-director of the Hispanic Health Disparities Research Center at UTEP.
Data collected by the Center for Border Health Research back Anders' claim. The center found that 44 percent of El Paso Hispanics lack insurance, as do about 50 percent of those with less than $25,000 annual household income.
Anders called for policies "to encourage employers to provide health insurance." He also said the majority of the uninsured in El Paso are women and children, in part because some employers that do provide insurance don't cover employees' families.
The national study also found that 53 percent of Hispanics and 85 percent of the poor received diminished quality of care when compared with non-Hispanic whites.
Experts said the trend exists in El Paso as well.
"There is no doubt," said Paso del Norte Health Foundation President Ann Pauli. It's partly because El Paso's ratio of doctors to patients is lower than the ratio in the rest of Texas, she said. "This is one of the reasons it will be so important to get that medical school here."
However, disparities in quality of care should not be blamed on the area's medical providers, said Enrique Mata, the foundation's senior program officer. "They are overwhelmed," he said.
At La Clinica Guadalupana, just three clinicians have 9,000 patient visits annually. Situated in the Agua Dulce colonia, southeast of Horizon City, the clinic provides basic family care to more than 3,000 people, most of whom are Hispanic and cannot afford insurance. Fees are determined on a sliding scale.
Medical Director Janet Gildae readily acknowledged that the clinic provides only the limited care it can afford. "But at least we're here," she said. Gildae said she founded Guadalupana 11 years ago because she saw that the area was in dire need of a health services. She thought other medical providers would follow, but that has not been the case.
Arcelia Rodriguez was among the people in the clinic's waiting room Friday afternoon who commended Guadalupana. She was there with her 6-year-old son, Pedro, who'd been unable to sleep the night before because of an earache.
Rodriguez said she considered taking Pedro to an emergency room until Guadalupana agreed to see him on short notice. Her family uses the clinic regularly because it's close and affordable and the doctors are good, she said.
Gildae said the survey's findings are not surprising but are appalling.
She and other health experts named a variety of actions that could help overcome disparities. Among those suggested were a national health care plan, more money for programs that seek to break the cycle of poverty or train medical professionals, and making "equitable" provider reimbursement rates for Medicaid -- rates that are lower in El Paso than other parts of Texas.
Efforts also need to be made to increase health literacy among Hispanics, to provide bilingual services and materials and to educate providers on Hispanic cultural norms, they said.
Salvador Balcorta, CEO of El Paso's Centro de Salud Familiar La Fe, was an appointee to the Minority Health Advisory Committee in the U.S. Department of Health and Human Services, which houses the body that produced the disparities report.
What's sad about the disparities study, he said, is that each year "it's almost the same."
El Paso Times
Sunday, January 22, 2006
El Paso health experts said local Hispanics and low- income earners suffer drastic shortages in health coverage and access to medical care, echoing a recent national study.
Hispanics had worse access to health services 88 percent of the time compared with non-Hispanic whites, according to the National Healthcare Disparities Report released this month. People earning low incomes faced worse access in 100 percent of the time when compared with wealthier U.S. residents.
And in El Paso, the access gap may be even wider because of the region's uninsured and undocumented populations, said Robert Anders, co-director of the Hispanic Health Disparities Research Center at UTEP.
Data collected by the Center for Border Health Research back Anders' claim. The center found that 44 percent of El Paso Hispanics lack insurance, as do about 50 percent of those with less than $25,000 annual household income.
Anders called for policies "to encourage employers to provide health insurance." He also said the majority of the uninsured in El Paso are women and children, in part because some employers that do provide insurance don't cover employees' families.
The national study also found that 53 percent of Hispanics and 85 percent of the poor received diminished quality of care when compared with non-Hispanic whites.
Experts said the trend exists in El Paso as well.
"There is no doubt," said Paso del Norte Health Foundation President Ann Pauli. It's partly because El Paso's ratio of doctors to patients is lower than the ratio in the rest of Texas, she said. "This is one of the reasons it will be so important to get that medical school here."
However, disparities in quality of care should not be blamed on the area's medical providers, said Enrique Mata, the foundation's senior program officer. "They are overwhelmed," he said.
At La Clinica Guadalupana, just three clinicians have 9,000 patient visits annually. Situated in the Agua Dulce colonia, southeast of Horizon City, the clinic provides basic family care to more than 3,000 people, most of whom are Hispanic and cannot afford insurance. Fees are determined on a sliding scale.
Medical Director Janet Gildae readily acknowledged that the clinic provides only the limited care it can afford. "But at least we're here," she said. Gildae said she founded Guadalupana 11 years ago because she saw that the area was in dire need of a health services. She thought other medical providers would follow, but that has not been the case.
Arcelia Rodriguez was among the people in the clinic's waiting room Friday afternoon who commended Guadalupana. She was there with her 6-year-old son, Pedro, who'd been unable to sleep the night before because of an earache.
Rodriguez said she considered taking Pedro to an emergency room until Guadalupana agreed to see him on short notice. Her family uses the clinic regularly because it's close and affordable and the doctors are good, she said.
Gildae said the survey's findings are not surprising but are appalling.
She and other health experts named a variety of actions that could help overcome disparities. Among those suggested were a national health care plan, more money for programs that seek to break the cycle of poverty or train medical professionals, and making "equitable" provider reimbursement rates for Medicaid -- rates that are lower in El Paso than other parts of Texas.
Efforts also need to be made to increase health literacy among Hispanics, to provide bilingual services and materials and to educate providers on Hispanic cultural norms, they said.
Salvador Balcorta, CEO of El Paso's Centro de Salud Familiar La Fe, was an appointee to the Minority Health Advisory Committee in the U.S. Department of Health and Human Services, which houses the body that produced the disparities report.
What's sad about the disparities study, he said, is that each year "it's almost the same."
Friday, January 20, 2006
Ex-Anthem CEO resigns from WellPoint board
Associated Press
INDIANAPOLIS - The former chief executive of WellPoint Inc.'s predecessor company resigned Thursday from the health insurer's 17-member board of directors.
L. Ben Lytle, 59, retired from the Indianapolis-based Anthem Inc. in 1999. Anthem acquired California-based WellPoint Health Networks Inc. in 2004 to become the nation's largest health insurer.
Officials said Lytle left the board to devote more time to his role as chief executive of AXIA Health Management in Tempe, Ariz.
Lytle joined the company in 1977. He was Anthem's chairman of the board until 2003 and has since been the company's chairman emeritus.
"He had the vision to help create a strategic plan more than a decade ago which focused on improving the health of the people we serve," Larry Glasscock, chairman, president and chief executive of WellPoint said in a statement. "This mission continues to guide our overall strategy yet today."
WellPoint has about 34 million members in 14 states.
INDIANAPOLIS - The former chief executive of WellPoint Inc.'s predecessor company resigned Thursday from the health insurer's 17-member board of directors.
L. Ben Lytle, 59, retired from the Indianapolis-based Anthem Inc. in 1999. Anthem acquired California-based WellPoint Health Networks Inc. in 2004 to become the nation's largest health insurer.
Officials said Lytle left the board to devote more time to his role as chief executive of AXIA Health Management in Tempe, Ariz.
Lytle joined the company in 1977. He was Anthem's chairman of the board until 2003 and has since been the company's chairman emeritus.
"He had the vision to help create a strategic plan more than a decade ago which focused on improving the health of the people we serve," Larry Glasscock, chairman, president and chief executive of WellPoint said in a statement. "This mission continues to guide our overall strategy yet today."
WellPoint has about 34 million members in 14 states.
State Researchers Find 117,000 Oregon Children Lack Health Insurance
PORTLAND, Oregon - Approximately 117,000 children in Oregon are without health insurance. And if recent trends hold true, more kids each year will grow up without health care insurance, which translates into inadequate or no health care. The percentage of children without Oregon health insurance has risen from 10.1 percent in 2002 to 12.3 percent in 2004.
