International Insurance Companies Information

Source(google.com.pk)
International Insurance Companies Information
Insurance in Pakistan is regulated under the Insurance Ordinance, 2000. In the past few years, it has transformed into a developing and fastly growing market that is generally divided into three components: life insurance, general insurance and health insurance. The Government of Pakistan established the Department of Insurance in April 1948 as a department of the Ministry of Commerce; the aim of this department is to take care of affairs related to the insurance industry. Out of the 54% that Pakistan's service sector contributes to the national GDP, insurance, along with transport, storage, communications and finance occupy 24% of the sector.

List of notable insurance companies in Pakistan:
Beema-Pakistan Company
EFU Life
NRSP Microfinance Bank
State Life
Universal Insurance company Limited
Adamjee Insurance Company Ltd
Agro General Insurance Company Ltd
Allianz EFU Health Insurance Company Ltd
Alpha Insurance Company Ltd
Amercian Life Insurance Company Ltd
Asia Insurance Company Ltd
Asian Mutual Insurance Company Ltd
Askari General Insurance Company Ltd
Business & Industrial Insurance Company Ltd
Capital Insurance Company Ltd
Central Insurance Company Ltd
Century Insurance Company Ltd
Commercial Union Life Assurance Company
Co-operative Insurance Society of Pakistan Ltd
Credit Insurance Company Ltd
Crescent Star Insurance Company Ltd
Dadabhoy Insurance Company Ltd
Delta Insurance Company Ltd
E.F.U.General Insurance Company Ltd
E.F.U.Life Insurance Company Ltd
East West Insurance Company Ltd
Excel Insurance Company Ltd
Gulf Insurance Company Ltd
Habib Insurance Company Ltd
Indus International Insurance Company Ltd
International General Insurance Co. of Pak
Ittefaq General Insurance Company Ltd
Jupiter Insurance Company Ltd
Metropoliton Life Assurance Company Ltd
Muslim Insurance Company Ltd
National General Insurance Company Ltd
New Jubilee Insurance Comapny Ltd
North Star Insurance Company Ltd
Orient Insurance Company Ltd
Pakistan General Insurance Company Ltd
Pakistan Guarantee Insurance Company Ltd
Pakistan Mutual Insurance Company Ltd
Platinum Insurance Company Ltd
Premier Insurance Company Ltd
Prime Insurance Company Ltd
Raja Insurance Company Ltd
Reliance Insurance Company Ltd
Seafield Insurance Company Ltd
Security General Insurance Company Ltd
Shaheen Insurance Company Ltd
Sliver Star Insurance Company Ltd
Union Insurance Company of Pakistan Ltd
United Insurance Company of Pakistan Ltd
Universal Insurance Company Ltd
ACE Insurance Aid Pacific Ltd
CGU Assurance Company Ltd
New Hampshire Insurance Company Ltd
New Zealand Insurance Company Ltd
Royal & Sun Alliance Assurance plcInsurance in Pakistan is regulated under the Insurance Ordinance, 2000. In the past few years, it has transformed into a developing and fastly growing market that is generally divided into three components: life insurance, general insurance and health insurance. The Government of Pakistan established the Department of Insurance in April 1948 as a department of the Ministry of Commerce; the aim of this department is to take care of affairs related to the insurance industry. Out of the 54% that Pakistan's service sector contributes to the national GDP, insurance, along with transport, storage, communications and finance occupy 24% of the sector.

List of notable insurance companies in Pakistan:
Beema-Pakistan Company
EFU Life
NRSP Microfinance Bank
State Life
Universal Insurance company Limited
Adamjee Insurance Company Ltd
Agro General Insurance Company Ltd
Allianz EFU Health Insurance Company Ltd
Alpha Insurance Company Ltd
Amercian Life Insurance Company Ltd
Asia Insurance Company Ltd
Asian Mutual Insurance Company Ltd
Askari General Insurance Company Ltd
Business & Industrial Insurance Company Ltd
Capital Insurance Company Ltd
Central Insurance Company Ltd
Century Insurance Company Ltd
Commercial Union Life Assurance Company
Co-operative Insurance Society of Pakistan Ltd
Credit Insurance Company Ltd
Crescent Star Insurance Company Ltd
Dadabhoy Insurance Company Ltd
Delta Insurance Company Ltd
E.F.U.General Insurance Company Ltd
E.F.U.Life Insurance Company Ltd
East West Insurance Company Ltd
Excel Insurance Company Ltd
Gulf Insurance Company Ltd
Habib Insurance Company Ltd
Indus International Insurance Company Ltd
International General Insurance Co. of Pak
Ittefaq General Insurance Company Ltd
Jupiter Insurance Company Ltd
Metropoliton Life Assurance Company Ltd
Muslim Insurance Company Ltd
National General Insurance Company Ltd
New Jubilee Insurance Comapny Ltd
North Star Insurance Company Ltd
Orient Insurance Company Ltd
Pakistan General Insurance Company Ltd
Pakistan Guarantee Insurance Company Ltd
Pakistan Mutual Insurance Company Ltd
Platinum Insurance Company Ltd
Premier Insurance Company Ltd
Prime Insurance Company Ltd
Raja Insurance Company Ltd
Reliance Insurance Company Ltd
Seafield Insurance Company Ltd
Security General Insurance Company Ltd
Shaheen Insurance Company Ltd
Sliver Star Insurance Company Ltd
Union Insurance Company of Pakistan Ltd
United Insurance Company of Pakistan Ltd
Universal Insurance Company Ltd
ACE Insurance Aid Pacific Ltd
CGU Assurance Company Ltd
New Hampshire Insurance Company Ltd
New Zealand Insurance Company Ltd
Royal & Sun Alliance Assurance plcInsurance in Pakistan is regulated under the Insurance Ordinance, 2000. In the past few years, it has transformed into a developing and fastly growing market that is generally divided into three components: life insurance, general insurance and health insurance. The Government of Pakistan established the Department of Insurance in April 1948 as a department of the Ministry of Commerce; the aim of this department is to take care of affairs related to the insurance industry. Out of the 54% that Pakistan's service sector contributes to the national GDP, insurance, along with transport, storage, communications and finance occupy 24% of the sector.

