Health Insurance eligibility audit

Typically, between 6% and 8% of dependents enrolled in a health insuance plan are not truly eligible for health coverage, but some employers have reported much higher percentages when conducting audits, according to Watson Wyatt Worldwide.

With more companies shifting to electronic enrollments in health plans, employees haven't had to provide documentation to prove who was eligible and who wasn't.

But as health insurance premiums rise, employers are paying closer attention to the people their employees report as dependents.

In some cases, employees really don't know they've signed up someone who is ineligible.

If you don't want any trouble, review the dependent eligibility rules for your plan. The list of who is covered varies by health insurance plan, but most often includes your spouse in a marriage legally recognized in your state, and your eligible children.

Children under age 19 are usually covered as long as the child is unmarried and counts on you for financial support. Disabled dependents over age 18 may be covered. In many cases children from age 19 to 25 are eligible if enrolled as full-time college students.

At the same time, don't assume automatically that an adult child isn't covered under your health plan. To combat the growing number of uninsured, many states have expanded the definition of a dependent, according to a report by the National Conference of State Legislatures.

Some plans now allow employees to enroll same-sex partners for benefits. Other plans might allow same-sex and opposite-sex partners. In either case, the partner may need to meet certain eligibility requirements specific to that plan or the state -- or both. To receive benefits, many employers require domestic partners to have lived together as a couple for at least six consecutive months.

Covered employees in domestic partnerships typically have to document the relationship. Such documentation varies by employers, but often requires proof of some financial relationship such as a joint lease or mortgage or copies of tax returns showing financial interdependence, according to the Employee Benefit Research Institute.

Health Insurance for all uninsured

America's Health Insurance Plans (AHIP) on Wednesday said it will announce a plan to provide health care coverage to all uninsured Americans. The plan -- expected to be introduced Nov. 13 -- would involve private health insurance carriers and government cooperation but would not necessarily mandate a new federal agency.

Small Group Health Insurance legislation

BlueCross BlueShield of Illinois (BCBSIL) has proposed legislation that would require small businesses with 2-50 employees to provide health insurance for their employees. Under the proposal, all private health insurers in the state of Illinois would have to participate in the program.

BCBSIL estimates that about 500,000 people would be interested in participating in the program, adding that about 1.1 million of the 1.7 million uninsured state residents are employed or have a family member who is employed.

BCBSIL is seeking sponsors in Springfield for the program and will be looking for additional input on the proposal from small businesses and small-business organizations.

Rising number of uninsured

The decline in the number of employers offering health insurance has led to a rise in the percentage of americans who are uninsured.

U.S. Census Bureau figures released in August found that the uninsured populatio rose from 15.6% to 15.9%, in 2005.

The Census figures also show that the number of uninsured children under age 18 has increased for the first time in seven years.

Despite an upturn in the economy, the percentage of U.S. workers covered by employer-sponsored insurance declined from 81.2% in 2001 to 77.4% in 2005.

In addition, there was no increase in Medicaid and SCHIP coverage last year to compensate for the decline in employer-sponsored health care

Reducing the uninsured in Indiana

Indiana House Republicans offered three proposals yesterday that aim to reduce the number of Indiana residents without health insurance.

About 800,000 people in Indiana have no health insurance -- about 13.5 percent of the state population.

Yesterday Republicans proposed to:

1) Create a pilot program that will allow up to 100 smaller employers (with 500 or fewer workers) to receive a tax credit for money spent on promoting health and wellness.

2) Establish an income-tax deduction for Hoosiers who buy individual health insurance, rather than through a group plan.

3) Allow parents to use their own health insurance policies to cover their children up to 24 years old -- if the insurance company will write the policy.

Democrats yesterday dismissed the Republican proposals.

Health Insurance in Oklahoma

Gov. Brad Henry has announced that he has signed Oklahoma Health Care Authority rules that expand eligibility for the program from businesses with up to 50 employees.

Under the program, the state of Oklahoma pays part of the health insurance costs of employers.

Under the voluntary program, the state covers 60 percent of the costs, employers pay 25 percent and employees are asked to pay 15 percent.

The program is administered by the OHCA and utilizes matching funds from the federal government.

Health Insurance Onus on Consumers

For many workers fall brings with it open-enrollment season for health insurance coverage.