Oregon Gov. Ted Kulongoski has made access to basic health care a top priority in his recent Children's Charter, calling for an increase in the number of the state's children with health insurance. One way to address this call is to learn more about the families of uninsured children, according to Jen DeVoe, M.D., principal investigator of a statewide survey to gather information directly from low-income parents and families about issues they face while trying to get health care insurance for their children.
DeVoe, a research instructor in family medicine, Oregon Health & Science University School of Medicine, collaborated with state researchers to prepare a research report for the Office of Oregon Health Policy and Research. This survey is one of several significant studies researchers at OHSU have undertaken to help explore the challenges of providing access to basic health care.
"One of the things that spurred me on to this research was hearing the story of a parent who recently came in to see me with bronchitis. She was employed full time and received employer-sponsored health insurance for herself. She asked me also to check her son's lungs because he had been unable to see his pediatrician recently. Her son was really sick, but he did not have health insurance. Her employer had stopped covering employees' children. This hard-working parent couldn't afford to pay the premium for her son because it was more than her monthly income. Also, she couldn't qualify for the Oregon Health Plan because her family income was too high. I was heartbroken to realize that she had no options whatsoever," DeVoe said.
According to the survey, low-income children most likely to be without health insurance are Hispanic, teenagers aged 14 and older whose families are at the higher end of the income threshold (earning less than 133 percent to 185 percent of the federal poverty level), and had one employed parent and one uninsured parent.
"Lack of access to adequate medical care - for whatever reason - creates a terrible burden for children - delayed diagnoses of treatable conditions that become acute, chronic or life-threatening; poor performance in school; and missing out on the opportunity to become happy, healthy, productive adults," Kulongoski said. "We cannot afford to fail our children by allowing so many of them to live a life without access to health care. No society can expect to achieve and maintain prosperity while compromising the health of its children, and my goal over the next year is to ensure that every child in Oregon, up to the age of 19, has their basic medical care needs met. My focus is on enrolling all eligible kids and keeping them enrolled through a plan that is also affordable for low-income parents whose incomes are too high to qualify for subsidized state and federal programs."
In order to gather information from low-income families with children eligible for publicly funded health insurance programs, the research team sent a mail-return survey to a random sample of all Oregon families whose children were enrolled in the food stamp program at the end of January 2005. DeVoe's report presents data from completed surveys from parents of 2,681 children.
Key findings of the statewide study include:
As many as 68,000 of Oregon's uninsured children may be eligible for publicly funded health coverage.
Uninsured children were three times more likely to use the emergency department for routine care.
Only 1 in 3 uninsured children visited a primary care provider in the past 12 months, and only one out of five uninsured children got necessary dental care.
One in 4 children in this low-income population had a health insurance coverage gap during the past year.
The longer the health insurance coverage gap, the less likely the child was to have a usual source of care.
Nearly all of the parents who responded to the survey were aware of the Oregon Health Plan (OHP), and most of them expressed a willingness to enroll their children in OHP if eligible. However, several parents reported they encountered difficulties with the OHP application process: 43.7 percent had difficulty gathering all of the required paperwork; three-fourths of the families suggested that it would be easier to maintain coverage if the requirement to re-enroll was extended beyond the current requirement to re-enroll every six months; and many parents were confused about the different OHP eligibility requirements for children and adults.
Policy strategies suggested by these results as potentially most effective included: simplification of the OHP application process, elimination of the six-month period of uninsurance for enrollment in the State Children's Health Insurance Program (SCHIP), and extension of the six-month OHP re-enrollment period.
The study was conducted for the Office for Oregon Health Policy. This state office is responsible for the development and analysis of health policy in Oregon and serves as the policy-making body for the Oregon Health Plan, Oregon's Medicaid program. The office provides analysis, technical and policy support to assist the governor and the Legislature in setting health policy. Funding was provided through the U.S. Department of Health and Human Services Health Resources and Service Administration.
Oregon Gov. Ted Kulongoski has made access to basic health care a top priority in his recent Children's Charter, calling for an increase in the number of the state's children with health insurance. One way to address this call is to learn more about the families of uninsured children, according to Jen DeVoe, M.D., principal investigator of a statewide survey to gather information directly from low-income parents and families about issues they face while trying to get health care insurance for their children.
DeVoe, a research instructor in family medicine, Oregon Health & Science University School of Medicine, collaborated with state researchers to prepare a research report for the Office of Oregon Health Policy and Research. This survey is one of several significant studies researchers at OHSU have undertaken to help explore the challenges of providing access to basic health care.
"One of the things that spurred me on to this research was hearing the story of a parent who recently came in to see me with bronchitis. She was employed full time and received employer-sponsored health insurance for herself. She asked me also to check her son's lungs because he had been unable to see his pediatrician recently. Her son was really sick, but he did not have health insurance. Her employer had stopped covering employees' children. This hard-working parent couldn't afford to pay the premium for her son because it was more than her monthly income. Also, she couldn't qualify for the Oregon Health Plan because her family income was too high. I was heartbroken to realize that she had no options whatsoever," DeVoe said.
According to the survey, low-income children most likely to be without health insurance are Hispanic, teenagers aged 14 and older whose families are at the higher end of the income threshold (earning less than 133 percent to 185 percent of the federal poverty level), and had one employed parent and one uninsured parent.
"Lack of access to adequate medical care - for whatever reason - creates a terrible burden for children - delayed diagnoses of treatable conditions that become acute, chronic or life-threatening; poor performance in school; and missing out on the opportunity to become happy, healthy, productive adults," Kulongoski said. "We cannot afford to fail our children by allowing so many of them to live a life without access to health care. No society can expect to achieve and maintain prosperity while compromising the health of its children, and my goal over the next year is to ensure that every child in Oregon, up to the age of 19, has their basic medical care needs met. My focus is on enrolling all eligible kids and keeping them enrolled through a plan that is also affordable for low-income parents whose incomes are too high to qualify for subsidized state and federal programs."
In order to gather information from low-income families with children eligible for publicly funded health insurance programs, the research team sent a mail-return survey to a random sample of all Oregon families whose children were enrolled in the food stamp program at the end of January 2005. DeVoe's report presents data from completed surveys from parents of 2,681 children.
Key findings of the statewide study include:
As many as 68,000 of Oregon's uninsured children may be eligible for publicly funded health coverage.
Uninsured children were three times more likely to use the emergency department for routine care.
Only 1 in 3 uninsured children visited a primary care provider in the past 12 months, and only one out of five uninsured children got necessary dental care.
One in 4 children in this low-income population had a health insurance coverage gap during the past year.
The longer the health insurance coverage gap, the less likely the child was to have a usual source of care.
Nearly all of the parents who responded to the survey were aware of the Oregon Health Plan (OHP), and most of them expressed a willingness to enroll their children in OHP if eligible. However, several parents reported they encountered difficulties with the OHP application process: 43.7 percent had difficulty gathering all of the required paperwork; three-fourths of the families suggested that it would be easier to maintain coverage if the requirement to re-enroll was extended beyond the current requirement to re-enroll every six months; and many parents were confused about the different OHP eligibility requirements for children and adults.
Policy strategies suggested by these results as potentially most effective included: simplification of the OHP application process, elimination of the six-month period of uninsurance for enrollment in the State Children's Health Insurance Program (SCHIP), and extension of the six-month OHP re-enrollment period.
The study was conducted for the Office for Oregon Health Policy. This state office is responsible for the development and analysis of health policy in Oregon and serves as the policy-making body for the Oregon Health Plan, Oregon's Medicaid program. The office provides analysis, technical and policy support to assist the governor and the Legislature in setting health policy. Funding was provided through the U.S. Department of Health and Human Services Health Resources and Service Administration.