List of notable insurance companies in Pakistan:
Beema-Pakistan Company
EFU Life
NRSP Microfinance Bank
State Life
Universal Insurance company Limited
Adamjee Insurance Company Ltd
Agro General Insurance Company Ltd
Allianz EFU Health Insurance Company Ltd
Alpha Insurance Company Ltd
Amercian Life Insurance Company Ltd
Asia Insurance Company Ltd
Asian Mutual Insurance Company Ltd
Askari General Insurance Company Ltd
Business & Industrial Insurance Company Ltd
Capital Insurance Company Ltd
Central Insurance Company Ltd
Century Insurance Company Ltd
Commercial Union Life Assurance Company
Co-operative Insurance Society of Pakistan Ltd
Credit Insurance Company Ltd
Crescent Star Insurance Company Ltd
Dadabhoy Insurance Company Ltd
Delta Insurance Company Ltd
E.F.U.General Insurance Company Ltd
E.F.U.Life Insurance Company Ltd
East West Insurance Company Ltd
Excel Insurance Company Ltd
Gulf Insurance Company Ltd
Habib Insurance Company Ltd
Indus International Insurance Company Ltd
International General Insurance Co. of Pak
Ittefaq General Insurance Company Ltd
Jupiter Insurance Company Ltd
Metropoliton Life Assurance Company Ltd
Muslim Insurance Company Ltd
National General Insurance Company Ltd
New Jubilee Insurance Comapny Ltd
North Star Insurance Company Ltd
Orient Insurance Company Ltd
Pakistan General Insurance Company Ltd
Pakistan Guarantee Insurance Company Ltd
Pakistan Mutual Insurance Company Ltd
Platinum Insurance Company Ltd
Premier Insurance Company Ltd
Prime Insurance Company Ltd
Raja Insurance Company Ltd
Reliance Insurance Company Ltd
Seafield Insurance Company Ltd
Security General Insurance Company Ltd
Shaheen Insurance Company Ltd
Sliver Star Insurance Company Ltd
Union Insurance Company of Pakistan Ltd
United Insurance Company of Pakistan Ltd
Universal Insurance Company Ltd
ACE Insurance Aid Pacific Ltd
CGU Assurance Company Ltd
New Hampshire Insurance Company Ltd
New Zealand Insurance Company Ltd
Royal & Sun Alliance Assurance plcDavid Dillon, chief executive of the Kroger supermarket chain, told the Financial Times that some companies might opt to pay a government-mandated penalty for not providing insurance because it was cheaper than the cost of coverage.

Nigel Travis, head of Dunkin’ Brands, said his doughnut chain was lobbying to change the definition of “full-time” employees eligible for coverage from those working at least 30 hours a week to 40 hours a week.

Some restaurants, including Wendy’s and Taco Bell franchises, have explored slashing worker hours so fewer employees qualify for health insurance, arguing that they cannot afford the additional healthcare costs. Other businesses are deliberately keeping headcounts below 50.

The penalty for not providing coverage is $2,000 per worker. According to the Kaiser Family Foundation, a non-partisan policy group, the average annual cost to employers of insurance is $4,664 for a single worker and $11,429 for a family.

Companies with more than 50 workers have to pay a penalty if they do not provide full-time employees with health insurance. The employees can instead buy private coverage subsidised by the government on new insurance exchanges.
There are numerous automobile insurance companies that you can warrant your car finished but if you do not get the good viable service then you are trustworthy to present problems at a subsequent date. Your efforts will give best results when you will able to select the best car insurance company that provides combination of most attractive of services and low premium rates. So, come let’s have a look at three tips that will guide in selecting the best car insurance company:

1. Swift approach at mishap occurrence: Service of the car insurance company can be assessed at best if it provides a swift approach gives at the time of occurrence of an accident. These services includes pick up of your vehicle with towing service and providing you substitute transportation facility and then they will shoulder the responsibility

2. Repairing services without any annoyance: most of the car insurance companies ensure their customers not to engage in the hassle of repairing their cars or any vehicles. Insurance company sends their persons to collect the vehicle and take it to the nearest auto repair shop. In addition to this insurance company settle the repairing claims at minimal cost

3. Policies with flexibility: Every insurer comes with the unique requirement of flexibility in insurance policies with automobile insurance companies. So there is motive in operation of insurance companies that they frame the policies with flexibility and elasticity.


Though above only three main topics are raised, there are several others to be looked upon while selecting best car insurance company in online insurance policy search. As you can see, there are quite a few things you possess to take when hunting a high auto insurance evaluate online. If you cover a contract supported only upon damage then you are trusty to lack out on cardinal services that you could screw done with. Therefore, to conclude on the above discussion at one point that

insurance price and the need for insurance service are the main constituents to be considered while selecting the best car insurance company through online mode.

 

 

 

Major Insurance Companies Information

Source(google.com.pk)
Major Insurance Companies Information
There are some essential things you'll have in mind when shopping around for the right dental insurance provider; price and copayment options, local dentist availability, actual coverage, etc. Here are the criteria we used to compare and evaluate the best dental insurance options available online:

Features
It’s important to investigate the available features when considering an online dental company. Most companies offer features that are designed to make things easier for you – both before you’re a customer and after. For instance, online enrollment certainly helps save a chunk of your time, and it’s convenient. Check for a company that features a secure site to protect your information, and obviously you'll want to know if the company has the desired plan (individual? group?) you're looking for.

Additional Features
Aside from the standard features, look for extras like the ability to track claims online, the ability to fill out forms online, dentist finder features and more. By checking the available features, you can determine which company would be best for you.

Help and Support
Great customer service and support are important in an online dental insurance agency. Find out what kind of customer service is available with each insurance company you’re considering. Most companies offer at least a telephone number and an email address so that you can contact a customer service representative. Some companies offer the added benefits of an FAQ section or online chat. If there isn’t at least one method of getting in touch with the company, it’s advisable to skip it and search for another company.

Payment
Find out how you’re supposed to pay your premiums with the company you’re considering. Most companies offer either online payment, manual payment or both. If it’s not indicated on their website, you may need to call them in order to determine how you’re going to pay. Many customers feel that online payment is most convenient, while others consider manual payments more advantageous. It’s important to find out which method the company you’re considering prefers.

By using the points above and investigating the company you’re considering, you can find the best dental coverage for you.

What to Looking For Insurance Quote Website ?
There are many services from which to choose, but finding the one that best fits your needs can be a challenge. We picked the most reputable online insurance quotes services available and rated them based on the following criteria:

Types of Insurance Quotes
The most comprehensive services offer many coverage options and have access to thousands of agencies. Some services offer only basic policies such as auto or home insurance, whereas others have access to special coverage like professional liability or medical malpractice.

Ease of Use
These sites should be easy to navigate from the start, and the quote request form should take only a few minutes to fill out.

Number & Type of Quotes
The more auto, home and health insurance quotes you receive, the more choices you'll have regarding policy options and pricing. A good service will offer up to four or five quotes as well as alternative links to agencies that may be able to help if you have a special need. It also helps if the quotes present different policies and plans so you can study them and see what will work best for you.

Help & Support Options
Insurance quote websites should offer a variety of contact methods for customer support including telephone, email, mail or instant message. Online support may range from help menus to FAQs pages to glossaries.

To find the insurance rates service that will work best for your insurance needs, whether you are looking for car insurance quotes or any other type of insurance, read our reviews and check out these firms. You may be happily surprised at how easily and smoothly the necessary, but often tedious, task of buying insurance can be.It's fair to say that everyone's personal conditions, valuables and possessions will change at some time or another and making sure that you have the right amount of insurance cover is critical, otherwise you could find yourself underinsured should the worst type of happen.

Get your sum insured right - it's important that you have the right level of cover to ensure you're able to reinstate everything should you have to make a claim. It might be wise to make an accurate assessment of what your house and contents are value.

Insure your home for its rebuild cost, not its market importance - your buildings insurance 'sum insured' must reflect the complete rebuild cost of your home, not its current marketplace value. If it's a new listed property, work will often should meet special Grade demands and insurance claims could workout more expensive - using specialist craftsmen and making use of traditional materials could increase the money necessary for rebuilding.

