Health Insurance Blog

In the recently released US News & World Report commercial health plan rankings (which takes into account both customer satisfaction and a number of different healthcare related measures such as disease prevention), The top 10 Wisconsin health insurance plans were ranked as follows.

1. Group Health Cooperative of South Central Wisconsin - driven by very high scores in both disease prevention and treatment
2. Security Health Plan of Wisconsin
3. Unity Health Plans
4. Network Health Plan
5. Dean Health Plan
6. Medical Associates Health Plan
7. WPS Health Plan
8. Medica - Serving Wisconsin, Minnesota, South Dakota, and North Dakota
9. United HealthCare
10. Humana

Not all of the Wisconsin health plans listed above offer individual health plans (non-group health coverage), if you are a Wisconsin resident and shopping for a health plan for you and your family, you can find more information about Wisconsin health plans for individuals here.

Select Health, a non profit health insurer serving Utah and Idaho, has launched a premium assistance program that will supplement the existing SelectHealth Kids Plan, and reduce monthly premiums by 40-60% for qualifying residents.

Utah’s children’s health insurance program (CHIP) currently provides a low cost health insurance plan to families in need who have uninsured children, however many families fall through the cracks of these state sponsored health insurance plans across the country because they make too much money to qualify for Medicaid and other Government funded programs.

Select Health’s premium assistance program reduces the avg monthly premiums to $25-$50 a month and qualification is based on household income combined with family size.  Approval into the program qualifies the family for 12 months of assistance, after the 12 months is up, families must apply for acceptance again.

For more information interested parties can call toll free 1-800-442-3125.

Kaiser Permanente now offers a subsidized individual health insurance plan that costs as low as $20 per month.  The plan is called Bridge Community Health Plan.  The Bridge plan targets individuals and families who are experiencing tough times but make too much money to qualify for government sponsored programs like Medicare of Medicaid.

Kaiser Permanente subsidizes 90 to 95% of the monthly premium as a community benefit.

The Bridge Plan offers up to 3 years of comprehensive health coverage to qualified individuals & families.  Applicants must live in the Washington D.C. and Baltimore metropolitan areas.  To determine eligibility, interested parties can contact 866-456-5902.

Limited Benefit Plans have not been well received since their inception, many health insurers have resisted offering them, and there hasn’t been a strong customer demand for them either despite their low-cost.

Given the economic climate that we are facing across the country, these stripped down health plans have been generating more chatter than in past years.

There are several states that have passed legislation to allow for limited benefit plans to be offered that do not contain the entire list of madated benefits that major medical plans are required to provide

According to Statecoverage.net the list of states that allow for exceptions to state mandates are as follows:

1. Arkansas - The Health Insurance Consumer Choice Act of 2001 allowed health insurers and HMOs to offer health insurance plan options to consumers that include all, some, or none of the Arkansas coverage mandates; and requires certain disclosures to be made to consumers so they may make a fully informed choice of offerings.
2. Colorado - In 2003, the Colorado legislature passed HB 1164, which requires carriers in the small group market to offer one of three basic health benefit plans: Basic Health Benefit Plan without specified mandates; Basic High Deductible Health Benefit Plan; or Basic High Deductible Plan without specified mandates.
3. Florida - In 2002, the Florida legislature passed SB46E, which allowed a Health Flex Plan to be sold by insurers, HMOs, provider-sponsored organizations, and public or private community-based organizations as a pilot in areas of the state with a high uninsured rate.
4. Georgia - In 2005, Georgia enacted the Georgia Consumer Choice Benefits Health Insurance Plan Act which allows health plans to offer products without all of the state mandated benefit requirements.
5. Kentucky - In 2005, the Kentucky legislature passed HB278, the Small Business Insurance Relief Act, which creates a state-established basic health benefit plan to make insurance more affordable by tailoring benefits to specific needs.  Available to groups with less than 50 employees
6. Maryland - The Minimum Benefit Legislation (SB 570), enacted in 2004, requires carriers who insure > 10 percent of the covered lives in the small group market to offer a limited-benefit plan.
7. Minnesota - In 2005, the Minnesota legislature enacted a new law that allows health plans to sell “small employer flexible benefit plans” that do not include any of the benefit mandates (except maternity).
8. Montana - In 2003, the Montana legislature passed HB 384 which allowed for limited-benefit plans to be available to those who purchase health insurance in the individual market as long as they are notified which services are not covered and have remained uninsured for 90 days or more.
9. New  Jersey - In 2002, the New Jersey legislature passed legislation which required individual market carriers to offer a limited-benefit plan, called Basic and Essential Health Care Services Plan (B&E).
10. North Dakota - In 2001, the North Dakota legislature passed HB 1226, The Individual and Small Employer Health Insurance Act, which allows an insurance company to offer a basic health insurance policy to individuals and small businesses with 50 or fewer employees.
11. Texas - Beginning in 2004, Texas required all small employer insurance carriers to offer at least one plan offering all the mandated benefits by law, and at least one Consumer Choice Plan that may exclude or limit coverage of certain mandated benefits.
12. Utah - In 2002, the legislature passed HB 122, which permitted insurance carriers to offer coverage that is similar to what is covered under Utah ’s 1115 Medicaid waiver (Utah ’s Primary Care Network).
13. Washington - In 2004, Washington passed legislation redefining the small group market, changing group size to 2 to 50, from 1 to 50.