Progressive's Lewis Honored as Insurance Leader of the Year
(BestWire Services Via Thomson Dialog NewsEdge)
About 1,000 insurance professionals gathered at New York's Marriott Marquis hotel to honor Peter B. Lewis, chairman of automobile insurer Progressive Corp., as Insurance Leader of the Year at the annual award dinner.
The award, given by the School of Risk Management at St. John's University, recognizes the contributions of outstanding individuals whose leadership in the worldwide insurance and financial services industry sets them apart from their peers.
In his acceptance speech, Lewis, 72, cited what he called Progressive's "unique culture" of dedicated service in "giving the customer what they need."
Lewis said Progressive's success comes down to five core values -- integrity; the Golden Rule [treat customers as you would want to be treated]; clear objectives; excellence in service; and profit. "Progressive thrives because of its commitment to especially good people who are guided by five clear core values and are measured against unusually high standards. I thrive for the same reasons," he said.
Progressive was formed in 1937 by Joseph Lewis [Peter's father] and Jack Green. The company moved into downtown Cleveland in 1951. With the death of Joseph Lewis in 1955, Green became chief executive and Peter joined the company.
In 1965, Peter Lewis took over as CEO, a position he kept until 2000. Under his watch, the company grew from sales of $6 million to more than $13 billion, becoming the third-largest auto insurer in the United States.
In his speech, Lewis said Progressive has been a success because of a clear vision of what auto insurance should be about. "The purpose of an auto insurer is to reduce the trauma, cost and inconvenience of auto accidents in cost-effective and profitable ways," he said.
Among the innovations Progressive is famous for are 24-hour immediate response claims services; rapid, no-hassle settlements; and mobile adjusters who can respond rapidly to an accident scene.
Progressive has done other things unusual for auto insurers -- it offers free, comparative quotes from other auto insurers, and in 2001, it became the first publicly traded company to announce financial results monthly.
In addition to his work building Progressive, Lewis is known as a generous contributor to education and a patron of the arts. He donated $36 million to Case Western Reserve University's Weatherhead School of Management, and $60 million to his alma mater, Princeton University, to build a science library. He also gave Princeton $55 million to endow the university's Institute for Integrative Genomics.
Lewis donated $62 million to the Solomon R. Guggenheim Museum and $15 million to the American Civil Liberties Union. He serves on the boards of trustees of the Guggenheim and the Cleveland Museum of Art.
This is the 11th year St. John's has presented the award. Last year's recipient was Ace. Ltd. Chairman Brian Duperreault (BestWire, Jan. 28, 2005).
The awards dinner is a scholarship fund-raiser for the St. John's School of Risk Management. This year's event raised $1.49 million, said Ellen Thrower, the school's executive director.
Members of Progressive Insurance Group currently have a Best's Financial Strength Rating of A+ (Superior).
About 1,000 insurance professionals gathered at New York's Marriott Marquis hotel to honor Peter B. Lewis, chairman of automobile insurer Progressive Corp., as Insurance Leader of the Year at the annual award dinner.
The award, given by the School of Risk Management at St. John's University, recognizes the contributions of outstanding individuals whose leadership in the worldwide insurance and financial services industry sets them apart from their peers.
In his acceptance speech, Lewis, 72, cited what he called Progressive's "unique culture" of dedicated service in "giving the customer what they need."
Lewis said Progressive's success comes down to five core values -- integrity; the Golden Rule [treat customers as you would want to be treated]; clear objectives; excellence in service; and profit. "Progressive thrives because of its commitment to especially good people who are guided by five clear core values and are measured against unusually high standards. I thrive for the same reasons," he said.
Progressive was formed in 1937 by Joseph Lewis [Peter's father] and Jack Green. The company moved into downtown Cleveland in 1951. With the death of Joseph Lewis in 1955, Green became chief executive and Peter joined the company.
In 1965, Peter Lewis took over as CEO, a position he kept until 2000. Under his watch, the company grew from sales of $6 million to more than $13 billion, becoming the third-largest auto insurer in the United States.
In his speech, Lewis said Progressive has been a success because of a clear vision of what auto insurance should be about. "The purpose of an auto insurer is to reduce the trauma, cost and inconvenience of auto accidents in cost-effective and profitable ways," he said.
Among the innovations Progressive is famous for are 24-hour immediate response claims services; rapid, no-hassle settlements; and mobile adjusters who can respond rapidly to an accident scene.
Progressive has done other things unusual for auto insurers -- it offers free, comparative quotes from other auto insurers, and in 2001, it became the first publicly traded company to announce financial results monthly.
In addition to his work building Progressive, Lewis is known as a generous contributor to education and a patron of the arts. He donated $36 million to Case Western Reserve University's Weatherhead School of Management, and $60 million to his alma mater, Princeton University, to build a science library. He also gave Princeton $55 million to endow the university's Institute for Integrative Genomics.
Lewis donated $62 million to the Solomon R. Guggenheim Museum and $15 million to the American Civil Liberties Union. He serves on the boards of trustees of the Guggenheim and the Cleveland Museum of Art.
This is the 11th year St. John's has presented the award. Last year's recipient was Ace. Ltd. Chairman Brian Duperreault (BestWire, Jan. 28, 2005).
The awards dinner is a scholarship fund-raiser for the St. John's School of Risk Management. This year's event raised $1.49 million, said Ellen Thrower, the school's executive director.
Members of Progressive Insurance Group currently have a Best's Financial Strength Rating of A+ (Superior).
Thursday, January 19, 2006
AssuranceAmerica Corp. Acquries Tampa No-Fault Insurance Agency
January 18, 2006
Atlanta-based AssuranceAmerica Corp. has announced the acquisition of Tampa No-Fault Insurance Agency Inc., a retail insurance agency in Tampa, Fla. producing more than $3 million in annual premium volume with emphasis on sales of non-standard auto insurance products.
AssuranceAmerica focuses on the non-standard automobile insurance marketplace, primarily in Florida, Georgia and South Carolina. Its principal operating subsidiaries are TrustWay Insurance, which sells personal automobile insurance policies through its 32 retail agencies, AssuranceAmerica Managing General Agency and AssuranceAmerica Insurance Co.
"This acquisition meets our objectives of acquiring agencies that are well established in their market, focused on our niche non-standard auto insurance business, do not overlap with our locations and allows us to add AssuranceAmerica Insurance Company's products into their existing product offerings," In announcing the acquisition, Lawrence (Bud) Stumbaugh, president and CEO of AssuranceAmerica said. "We expect to see increasing revenues and efficiencies as a result of this new addition to our agency group."
AssuranceAmerica Insurance recently received approval to commence operations in Mississippi. This is the seventh state that has given approval to AssuranceAmerica's carrier and/or MGA to write automobile insurance policies. In addition to Mississippi, these states are Georgia, South Carolina, Florida, Alabama, Arkansas and Texas.
Atlanta-based AssuranceAmerica Corp. has announced the acquisition of Tampa No-Fault Insurance Agency Inc., a retail insurance agency in Tampa, Fla. producing more than $3 million in annual premium volume with emphasis on sales of non-standard auto insurance products.
AssuranceAmerica focuses on the non-standard automobile insurance marketplace, primarily in Florida, Georgia and South Carolina. Its principal operating subsidiaries are TrustWay Insurance, which sells personal automobile insurance policies through its 32 retail agencies, AssuranceAmerica Managing General Agency and AssuranceAmerica Insurance Co.