Reflect home improvements inside your sum insured - household extensions, new kitchens and bathrooms need to be included when renewing your house insurance as they increase rebuilding costs and then the sum insured. Also remedies fitted solar panels or other energy saving devices for a property you should make your insurer aware.

Review your policy often and update your subject matter - keep a review expensive items like flat-screen Tv set, music players, laptops and jewellery. Gold prices have increased significantly over past years, so it might be worth valuing your appreciated items again and making sure they're covered.

Also consider your clothes, shoes, hobbies and sporting activities - have you got expensive gear stored aside? If you're a financial institution, you may also want to consider how much it would cost to exchange your valuable or exceptional items.

And don't underestimate the money necessary for replacing carpets, curtains and other fixtures and fittings - important items we all neglect, but the costs rapidly add up if they have to be replaced.

Buy home and contents cover as well - the average cost of an home and contents policy is £237, but it could work out much more if you buy these people separately or from different companies. Buildings insurance covers the fabric from the building while contents insurance covers your belongings and everything inside. Usually by combining ones cover means there's only one excess to pay if you were to manufacture a claim.

Don't go with price alone - everyone's home, possessions and circumstances will vary so choose the cover you need and be sure to compare like-for-like. If you might have specialist requirements, contact ones insurer direct.

Tell your insurer in relation to security measures - you could possibly well benefit from fitted approved window and doorway locks, installing and making use of burglar alarms or joining a neighbourhood watch structure.

And make sure a person tell your insurer in relation to past claims - you have to let them know remedies previously made a claim as it avoids potential problems at a later date. If you withhold data, knowingly or unwittingly, you could run the risk of an future claim being broken. If in doubt, always confer with your insurer.
 

 

 

Overseas Health Insurance

Source(google.com.pk)
Overseas Health Insurance
Some years back, I had a post criticizing the widely cited (and often misrepresented) WHO study comparing medical care in a large number of countries. More recently, an online discussion resulted in someone pointing me at a book by Sheila Leatherman and Kim Sutherland, aimed mainly at evaluating the British National Health Service but with a number of international comparisons, in most cases among the U.S., UK, Canada, Australia and New Zealand. Parts of the book are available online at Google Books.

Judging by the information on the pages shown, the widely believed claim that the U.S. not only spends more per capita on health care than other developed countries but also gets worse results for its money is not supported by the evidence. The webbed parts of the book contain the following comparisons (pp. viii-xviii):

---
For “mortality from causes considered amenable  to healthcare,” “in 1998 the UK had the highest mortality rates of the five countries compared.”

“England continued to have the highest breast cancer mortality rates among these comparator countries.”

“Of the five countries compared, the US had the highest survival rates from breast cancer, ...”

For colorectal cancer, “New Zealand had the highest mortality rate ... and the US had the lowest.”

“In 2001, England's mortality rate from stroke ... was lower than that in Australia ... but higher than that in the US ...”

“82% of UK respondents indicated that they were treated in [Accident and emergency] in less than four hours, a figure broadly in line with comparator countries (AUS 87%; CAN 74%; NZ 86%; US 87%).

“Patient reports of access to primary care within 48 hours saw the UK … outperform both the US and Canada” (Australia and New Zealand did still better).

“In response to a question regarding whether recent [Accident and emergency] visits would have been necessary if appropriate primary care had been available … the UK had the best result.”

“The UK had the lowest level of health consequences resulting from … errors and mistakes.”

 ---

I think these are all of the pieces of information shown that provide information on the relative performance of either the U.S., the U.K. (or in some cases England), or both, although I might have missed something. I am not including various input measures.

By my count, U.S. medical outcomes (including things such as speed of treatment) are superior to U.K. outcomes (in some case English outcomes) on five different measures, inferior on three. On two measures the U.K. (or England) is the worst of the five countries considered, on two the best; on three the U.S. is the best of the five (counting one tied for best), on none the worst.

There are four pure outcome measures, mortality and survival rates from various causes. The US was superior to the UK on all of them, best of the five countries on two. The UK was worst of the five countries on two.


The overall conclusion, based on this (very fragmentary) data, is that U.S. healthcare outcomes are on the whole better, not worse, than UK healthcare outcomes.

These results might change if I had a chance to look at the entire book. Unfortunately, neither the library at GMU, where I’m currently visiting, nor the library at SCU, where I teach, appears to have it. If by any chance someone reading this has access to the book, I would be interested in a more complete list of comparisons.

Two other points in the book struck me. Judged by per-capita spending on health the U.S. is  the worst of the five, as I would expect, but North Ireland and Wales are close behind, which surprised me a little.

Also, the text has, under “Waiting for elective surgery,” the information that “The UK in 1998 and 2001 had high numbers of patients waiting: and in 2000 had long waits for elective surgery, relative to comparative countries.”

That’s a charge often made against the English system by its critics and routinely denied by its supporters. In this case it is coming from authors whose speciality seems to be the study of NHS performance.Living and working overseas as an expatriate can be exciting and have many benefits, but you may find that access to high quality international healthcare for you and your family is not one of them.

When living in a strange country, where the traditions and ways of life are unfamiliar to you. The simple things like shopping can be a trial, so obtaining medical treatment for you or your family could be a nightmare, without a comprehensive expatriate health insurance plan.

The international healthcare arrangements for expatriates vary from country to country, and even where there are established state schemes, entitlement to such care for the expatriate worker may be restricted or non-existent. More importantly, in certain parts of the world, the standard of healthcare you might expect as an expatriate just may not be available.

1. Whatever the situation, without adequate expatriate health insurance the cost of paying for even the most basic of care could be very high - and that is if you can find the right hospital or doctor in the first place.

2. If you choose an international health insurance policy, you want the reassurance that you can count on it wherever you are in the world, at any time.

3. The health insurance plans you will enjoy the following:

THE FLEXIBILITY
Our plans have different levels of benefits and are split into geographical areas to assist with your choice of the most appropriate cover for your expatriate circumstances.

THE WIDE RANGE OF BENEFITS
Cover in-patient and day-patient hospital treatment costs, as well as offering a wide range of comprehensive out-patient benefits. In addition, there is cover available for routine dental treatment and routine maternity costs.

THE HEALTH CHECKS
Included cover for routine health checks on our more comprehensive plans as we feel prevention is just as important as treatment!

THE EMERGENCY ASSISTANCE
The plans include access to our 24 hr multi lingual assistance helpline, 365 days per year. For emergency admissions to hospital available within 48 hours. This will give the opportunity to arrange the direct settlement of your hospital bills.

