Health Insurance Blog

Last week Humana announced that they were expanding the footprint of their Humana One short term health insurance plans to five additional states.  The five new states include Illinois, Iowa, Kansas, Missouri, and georgia.

The Humana One short term individual health insurance plan is now available in twenty states.  Like most short term health insurance coverage, these plans can be purchased for as little as 30 days or as much as 1 year.

Short term health insurance plans are designed primarily for recent college graduates who are job hunting, adults who are in-between jobs or recent retires who are not yet eligible for Medicare related products.

Humana also offers a portfolio of individual health insurance plans that are not short term in nature and can be held for indefinite periods of time.

Both the House and Senate have passed their versions of health care reform according to the article “Understanding Key Provisions in Federal Health Care Reform” found on Business Journal’s website.  Congressional negotiators are currently working on an agreement between the two bills.  The full House and Senate must approve the package then it’s presented to the President to sign it into law.

It’s predicted to take until at least mid-February before an agreement is reached and it wouldn’t start until 2013 and possibly longer for certain plans.  In 2014 and years after, the health care reform plan budget would increase to match the Consumer Price Index, plus 1%.  Insurance companies and plan administrators would pay this extra tax.  Under the House bill there would be a penalty for each employee not covered by health insurance of 8%, and under the Senate bill the penalty would be $750 per employee not protected.

The article points out that about 30 million of the country’s 46 million uninsured would get health insurance, mostly through federal health insurance subsidies under the new plan.  Health insurance companies would have to redo their criteria for approving policies such as stopping exclusions for pre-existing medical conditions.  This is an important point for those shopping for individual health insurance who have been turned down previously because of an chronic illness they may have.

According to the article “An Extended Subsidy for COBRA Health Coverage” by Kimberly Lankford on The Washington Post’s website, Congress has extended the COBRA Subsidy from 9 months to 15 months.  This is great news for those whose subsidy was coming to an end, still unemployed and worrying about finding affordable individual health insurance.

Last year’s stimulus package originally set up the COBRA subsidy for those who lost their job between 9/1/08 and 12/31/09.  It covered 65% of their COBRA health insurance premium for up to 9 months.  While this was extremely helpful to many, the 9 months is coming to an end for some and unemployment is still up.  With the newly amended law that occurred in late December, these individuals have another 6 months to find relief.

If you were receiving the subsidy, there is nothing you need to do to continue receiving it.  You continue to pay the 35% to COBRA and your former employer is reimbursed by the government for the remaining 65%.  Once your 15 month subsidy expires, you will be responsible to pay for 100% of the premiums in addition to an administrative charge.  COBRA coverage generally only lasts 18 months.

With health care reform just around the corner this may change as well, in addition to changes in medicare supplement plans. It’s important to ensure you have the most up to date information on COBRA and other government health insurance programs.

According to the article “The Missing Link in Health Reform: A Guarantee of Good Coverage At Work” by Richard Kirsch on huffingtonpost.com, the new House bill will require all but very small employers to offer and help pay for good health insurance benefits.  They can also choose to pay a percent of their payroll to the government to assist with covering subsidies.

The Senate bill on the other hand doesn’t require employers to offer or pay for health insurance for their employees.  The Senate bill will require employers with 50 or more full time employees to pay a fine if their employees end up getting subsidies from the government.  What will actually end up happening depends on which bill gets implemented.

The article points out that currently 150 million Americans get health insurance through their work so there are a lot of people who need to understand the changes.  During the past 10 years health insurance at work has deteriorated and more consumers are turning to individual health insurance.  A study of employers released in the fall says the trend is likely to continue in 2010.  Health care reform is a key component to how it will all play out.

Upon the heels of the H1N1 virus outbreak, Geisinger Health Plan hospitals will continue to have visitation restrictions.  Geisinger Medical Center and Geisinger Wyoming Valley Medical Center will keep enforcing the visitor restrictions to help prevent the spread of H1N1 and other dangerous viruses.

Dr. Lisa Esolen, Medical Director for Infection Control at Geisinger Health System says that this has been an unpredictable flu season and they are committed to protecting patients.  Children under 12 are restricted from visiting all areas and everyone else will be screened for flu-like symptoms.  The H1N1 pandemic has slowed down but seasonal flu is starting up.  Past flu viruses have shown spikes in January through March.

Many people each year are hospitalized for the flu which is just one more reason to ensure you are protected with individual health insurance.  With the new health care reform bill which recently passed in Congress, most Americans will be required to carry health insurance coverage which will help cover costs for such flu pandemics.