"This acquisition meets our objectives of acquiring agencies that are well established in their market, focused on our niche non-standard auto insurance business, do not overlap with our locations and allows us to add AssuranceAmerica Insurance Company's products into their existing product offerings," In announcing the acquisition, Lawrence (Bud) Stumbaugh, president and CEO of AssuranceAmerica said. "We expect to see increasing revenues and efficiencies as a result of this new addition to our agency group."
AssuranceAmerica Insurance recently received approval to commence operations in Mississippi. This is the seventh state that has given approval to AssuranceAmerica's carrier and/or MGA to write automobile insurance policies. In addition to Mississippi, these states are Georgia, South Carolina, Florida, Alabama, Arkansas and Texas.
Health insurance, grandparent rights on the table
TOM MCKEE | COMMUNITY RECORDER GUEST COLUMNIST
FRANKFORT -- With the second week of the 2006 Regular Session now behind us, the General Assembly is getting into a comfortable rhythm as the various legislative committees ready the first bills for a vote by the full House or Senate.
The leaders of both chambers use this time to promote legislation they especially would like to become law, and they try to give the other chamber plenty of time to consider their proposals.
For the House, that is centered around an agenda we are calling "A Commitment to Kentucky Families." It consists of several dozen bills, the first of which are now ready for a vote by the 100 House members.
That includes a bill I was proud to co-sponsor that ensures veterans have a built-in advantage for all non-political state government jobs, not just a portion of them. The House's State Government Committee unanimously approved it (House Bill 24) last Tuesday.
On Wednesday, House leaders unveiled their plan to give small businesses a little financial relief from the high cost of health insurance. Our goal is to give each of these businesses a credit each month for every employee.
It is estimated that 578,000 Kentuckians, or 14 percent of the state's population, do not have health insurance. While that percentage is a little better than the national average, it still is much too high, and our hope is that this bill will play a strong role in lowering it.
We in the House were glad to see that Gov. Ernie Fletcher, in his State of the Commonwealth address early last week, favored a similar approach. His support for the House goal of raising teacher pay to the average of the seven surrounding states is also a positive step.
On Thursday, the House's Health and Welfare Committee spoke up in favor of grandparent rights by approving House Bill 45. This legislation will give grandparents and other guardians legal authority to make medical or school-related decisions if they are the child's primary caregiver. This bill would not be absolute, however. It could be revoked if the child moves back with his or her parents, for example.
That same day, the full House voted unanimously for House Bill 75, which will give our public universities the ability to issue their own bonds for projects that bring in a steady stream of revenue, such as a dormitory. Nearly every state already allows this, so we are hoping that Kentucky can be added to the list, giving our universities more control over meeting the needs of their students.
As chairman of the House's Agriculture and Small Business Committee, I often sponsor many bills that are designed to help our farmers. This legislative session is no different.
Perhaps the most important is HB 183, which will define just how far local and state governments can go in condemning private property for the public good.
There is little question that eminent domain, as this practice is called, is warranted for such public projects as roads and courthouses. This bill would not interfere with that, or when it is used to condemn areas that are clearly run down, but it will ensure that governments do not just hand over one person's private property to a private developer for such things as a shopping mall.
I believe this bill will go a long way to protecting our family farms.
Some of the other legislation I am sponsoring includes House Bill 247, which will create a standard grading program for hay quality; House Bill 268, which calls on the Department of Agriculture to prescribe the best methods to test pesticides; House Bill 267, which modifies the law governing the production of apples and strawberries; and House Bill 269, which re-defines the Kentucky Grape and Wine Council.
FRANKFORT -- With the second week of the 2006 Regular Session now behind us, the General Assembly is getting into a comfortable rhythm as the various legislative committees ready the first bills for a vote by the full House or Senate.
The leaders of both chambers use this time to promote legislation they especially would like to become law, and they try to give the other chamber plenty of time to consider their proposals.
For the House, that is centered around an agenda we are calling "A Commitment to Kentucky Families." It consists of several dozen bills, the first of which are now ready for a vote by the 100 House members.
That includes a bill I was proud to co-sponsor that ensures veterans have a built-in advantage for all non-political state government jobs, not just a portion of them. The House's State Government Committee unanimously approved it (House Bill 24) last Tuesday.
On Wednesday, House leaders unveiled their plan to give small businesses a little financial relief from the high cost of health insurance. Our goal is to give each of these businesses a credit each month for every employee.
It is estimated that 578,000 Kentuckians, or 14 percent of the state's population, do not have health insurance. While that percentage is a little better than the national average, it still is much too high, and our hope is that this bill will play a strong role in lowering it.
We in the House were glad to see that Gov. Ernie Fletcher, in his State of the Commonwealth address early last week, favored a similar approach. His support for the House goal of raising teacher pay to the average of the seven surrounding states is also a positive step.
On Thursday, the House's Health and Welfare Committee spoke up in favor of grandparent rights by approving House Bill 45. This legislation will give grandparents and other guardians legal authority to make medical or school-related decisions if they are the child's primary caregiver. This bill would not be absolute, however. It could be revoked if the child moves back with his or her parents, for example.
That same day, the full House voted unanimously for House Bill 75, which will give our public universities the ability to issue their own bonds for projects that bring in a steady stream of revenue, such as a dormitory. Nearly every state already allows this, so we are hoping that Kentucky can be added to the list, giving our universities more control over meeting the needs of their students.
As chairman of the House's Agriculture and Small Business Committee, I often sponsor many bills that are designed to help our farmers. This legislative session is no different.
Perhaps the most important is HB 183, which will define just how far local and state governments can go in condemning private property for the public good.
There is little question that eminent domain, as this practice is called, is warranted for such public projects as roads and courthouses. This bill would not interfere with that, or when it is used to condemn areas that are clearly run down, but it will ensure that governments do not just hand over one person's private property to a private developer for such things as a shopping mall.
I believe this bill will go a long way to protecting our family farms.
Some of the other legislation I am sponsoring includes House Bill 247, which will create a standard grading program for hay quality; House Bill 268, which calls on the Department of Agriculture to prescribe the best methods to test pesticides; House Bill 267, which modifies the law governing the production of apples and strawberries; and House Bill 269, which re-defines the Kentucky Grape and Wine Council.
Wednesday, January 18, 2006
Indiana Lawmakers May Lose Free Ride on Health Insurance
January 18, 2006
Indiana House representatives and their families could lose a lifetime of free health insurance if a policy released by the speaker of House is adopted. In 2002, a series of laws passed by the General Assemby gave representatives and their families free health insurance for life.
But in recent days, the free ride on health insurance became a key campaign issue for some lawmakers and was called an "unfunded liability for the state" by Indiana State Auditor Connie Nass.
Leadership complained that the plan had not been comfortable from the start. Thre House Speaker's move would not change existing law, however, and future speakers would have the ability to reinstate the free insurance, according to an account by Star Tribune.
The Legislative Services Agency estimated that it costs the state between $3,826 and $5,174 a year to pay the premium of an individual lawmaker, or between $10,711 and $14,511 a year if the lawmaker chooses a family plan.
The plan is already expected to cost the state $306,000 a year by 2008, to pay the employee portion of the premiums of retired lawmakers, their families, surviving spouses and even divorced spouses according to Rep. Troy Woodruff (R-Vincennes). Woodruff added that the free insurance was an embarrassing centerpiece of his campaign for the House in 2003.
Some are speculating that many representatives would choose to retire if the plan is changed in order to preserve their elgiblity. Lawmakers have qualified for the benefit if they retired after six years and one day in office, which would include the start of a fourth term in the House or halfway through a second term in the Senate.
Nineteen retired House lawmakers area already receiving benefits paid for by the state. The speaker's decision will only effect the House and since the proposed policy was released yesterday evening, there is no word whether the Senate would follow the House lead and also nix the free insurance for its retirees.