THE CLAIMS SERVICE
Claims payments are wired directly to the treatment provider, or if you have paid them your self and are claiming back from us, directly into your bank account. What could be easier?
For a complete list of covered benefits please refer to the Benefits Table of your chosen international healthcare plan.An insurance survey states that only 3% of the total Indian population had health insurance coverage. Only 2 percent of total health expenditure is funded by public/social health insurance and 18 per cent is funded by government budget. India spends about 4.9% of GDP on health. The per capita total expenditure on health in India is US$ 23, of which per capita Government expenditure on health is only US$ 4. So private expenditure on health is more that is from personal savings of the individual.
As the cost of medical treatment is rising like anything and at the same time due to increase in middle class families, it is estimated that the demand for health insurance policies are rising at the rate of 25 per cent in India. Before going to the health insurance plan, one should determine the health care needs that may vary on several factors like, age, family needs, financial conditions etc. it is important to consider the following points before going to the health insurance policy.
Individual health insurance v/s Family floater
Health insurance is a hospitalization cover and reimburse the medical expenses of the covered disease or surgery when the insured is admitted in the hospital .There are various types of medical insurance available in the market like, individual medical insurance, group medical insurance and overseas medical insurance.  Family floater and individual health insurance are the two options available for customers  while  seeking personal health coverage. Family floater is more beneficial as the same is less expensive and family members are less likely to fall sick together. At the same time, there is a higher coverage for family member who may need it in any eventuality.
Critical illness insurance
Critical illness plan insures against the risk of serious illness. If the insured is diagnosed with any critical illness, he/she receives a lump sum assured amount within a specified period of time of a illness being diagnosed.   The illness may be like, cancer, coronary artery bypass surgery, first time heart attack stroke, paralysis e.t.c. The above mentioned illness is not exhaustive list and the same is vary from insurance plan to plan. It is always suggested to include critical illness cover for better health care planning.
Importance of health insurance
The following benefits makes one understand how importance to go for health insurance plan at the present scenario:
a)      Health insurance protect from the  risk of uncertain bills for health care which is usually huge, that arises all of a sudden.
b)      Apart from hospitalization and medical bills, it also covers disability and custodial bills.
c)       Health insurance provides financial security and peace of mind at all the times.
d)      Proper health coverage can help the insured to go for quality care as he/she is a member of coordinated health plan.
Features of health insurance
It is important to know some of the main features of health insurance plan.
Ø  Hospitalization cash benefit entitles the client to cash benefits for every completed day of hospitalization.
Ø  There are network hospitals tied up with insurance companies. Those network hospitals accept medical cards issued by insurance companies to the insured and provide cashless facility at the time of emergency.
Ø  Some insurance policies also cover ambulance charges.
Ø  Most of the insurance policies  cover upto 60 to 90 days pre and post hospitalization expenses.
Ø  There is also a facility of free health check-up under some health insurance policies for the well being of the individual if there is no claim made for certain number of years.
Ø  Most of the health insurance policies provide no-claim bonus if there was no claim in the previous year.
Tax benefits
There are various tax benefits available for the one who goes for health insurance policies.
a)      Deduction under section 80D for health insurance premiums: All Individuals and HUFs are eligible for deduction under section 80D up to Rs 15000  for self, spouse and the dependent children for  the premiums paid in respect of health insurance policies . For the senior citizen, an additional exemption of Rs 5000 is available.
b)      Deduction under section 80DD for medical treatment of handicapped: This deduction is applicable for expenditure incurred in respect of assessee  himself or his dependent spouse,children,parents,brothers/sisters.  This deduction available upto Rs 50,000 or actual expenditure incurred, whichever is less. Deduction of RS 100,000 is allowed in case where the dependent has the disability of more than 80 per cent.
c)        Deduction under section 80DDB for treatment of specified diseases: The insured can avail tax benefit if they have incurred costs for treatment of special diseases. It is applicable for treatment of self, spouse, children, siblings  and parents wholly dependent. For individual assessee less than 65 years of age, a deduction is actual amount paid or Rs 40000, whichever is lesser. In case the amount is incurred is in respect of a person who is a senior citizen then actual amount or Rs 60000, whichever is lesser.
Some of the precautions to be taken before going to the health insurance policies:
Ø  Check whether cashless facility is available in health insurance policy. Cashless facility means, at the time of emergency one doesn’t have to rush for arranging cash to deposit at the hospital. This facility is available only in specific list of hospitals.
Ø  Most of the health insurance policies do not cover many diseases for specific period like, for the first two years.
Ø  Most of the insurance policies have some limit up to which they will cover specific expenses.
Ø  Many insurance companies do not renew policy beyond a particular age. So it is good to go for a policy that provides for renewal even at older age as at that time one will need it the most.

 

 

 

Personal Health Insurance

Source(google.com.pk)
Personal Health Insurance
Last week the President waded directly into the national debate over "ObamaCare" by calling a big media event in the East Room of the White House to talk about the $100 rebates a small percentage of potentially eligible people are getting under the new health law.

Senate Republican Leader Mitch McConnell countered, "If you’re a family in Covington facing a $2,100 premium increase under ObamaCare, then, really, what would you rather have: a check for $100 or so, or a way to avoid the $2,100 premium increase in the first place?”

NPR's Julie Rovner had a story on Friday––"White House Muddles Obamacare Messaging Again"––that caught my eye.

She drew a distinction between how the administration has been going about unsuccessfully selling the new health law and the way the Republicans have been more successfully attacking it:
Still, there's a major difference in the way Republicans talk about the law and the way the president does, says George Lakoff, a professor of linguistics at the University of California, Berkeley and an expert on political messaging.

Lakoff says Republicans talk about the law as a moral issue. "Basically ... they say that democracy is about liberty, the liberty to pursue your own self-interest without you having to take care of anybody else's interests or anybody else having to take care of yours."
But when Obama talks about the health law — at least this week, says Lakoff — "his message was all about money."
And Lakoff says that's pretty much been the president's problem: He's mostly shied away from talking about health care on the same moral terms as have the Republicans.
I have been very surprised at the way the Obama administration has seemingly stood by helplessly while half of the states have rejected the Medicaid expansion. Here we have the opportunity to uniformly bring people who live under 138% of the federal poverty level into a rational system of insurance and the administration has not been able to paint that failing in moral terms.

And, yes I understand the Medicaid system is not sustainable. But Republican Medicaid reform proposals allowed to play out in the state laboratories could have shown the way to sustainability. See: The Medicaid Controversy––The Republican Governors Should Put Up or Shut Up

So, while the Republicans consistently win on the Big Idea––albeit in almost entirely negative terms because they don't have a comprehensive alternative to "ObamaCare," Democrats play small ball.

Perhaps Democrats can't get past small ball because The Affordable Care Act ("ObamaCare") itself is small ball.

It is not health care reform––it is an attempt at health insurance reform at a time when all of our health care system––Medicare, Medicaid, and private health insurance––is not sustainable.

"ObamaCare" is also lots of pages of health insurance market micro management––small ball if there ever was any. Now, the administration is tying itself up like a pretzel trying to figure out how to make it all work with time running out. All the while individuals, small employers and large employers are fretting over how the new law will impact them.

It shouldn't be a surprise that this administration, now buried in the minutia of injecting an extraordinary amount of micro management into a sixth of our economy, would think a $100 rebate for someone already paying thousands of dollars in health insurance premiums would be a major accomplishment.

