We're only a few months into OUR Government's Healthcare Reform 4 year phase-in, and yet it's already causing chaos on several fronts. The taxpaying consumer is the ultimate and greatest victim of this debacle.

"Insurers Raise Rates, Cancel Coverage, Cancel Plans, in Response to Healthcare Overhaul":
Insurers Raise Rates, Cancel Plans In Response To Overhaul - Kaiser Health News

The way things are going, we'll either have portions of this law repealed before 2014 (hopefully), or Nationalized Healthcare, complete with street riots, because Americans aren't used to dying while waiting for care.
:mad:
-A.C.

PPACA Section 9003 creates Internal Revenue Code Section 106(f). The new section will require users of health flexible spending arrangements (FSAs) and health reimbursement arrangements (HRAs) to get prescriptions before using health account funds to pay for over-the-counter (OTC) drugs other than insulin.

Section 9003 also will require holders of health savings accounts (HSAs) and Archer Medical Savings Accounts (Archer MSAs) to get prescriptions if they want to use account funds to buy OTC drugs. HSA and MSA holders who use account funds to buy OTC drugs without a prescription will have to include the expenditures in gross income and pay an additional 20% tax, officials say.

PPACA: OTC Rules Bitter Pill for Card Firms - Regulatory,Legislative and Tax Issues - Life and Health Insurance News

This I read just now on Senior Advisor Magazine

Why are the Dutch doing the auction, and not a US Broker? And don't use world wide marketing.... I don't buy that US doesn't have firm that can handle this and keep some commissions in our economy.





"Treasury to Sell Positions in Insurers

By NU ONLINE NEWS SERVICE
Published 9/7/2010 Subscribe to Life & Health
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The U.S. Department of the Treasury says it plans to sell warrant positions in two life insurers over the next several weeks.
The moves will dispose of Treasury’s remaining holdings under federal bailout programs in the Hartford Financial Services Group, Inc., Hartford, and Lincoln National Corp., Radnor, Pa.

Each insurer previously had fully repurchased Treasury’s stock investments in the firms.

The Treasury received the warrants in consideration for investments made under its Capital Purchase Program (CPP) and Targeted Investment Program (TIP).

The CPP is a preferred stock and equity warrant purchase program conducted by the Treasury’s Office of Financial Stability as part of the government’s Troubled Assets Relief Program (TARP). The Treasury created TIP to steady the financial system by making investments in critical institutions.

If completed in full, the sales would liquidate Treasury’s remaining holdings in the insurers, Treasury says.

Treasury intends to sell the warrants through modified Dutch auctions, which establish a market price by allowing investors to submit bids above a minimum price specified for each auction.

The department named Deutsche Bank Securities Inc., Frankfurt, Germany, as auction agent and manager for the offerings.

Wh

DONE........

As insurers face health care law requirements, customers face cancellations | News for Dallas, Texas | Dallas Morning News | Dallas Business News

As insurers face health care law requirements, customers face cancellations

01:03 PM CDT on Wednesday, September 8, 2010


Two months ago, Al and Jill Alcantara, both 63, of McKinney, got a letter from their health insurer saying their policy would not be renewed. n the letter sent to the Alcantaras and other customers, Grand Prairie-based National Health Insurance Co. said it could no longer offer individual accident and health insurance policies. It blamed its decision on the company's inability to meet requirements of the health care overhaul signed into law this year.
The cancellation highlights one way the new law is reshaping the health care landscape in North Texas and elsewhere. Some health economists say more small insurers may soon buckle under the weight of the law's mandates.
The law's biggest challenge for insurers is a requirement starting Jan. 1 that specifies "medical loss ratios" – the percentage of an insurer's premiums spent on medical services for its customers. For individual plans, the new law requires that at least 80 percent of premiums go toward paying medical expenses; for large group coverage, the minimum rises to 85 percent.
Insurers that fail to meet the requirement will have to pay rebates to customers.
"The fact is that there are a number of plans who won't be able to meet this requirement and will simply exit the market," said Jared Wolfe, executive director for the Texas Association of Health Plans, an Austin-based group representing concerns of insurers.
But Ben Gonzalez, spokesman for the Texas Department of Insurance, said, "There is always some movement in and out of the market by smaller players. We do not see a specific trend at this point."
The U.S. Department of Health and Human Services, which has the responsibility of writing the rules for what will qualify as a medical expense, said insurers like National Health may be acting prematurely.
"We have recently heard reports that some insurers are making decisions about participation in particular markets based on the effect of these requirements," Kathleen Sebelius, U.S. secretary of health and human services, said in a statement. "It is premature for insurers to make business decisions about participation in particular markets based on rules that have yet to be published, or to apply for exemptions to rules that have not yet been drafted."