Indiana House representatives and their families could lose a lifetime of free health insurance if a policy released by the speaker of House is adopted. In 2002, a series of laws passed by the General Assemby gave representatives and their families free health insurance for life.
But in recent days, the free ride on health insurance became a key campaign issue for some lawmakers and was called an "unfunded liability for the state" by Indiana State Auditor Connie Nass.
Leadership complained that the plan had not been comfortable from the start. Thre House Speaker's move would not change existing law, however, and future speakers would have the ability to reinstate the free insurance, according to an account by Star Tribune.
The Legislative Services Agency estimated that it costs the state between $3,826 and $5,174 a year to pay the premium of an individual lawmaker, or between $10,711 and $14,511 a year if the lawmaker chooses a family plan.
The plan is already expected to cost the state $306,000 a year by 2008, to pay the employee portion of the premiums of retired lawmakers, their families, surviving spouses and even divorced spouses according to Rep. Troy Woodruff (R-Vincennes). Woodruff added that the free insurance was an embarrassing centerpiece of his campaign for the House in 2003.
Some are speculating that many representatives would choose to retire if the plan is changed in order to preserve their elgiblity. Lawmakers have qualified for the benefit if they retired after six years and one day in office, which would include the start of a fourth term in the House or halfway through a second term in the Senate.
Nineteen retired House lawmakers area already receiving benefits paid for by the state. The speaker's decision will only effect the House and since the proposed policy was released yesterday evening, there is no word whether the Senate would follow the House lead and also nix the free insurance for its retirees.
State-subsidized House insurance changes coming
By Lesley Stedman Weidenbener
The Courier-Journal
INDIANAPOLIS — House Speaker Brian Bosma said yesterday that, starting next year, he is ending state-subsidized, lifetime health insurance for any House members who leave the body.
The change won't affect the 25 former lawmakers and spouses already taking advantage of the benefit. They get health insurance at the same price — or in some cases an even lower one — than current state employees pay, even if they are eligible for Medicare.
And it will allow members of the House with more than six years of service to retire after their current term and still take advantage of the benefit.
But those elected in November and thereafter — even if they're now serving — will have to pay the full cost with no state subsidy to remain part of the state health-insurance plan when they retire, and then only until they are eligible for Medicare.
That's expected to cause some members to rethink whether to run for re-election in November or retire now to take the insurance.
Rep. Dave Crooks, D-Washington, said there might be a "mass exodus" of lawmakers who decide the retirement deal is too good to pass up.
"If you do the math, it adds up," Crooks said. "It's probably more valuable than any income that legislator may have made in their years of service."
Bosma acknowledged that could happen. But he said he believes members are not serving for the pay or benefits.
"They're here to serve the public, and I do not believe that putting this benefit back where it should be will change that dedication," he said.
Bosma said he has been "uncomfortable" for some time with the insurance program, which was authorized by a series of provisions slipped quietly into bills in 2001 and 2002 and then instituted by former House Speaker John Gregg, D-Sandborn, and Senate President Pro Tem Robert Garton, R-Columbus.
But he didn't want to revoke it for members serving now.
"While I disagree with the current benefit, it was in place when each of us ran for our office in 2004, and is part of the contract between the voter and their elected officials, whether the voter realized it or not," Bosma wrote in a letter distributed to members yesterday.
The program allowed any member retiring with at least six years and one day of service to lock in relatively modest health-insurance rates for the rest of their lives.
Essentially, they would continue to pay the same percentage of the total health-care premium that they did when they were lawmakers. The state would pick up the remaining costs.
This year lawmakers — just like state employees — can choose among health-insurance plans that have a total cost of between $3,826 and $14,511 annually, depending on the amount of coverage they choose and the number of family members covered.
The recipient's share of that total premium can be no higher than 24percent, depending on the plan, with the state picking up at least 76percent, according to the Legislative Services Agency. One plan requires no payment from a lawmaker or employee.
Retired lawmakers (or their surviving spouses) have simply continued to pay the same percentage of the total state premium as when they were actively serving.
The state's share of the current retired lawmakers' insurance premiums costs about $300,000 annually.
Senate President Pro Tem Robert Garton, R-Columbus, also has been looking into the issue. But he hasn't announced any changes for current or former members of his chamber.
Bosma voted for the bills that authorized the speaker and president pro tem to put the subsidized health insurance in place. So did the vast majority of lawmakers.
But in 2004 several Republican candidates for the House used the issue against the Democratic incumbents they were trying to unseat.
Rep. Billy Bright, R-North Vernon, who that year defeated Democrat Markt Lytle of Madison, was one of them.
Yesterday he called Bosma's decision "courageous."
"It was the right thing to do," Bright said.
Rep. Troy Woodruff, R-Vincennes, introduced legislation this year to do away with the health-insurance program, even for the former retirees now using it. Woodruff used the insurance issue in his campaign in 2004 when he defeated Democratic incumbent John Frenz.
Yesterday Bosma said that the legislation probably is not necessary now. However, a future speaker could decide to change Bosma's policy.
Several members said the change will cause them to think about quitting.
Crooks, who owns radio stations in Daviess County, said he will have to evaluate it.
"You'd be foolish not to take a close look at it because of the cost of insurance and the availability of it, and I still have two very young children," Crooks said. "It would be irresponsible not to consider it."
Rep. Bill Cochran, D-New Albany, said he believes the decision will affect the re-election decisions of some lawmakers. But he added that he won't be among them.
"That wouldn't be the reason I'd decide not to run," he said.
House Minority Whip Dennie Oxley, D-English, also said the change won't affect his decision to run again. He said he doubted it would affect many other members.
"A mass exodus?" Oxley said. "I haven't heard of anything like that."
The Courier-Journal
INDIANAPOLIS — House Speaker Brian Bosma said yesterday that, starting next year, he is ending state-subsidized, lifetime health insurance for any House members who leave the body.
The change won't affect the 25 former lawmakers and spouses already taking advantage of the benefit. They get health insurance at the same price — or in some cases an even lower one — than current state employees pay, even if they are eligible for Medicare.
And it will allow members of the House with more than six years of service to retire after their current term and still take advantage of the benefit.
But those elected in November and thereafter — even if they're now serving — will have to pay the full cost with no state subsidy to remain part of the state health-insurance plan when they retire, and then only until they are eligible for Medicare.
That's expected to cause some members to rethink whether to run for re-election in November or retire now to take the insurance.
Rep. Dave Crooks, D-Washington, said there might be a "mass exodus" of lawmakers who decide the retirement deal is too good to pass up.
"If you do the math, it adds up," Crooks said. "It's probably more valuable than any income that legislator may have made in their years of service."
Bosma acknowledged that could happen. But he said he believes members are not serving for the pay or benefits.
"They're here to serve the public, and I do not believe that putting this benefit back where it should be will change that dedication," he said.
Bosma said he has been "uncomfortable" for some time with the insurance program, which was authorized by a series of provisions slipped quietly into bills in 2001 and 2002 and then instituted by former House Speaker John Gregg, D-Sandborn, and Senate President Pro Tem Robert Garton, R-Columbus.
But he didn't want to revoke it for members serving now.
"While I disagree with the current benefit, it was in place when each of us ran for our office in 2004, and is part of the contract between the voter and their elected officials, whether the voter realized it or not," Bosma wrote in a letter distributed to members yesterday.
The program allowed any member retiring with at least six years and one day of service to lock in relatively modest health-insurance rates for the rest of their lives.
Essentially, they would continue to pay the same percentage of the total health-care premium that they did when they were lawmakers. The state would pick up the remaining costs.
This year lawmakers — just like state employees — can choose among health-insurance plans that have a total cost of between $3,826 and $14,511 annually, depending on the amount of coverage they choose and the number of family members covered.
