Health Insurance Blog

The UnitedHealth Group is now offering UnitedHealth Continuity, a policy for those that already have health insurance but are worried that they may lose it in the future. These people may be considering early retirement, or may fear unemployment and the resulting loss of health care coverage. Reed Abelson says in the New York Times that applicants must pass a medical review before being accepted. However, many individuals who have been unable to get insurance on their own are those with pre-existing conditions. The Continuity plan doesn’t seem to be helpful for them.

The UnitedHealth Continuity policy charges members 20% of the current health insurance premium to reserve the right to future coverage, and varies due to age, gender, location, and level of coverage selected. The monthly fee is also subject to increase in the future. There is also the danger of the plan becoming a costly high-risk pool that attracts people more likely to develop serious conditions.

Reed also speculates that proposed health care reforms from the incoming Obama administration include a requirement that private insurers offer individual health coverage to everyone, no matter the state of their health. That type of law would make the new UnitedHealth guarantee unnecessary. The president of UnitedHealth’s individual insurance unit, Richard A. Collins, claims that political wrangling and legislative delays make the Continuity plan viable, at least in the short term.

UnitedHealth Continuity is currently available in 25 states in which UnitedHealth already sells individual insurance. It believes that it will soon be able to offer the Continuity plan in 15 more states.

(Photo credit: Shahram Sharif under CC 2.0)

In yesterday’s Miami Herald, John Dorschner reported that Blue Cross and Blue Shield of Florida is now offering a discount card statewide for those without health insurance. For $20 per month, the new FamilyBlue card administered by Coverdell gives individuals discounts on routine medical expenses such as:

• prescription drugs and vitamins
• doctor visits
• dental, vision, and hearing care
• diabetes supplies

However, unlike individual health plans the card doesn’t cover hospital stays, which are most likely to lead to medical bankruptcy. Dorschner also wrote of problems surrounding doctor awareness about the program. Out of 10 approved providers for the FamilyBlue card, only one doctor accepted it when asked. Experts say these discount cards may be more suitable for young and healthy individuals less likely to need hospitalization.

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.

A brief prepared by Mark Farrah, ranks health insurance companies across the nation based on their enrollment of individuals & families in non-group health plans, i.e. individual health insurance.

In the private health insurance marketplace there are an estimated 17 million individuals enrolled in non-group health insurance coverage purchased directly from insurance companies, although only just over 11million in membership was captured in this analysis which relied on NAIC and CA Dept of Managed Care Data.

Major medical health insurance plans make up the vast majority of non-group health plans, but limited benefit plans make up a material portion and are growing in popularity as health insurance premiums continue to outpace wage increases.

The brief found that 229 health plans were offering major medical health coverage to individuals & families.

The rankings were as follows:

1. Wellpoint/Anthem (BCBS in 11 states)      21% market share
2. HCSC (BCBS in 4 states)                              7%
3. BCBSNC                                                      4%
4. BCBSFL                                                       4%
5. Regence (BCBS in 4 states)                         4%
6. United HealthCare                                     3%
7. Aetna                                                         3%
8. Humana                                                     3%
9. BCBSMN                                                     2%
10. Assurant                                                    2%
11. Other (219 companies)                            46%

In the limited Benefit Plan marketplace, United American maintains a dominant position with 70% market share.

The most surprising finding in the major-medical health insurance rankings is that Blue Cross Blue Shield of North Carolina as the 3rd highest membership across the country, covering over 350,000 individuals with their Blue Advantage offering for individuals despite covering a service area that is limited to the state of North Carolina.

Gary Bolt, and Bruce Allen deserve much praise for their work managing the individual direct sales unit at BCBSNC.