Health Insurance Blog

According to the article “Health care: Dose of Uncertainty” by William Pack on mysanantonio.com, small business owners in San Antonio are uneasy about the possible shift of the health care system.  There is an angry attitude from small business owners towards the possibility of health care reform.

For the past years, small business owners have been demanding health insurance changes to decrease costs and help them remain competitive against larger competitors.  San Antonio health insurance may end up being more expensive with more mandates and fewer benefits with reform and hurt small business owners.  But government officials believe that the $1.1 trillion health care plan will bring health insurance costs under control for smaller businesses.

The bill produced by the House claims that they will reduce the number of uninsured people by 34 million over the next 10 years and would end the exclusion of people with pre-existing conditions as well as the dropping of ill individuals.  And mandates are designed to expand the risk pool so costs will drop.  It is still to be determined if fears are warranted, but small business owners who cannot afford to offer individual health insurance now are not confident.

Effective January 1, Blue Shield of California will be removed from the Major Risk Medical Insurance Program (MRMIP) because their premiums were substantially higher than the rates offered by the other two insurers that make up the Program.

The MRMIP currently covers almost 7,000 California residents who are unable to purchase private health insurance due to pre-existing conditions.

Health insurance companies that participate in the MRMIP Program are allowed to charge 25% higher premium than the market rate for a given health insurance policy, and if the insurer loses money they will be reimbursed by the state.  Despite the state subsidization, Blue Shield’s health insurance rates were much higher than both Kaiser Permananete’s or Anthem Blue Cross of California.

Current enrollees in the MRMIP Program via Blue Shield will be able to keep their existing coverage until January 1, and then must enroll with one of the other health plans that participate in the Program.

More information about California health insurance.

The Texas Health Insurance Pool website gives some history and background to what the pool is and how it benefits Texas residents.

The Texas Legislature created the Texas Health Insurance Pool to provide Texas health insurance benefits to eligible Texans who are unable to get coverage from commercial insurance companies because of previous or current medical conditions. 

The Pool is also an alternative means for individual health insurance coverage which guarantees transferring coverage to qualified residents who lose their coverage under an employer based plan, a church plan, or a state plan.  This is mandated by the federal Health Insurance Portability and Accountability Act of 1996, also known as HIPPAA.

According to the article “NC high-risk pool an option for many seeking health insurance” by Vicky Eckenrode on starnewsonline.com, there is a new state program to cover high risk applicants to ensure North Carolina health insurance is made available to them.

In 2007, state legislators started the Inclusive Health program.  It’s also known as the North Carolina Health Insurance Risk-Pool and it’s intended to assist people who are struggling to get covered because the industry considers them high risk.  Michael Keough, the program’s executive director says that this is an alternative mechanism to provide affordable health insurance to those high risk applicants.  Enrollment began in January and is up to about 1,600 covered now. 

State risk pools have been in existence for decades.  North Carolina is the 35th state to start this type of program.  The health insurance premiums for Inclusive Health are capped at 175% of the standard risk rate.  In other words, it tops out at 75% more than what a healthy person would pay for a similar policy.  The average age for this program is 50 years old.  This is a great option for many as Congress continues to figure out the health care reform debate.

In today’s economy many individuals and families are losing their health insurance coverage for a variety of reasons, including job loss.  There are many viable options for the uninsured, and if you have been unfortunate enough to be in that situation you should explore these options and obtain coverage.

Individual Health Insurance - The best option for individuals without access to employer sponsored coverage.  some states off this coverage to people regardless of health status.

High-Risk Pools - For people who can’t qualify for health insurance coverage due to medical conditions.  High risk pools exist in morethan 30 states.

COBRA - Allows individuals and families to continue their job based health coverage for up to 18-36 months should they be become unemployed.  Previous employer must have 20 employees or more, in order to be eligible. 

State Continuation Plans - are available in some states which provide similar coverage to people who were employed by small companies (<20 employees) but lost their jobs.

Other options that may be available in various states under certain circumstances to uninsured individuals include: HIPAA-Eligible, Conversion Plans, TAA Tax Credits, and Prescription Assistance Plans.