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Insurance Companies

Health Insurance Across State Lines Not As Simple As It Sounds

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[…] I’m not opposed to the idea of health insurance companies that could operate on a national basis, allowing people to keep their health insurance if they move to another state. But such a plan would have to be overseen by federal guidelines. Simply opening things up to allowing health insurance companies to base themselves in any state they choose, operate under that state’s laws, and sell health insurance in all states, would take us to the lowest common denominator in terms of consumer protections.

Imerica Placed In Rehabilitation

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[…] If it is determined that Imerica can be rehabilitated, they will continue to do business under the rehabilitation plan. If not, Imerica would be liquidated, and policyholder claims not paid by Imerica would become the responsibility of the life and health insurance guaranty funds in the states where Imerica was licensed. In Colorado, this group is known as the Life and Health Insurance Protections Assocation (LHIPA). LHIPA has a maximum benefit of $500,000 for major medical insurance, which is significantly lower than most of the benefit maximums offered on private health insurance policies in Colorado (including Imerica, which offered policies with lifetime maximums ranging from $2 million to $8 million) […]

Obesity As A Pre-Existing Condition

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[…] I can see the benefit to making sure that everyone gets accepted for health insurance, as it’s counterproductive for society as a whole to have people who are uninsured. But I believe that it makes sense for obese applicants, and tobacco users, to pay more for their health insurance in order to offset the higher claims they are statistically likely to have. […]

Expanding Access To Cover Colorado

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I have often wondered about the feasibility of Cover Colorado expanding their eligibility to attract healthier applicants and perhaps improve their loss ratio. The state high risk pool health insurance policy – has claims expenses that far exceed premiums collected. Fees on private health insurance companies and a grant from Medicare help to make up the difference. […]

Outcome Based Incentives For Doctors

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[…] In order to truly provide quality care, a doctor is likely going to have to spend more time with sicker patients. This should be reflected in how the doctor is compensated, along with the outcome-based incentives. There are ways to implement an outcome-based incentive system for doctors while at the same time making sure that they aren’t encouraged to avoid the sickest patients.

Marketing in Disguise

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I almost tossed it. But then I saw the notice across the front of the envelope: “Attention Rural Co-operative Members. You may now qualify for a Hospitalization Policy that helps pay outpatient expenses.” My curiosity was piqued, given the health insurance co-op ideas that have been tossed around this summer […]

Complaint Ratios Updated With 2008 Data

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The Colorado Division of Insurance has finished compiling and organizing the data for 2008. Visit the Colorado Health Insurance Company Complaint Ratio Comparison page to see the updated complaint, revenue, and market share statistics from the division of insurance along with the A.M. Best Rating information we’ve added […]

Some Claims Should Be Denied

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What if they refused to pay for some of the CT scans being done at a clinic that purchased its own CT scanner and subsequently had a 700% increase in the number of scans ordered? Would the health insurers be held up as the bad guys, for not paying for the scans? I have to imagine they would, even though it’s likely that a good number of those scans were unnecessary. […]

Not Just Health Insurance That Needs Reform

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Has anyone else noticed that the the term “health insurance reform” has started to be used in place of the term “health care reform”? Perhaps reform proponents are counting on the poor perception of the health insurance industry held by many Americans. By renaming the reform, perhaps they believe that more people will support it. […]

What Women Want

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[…] Glenna’s article sheds light on what most of us (not just women) want when it comes to health care reform. We want something that is well-thought-out, focused on what works best for patients and health care professionals alike, and with a minimum of political grandstanding.

What We Expect Of Insurance

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[…] In Colorado, if a person chooses to go without health insurance and ends up with a catastrophic medical bill, bankruptcy will be the likely outcome. Same story for a person who chooses to drive without car insurance and then causes a serious accident, except that the person driving without car insurance will also be facing legal action for making that choice. […]

Physicians, Not Providers

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I wonder how many times I’ve used the term “primary care provider” on this site? I try to be as PC as possible, but I never knew that term wasn’t appreciated by the doctors to whom it refers, until I read an article by Dr. Toni Brayer at ACP Internist. It seems the term primary care provider was created by health insurance companies, not doctors. […]

The Drug Industry Is Dancing

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[…] Drug costs have played a major role in driving up health care costs over the years. Many of the health insurance companies we work with in Colorado now require a separate pharmacy deductible to be met before copays kick in for drugs. And then I read articles that describe how psychiatric drugs have become common-place in our society. I think there’s a connection here somewhere…

Anthem Blue Cross And Boulder Chamber Offer New Health Insurance

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[…] This is a big step forward for health insurance. Boulder is a great place to start something like this, as residents there do utilize alternative health care a bit more than the average Colorado resident. But over the years, we’ve had inquiries from people all over the state who are looking for a health insurance policy that will allow them to utilize alternative care. […]

The 82nd Cavalcade Of Risk

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[…] Jaan homes in on the notion Bob puts forth that health insurance carriers are responsible for spiraling healthcare costs, and should thus be accountable for keeping those costs in check. I agree with Jaan here – health insurance companies are already highly regulated entities, and don’t have as much say when it comes to costs as the public would like to believe. […]

Surgery Might Not Be Best For Breech Births

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[…] In the current quest to reform health care, everyone is talking about controlling costs. Lowering the rate of c-sections would have a significant impact on the cost of maternity care, since vaginal births are much less expensive than surgical births. Maternity care is something that most women eventually use, and lowered costs would translate to lowered health insurance premiums for all of us. […]

Medical Underwriting And Policy Rescission

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[…] Electronic medical records that allow underwriters to see complete medical histories at the time of application would greatly reduce the number of policy recissions. Then again, there’s a lot of talk on the table right now about eliminating medical underwriting all together, which would solve the problem once and for all.

Profitability And The Health Insurance Industry

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[…] The industry as a whole chalked up a profit margin of more than 10% in 2007, but that was carried by the life insurance side of the industry. Health insurance companies don’t fare nearly as well when it comes to making profits. Far more of their revenues are eaten up by claims, which continue to grow year after year as health care costs increase.

Designing An Effective, Enforceable, Individual Mandate

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[…] As readers of the Colorado Health Insurance Insider know, Insurance markets pool risk. An insurance system will only work if the exposures of low risk individuals are pooled together with the exposures of higher risk individuals. Life insurance, homeowner’s insurance, auto insurance; they all work the same way. If health insurers are required to offer guaranteed access without an effective mandate requiring all Americans to maintain coverage, there would be a clear disincentive for healthy people to secure or maintain coverage. […]

Steps Towards Health Care Reform

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The House has pledged to have a sweeping health care reform bill on the floor by the end of July, and details are starting to come out about the direction they want to take. Requiring everyone to have health insurance coverage is one of the cornerstones of the reform, and I strongly believe that without this piece of the puzzle in place, no reform will truly be effective. […]

Too Important To Fail

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[…] I would argue that instead of being considered too big to fail, major health insurance carriers might be seen as too important to fail. AIG’s collapse would have been primarily indirect, but health insurance companies work directly with individual Americans. Even in large groups, individual employees are the ones who carry the id cards with the insurance carrier’s logo on them. […]

Looking For Solutions

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[…] I have yet to see an article that is critical of the public health insurance idea and also proposes alternative solutions. Here in Colorado, we have 800,000 people who are uninsured. Nationwide, that number is 47 million, and that was last year, before the recession hit and unemployment numbers started to climb. I have no doubt that it is higher now. […]