Approval to cancel

On July 26, the Texas Department of Insurance gave National Health approval to stop offering individual accident and health insurance policies. National Health sent letters to the Alcantaras and other customers four days later.
"After careful consideration of the recent health care legislation, National Health Insurance Co. has determined that it will not be able to meet the requirements set forth by the [health care law] recently enacted by the United States federal government," the company said in its letter. "With this knowledge, NHIC has decided to cease distributing and renewing its medical expense plans."
National Health, which declined repeated requests for interviews, did not say in its letter which of the requirements in the 906-page law it has trouble meeting.
But Wolfe said the new medical-loss ratio requirements will be more of a hardship for smaller insurance companies like National Health than for larger companies.
"The individual market has much higher administrative costs than the large group market due to a number of factors, [such as] costs are spread across fewer lives, the cost of underwriting and the role of brokers," Wolfe said.
A company the size of Blue Cross Blue Shield of Texas – the state's largest insurer, with 3.8 million members, 400 hospitals and 40,000 physicians – can rely on name recognition to generate business. But smaller insurers have to heavily rely on insurance brokers, and the new medical loss requirements will hurt their commissions, Wolfe said.
And, as smaller insurance companies bow out under weight of the medical loss ratio requirements, larger insurers stand to increase their market share. Blue Cross Blue Shield of Texas says it sees an opportunity.
"Although we are actively evaluating all aspects of pending health reform definitions and regulations, including the implications of minimum medical loss ratio requirements, we believe that individual insurance is a valuable service and are committed to that market," said spokeswoman Margaret Jarvis.

Financial pressures

The new law is adding to the pressures felt by companies like National Health, which has had financial troubles for at least three years, according to the insurer's financial records kept with the Texas Department of Insurance.
Since December 2007, its assets have fallen 31 percent, from $36.7 million to $25.2 million in December 2009. Premiums from its accident and health division fell 27 percent during the same period, from $8.1 million to $5.9 million.
And since October 2009, the insurer has racked up penalties in several states for not filing health care cost reports or financial statements on time, according to records kept by the Department of Insurance.
The insurer plans to continue writing Medicare supplement policies and specified disease policies. But as a condition of stopping its individual health insurance business, National Health will not be allowed to re-enter that market until 2015.
For the Alcantaras, the loss of their insurance policy is major blow, but not a complete surprise.
They've been pleased with their high-deductible policy, which is tailored to cover Al's Type 2 diabetes and gives them access to all the doctors they want. Their policy will be terminated Feb. 1.
"I honestly believed this would happen," said Jill Alcantara, a critic of the new health law.

High-risk pool

The Alcantaras now plan to join the Texas High Risk Insurance Pool. The plans available range from a $2,500 deductible with $1,025 monthly premium to a $7,000 deductible with a $662 monthly premium. Jill Alcantara acknowledges that's expensive.
"But that's just what we're going to have to do," she said.

Blue Shield has discontinued their 12 month rate guarantee program on Individual business and UHC has lowered our commission to 4% on new and renewing Individual business. Hooray for Health Care Reform!

I'm waiting for the ever-famous, "where have you been?" or "this is old news" post.

I see this as an excellent opportunity to break-up small groups into indy plans. I'm thinking my focus will be 10 employees and under since those small groups will likely have less chance of involving folks with major preX. Thoughts?

Workers Paying 14% More For Family Health Coverage This Year, USA

Also, prospects I spoke to last week have stated rate increase notices are starting to be received from BCBS of NC. Notice states 10-30% increases, but no definite number.

This might turn out to be an extremely busy fall season!

Today I learned of a new aspect of health reform. A major medical plan can no longer contain limited-medical plan attributes.

One of our carriers is canceling, as of today, sales of it's most popular policy. It's a major medical that limits Outpatient Diagnostic Testing (CT Scans, MRI's, etc.) to $500 and Outpatient Surgery to $20,000 in a given policy year. What a bummer. It was one of my favorite plans due to its low premium.

In addition, the option to limit the dollar amount of the outpatient testing and surgery benefit (in order to reduce the premium) on all their other plans is being removed.

So it appears that there will be Major Medical and Limited Benefit medical policies, but the two cannot be intermingled.