The recipient's share of that total premium can be no higher than 24percent, depending on the plan, with the state picking up at least 76percent, according to the Legislative Services Agency. One plan requires no payment from a lawmaker or employee.
Retired lawmakers (or their surviving spouses) have simply continued to pay the same percentage of the total state premium as when they were actively serving.
The state's share of the current retired lawmakers' insurance premiums costs about $300,000 annually.
Senate President Pro Tem Robert Garton, R-Columbus, also has been looking into the issue. But he hasn't announced any changes for current or former members of his chamber.
Bosma voted for the bills that authorized the speaker and president pro tem to put the subsidized health insurance in place. So did the vast majority of lawmakers.
But in 2004 several Republican candidates for the House used the issue against the Democratic incumbents they were trying to unseat.
Rep. Billy Bright, R-North Vernon, who that year defeated Democrat Markt Lytle of Madison, was one of them.
Yesterday he called Bosma's decision "courageous."
"It was the right thing to do," Bright said.
Rep. Troy Woodruff, R-Vincennes, introduced legislation this year to do away with the health-insurance program, even for the former retirees now using it. Woodruff used the insurance issue in his campaign in 2004 when he defeated Democratic incumbent John Frenz.
Yesterday Bosma said that the legislation probably is not necessary now. However, a future speaker could decide to change Bosma's policy.
Several members said the change will cause them to think about quitting.
Crooks, who owns radio stations in Daviess County, said he will have to evaluate it.
"You'd be foolish not to take a close look at it because of the cost of insurance and the availability of it, and I still have two very young children," Crooks said. "It would be irresponsible not to consider it."
Rep. Bill Cochran, D-New Albany, said he believes the decision will affect the re-election decisions of some lawmakers. But he added that he won't be among them.
"That wouldn't be the reason I'd decide not to run," he said.
House Minority Whip Dennie Oxley, D-English, also said the change won't affect his decision to run again. He said he doubted it would affect many other members.
"A mass exodus?" Oxley said. "I haven't heard of anything like that."
Health Plan to aid farmers
Cargill AgHorizons will hold a teleconference 7 p.m. Thursday at the Sheraton Hotel in Sioux Falls to introduce a new way for farm families to to pay for health care expenses and save for the future.
The plan, called Harvest Health, combines a health savings account provided by Wells Fargo with funding for the account provided by Cargill. The plan gives farm families the opportunity to more closely manage their own health care spending, control their health insurance premiums and set aside tax-favored dollars for future medical expenses.
The plan, called Harvest Health, combines a health savings account provided by Wells Fargo with funding for the account provided by Cargill. The plan gives farm families the opportunity to more closely manage their own health care spending, control their health insurance premiums and set aside tax-favored dollars for future medical expenses.
Tuesday, January 17, 2006
Millions Of Young Adults Forgo Health Insurance
NEW YORK -- In 2003, more than 13 million young adults lived without health insurance -- a decision that could lead to serious consequences later in life.
NBC News reported the combination of expensive health insurance and low entry-level wages force many people to go without insurance. Further, most young people are healthy and don't see the need for health insurance.
"Even though this is the lowest-cost coverage that they're going to face in their careers, it's still high relative to their incomes," said William Custer, a professor of risk management and insurance at Georgia State University.
Custer added, "If they don't feel they're going to need health care, they don't feel they're going to need health insurance."
But that could mean serious health and financial problems in the future.
"I'm afraid our society is playing Russian roulette when young adults go without health insurance," said Joel Miller, senior vice president for operations at the National Coalition on Healthcare. "They deny needed care ... and it increases out-of-pocket expenses for them and their families."
Experts said families should search the Internet for health insurance providers that offer plans specifically designed for young adults.
"Some plans are coming around to the fact that this is the fastest- and largest-growing population of the uninsured population -- they're trying to market some different plans," Miller said.
At the very least, experts advise healthy young adults to carry catastrophic insurance. The plan may require a high deductible with limited or no routine medical coverage, but it will cover serious accidents or illnesses.
"Having a catastrophic plan, even with a large deductible, may mean this individual will have access to health care that can save their life," Custer said.
As with any large purchase, families need to do their research and find the policy that best fits the lifestyle for the young adult in their life.
NBC News reported the combination of expensive health insurance and low entry-level wages force many people to go without insurance. Further, most young people are healthy and don't see the need for health insurance.
"Even though this is the lowest-cost coverage that they're going to face in their careers, it's still high relative to their incomes," said William Custer, a professor of risk management and insurance at Georgia State University.
Custer added, "If they don't feel they're going to need health care, they don't feel they're going to need health insurance."
But that could mean serious health and financial problems in the future.
"I'm afraid our society is playing Russian roulette when young adults go without health insurance," said Joel Miller, senior vice president for operations at the National Coalition on Healthcare. "They deny needed care ... and it increases out-of-pocket expenses for them and their families."
Experts said families should search the Internet for health insurance providers that offer plans specifically designed for young adults.
"Some plans are coming around to the fact that this is the fastest- and largest-growing population of the uninsured population -- they're trying to market some different plans," Miller said.
At the very least, experts advise healthy young adults to carry catastrophic insurance. The plan may require a high deductible with limited or no routine medical coverage, but it will cover serious accidents or illnesses.
"Having a catastrophic plan, even with a large deductible, may mean this individual will have access to health care that can save their life," Custer said.
As with any large purchase, families need to do their research and find the policy that best fits the lifestyle for the young adult in their life.
Zurich Financial Services pulls out of US auto insurance unit sale
By Stephen McNamara
European banking and insurance services provider Zurich Financial Services has pulled out of a deal to sell its US-based auto dealer insurance business to Hellman & Friedman because final details could not be agreed.
According to Zurich, a consortium of proposed buyers led by private investment house Hellman & Friedman mutually agreed with the Swiss financial firm to break off the $1.1 billion purchase of Universal Underwriters Group, which provides specialty insurance to car, truck and motorcycle dealerships, because of their inability to agree terms.
Zurich said that since the announcement of the agreement last April, both parties had been working toward finalizing the transaction and had expected to complete in the third quarter of last year.
However as a result of being unable to complete the transaction at mutually agreeable terms both Zurich and Hellman & Friedman have agreed not to pursue the transaction any further and Zurich has decided to retain Universal Underwriters as part of its North America Commercial business division.
European banking and insurance services provider Zurich Financial Services has pulled out of a deal to sell its US-based auto dealer insurance business to Hellman & Friedman because final details could not be agreed.
According to Zurich, a consortium of proposed buyers led by private investment house Hellman & Friedman mutually agreed with the Swiss financial firm to break off the $1.1 billion purchase of Universal Underwriters Group, which provides specialty insurance to car, truck and motorcycle dealerships, because of their inability to agree terms.
Zurich said that since the announcement of the agreement last April, both parties had been working toward finalizing the transaction and had expected to complete in the third quarter of last year.
However as a result of being unable to complete the transaction at mutually agreeable terms both Zurich and Hellman & Friedman have agreed not to pursue the transaction any further and Zurich has decided to retain Universal Underwriters as part of its North America Commercial business division.
Wal-Mart Insurance
A bill before the state Legislature is questioning whether Wal-Mart, West Virginia's largest private employer, is driving up health care costs.
The West Virginia Fair Share Health Care Act would require any employer with ten-thousand or more workers to spend eight percent of its wages on health care.
Those who don't must pay the difference to the state's Medicaid insurance program for the poor.
The bill doesn't specifically name the retail giant, but Wal-Mart alone appears to fall under the bill's provisions with more than 12,000 employees statewide.
Wal-Mart says three-fourths of its employees nationwide have some sort of health insurance, but bill supporters say the retailer leaves workers and their families uninsured or on government-funded health care.
Maryland enacted similar legislation last week, overriding a veto by the governor there. Versions of the bill are expected in 30 states this year.