I opposed "ObamaCare" in the first place because I thought it was a clumsy attempt at insurance reform and certainly not health care reform. Most importantly, I thought it was wrong to make promises––"The Affordable Care Act"––the law was never designed to keep.

Now the administration is in the final phase of trying to convince people this was all a good idea.Since last year's summit, all I could think about was going to Paris Casino and buying one of those Eiffel Tower strawberry daiquiris. The reason why, is because last year I was in no position to buy one of those daiquiris. It was my first year going to a conference that would connect me with other young adult cancer survivors, actually discuss my feelings as a young adult cancer survivor, and find resources I didn't know existed to help me as a young adult cancer survivor.

Last year's summit was amazing, but all encompassing for me. I had never been to Las Vegas, so I tried to cram way too many things into the weekend.

This year, I wasn't going to let that happen. I purposefully didn't schedule tickets for theatre productions or attractions. I didn't even focus on finding the "best buffet on the strip." I went all in for this summit. I decided to be fully present. That was the best decision I could have possibly made.

This year, I went to break out sessions I didn't think I wanted to go to last year. I went to cancer as chronic, survivors guilt, and the just for girls session. You see last year, I was in the middle of writing my book and completely focused on health care legislation and insurance issues regarding my journey. I published the book last year, so this year I was free to focus on my emotions surrounding my journey.
And boy did those emotions pop out of nowhere. I actually cried for the first time in a long time. I even caught myself with wobbly voice when I spoke to others.

This year was cathartic for me-- but it was also incredibly fun. If you're even remotely considering going to this conference next year-- Do It! You'll meet great people, you'll reconnect with yourself, and you'll learn so much that you didn't even realize you might have wanted to know.Maybe part of the reason Americans have a difficult time healing after a traumatic medical event is because of the potential non-health related aftermath.

As some of you are aware, I was in active monthly treatment for an arteriovenous malformation (AVM) from 2005-2010. Since that time my doctors are in a holding pattern, watching the condition with annual MRIs. Although those annual tests do remind me of the rough patch I've been through regarding those treatments, I usually try and not think about them. They were a huge financial burden, physically/emotionally draining, and although there are residual issues from the built up scar tissue etc... I really try and focus on my life now rather than living in the past.

Focusing on the present is difficult, however, when just yesterday I received a statement for one of those treatments done in May of 2008!

I'm not sure why a single bill from almost 5 years ago, that should have long ago been paid by my primary and secondary insurance (from that time), would just now resurface. Looking at the statement it appears my 2008 insurance companies were only first billed this past November (2012). That doesn't make any kind of sense to me though.

It's possible I still have an EOB (explanation of benefits) somewhere in the stack of paperwork I tossed into a file cabinet so many years ago--- but to be honest with you, the idea of having to dig through all of that to find one single piece of paper sounds like a punishment I wouldn't wish on anyone.  Don't get me wrong, if I have to do it I will do it. However, the fact that this is even a topic for discussion seems inherently incorrect.

Perhaps I'm wrong, but by this point if there was an unpaid charge wouldn't the hospital have written it off on their books?

I live at the exact same home address since before this billed treatment and I never received a bill until now for it. I also haven't received a bill for any of the other treatments I had done within that year. So why this bill? Why now?

I am not the only one who has received medical bills for a surgery/treatment years after the fact, but I do not understand how this occurs. No one can tell me with a straight face that the hospital simply "forgot" I had a treatment and only remembered 5 years later.

No wonder Americans (particularly-because we are the only ones with an insurance system like ours) often times are unable to pick themselves up after a medical trauma.  How can someone completely move on when they are unexpectedly reminded of it again and again years after the fact?In a landmark class action lawsuit, Seattle based Swedish Hospital, now part of the Providence Hospital Group is being sued for charging an uninsured Issaquah man who visited the emergency room much more than what it charged privately insured patients or those covered on government health insurance programs. Though this disparity in hospital billing phenomenon is not new, what is raising the level of accountability is the class action lawsuit, because this will allow the courts to examine the billing of all uninsured patients for all seven of Swedish Hospital’s emergency departments. Though class action lawsuits often end in relatively small settlements for the plaintiffs in the suit, they are big money for the attorneys, at least those with the cojones to see them through to the end.
Lifting the Veil on Hospital Billing
 Basically here is how hospital billing works, there are different reimbursement levels for services for different contracts, including the various insurers, as well as Medicare, and Medicaid. The government plans of course, by virtue of their bully pulpit actually pay the least for services and private insurers pay more of the reduced gross hospital charges, per patient. As in the Puget Sound Business Journal Article[1], the uninsured person was charge $10,000 for the same services(found in legal discovery) for which the insurance company contracts paid $3,500.
Why charge the patient without health insurance more than the insured person? The answer is two-fold, first there is no underlying contract to secure payment for the hospital, so the facility takes on the risk(as required by the government under Emergency Medical Treatment Act) of providing potentially costly services. Secondly, often the uninsured person is not able to pay the normal fees for services, so there are charitable discounts or write offs for this patient demographic. Is this method of billing legal, yes, ethical, well that is where it gets to be a sticky wicket. The hospital can charge 100% of gross prices for services to anyone without insurance coverage, but it rarely gets that amount of money from the uninsured patients, so the hospital offers a charitable discount to entice the patient to pay the services, and then the hospital takes a charitable deduction for the unpaid portion of the gross charges. Though this may seem reasonable from an accounting standpoint, the hospital is able to take a deduction for gross charges it never expects to receive, because the gross charges are inherently designed to provide at least enough payment from the other payers, including Medicare, Medicaid, and private insurers to keep the facility solvent. Thus, in the case of an uninsured patient who actually pays his bill, even if it is paid at a higher rate than the hospital normally would receive for those services, the hospital  still deducts any portion of the unpaid gross charges  as  their charitable discount.  This  may even make the reimbursement from the uninsured patient better than from the other contracts, just not as consistent. So, is it fair that we allow hospitals to charge the uninsured patients more than what they get from patients with greater resources?
At various times when I have been uninsured and forced to access services at hospitals, I found quite a variance in the charitable care discount I was offered, and the billing practices of different facilities. One hospital required a 40% payment based on gross charges and the other wanted 60%.  If one hospital requires the patient to pay 60% of gross charges for services, this is greater reimbursement than most insurance contracts, and hence a very good deal for the hospital. This is also enhanced by the fact the hospital can claim the 40% as charitable care, assuring political fodder for future negotiations with state and federal regulators.This is yet another example of a health system failure in the United States, because of our bifurcated financing system, and social inequities. Of course it isn’t right that the uninsured are charged more than those with insurance plans, but it is legal, and hospitals develop their fee schedules based on a complex mix of patient demand, high marginal cost for services, and regulatory requirements. The class action lawsuit will be costly and in the end just add to the hospital fees, but it does shine a light on this inequity. One of the things we all could use is transparency in the prices of health care services in this country. Though we are making progress on patient safety outcomes and reporting, thanks in large part to the IOM’s report more than a decade ago, we still have a huge battle ahead to fully inform and empower health care consumers as they navigate the black box of the American health care system.
For more information on this hospital conundrum and how to negotiate with a hospital should you need services and lack health insurance(fifty million at last count), go to Chapter Nine of Unraveling U.S. Health Care-A Personal Guide, out this month by Rowman and Littlefield.