This year, as in years past, lots of employees will be asked to contribute more to their health-care costs, through increased premiums, surcharges or higher deductibles on items ranging from doctors' visits to prescription drugs.

The good news is that the percentage increase in health-care costs, which for the first time in four years fell into the high single-digits last year, ebbed again this year, rising 7.7 percent, about half the increase seen three years ago.

Still, employers and employees are having to make stark choices. Some businesses are discontinuing health insurance coverage. In the last year, the share of people covered by employer-provided insurance fell by 4.1 percent, or more than 3 million Americans, according to analysis by the Economic Policy Institute.

One way smaller businesses are hanging on to health coverage or able to offer any health plan at all is through consumer-directed health plans (CDHPs), also known as high-deductible health plans.

Health-savings accounts, go hand-in-hand with CDHPs. Unlike flexible-spending accounts, which allow workers to contribute money for health-related expenses through payroll deduction, HSAs allow users to roll over contributions year-to-year and are portable.

Student health insurance up for bid

Through a campus survey e-mailed to all Boise State students registered with the Student Health Insurance Plan, students will get a chance to weigh in on the school's health insurance coverage.

Boise State is at the end of its current contract with United Healthcare - the university's health insurance provider.

In the next few weeks, students enrolled in SHIP should expect to see a survey in their e-mail account asking what they would like to change about their insurance plan. Schlapper is looking at different companies and seeing which offers the best package. He would like to keep premiums low, but provide comprehensive service.

Auto Insurance Rate Reduction for towns fighting fraud

A partial settlement of the annual automobile insurance rate setting proceedings will yield significant rate savings for key fraud fighting towns in Massachusetts, Attorney General Tom Reilly announced today.

The settlement will reward the City of Lawrence and the City of Boston for their recent fraud fighting efforts. These cities, as part of the CIFI program (Community Insurance Fraud Initiative), have worked with industry and law enforcement to aggressively target and pursue auto insurance fraud. Their efforts have helped greatly reduce fraud costs within the auto insurance system.

Under the settlement, rates for Lawrence on major compulsory auto insurance coverages drop 20% more than the state average rate change, and Boston rates will drop10% more than the statewide change.

Health Insurance Expansion Plans

COLUMBUS - Both major candidates for governor agree Ohio needs to expand Ohio health care coverage for its 1.3 million uninsured, but they disagree on how to pay for it.

"Many hardworking Ohioans cannot afford even basic health insurance coverage for themselves or their families," said Democrat Ted Strickland, a U.S. congressman who refuses to accept the federal government's health insurance benefit for employees.

Both Strickland and his Republican opponent, Ken Blackwell of Cincinnati, have policy proposals that borrow aspects of a Massachusetts health insurance program. Using a combination of state subsidies and sliding-scale premiums, that state adopted auniversal health insurance plan that would cover its 372,000 uninsured by July.

Bogus Auto Insurance

The Michigan Office of Financial and Insurance Services (OFIS) has issued a Cease and Desist order against a Roseville auto repair shop for selling no fault Michigan auto insurance certificates without a license.

The Pearson Service Center is licensed as an auto repair facility through the Michigan Secretary of State. OFIS has notified Secretary of State officials of the illegal sales of no-fault certificates at the service center.

Health Insurance Premiums Soar

WASHINGTON - For the seventh straight year, premiums for group health insurance rose more than twice as fast as overall inflation and wages, an annual survey of employers shows.

The average 7.7 percent premium increase for 2006 was the smallest since 2000 and marked the third straight year that the rate of growth has slowed, according to the survey, released Wednesday by Kaiser Family Foundation and the Health Research and Educational Trust.

But most Americans probably have felt little or no relief because their paychecks haven't kept pace with the rate hikes. Workers' earnings increased only 3.8 percent on average from April 2005 to April 2006, while inflation, up 3.5 percent, erodes their disposable income.

Since 2000, inflation has jumped 18 percent and the amount that workers pay toward family health-care coverage has skyrocketed 84 percent, the survey found. Average wages have increased 20 percent over the same period.

So even while the premium-rate increases have moderated -- down from a 9.2 percent jump in 2005 and an 11.2 percent spike in 2004 -- experts say there's no reason to celebrate.