The West Virginia Fair Share Health Care Act would require any employer with ten-thousand or more workers to spend eight percent of its wages on health care.
Those who don't must pay the difference to the state's Medicaid insurance program for the poor.
The bill doesn't specifically name the retail giant, but Wal-Mart alone appears to fall under the bill's provisions with more than 12,000 employees statewide.
Wal-Mart says three-fourths of its employees nationwide have some sort of health insurance, but bill supporters say the retailer leaves workers and their families uninsured or on government-funded health care.
Maryland enacted similar legislation last week, overriding a veto by the governor there. Versions of the bill are expected in 30 states this year.
Monday, January 16, 2006
Health Insurance for One
By Morgan Kelly
Staff writer
Without an employer to cushion the blow, the price of individual health insurance can hit an independent buyer rather hard.
“If all of us had to have it, we’d probably be lucky to get it for a couple thousand a month,” said Debbie Kimble of Charleston’s Peanut Shoppe. Fortunately, the store’s three employees — all family — get coverage through spouses or the government.
“Anytime you have to put an extra $2,000 out, it’ll be harder,” she said. “But that’s when you tighten up your belt and cut back somewhere else.”
Although independently sought policies do not fall into most people’s view of reasonable, the average person can buy health coverage without breaking the bank as long as they can part with the usual workplace benefits, insurance experts say.
“If you’re young, the premiums can be relatively modest, but you’re talking about the deductibles in that market being $1,000 sometimes,” said Gary Claxton, director of the Kaiser Family Foundation’s Health Care Marketplace Project.
“You’re not going to get what most of us call a good policy for not a whole lot of money, but you can avoid making mistakes.”
First of all, avoid being roped in by your own health problems, Claxton said. Some insurers won’t sell to people who are already sick. Even if you do manage to secure a policy, there are several ways you can still be left uncovered when you can least afford it.
In West Virginia, insurers can set your premiums based on your health by 30 percent more or less than the standard cost, said Jessica Waltman, director of health policy research for the National Association of Health Underwriters, or NAHU, an insurance trade group.
“The rate you see online is the best-case-scenario rate,” she said.
Companies can also look at your health for the last year and refuse to cover conditions you had before applying for the policy, or pre-existing conditions, Waltman said. These conditions can go on for up to two years.
The point, of course, is to keep people from getting insurance just because they are sick, Waltman said.
But these exclusions can be somewhat arbitrary, said Trudy Lieberman, director of the Center for Consumer Health Choices, part of Consumers Union, which publishes the magazine “Consumer Reports.” A case of asthma could lead an insurer to deny all claims involving respiratory illnesses.
“These can be very minor problems, but you’re still not wanted by insurance providers,” Lieberman said. People looking for a policy should contact a broker who represents more than one company to get a good variety of choices.
The point of group- or work-based insurance is to spread the cost out over a large group of people, Waltman said. The larger the group, the less everyone pays (more or less the principle behind national health coverage). The idea is that if someone gets sick, there will be money flowing in to cover that person’s health needs.
On the other hand, when a single person or a small family gets a policy, the risk of illness shoots up while the chance of having enough cash to cover your health expenses goes down. Therefore, the policy costs more, Waltman said.
Plans employers buy — particularly those with good benefits — are more expensive than the average individual plan, but the employer fronts a lot of the cost, she said.
“It’s not that the [individual insurance] costs more. It’s just what people are used to paying out of pocket themselves,” she said. “Medical costs are still the same. Most people don’t realize what employers were paying for them.”
Until they try to pay for that policy themselves, that is. The Consolidated Omnibus Budget Reconciliation Act, or COBRA, lets people stay on a company’s insurance plan for a year and a half as long as they pay the premium themselves. Premiums can increase by several thousand dollars.
“COBRA is really a rock and a hard place,” Claxton said. “It’s usually too expensive, but it’s good coverage.”
Employees who opt for COBRA can eventually buy an individual policy without worrying about pre-existing conditions, their age or their health, Lieberman said. But you have to stay with your COBRA policy to the very end of its life. You could lose thousands before you start to save anything.
More people are being pushed into the private market as health-care costs skyrocket and employers trim back on health benefits, she said. For older employees, this can mean the inevitable ailments of age become a huge problem, Lieberman said. “The individual market is a pretty dark place.”
As the only employee of Charleston’s Shear Cut barbershop, John Ciampanella would need individual health coverage if not for his wife’s work-based insurance. (In West Virginia, a small business, for insurance purposes, means two to 50 employees, according to NAHU’s Web site.)
With his diabetes, he would be a tough sell to an insurance company.
“If you’ve got diabetes, no insurance company will take you on,” he said. “If I didn’t have [my wife’s insurance] I’d probably be up there standing in line for free shots.”
West Virginians who have been turned down for insurance because of chronic problems like diabetes can join AccessWV. Known as a “high-risk pool,” the rates and deductibles are a tad higher than the state average because mostly everyone in the plan is sick.
For instance, if the average rate is $100, the AccessWV rate would be $125, Waltman said.
On the opposite spectrum, people in good health could consider a health savings account. People going this route buy a cheap policy with a high deductible ($1,000 to $2,700 for individuals), Waltman said. Each year, the account holder can deposit money into the account up to the amount of the deductible.
The theory is that you’ll have a lot of money saved for medical care if you want it or need it. Unfortunately, it really only works if you never get sick, Lieberman said.
“They’re a gamble,” she said. “How many people can say they’ll never get sick? We don’t know.”
Staff writer
Without an employer to cushion the blow, the price of individual health insurance can hit an independent buyer rather hard.
“If all of us had to have it, we’d probably be lucky to get it for a couple thousand a month,” said Debbie Kimble of Charleston’s Peanut Shoppe. Fortunately, the store’s three employees — all family — get coverage through spouses or the government.
“Anytime you have to put an extra $2,000 out, it’ll be harder,” she said. “But that’s when you tighten up your belt and cut back somewhere else.”
Although independently sought policies do not fall into most people’s view of reasonable, the average person can buy health coverage without breaking the bank as long as they can part with the usual workplace benefits, insurance experts say.
“If you’re young, the premiums can be relatively modest, but you’re talking about the deductibles in that market being $1,000 sometimes,” said Gary Claxton, director of the Kaiser Family Foundation’s Health Care Marketplace Project.
“You’re not going to get what most of us call a good policy for not a whole lot of money, but you can avoid making mistakes.”
First of all, avoid being roped in by your own health problems, Claxton said. Some insurers won’t sell to people who are already sick. Even if you do manage to secure a policy, there are several ways you can still be left uncovered when you can least afford it.
In West Virginia, insurers can set your premiums based on your health by 30 percent more or less than the standard cost, said Jessica Waltman, director of health policy research for the National Association of Health Underwriters, or NAHU, an insurance trade group.
“The rate you see online is the best-case-scenario rate,” she said.
Companies can also look at your health for the last year and refuse to cover conditions you had before applying for the policy, or pre-existing conditions, Waltman said. These conditions can go on for up to two years.
The point, of course, is to keep people from getting insurance just because they are sick, Waltman said.
But these exclusions can be somewhat arbitrary, said Trudy Lieberman, director of the Center for Consumer Health Choices, part of Consumers Union, which publishes the magazine “Consumer Reports.” A case of asthma could lead an insurer to deny all claims involving respiratory illnesses.
“These can be very minor problems, but you’re still not wanted by insurance providers,” Lieberman said. People looking for a policy should contact a broker who represents more than one company to get a good variety of choices.
The point of group- or work-based insurance is to spread the cost out over a large group of people, Waltman said. The larger the group, the less everyone pays (more or less the principle behind national health coverage). The idea is that if someone gets sick, there will be money flowing in to cover that person’s health needs.