For practical advice on resourcing your health care, read more of what the healthpolicymaven has to say. This article was written by Roberta E. Winter, MHA, MPA, someone who has negotiated insurance contracts for private employers, analyzed network reimbursement data for hospitals, and advocated for the empowerment of health care consumers.Here's a brief explanation of PCCS and what a PCCS-enabled EHR system would do:
Clinicians have a “virtual patient” in mind—a conceptual model of an actual patient that reflects their understanding of the patient’s problems and needs
This virtual patient model (VPM) consists of multiple submodels reflecting the interaction between biomedical and psychological subsystems in the real patient
New findings—raw data—are used to refine the VPM
PCCS-enabled software provides clinical decision support by:
Simulating and predicting the likely reaction of the VPM to different care interventions
Identifying the interventions most likely to benefit the actual patient
Without PCCS-enabled software to help make decisions, clinicians may:
Spend considerable time and energy searching and sifting through all the raw data
Have to integrate ill-structured, uncertain, and potentially conflicting information
Experience information overload, confusion, uncertainly and doubt
With PCCS-enabled software, a clinician:
Has much less cognitive burden
Makes decisions supported by deeper &; clearer understanding of the patient
Can stay focused on implementing the patient’s care plan
Patients should also have a version of PCCS software available.
The whole product companion applications I've described in previous posts in this thread will focus, in part, on developing, evolving, and deploying EHR companion applications that are PCCS-enabled. Toward this end, we are prepared to offer:
A novel, robust software development platform that uses off-the-shelf software tools to create and continually evolve next-generation analytical decision models
A communication architecture that promotes collaboration in loosely coupled social networks
The means to combine the development platform and communication architecture to provide:
“Technological glue” that connects companion app components via the CP Split method
“Model ecology networks” in which teams of collaborators build, share, evaluate, and evolve analytical decision models, which they may sell.
Implementing this strategy will be done through collaboration among a widespread alliance of business partners. We are compiling lists of people and companies we believe may be interested in receiving an invitation to join the alliance. They include clinicians of all types, informaticists, analytical decision model-builders, and EHR vendors.It has been said that the road to Hell is paved with good intentions. It is hot, really hot, in New York. Years ago it was decided that all adults under age 65 should pay the same premium. Twenty-two or sixty-two, the price is the same. That sounds great if you are in your sixties, but it only works if you can drag the twenty-somethings to the table. In the beginning your average participant age is in the mid-forties. As the young drop out, the average age, and the price, increases.

But age wasn’t the only pricing determinant abandoned in the interest of fairness. New York insurers were forbidden to underwrite the risks. The sicker you are the better that deal. An insulin dependent diabetic with AIDS pays the same premium as someone who is perfectly healthy. The system, in essence, welcomed pre-existing conditions and penalized the young and healthy.

And of course, the cost of living is higher in New York, especially in NYC.

As we have noted previously, Ohioans, on average, pay a lot less for health insurance for all of the reasons that New Yorkers pay more. I have lots of clients, male and female, under the age of 30. Some of these young adults shopped for this coverage and pay for it themselves. The rest of these cases have some degree of parental involvement. It is much easier for a parent to come up with $70 to $120 a month in Ohio than hundreds more in New York.

Why are there millions of uninsured New Yorkers? The 2.6 million number is actually from six years ago. That number hasn’t gone down. New Yorkers weren’t required to purchase insurance. There was no Individual Mandate. Penalized for their health and youth, many New Yorkers simply chose to not participate. Making insurance affordable might get them back into the market. Making insurance mandatory will have more impact.

It has been announced that the New York rates will be plummeting under the Patient Protection and Affordable Care Act (PPACA). Governor Cuomo is ecstatic. The President is pointing to New York as a model for the future. And it is true, at least for the moment, that New York rates are coming down. A lot. But if you consider $1,000 per month normal, your great bargain may still sound awful to consumers in Ohio. This link is to an article that dreams of young people paying only $190 for a basic policy, one that a guy living in Cleveland might buy today for $70!

Will the New York rates stay cheap? There are two major speed bumps ahead. The first is the PPACA. The 2014 New York rates are certainly much less than the current pricing, but are they cheap enough? Will the subsidies be enough to spur sales when the penalty (tax or fee depending on your political persuasion) is only $95 or about 1% of income? With the penalty so low, enforcement challenging, and the entire process confusing, the prediction is that many of the currently healthy uninsured will sit out a year or two. Lose the young and healthy and New York is right back where it was.

The second speed bump facing New York is the U S House of Representatives. The Republicans sensed weakness in the Obama administration’s decision to shelve the employer mandate for a year. (See previous blog) Last week the Republicans attempted to put the individual mandate on hold, too. Of course the bill passed the House. And you might think that the bill will never see the light of day in the Senate, but don’t be so sure. Punting the individual mandate might seem like a good idea to a group of people who are used to putting off important decisions and deflecting responsibility.

Both the Democrats and the Republicans have a reason to kill the individual mandate. As New York already proved, if we create super health policies that do everything but drive you to the doctor, don’t factor in the health conditions of the insureds, and don’t weigh the premiums properly for the ages of the participants, the rates will go through the roof if you can’t corral the young and healthy into the insurance pool. Without an individual mandate forcing participation, you create a death spiral. As the rates increase to reflect the claims, the young and healthy leave. First the twenty somethings jump out. Eventually the average age of the participants will be over 50. Prices will be out of control and there will be only one answer – Single Payer.

Your friends in New York and California are celebrating the health insurance rates they expect to see in 2014. It would be tacky to point out that their new rates will still be significantly more than the rates we pay today. And it is just sad to think that our new rates and their new rates are going to be about the same.
It has been said that the road to Hell is paved with good intentions. It is hot, really hot, in New York. Years ago it was decided that all adults under age 65 should pay the same premium. Twenty-two or sixty-two, the price is the same. That sounds great if you are in your sixties, but it only works if you can drag the twenty-somethings to the table. In the beginning your average participant age is in the mid-forties. As the young drop out, the average age, and the price, increases.

But age wasn’t the only pricing determinant abandoned in the interest of fairness. New York insurers were forbidden to underwrite the risks. The sicker you are the better that deal. An insulin dependent diabetic with AIDS pays the same premium as someone who is perfectly healthy. The system, in essence, welcomed pre-existing conditions and penalized the young and healthy.

And of course, the cost of living is higher in New York, especially in NYC.

As we have noted previously, Ohioans, on average, pay a lot less for health insurance for all of the reasons that New Yorkers pay more. I have lots of clients, male and female, under the age of 30. Some of these young adults shopped for this coverage and pay for it themselves. The rest of these cases have some degree of parental involvement. It is much easier for a parent to come up with $70 to $120 a month in Ohio than hundreds more in New York.

Why are there millions of uninsured New Yorkers? The 2.6 million number is actually from six years ago. That number hasn’t gone down. New Yorkers weren’t required to purchase insurance. There was no Individual Mandate. Penalized for their health and youth, many New Yorkers simply chose to not participate. Making insurance affordable might get them back into the market. Making insurance mandatory will have more impact.

