Friday, January 16, 2009
Congress, Obama Toil to Help Jobless Get Health Care
Monday, January 12, 2009
Dallas police connect to statewide car insurance database
Health insurance unaffordable for most who get laid off
Continuing family health insurance coverage after being laid off consumes 84 percent of employment benefits nationally, according to a new report by Families USA, a health care think-tank.
In Wisconsin and 40 other states, paying for such health insurance coverage consumes 84 percent of unemployment benefits.
Single people do not fare much better. In Wisconsin and 16 other states, the cost of continuing single health insurance coverage consumed more than one-third of unemployment insurance income.
Des Moines area insurance companies plan merger
West Des Moines-based Homesteaders Life Co. and American Enterprise Mutual Holding Co. of Des Moines will merge under the plan, with Homesteaders' seven board members joining American Enterprise's board.
American Enterprises is the holding company of American Republic Insurance Co. in Des Moines and Omaha-based World Insurance Co.
Homesteaders is the nation's second-largest provider of burial insurance. American Republic is a provider of health savings accounts and Medicare supplement insurance. American Republic has 548 employees in Des Moines. Homesteaders has 129 workers in the Des Moines area and 33 field employees nationwide.
Sunday, January 11, 2009
Insurance denial can seem arbitrary
Three years ago, Ivy Emery left her job at Aveda Corp. to work as an independent hair stylist at an Uptown salon.
No longer covered by Aveda's group health insurance, Emery applied for individual coverage for her husband and herself. Her husband, a self-employed construction worker and a smoker, was accepted. Emery, then 32, was rejected.
The denial letter from Blue Cross and Blue Shield of Minnesota listed three reasons: She was using topical medication for acne, she had once sought emergency care for a migraine and she was on Paxil, a drug for anxiety and depression.
"It was just insane," she said, her voice rising at the memory. "They wrote 'acne.'"
An outraged Emery found herself a member of a club nobody wants to join: the Uninsurables.
It's a bigger club than you might think. Each year, one in six Minnesotan applicants for health insurance in the individual market is denied coverage because of a variety of pre-existing conditions.
The market is small but growing fast.
In 2002, there were 192,942 enrollees, or 3.8 percent of Minnesotans, in the individual market. By 2007, the number had climbed to 246,190, or 4.7 percent of the population.
Most Minnesotans have never ventured into the individual market, but if they did they might be surprised by its rules.
"Once you get individuals out there trying to shop for insurance, the [companies] will slice and dice those people, take the healthy people and charge them for whatever package," said Judy Waxman, a vice president at the National Women's Law Center in Washington. "This is why we want to get away from people being judged individually. It's not really insurance."
Ironically, the conditions that can cause a denial are sometimes the very reasons why consumers seek insurance in the first place.
In Minnesota, the most common reasons for denial are obesity, mental health conditions, hypertension, diabetes and cardiovascular disease. But there are less well-known reasons insurers consider on a case-by-case basis: chemical dependency, allergies that require costly injectable drugs, a previous C-section, previous use of infertility medicine or something as simple as being pregnant.
Blue Cross and other insurers say they face a dilemma. If they took in too many sick people, they'd have to raise everyone's premiums.
"We understand people are going to be very upset and surprised [when they get denied]," said Craig Ashby, director of individual products at Medica, the state's second-biggest health insurer after Blue Cross. Denials help ensure a "competitive price for the vast majority of people," he said.
In states such as New York, where insurers are required to take all applicants, healthy people sometimes put off buying insurance until they get sick. The result: Premiums tend to be higher for everyone, according to a study commissioned by America's Health Insurance Plans. The association is urging the Obama administration to consider a system in which insurers must accept all applicants but all consumers must buy insurance.
Group vs. individual
About two-thirds of Minnesotans get group coverage through their employers, where health is not a factor for coverage. The rest are covered by federal and state plans, by policies in the individual market, or simply are uninsured.
But many employers are asking employees to pay more of the cost, to the point where some employees are dropping company coverage and buying cheaper, leaner policies on their own -- or going without.
But the individual market isn't like group insurance.
"In the individual market, people can and do get denied for things that are automatically covered in the group market," said Bob Schmitz, president of Schreifels & Associates, a benefits consultant in Brooklyn Center.