This company is also removing the options for premium guarantee periods beyond 12 months in duration for all of its plans with effective dates of 10/1/2010 and later.

-A.C.:no:

Suddenly I get two applications declined for individuals who requested a October 1st effective date. Coincidence? Could underwriters be under pressure from their finance overlords to be extra stingy due to all the new mandates coming?

Aetna: Turned down a 52 year old female who takes a pill for diabetes..since 2002. No other adverse health issues or history. Prior to this, I could always count on good old Aetna to insure middle-aged Type II diabetics on a $5,000 deductible plan.

Celtic: Turned down a 56 year old female who has her Cholesterol and Hypertension controlled with medication. No other negative health factors. Celtic has always EASILY approved these applicants (and worse..) over the past 2 years that I've worked with them. In fact, the reason I contracted with Celtic is because people who were turned down by the "BIG BOYS" were approved by Celtic. They had riders and rate-ups, but they were never declined.

If any of you begin to see a pattern like this with your applicants for 10/1/10 or later, please post your experience and observations in this thread. Thanks in advance.
-Allen

I scanned it and uploaded it:

WWW DOT MILBERINSURANCE DOT COM/Pacificare%20Letter.pdf



A very scary look at things to come =-\ There's a few good things that came out of this---

The changes are prospective-- if other companies follow suit, we can keep our residuals and try to convince people to stick with their carrier.

A lot of insurance agents will leave the industry--- more market share for the good agents. If we work super hard and make 3 times the sales, we can stay in business hopefully. Who knows what 2014 will bring though.

Does anyone have information on the tax credit for small business? Under 50 markets. What is the exact language?


Thanks Bryant

Someone sent this PDF to me today and figured I would pass it along.

http://www.ncpa.org/pdfs/What-Does-H...mers-Guide.pdf

http://www.mrmib.ca.gov/MRMIB/High_R...noon_final.pdf

Someone might have posted this earlier but if not, here it is.

It may change, but my guess is that the plan and the rates (see Appendix at end for both) will stay about the same.

Elig. requirements are on page 7.

I'll be interested in reading the analysis of agents like Dave020 and Greensky as they are probably closer to this issue than most of the rest of us... Dave has a great blog on the topic and Rick is running for DOI in this state.

Al
Find me here.

I miandered onto the site, and indicated that I live in Ohio and am looking for health insurance yada yada yada.

So...they have some plans for me. Some of these companies...well, I don't know who the heck they are?

Pekin Insurance?

Independence American?

Sheesh! Try your state and see what comes up? This is the last place I want consumers to go. It just confuses them.


View companies offering plans in 45066:

http://finder.healthcare.gov/images/...gif?1280198381 Not sure how to decide? Read 5 Important tips for Picking Plans
http://finder.healthcare.gov/images/...gif?1280198381 http://finder.healthcare.gov/images/...gif?1280198381 SHOW MORE

It can be a challenge to find coverage that meets your healthcare needs and fits your budget. Health insurance that covers more tends to cost more.

1. Do your best to balance the cost (monthly premium) of a policy with the protection it offers.
2. Determine what you will have to pay yourself for covered services (deductible, coinsurance, copayments, and out-of-pocket limit).
3. Estimate costs for non-covered care (services excluded or limited by the policy) and charges (fees above what the plan recognizes).
4. Avoid policies that don't have some kind of maximum out-of-pocket limit on covered charges.
5. Don't mistake insurance-like products for comprehensive coverage.

Madison National Life 1 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Celtic Insurance Company 4 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Independence American Ins Co 1 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Freedom Life Insurance 2 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Aetna Life Insurance Company 2 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 John Alden Life Insurance Company 3 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Coventry Health and Life 1 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 American Republic Insurance Company 3 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Community Insurance Company(Anthem BCBS) 5 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 McKinley Life Insurance Company 2 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Pekin Life Insurance Company 1 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 World Insurance Company 3 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Humana Insurance Company 9 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Golden Rule Insurance Company 6 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Guarantee Trust Life Insurance Company 1 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Standard Security Life 1 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Time Insurance Company 9 Plan(s) Available http://finder.healthcare.gov/images/...gif?1278022300 Aetna Health Inc. (a PA corp.)

I just got another rumor that Assurant might leave the individual market completely.

So Sept 23rd they might be pulling out on concentrating on the small group market.

I am posting this rumor because I think we will see a lot of small carriers pick and choose what markets they want to compete in.