Anthem Blue Cross Blue Shield of Wisconsin has introduced a new low-cost health insurance plan for individuals called CoreShare.  In addition they have enhanced their SmartSense and Premier health plans.

CoreShare has a simple plan design and can be as cheap as $45 per month for a 25 year old Male in Milwaukee.

Among other benefits, CoreShare health plans offer:  A choice of nine deductible options (ranging from 750 to 25000), $2,000,000 in lifetime protection per member, access to both PPO and Point-of-Service networks, and access to the Blue Cross Blue Shield BlueCard Program.

Members choosing Anthem’s CoreShare, SmartSense, Premier or Lumenos (HSA) plans have access to more than 13,820 Wisconsin POS network doctors and specialists, and nearly 140 hospitals.

More information about Wisconsin health insurance.

The Senate voted for health care reform last week and changes are just around the corner.  According to the article “Senate Approves Health Care Bill” by Robert Pear on nytimes.com, the passing of the bill will guarantee individual health insurance to millions of Americans and also keep health care costs down.

The new bill has many parts to it but one of the main points is that it would require most Americans to carry health insurance and it would add 15 million people to Medicaid to subsidize private coverage for low and middle income residents.  The budget office believes the bill would offer coverage to about 31 million uninsured Americans but still leave an unsettling 23 million uninsured by 2019.

If this bill does end up becoming a law it will be a major milestone in US history.  This initiative does not carry full support from both sides of Congress which makes it even more complicated.  Only one Republican voted for the House bill last month and in regards to the Senate version, no Republicans voted for that.  This my end up being counterproductive as government tries to improve our health care system.

PacificSource Health Plans has acquired Clear One Health Plans for $46 Million.  Under the merger agreement, Clear One will become a wholly owned subsidiary of Eugene Oregon based PacificSource.

The merger will allow PacificSource to increase its presence in Central Oregon and expand into the Medicare and Medicaid markets through Clear One Health Plans  operation while continuing to devote energy towards PacificSource’s commercial health insurance business.

The deal still requires approval by the Oregon Insurance Division, the Centers for Medicare & Medicaid Services and the Oregon Division of Medical Assistance Programs, as well as final shareholder approval.

Bend Oregon based Clear One provides health insurance, including Medicare Advantage plans, commercial plans, individual health insurance plans as well as administrative services to individuals and businesses throughout the West.

After the merger, PacificSource Health Plans is expected to cover about 228,000 members and PacificSource TPA about 80,000. Employer clients are expected to total 5,676 and 303 respectively.

More information about Oregon Health Insurance.

According to the BCBSA website, BCBSA has started a new Pediatric Obesity and Diabetes Prevention Pilot Program in Texas, New Mexico, Mississippi, North Carolina and Kansas.  Through this program Blue Cross Blue Shield plans on reducing the epidemic of childhood obesity and stop further cases of young people getting Type 2 Diabetes.

The plan consists informational toolkits for doctors to use as reference guides when addressing obesity.  The kit was designed with the American Diabetes Association and the American Academy of Pediatrics to encourage healthy choices and was passed out in mid-November.  BCBS collectively protects over 100 million Americans through individual health insurance and other health insurance policies, so this large effort by them should have a great impact.

The toolkit offers healthy lifestyle suggestions such as eating 5 servings of fruits and vegetables a day, limiting TV time to 2 hours a day, getting an hour of physical activity every day, and stop drinking sweetened drinks.  According to the US Department of Health and Human Services, an overweight teen has a 70% chance of becoming an obese adult which is one of the leading causes of health issues in our country.  This type of action is proving very necessary.

Texas insurance consumer advocate is looking to get rid of the blanket authority of health insurance companies to decide what their policies will cover according to the article “Texas Consumer Advocate Wants Ban on Health Insurers’ Blanket Clauses” by Terrence Stutz on DallasNews.com.  This would cause a big impact on individual health insurance in Texas.

Deeia Beck, the Public Insurance Counsel, asked the state’s insurance commissioner to stop provisions present in many health insurance policies, called discretionary clauses.  This gives health insurance companies the freedom to decide what benefits will get paid.  The health insurance industry strongly opposes this type of change being made.

There are currently 22 states who have banned this clause, and Texas may be next.  Insurance Commissioner, Mike Geesline, has held a hearing to consider whether or not to move forward with this proposal.  The National Association of Insurance Commissioners has urged its members to stop this practice.