Blue Cross and Blue Shield of Minnesota said its denial rate is 15 percent. Medica says it's in that range, while HealthPartners declined to be interviewed for this report.
To further complicate matters, underwriting guidelines vary by insurer and can change from one year to the next.
Denied applicants may appeal. Sometimes a letter from a physician can help. Or they can go straight to the insurer of last resort: the Minnesota Comprehensive Health Association, or MCHA, a state pool for sick people who have been rejected by at least one private insurer.
That's where Emery and her husband ended up. They now have a toddler and pay a monthly premium of $427 with an annual deductible of $15,000. (A Blue Cross spokeswoman said the insurer doesn't comment on individual clients as a matter of policy.)
Emery is now applying to nursing school in a quest to get a job with health insurance.
Gender bias?
Some think women applicants have it harder than men. Last year, the National Women's Law Center published a report titled "Nowhere to Turn: How the Individual Health Insurance Market Fails Women," citing disqualifiers such as pregnancy and a previous C-section.
Women in Minnesota fare better than elsewhere, said the center's Waxman. Unlike some other states, Minnesota prohibits plans from charging higher premiums for women compared to men of the same age and health status. It also has MCHA, where premiums are capped at 125 percent of comparable private plans.
Some worry, however, that as the weak economy pushes more individuals into the high-risk pool, MCHA will become overextended.
Already, MCHA members spend over $100 million more annually in medical bills than they pay in premiums. That shortfall is now covered by a 2 percent premium tax on certain other segments of the insurance market. MCHA may seek legislation to expand that tax to the rest of the market, said Lynn Gruber, MCHA's chief executive. "We have to," she said, "because it's not sustainable."
'Don't get mad'
Deborah Morse-Kahn, 56, of Minneapolis, applied for individual coverage three years ago after she lost her job at the University of Minnesota. She's not sure why the first insurer rejected her. "There was a veil of mystery over it," she said. But she's convinced that "age was the biggie."
She had a history of hypoglycemia, or low blood sugar, and was taking prescriptions for restless leg syndrome and for nausea associated with menopause. She had also sought psychiatric counseling in the past.
What she remembers clearly, though, is her insurance agent walking her through the process -- and predicting a rejection.
Her agent warned her ahead of time not to get mad, said Morse-Kahn, now self-employed as a public historian and writer. "She said: here's what they [the insurance companies] have to do, here's what we'll have to do [apply to MCHA], and you're going to get your coverage because this is Minnesota."
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Insurance that worsens crunch
Taken fromBBC News that might give you an usefull information.
An essential element in the Government's forthcoming package to stem the pernicious shrinkage of credit in the economy will be measures to compensate for the devastating impact on many companies of the withdrawal of trade credit insurance.
That probably sounds deeply dull and technical. But please read on, because this stuff matters to all of us.
For smaller companies, the importance of trade credit insurance is often that they can't borrow from banks, unless they've insured their sales to corporate customers.
The banks make this stipulation because it absolves them from having to assess the credit-worthiness of their borrowers in detail - because at least part of the credit risk has been laid off to an insurance company.
So the availability of such insurance is literally a matter of life and death for many businesses.
Woolworths is one of the more extreme examples.
When insurers would no longer provide cover to Woolies' suppliers in the autumn, that was the penultimate nail in the coffin of the ailing general retailer - because suppliers insisted that Woolworth pay cash upfront to them for orders, which meant that Woolies was forced to draw on its borrowing facilities, which in turn took the retailer up to the limit of what its bankers were prepared to lend.
And the rest is the sorry story you know: the demise of a historic high street name that was forced to liquidate everything so that the bankers could get their money back.
The point is that trade credit insurance is central to hundreds of billions of pounds in trade and the provision of finance to companies of all sizes.
When it's withdrawn, as has been happening for months, small companies are unable to fulfil valuable orders placed by big companies and those bigger companies lose access to vital supplies.
So a rational decision by insurers to scale back their cover on sales to companies perceived as vulnerable to our economic contraction is rippling through the economy in a damaging way: cover is being withdrawn because we appear to be in a sharp recession, and its withdrawal is making that recession significantly worse.
Part of the problem is that the insurers seem to me to have massively under-priced the cover they provide. Just as banks charged ludicrously low rates of interest during the years of the credit bubble, so the trade credit insurers insured hundreds of billions of pounds of trade for tiny premiums.