It has been announced that the New York rates will be plummeting under the Patient Protection and Affordable Care Act (PPACA). Governor Cuomo is ecstatic. The President is pointing to New York as a model for the future. And it is true, at least for the moment, that New York rates are coming down. A lot. But if you consider $1,000 per month normal, your great bargain may still sound awful to consumers in Ohio. This link is to an article that dreams of young people paying only $190 for a basic policy, one that a guy living in Cleveland might buy today for $70!

Will the New York rates stay cheap? There are two major speed bumps ahead. The first is the PPACA. The 2014 New York rates are certainly much less than the current pricing, but are they cheap enough? Will the subsidies be enough to spur sales when the penalty (tax or fee depending on your political persuasion) is only $95 or about 1% of income? With the penalty so low, enforcement challenging, and the entire process confusing, the prediction is that many of the currently healthy uninsured will sit out a year or two. Lose the young and healthy and New York is right back where it was.

The second speed bump facing New York is the U S House of Representatives. The Republicans sensed weakness in the Obama administration’s decision to shelve the employer mandate for a year. (See previous blog) Last week the Republicans attempted to put the individual mandate on hold, too. Of course the bill passed the House. And you might think that the bill will never see the light of day in the Senate, but don’t be so sure. Punting the individual mandate might seem like a good idea to a group of people who are used to putting off important decisions and deflecting responsibility.

Both the Democrats and the Republicans have a reason to kill the individual mandate. As New York already proved, if we create super health policies that do everything but drive you to the doctor, don’t factor in the health conditions of the insureds, and don’t weigh the premiums properly for the ages of the participants, the rates will go through the roof if you can’t corral the young and healthy into the insurance pool. Without an individual mandate forcing participation, you create a death spiral. As the rates increase to reflect the claims, the young and healthy leave. First the twenty somethings jump out. Eventually the average age of the participants will be over 50. Prices will be out of control and there will be only one answer – Single Payer.

Your friends in New York and California are celebrating the health insurance rates they expect to see in 2014. It would be tacky to point out that their new rates will still be significantly more than the rates we pay today. And it is just sad to think that our new rates and their new rates are going to be about the same.
Recent months have brought travel risks to the forefront of consumers’ minds: the economic downturn, safety risks overseas due to political unrest, and a potential new strain of influenza that has emerged from Mexico.

There are two broad types of travel-related coverage for those leaving the United States:
Travel insurance covers the loss of the prepaid travel costs of a trip should it be canceled, interrupted, or postponed. It also can reimburse unexpected expenses incurred due to a sudden change in travel plans due to illness or other causes.
Specialty medical coverage protects against personal insurance risks when someone is outside the United States.

Travelers can buy travel coverage in conjunction with their travel tour, hotel bookings or flight reservations. It’s also available from providers that specialize in the international insurance market. For example, Continental, a major international airline, offers trip cancellation and interruption coverage through its reservations Web site. The coverage reimburses the traveler for “prepaid, unused, non-refundable travel expenses should your trip be cancelled or interrupted due to any covered reason.” Such reasons include: inclement weather, an unexpected illness, death of a traveler, and travel delays.

The Insurance Information Network of California notes that trip insurance providers sometimes require a physician’s verification if a trip must be canceled before it occurs. It advises buyers to check whether the travel coverage is “cancel for any reason protection,” or more limited coverage.

Trip interruption insurance is another variation. It can provide reimbursement for extra food and lodging costs if a traveler becomes ill during the course of a trip. Some plans cover medical costs. Trip delay insurance covers expenses a traveler incurs in resuming a planned trip or returning home after being quarantined in another country. Often these various coverages are bundled and sold together in a package.

Short-term medical insurance may be appropriate for the millions of U.S. residents who travel outside the U.S. every year. Those who travel outside of America may be going beyond the boundaries of their medical insurance without knowing it, according to Clements International, a provider of international insurance policies.

The unpredictable nature of the spreading of swine flu that began in April 2009 has heightened awareness of health risks while traveling around the world. Travelers may wish to consider short-term medical insurance if they’re traveling outside of the United States for an extended vacation or business trip. To determine whether it’s necessary, it’s advisable to check if a domestic health insurance policy covers out-of-country travel. If not, short-term medical insurance provides coverage for illnesses or medical evacuation that occurs while traveling outside of the United States.

International travelers face the same insurance risks (and sometimes additional risks) while outside the country that they do while stateside. Life insurance issued in the U.S. may not be available on the same basis while a person is traveling for an extended period as when not traveling. It’s prudent to check on the validity of life insurance coverage as part of the travel-planning process.

 

 

 

Health Plan Information

Sour(google.com.pk)
Health Plan Information
Communication exchange has never been so easily accessible and critical to the success of a national health programme. Gain a greater understanding of how effective communications strategies can help promote TB and HIV programmes and further disseminate important health messages to the public. During this course participants will receive training on how to write a professional press release, develop useful promotional tools, conduct media outreach, and discover how to build positive public awareness around an organisation’s work. Learning directly from experts working in mass communications, participants will engage in class exercises, discussions, and real-life simulations that demonstrate how skillful use of the media and communications can propel any health programme to excellence.

Benefits of Attending

Create powerful health-education messages that resonate with the public
Watch how to write a professional press release for public health topics
Increase TB/HIV advocacy abilities for community mobilisation
Discover how to manage a communications crisis
Prepare a communications plan for a health organisation
Confidently navigate the media landscape to identify useful players to promote health initiatives
Organise special events that put the spotlight on your health organisation
Find out how to make use of brochures, newsletters, activity reports, and other promotional tools that build health project awarenessI have to say I was surprised with the press reports last week that there wasn't "rate shock" in California when the California exchange offered preliminary information about their new plans and rates.

At least one prominent health actuarial group had predicted a 30% baseline increase in costs for California's new health insurance exchange plans under the Affordable Care Act (ObamaCare").

As the director of the California exchange put it, "These rates are way below the worst-case gloom-and-doom scenarios we have heard."

But a few days later there is lots more information coming out and it would appear we have a case of apples to oranges to grapefruit. And, we have a pretty good case of rate shock.

First, the exchange officials pointed out that we have to be careful to compare apples to apples when looking at 2013 rates and comparing them to the 2014 exchange rates because the 2014 exchange plans have far more generous benefits.

Yes we do, particularly when the California exchange forces us to give up our apple and buy a more expensive orange.

One of the reasons health insurance in the exchange will cost a lot more in most states is because the new health law outlaws many of the existing plans now being offered and requires only those much richer plans to be sold.

Are people going to get more coverage for their money? Yes. Do they want more coverage if the premium costs for those plans is a lot higher? Likely yes if taxpayers are paying for most of it. If not, clearly they didn't want to pay for it before. Come January, lots of California consumers in the small group and individual market are going to get a letter from their existing insurer telling them their current plan is no longer available and the cost of the new required plans will be a lot more.

Simply, the new law is taking plan design choices away instead of letting the consumer decide what is good for them. Does that matter in California?