On the other hand, when a single person or a small family gets a policy, the risk of illness shoots up while the chance of having enough cash to cover your health expenses goes down. Therefore, the policy costs more, Waltman said.
Plans employers buy — particularly those with good benefits — are more expensive than the average individual plan, but the employer fronts a lot of the cost, she said.
“It’s not that the [individual insurance] costs more. It’s just what people are used to paying out of pocket themselves,” she said. “Medical costs are still the same. Most people don’t realize what employers were paying for them.”
Until they try to pay for that policy themselves, that is. The Consolidated Omnibus Budget Reconciliation Act, or COBRA, lets people stay on a company’s insurance plan for a year and a half as long as they pay the premium themselves. Premiums can increase by several thousand dollars.
“COBRA is really a rock and a hard place,” Claxton said. “It’s usually too expensive, but it’s good coverage.”
Employees who opt for COBRA can eventually buy an individual policy without worrying about pre-existing conditions, their age or their health, Lieberman said. But you have to stay with your COBRA policy to the very end of its life. You could lose thousands before you start to save anything.
More people are being pushed into the private market as health-care costs skyrocket and employers trim back on health benefits, she said. For older employees, this can mean the inevitable ailments of age become a huge problem, Lieberman said. “The individual market is a pretty dark place.”
As the only employee of Charleston’s Shear Cut barbershop, John Ciampanella would need individual health coverage if not for his wife’s work-based insurance. (In West Virginia, a small business, for insurance purposes, means two to 50 employees, according to NAHU’s Web site.)
With his diabetes, he would be a tough sell to an insurance company.
“If you’ve got diabetes, no insurance company will take you on,” he said. “If I didn’t have [my wife’s insurance] I’d probably be up there standing in line for free shots.”
West Virginians who have been turned down for insurance because of chronic problems like diabetes can join AccessWV. Known as a “high-risk pool,” the rates and deductibles are a tad higher than the state average because mostly everyone in the plan is sick.
For instance, if the average rate is $100, the AccessWV rate would be $125, Waltman said.
On the opposite spectrum, people in good health could consider a health savings account. People going this route buy a cheap policy with a high deductible ($1,000 to $2,700 for individuals), Waltman said. Each year, the account holder can deposit money into the account up to the amount of the deductible.
The theory is that you’ll have a lot of money saved for medical care if you want it or need it. Unfortunately, it really only works if you never get sick, Lieberman said.
“They’re a gamble,” she said. “How many people can say they’ll never get sick? We don’t know.”
Job-based health insurance vanishing in AZ
The Arizona Republic
For decades, most Americans have counted on their employers for health insurance.
But that system is crumbling, and it's crumbling faster in Arizona than it is elsewhere in the nation.
Fewer than half of the state's residents are insured through an employer's plan, one of the lowest levels in the country. The rate of employer-based health coverage is falling in Arizona faster than in the nation as a whole.
Job-based insurance took hold during World War II as companies offered health benefits to attract scarce workers. Encouraged by federal tax breaks, job-based benefits soon became the financial foundation of the U.S. health care system, eventually covering more than two-thirds of the population.
Rising health care costs and the competitive pressures of the world economy have chipped away at that system. Now, slightly more than half of Americans have insurance through a job, a number that has been declining steadily since 2000.
In Arizona, the percentage of residents with job-based insurance fell from 55 percent in 2000 to 48 percent in 2004, according to an analysis this fall by the Kaiser Family Foundation.
Almost 1 million Arizonans were without insurance in 2004: about 20 percent of the population under age 65, one of the highest levels in the country. And more than 1 million residents get their insurance through the state's Medicaid program, costing state and federal taxpayers more than $5 billion per year.
"We have a real serious problem in this state," said Bradford Kirkman-Liff, a professor of health policy at Arizona State University. "I think the job-based system is clearly no longer viable."
The federal government predicts health care costs will nearly double again in the next decade. Corporate executives, union officials, economists and political leaders are warning that the job-based insurance system is no longer sustainable. Many Americans cannot qualify for or afford private insurance on their own.
Without drastic changes, many experts predict that a major crisis affecting the majority of Americans is not far off: more middle-class families without insurance; unprecedented strain on hospitals and other health care providers; the fiscal collapse of public health care programs.
"There is a huge collision on the horizon between the forces that are driving medical costs up . . . and the ability to pay for health insurance," said Paul B. Ginsburg, president of the Center for Studying Health System Change, a nonpartisan policy research group in Washington, D.C.
Increasingly the discussion about our health care crisis is on how to replace the financial foundation that job-based coverage once provided.
When America's job-based insurance system took hold in the 1940s, most European nations had already created national health systems. In the United States, several attempts to do the same failed, attacked by doctors who feared government intervention in their practices and others who said it smacked of socialism. So the government promoted job-based benefits through tax incentives. (Employer contributions to health insurance premiums are tax-deductible for employers and tax-exempt for employees.) Today, the United States is the only industrialized nation in the world that depends on employers to finance the medical needs of most of its population.
The U.S. job-based insurance system has always been subject to fluctuations in the economy and has never been able to provide coverage for everyone. Historically, job-based health coverage expanded in good economic times and declined during recessions.
For decades, most Americans have counted on their employers for health insurance.
But that system is crumbling, and it's crumbling faster in Arizona than it is elsewhere in the nation.
Fewer than half of the state's residents are insured through an employer's plan, one of the lowest levels in the country. The rate of employer-based health coverage is falling in Arizona faster than in the nation as a whole.
Job-based insurance took hold during World War II as companies offered health benefits to attract scarce workers. Encouraged by federal tax breaks, job-based benefits soon became the financial foundation of the U.S. health care system, eventually covering more than two-thirds of the population.
Rising health care costs and the competitive pressures of the world economy have chipped away at that system. Now, slightly more than half of Americans have insurance through a job, a number that has been declining steadily since 2000.
In Arizona, the percentage of residents with job-based insurance fell from 55 percent in 2000 to 48 percent in 2004, according to an analysis this fall by the Kaiser Family Foundation.
Almost 1 million Arizonans were without insurance in 2004: about 20 percent of the population under age 65, one of the highest levels in the country. And more than 1 million residents get their insurance through the state's Medicaid program, costing state and federal taxpayers more than $5 billion per year.
"We have a real serious problem in this state," said Bradford Kirkman-Liff, a professor of health policy at Arizona State University. "I think the job-based system is clearly no longer viable."
The federal government predicts health care costs will nearly double again in the next decade. Corporate executives, union officials, economists and political leaders are warning that the job-based insurance system is no longer sustainable. Many Americans cannot qualify for or afford private insurance on their own.
Without drastic changes, many experts predict that a major crisis affecting the majority of Americans is not far off: more middle-class families without insurance; unprecedented strain on hospitals and other health care providers; the fiscal collapse of public health care programs.
"There is a huge collision on the horizon between the forces that are driving medical costs up . . . and the ability to pay for health insurance," said Paul B. Ginsburg, president of the Center for Studying Health System Change, a nonpartisan policy research group in Washington, D.C.
Increasingly the discussion about our health care crisis is on how to replace the financial foundation that job-based coverage once provided.
When America's job-based insurance system took hold in the 1940s, most European nations had already created national health systems. In the United States, several attempts to do the same failed, attacked by doctors who feared government intervention in their practices and others who said it smacked of socialism. So the government promoted job-based benefits through tax incentives. (Employer contributions to health insurance premiums are tax-deductible for employers and tax-exempt for employees.) Today, the United States is the only industrialized nation in the world that depends on employers to finance the medical needs of most of its population.
The U.S. job-based insurance system has always been subject to fluctuations in the economy and has never been able to provide coverage for everyone. Historically, job-based health coverage expanded in good economic times and declined during recessions.
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