According to statistics from the Association of British Insurers, there were £334m of premiums written by the insurers in 2007, covering £282bn of sales by British companies.
Or to put it another way, insurers were receiving premiums equivalent to the turnover of a medium size business to protect more than 20 per cent of the output of the entire British economy.
Scary or what?
Those aggregated premiums were equivalent to a minute 0.1 per cent of the sum insured - down from 0.26 per cent in 1995. Which would only make economic sense in a world where there are never recessions.
One illustration that the premium was too low is that claims received by insurers in 2008 are likely to have been rather more than total aggregated gross premiums received in the previous year, extrapolating from trends in the first nine months of the year.
But the insurers have been protecting themselves from the worst losses by simply withdrawing cover for new orders to companies seen as weak. In other words, unlike insurance provided to you and me on our homes, for example, the trade credit insurers have been able to withhold protection as soon as they detected stormy conditions.
To restate the painful paradox: insurance designed to give confidence to companies that they would be paid by corporate customers is being scaled back in a way that's magnifying the woes of businesses big and small.
What's to be done?
Well in France a new system is being implemented whereby taxpayers are sharing the insurance risk with private-sector insurers on supplies to viable companies.
And I would expect the Business Department and the Treasury to implement a similar system of co-insurance by taxpayers.
But that can only be a short-term solution.
In the longer term, the supply of finance to small and medium-size businesses has to be overhauled, so that the viability of those businesses is no longer dependent on insurance that's only available when the sun is shining.
Jobless, with no health insurance
Nearly 200,000 Minnesotans have one thing in common right now: They’ve lost their jobs and, in many cases, their health insurance. These historic unemployment numbers are just one symptom of the current economic crisis facing our state and nation. Families are losing their homes, bankruptcies are on the rise, and a lack of health insurance exacerbates both. When the Legislature undertakes its staggering task this year of balancing the state budget, we must do so with an eye to easing the pain job loss wreaks on our communities and families. We can start with short-term, affordable health insurance. Most of us can identify with the toll on families when they don’t have insurance. Cost-effective, preventive care is often delayed or skipped altogether; visits for injury or illness may be put off until more costly emergency care or hospitalization is required. A lack of health insurance may even compound the challenge of finding a new job when chronic conditions go untreated.In addition, there is a broader economic impact as fewer people seek care. More than one in eight Minnesotans work in the health care industry. As people put off routine care and delay treatment for more serious ailments, local clinics and hospitals suffer. We have already seen major health-care layoffs in recent months. We cannot afford to let rising unemployment and the subsequent loss of health insurance further weaken one of our state’s largest economic engines. The one option that is currently available to laid-off workers, Continuation of Health Coverage, otherwise known as COBRA, is too expensive for most families. Qualified individuals are required to pay 102 percent of both the employer’s and employee’s share of the cost of the policy. The cost of COBRA premiums is more than $1,000 per month on average for family coverage, simply unaffordable when unemployment benefits average about $324 a week. As a result of this high cost, only 20 percent of those individuals who qualify for COBRA actually buy it, leaving 80 percent of the newly unemployed uninsured. That is unacceptable. What can we do? One immediate option is to offer MinnesotaCare — the state’s health-care plan for working Minnesotans — to those who are approved for unemployment benefits. People would remain covered as long as they continue to receive unemployment benefits and pay the low-cost premiums. This unique program could sunset in two years, after the current economic crisis has passed. Using the MinnesotaCare fund, which currently has a surplus balance of dedicated health-care dollars, to help Minnesotans in this time of economic crisis is the right thing to do, will help Minnesotans get back to work even faster, and offers additional stimulus to our economy. Admittedly, this is a short-term solution. We must continue to move forward on more fundamental, broad-ranging reform of our health-care system. But right now there is a need for immediate relief. The Legislature can and should deliver it.
Friday, January 9, 2009
California Hosts Insurance Recovery Forum for Wildfire Survivors
Congressional health-care reform proposals would offer coverage to many without insurance
What you should know about flood insurance
Q: How do I get flood insurance?
A: It's available only from the Federal Emergency Management Agency. But numerous insurance agencies can help owners of homes and businesses obtain it.