In an attempt to close the $11 Billion budget cap this year, the state of California is considering putting a freeze on Healthy Families, California’s state sponsored health insurance plan for children.

Nearly a million California children are enrolled in Healthy Families that would not have health insurance coverage otherwise.

The Healthy Families Program is $17 Million over budget, as enrollment is growing by 27,000 new children each month, largely due to the tough economic climate and growing unemployment.

Freezing enrollment in the program is clearly not a desired action to address the budget shortfall, and although President Elect Obama is making children’s healthcare a priority, a decision will need to be made regarding this programs solvency before he takes office in January.

Mark Farrah wrote a nice report on the Medicare Advantage marketplace in Pennsylvania.   In summary he found that the 30 health insurers offering Medicare Advantage Plans in PA had a 37% market penetration, one of the highest in the country.  Of the 30 health insurers, more than 20 were based in PA, including three separate Blue Cross Blue Shield member plans.

The Pennsylvania health insurance marketplace is divided into four distinct regions, Western, Southeastern, Central, and Northeastern, with many health insurers focused on specific regions within the state.  For instance, in Western Pennsylvania, there are 20 companies offering Medicare Advantage Plans, but Highmark, and UPMC enroll about 75% of the members in that region.

Statewide there are five health insurers that Mr. Farrah considers the “top tier” in the Medicare Advantage marketplace, and they represent about 75% of statewide enrollment.  They are

1. Highmark with 249,023 members, 30.4% market share
2. Independence Blue Cross with 149,525 members, 18.3% market share
3. Coventry Healthcare with 91,724 members and 11.2% market share
4. UPMC Health plan with 69,758 members and 8.5% market share
5. Aetna with 58,778 members and 7.2% market share

The Pennsylvania competitive landscape will go through drastic changes in 2009, as the two largest players, Highmark, and Independence Blue Cross will finalize there merger this year.  In combination they will insure over 400,000 members and nearly 50% of the market.

2008 was the fourth year that US News and World Report, released their annual ranking of commercial health insurance plans.  The results are in, and the following list is how US News and World Report ranks the top Indiana health insurance plans.

1. CIGNA Healthcare of Ohio - was the top rated health plan in Indiana, as their service area covers portions of both Ohio, Indiana, and Kentucky
2. Anthem Blue Cross Blue Shield of Indiana - received the highest rating by customers
3. Aetna Health
4. CIGNA Healthcare of Indiana
5. CIGNA Healthcare of Illinois - serving both Indiana and Illinois
6. United Healthcare of Kentucky - serving both Indiana and Kentucky
7. United Healthcare of Illinois - serving both Indiana and Illinois
8. Humana Healthplan of Kentucky - serving both Indiana and Kentucky

Compared with other states, the overall ranking score (scale of 1 to 100) for Indiana health plans were lower than the other states that we have blogged about so far, with the top plan scoring only an 83.

Wellpoint became the latest health insurance company to dabble with a medical tourism program.  Under this new Wellpoint pilot, members can travel to India to have some surgeries done.

Wellpoint would not only save thousands on medical costs, but they would also gain leverage in negotiatons with doctors.

Blue Cross Blue Shield of South Carolina, and Aetna have already launched medical tourism programs and both CIGNA and United Healthcare are currently researching the proposition.

Continuing on our series of top state health plans, as determined by US News and World Report, in conjunction with the NCQA, below are the top health plans in Michigan for 2008.

Only 8 Michigan Health Insurance Plans were included in the ranking, so this list is a top 8 list as opposed to top 10.

1. Grand Valley Health Plan
2. Priority Health
3. HealthPlus of Michigan
4. Health Alliance Plan of Michigan (HAP)
5. Physicians Health Plan of Mid-Michigan
6. Blue Care Network of Michigan
7. Total Health Care
8. Physicians Health Plan of Southern Michigan

It is interesting to note that the Michigan health plans listed here, do business only within the state of Michigan, wheras the top 10 health plans in Illinois by-and-large operated in multiple states.

US News and World Report’s 2008 ranking of the top Illinois Health Insurance Plans are listed below.  Based on 1) consumer surveys and 2) success in preventing and treating illness compared with average plan.

1. PersonalCare Insurance of Illinois (conducting business exclusively in Illinois)
2. Health Alliance Medical Plans (Illinois, Iowa)
3. CIGNA Healthcare of St. Louis (Illinois, Missouri)
4. Medical Associates Health Plan (Illinois, Iowa)
5. United Healthcare plan of the River Valley (Illinois, Tennessee, Iowa, Virginia
6. OSF Health Plans (Illinois)
7. United Healthcare of the Midwest (Illinois, Kansas, Missouri)
8. United Healthcare of the Midlands (Illinois, Nebraska, Wisconsin, Iowa)
9. CIGNA Healthcare of Illinois (Illinois, Indiana)
10. United Healthcare of Illinois (Illinois, Indiana)

You’ll notice, on this top 10 list, there are 4 distinct United Healthcare plans listed as well as 2 CIGNA health plans.  This generally results from various regional health plans being responsible for a service area that covers specific MSAs, or specific regions within a state or states.

Blue Cross Blue Shield and Aetna are noticably absent from this list