Health Insurance Blog

Recently, the Asian Health Coalition of Illinois (AHCI) announced that it will be giving its Corporate Leadership award to Blue Cross Blue Shield of Illinois for their efforts to promote wellness and for its strong support of AHCI.

According to BCBSIL’s site, BCBSIL supports hundreds of nonprofit organizations every year that offer services to people who are unable to become insured.  They take their role in community very seriously and are honored to accept this great award.  The award was accepted by President of BCBSIL, Paul Boulis, at an AHCI fundraiser last month. 

A recent report prepared by PriceWaterHouseCoopers and released by AHIP breaks down how each dollar that is spent by Americans on health insurance is broken down.

According to the report:

• $0.33 is spent on physicians services
• $0.20 is spent on inpatient costs
• $0.15 is spent on outpatient costs
• $0.14 is spent on drugs
• $0.05 is spent on other medical services
• $0.06 is spent on government payments, compliance & other administrative expenses
• $0.04 is spent on consumer services, provider support & marketing
• $0.03 health insurance company profits

The Complete report can be found here http://www.americanhealthsolution.org/assets/Uploads/risinghealthcarecostsfactors2008.pdf

Congress is pushing for a bill to reform health insurance by the end of the year.  An overview has been published outlining the options that are being considered and a health insurance mandate is on the table. 

The overview has the option of requiring Americans to be covered by health insurance.  Those who choose not to buy in and do not meet certain requirements for exemption would pay a tax which would be the same as the premium for the lowest price insurance option.  This mandate was an option that Obama opposed in his campaign.  The health-reform debate will continue for many more months, even after a decision has been made.

According to Valerie Bauman at Newsday.com, New York’s Governor David Paterson wants to ensure health insurance is more affordable by requiring health insurance companies to get state approval if they are going to raise premiums.

This bill is one of four that Paterson has proposed to help people who can’t afford private health insurance, but do not qualify for Medicaid.  One third of New York’s uninsured is between the ages of 19-29.  Paterson’s proposal would permit families to cover their children up to 29 under insurance through their employer.   Most plans currently stop this kind of coverage at 23.  This could dramatically help families stay insured that fall into this category. 

Also, part of Paterson’s plan is to extend COBRA from 18 months to 36 months, and to cut down on the amount of claims that are inappropriately delayed or denied.  If the deadline cannot be met to review a claim, then the claim would have to be approved by the health insurance company.   All aspects of this proposal have the goal of ensuring health insurance is a fair and smooth process.

Pfizer has announced that they will provide free prescription drugs to current customers who have lost their jobs and subsequently lost their health insurance coverage.  More than 70 medicines will be available through this temporary program.

To be eligible, a person must have lost their in 2009 and started taking an eligible Pfizer medicine at least three months before losing their job. In addition, to be eligible, customers must also be without prescription drug benefits and must be able to attest to financial hardship.

Pfizer stands to gain, by gaining favor among their customers as well as increasing the likelyhood that these financially strapped customers will continue to take the perscriptions once they get their feet back on the ground.

Eligible participants will receive 12 months of free refills of the eligible perscriptions or until they obtain a replacement health insurance plan.

Senate Bill 189 recently passed the Pennsylvania House of Representatives which will allow children of parents covered on their group health insurance plan to remain on the health plan until age 30.  Seventeen other states have already extended the age limit for dependent health insurance coverage.

To be eligible for the Pennsylvania health insurance extention, the child must be unmarried, have no dependents themselves, be a Pennsylvania resident or be enrolled as a full-time college student and have no other health insurance coverage.

Some of the top individual health insurance plans available to PA residents include:  Aetna, Highmark BCBS, Health, HealthAmerica, and Capital Blue Cross , Independence Blue Cross Blue Shield

Many Americans have health insurance through their employers.  But as the economy struggles and the working world changes, employment is no longer a health insurance guarantee.  America continues to move from a manufacturing based economy to a service economy and working patterns are evolving.  This, in turn has made employer based health insurance less stable. 

Many small employers cannot afford to offer health benefits.  And of the companies who do offer health benefits, many are charging the employee more of the cost.  Because of these factors, many Americans are choosing to not take advantage of job based health insurance.  But having coverage is still as important as ever.  Everyone should have health insurance with basic benefits at a minimum. 

President Barack Obama and Speaker of The House Nancy Pelosi have promised to have a sweeping health care reform bill on the floor by the end of July.  President Obama sited new Medicare forecasts that suggests the system will become unsustainable much sooner than originally projected.

Obama’s overaching plan to provide health insurance coverage to the nations 50 Million uninsured is the cornerstone of the promise overhaul the country’s broken system.

Independent experts have estimated the costs of such an overahaul at about $1.5 trillion over 10 years.

Blue Cross and Blue Shield companies across the country are working with employers to get their employees healthier. Blue Cross and Blue Shield companies are holding lunchtime walks across America as part of the third annual National Walk @ Lunch Day® because of the high costs that come along with an inactive lifestyle.

Walks are being hosted in all 50 states, the District of Columbia and Puerto Rico to engage employees, consumers and community leaders in healthy activities to promote the health benefits of walking. Thousands of walkers are participating in this healthy initiative.

Daily, brisk walking is one of the easiest and safest forms of exercise. A regular walking program can help control weight, condition the heart and lungs, strengthen bones and help you towards a healthier lifestyle.  This can even save you money in the long run on health insurance.

The State Health Plan - North Carolina’s health plan for state employees lost $137.6 Million in the fiscal year ending in June 2008.  The plan covers roughly 667,000 North Carolinians.  The primary driver of the financial implosion was the introduction of a more generous PPO health insurance option that prompted 76,000 existing enrollees to switch over to this plan, as well as prompting an additional 30,000 state employees to sign up for the state sponsored plan.

The members who were enrolled in the PPO plan specifically took advantage of routine eye and hearing exams and their increased utilization of services overwhelmed the discounts with network hospitals and doctors negotiated by Blue Cross Blue Shield of North Carolina (BCBSNC).

BCBSNC, The largest North Carolina health insurance company administers the PPO plan, and claims ended up costing nearly $164 million more than was projected.  In addition, administrative costs were extremely high ($66.6 Million), but they were allowed based on the contract that was signed.