Q: How much does flood insurance typically cost?
A: The average annual cost for a residential policy in Washington state is $580. In King County, the average annual cost is $590.
Q: Is everyone eligible to buy flood insurance?
A: Anyone is eligible who lives in a community participating in the national flood insurance program. That program ensures communities are passing ordinances that protect their citizens against flooding. Virtually every community in Washington state participates in the program.
Q: If I sustained flood damage once and made a claim, can I still get insurance now?
A: Yes. That is the virtue of the national flood insurance program. But your degree of flood risk may affect your policy's cost.
Q: If my property floods repeatedly, can I still be insured?
A: Again, yes, if you've paid the premiums. No matter how often an area floods, properties there can be protected by insurance, so long as the properties comply with flood plain ordinances.
But FEMA may work with your community to reduce the incidence of flooding by encouraging a buyout or facilitating the elevation of your property.
Thursday, January 8, 2009
What Employees Need Is Health Insurance, Not Cash
This is a story about a guy who started his career in the 1960s, it was generally assumed he would have health benefits funded by his employer for the remainder of his life. But now, as he heads toward retirement, those benefits have all but disappeared, with health care one of his largest monthly expenses.
This situation is not unique to him. As business owners have become saddled with double-digit increases each year for the cost of health insurance, workers are seeing diminished policies, higher co-pays, and higher cost-shares with employers. Today, many small businesses simply can't afford to provide the same level of health benefits they used to.
The entitlement once given my father has gone the way of the $1 cup of coffee.
I've seen how large corporations are now hiring people for the maximum number of part-time hours - just to avoid the expense of offering health insurance. And there is an alarming trend now surfacing that I believe has truly crossed the line. It is an issue of paramount concern to the New Jersey Association of Health Underwriters, of which I am affiliated.
We are seeing employers opt to give their employees an increase in their annual wages in lieu of health insurance. This is not a Health Savings Account, a tax-advantaged medical savings account available to U.S. taxpayers in high deductible health insurance plans. Rather, it is a simple payout of additional wages - not affiliated with any insurance plan.
Such an arrangement may seem to work well for the employer, who no longer feels the obligation to offer employee health insurance. And, for the employee, the additional bump in salary appears to be a nice perk - at first.
Yet, if this practice becomes a universal trend, nobody wins. That's because of human nature - many people tend to spend what they have and leave little left over for a rainy day. Without adequate health coverage in place, or the means to afford the escalating costs of medical care, the ramifications are sweeping. Simply stated:
• Employees without health coverage and their family members, unable to get preventative care or proper treatment for an illness, may become sicker, resulting in the loss of an employee for an extended period of time.
• Lacking other options, employees without health care and their family members may turn to the emergency room for non-emergency care. Under the state's charity care laws, the hospital must care for the sick person, whether they can pay or not. That drives up health costs for the rest of us, as we are the ones who ultimately pay for that care.
• Without the buying power of the company behind them, employees will wind up paying more for individual health coverage than their employers would have paid to put them on group coverage.
• Older employees or those with existing conditions will be hit especially hard by the higher cost of health insurance.
While there is no easy answer to the problem of health care in America today, we can all agree that leaving employees on their own to find insurance, rather than giving them the benefit of group rates, is not the solution. And if the next generation of workers can not expect adequate health care coverage from their employers, the numbers of uninsured workers will only continue to rise - careening our country's health care into a crisis.
In our corner of the country, the New Jersey Association of Health Underwriters spends much time discussing the future of health care. After all, there is no one who knows more about health insurance. We are the ones who meet every day with the consumers and the insurance carriers.
Health insurance brokers are the ones called upon when someone is standing at the pharmacy counter and wondering why their prescription is no longer covered. And, we are the ones who sit in lengthy meetings with insurance carriers, staring at PowerPoint presentations, as they reiterate why costs are rising, once again, for our clients.
For an honest and accurate discussion about the future of health insurance, our elected officials and political candidates need to rely on health insurance brokers. We cringe at the thought of our next President stepping into office with the misperception that his or her health insurance solution "won," and, more importantly, that this country can actually afford to implement it.
To that end, organizations such as the New Jersey Association of Health Underwriters need to have a seat at the table to ensure our policy makers have the proper perspective and to ensure that no American falls through the cracks