As the LA Times reported, "The average premium for individual plans sold through EHealthInsurance in California was $177 per month last year. Covered California said the average premium for the three lowest Silver plans statewide will be $321 a month [+81% over two years], albeit for more comprehensive benefits."

For those insured right now, and the estimated 40% that won't be eligible for a federal premium subsidy, that sure looks like rate shock to me. For the 60% who will get a subsidy, this means the taxpayers are going to have to fork out lots more money.

Then one of the largest insurers in California, Blue Shield, announced that their average rate increase would be 13% under the new law. That sure looks better than the predicted 30% increase for California exchange plans.

But wait, that Blue Shield exchange plan in LA, for example, does not include UCLA Medical Center or Cedars Sinai. In fact, Shield's exchange network includes a total of only 24,000 physicians compared to 66,000 doctors in their full PPO network––only 36% of their usual network docs will be available.

Last week a national player told me there is a nationwide trend growing where the insurer offers a very limited list of providers exclusivity in their exchange plans for deeper payment discounts in the 30% range––the narrow network plan would be the health plan's only offering in the exchange. The tactic was described to me as a "quasi Medicaid strategy for the exchanges."

Health insurers have long struggled to keep premiums low by offering their customers lower benefit options at renewal. Apparently, with that option limited under the new health law, insurers are now sometimes opting to keep premiums lower by limiting provider options.

Let's be clear, "narrow network" plans that contract with fewer lower cost providers are a legitimate cost containment strategy. But Shield is only offering the narrow network in the exchange. While some health plans will sell their regular broader network outside the exchange, consumers can only get the federal premium subsidy inside the exchange. Looks like oranges to grapefruit to me.

The California exchange touted its announcement saying, "This is a home run for consumers in every region of California."

Let's see what California's individual and small group market consumers have to say once they start getting those renewal letters and go to the provider directory to see which doctors and hospitals they can go to.

An aside: I have to give LA Times reporter Chad Terhune lots of credit for staying with this story. During the past few days, he has written three articles (see links above). The first generally summarized the California Exchange press conference, the second dug a little deeper, and the third really got to the heart of the matter. In the end, LA readers got the whole story.
Health Information Exchange (HIE) is challenging.   As I've written about previously, several state HIEs have failed or are failing.

There are Federal HIE goals,  State Medicaid goals, private sector goals, and many varied sources of funding.   Each stakeholder has their own self interest.

The Harvard Program for Health Care Negotiation and Conflict Resolution teaches about the "Walk in Woods", moving from self interest, to enlarged interests, to enlightened interests, to aligned interests.

On September 19, the HIT Council and the HIT/HIE Advisory Committee of Massachusetts stakeholders took such a walk to review a straw man plan that aligns all the interests and optimizes available budgets.

Here's the idea.

There's an ONC-approved State Health Information Exchange plan.   There's a State Medicaid plan.   There are many existing regional health information exchanges in Massachusetts.

We created a Venn diagram of all these projects and identified their points of intersection.

Then, we developed objective criteria for what could be done now, what needs minor policy/technical work and what needs substantial additional work.

The end result was a phased plan making 2012 the year of connectivity to support push transactions, 2013 the year of databases to support analytics/population health and 2014 the year of the pull transaction.

We then worked on reconciling sources of funds.

There are two state programs with substantial federal matching grants - the Medicaid Management Information System (MMIS) and HITECH funds for State Medicaid Health Plans.    Every dollar from state resources that is invested in these programs yields $10 of spending.   A very wise use of state funds would be to leverage every dollar using federal matching programs.   Since 100% of hospitals in Massachusetts receive Medicaid funds,  Federal matching programs for Medicaid improvements are ideal for building the "information highway" to connect stakeholders as well as for state public health gateways to receive syndromic surveillance, reportable lab, and immunization data required by meaningful use.

However, what if we build the highway, but no one uses it?   It's important to connect EHRs by overcoming technical and resource barriers.   Our workgroups will devise a plan to create a grant or procurement program that leverages ONC HIE funds to  accelerate EHR to HIE connectivity.

With senders, receivers, and a pipe connecting the stakeholders, we have a clear HIE plan.

With aligned federal, state and private resources, we can define the timelines and we've developed Gantt charts for all our FY12 projects.

To guide the projects, we'll have 3 "functionality" workgroups
Finance and Sustainability Workgroup,
Technology and Implementation Workgroup
Legal & Policy Workgroup

and 2 "engagement" workgroups
Provider engagement & Adoption Workgroup
Consumer and Public Engagement Workgroup

With clear goals that align the interests of all parties, a budget that optimizes every source of funds, and a multi-stakeholder Advisory Committee with community-wide participation in workgroups, we have the foundation to move forward.

As we proceed with a sense of urgency, our rallying cry to all stakeholders is "focus on making the HIE happen, not on the impediments and barriers that we'll encounter along the way."
On March 22, ONC issued important privacy and security guidance to State Designated Entities.  It addresses concerns from State leaders and other stakeholders that health information exchange efforts have been hampered and slowed by the lack of consistent approaches to core privacy and security issues.  The Program Information Notice (PIN) provides clear national guidance.

It covers eight Core Domains
1. Individual access
2. Correction
3. Openness and transparency
4. Individual choice
5. Collection, use and disclosure limitation
6. Data quality and integrity
7. Safeguards
8. Accountability

Here's a summary of the highlights:

Access and Correction
Where HIE entities store, assemble or aggregate individually identifiable health information (IIHI), such as longitudinal patient records with data from multiple providers, HIE entities should make concrete plans to give patients electronic access to their compiled IIHI and develop clearly defined processes (1) for individuals to request corrections to their IIHI and (2) to resolve disputes about information accuracy and document when requests are denied.

Openness and transparency
Where HIE entities store, assemble or aggregate IIHI, individuals should have the ability to request and review documentation to determine who has accessed their information or to whom it has been disclosed.

Individual Choice
Push Model
Where HIE entities serve solely as information conduits for directed exchange of IIHI and do not access IIHI or use IIHI beyond what is required to encrypt and route it, patient choice is not required beyond existing law. Such sharing of IIHI from one health care provider directly to another is currently within patient expectations.

Pull Model
Where HIE entities store, assemble or aggregate IIHI beyond what is required for an initial directed transaction, HIE entities should ensure individuals have meaningful choice regarding whether their IIHI may be exchanged through the HIE entity.   Both opt-in and opt-out models can be acceptable means of obtaining patient choice provided that choice is meaningful

Use and Disclosure Limitation
In principle, a health care provider should only access the minimum amount of information needed for treatment of the patient.

Data quality and integrity
Where HIE entities store, assemble or aggregate IIHI, they should implement strategies and approaches to ensure the data exchanged are complete and accurate and that patients are correctly matched with their data.

Safeguards
HIE entities should conduct a thorough assessment of risks and vulnerabilities.

Accountability
HIE entities should ensure appropriate monitoring mechanisms are in place to report and mitigate non-adherence to policies and breaches.

In my view, these are very reasonable principles.   The use of "shall" and "should" in these guidelines is important to note.   Shall means your must and should means it's a good idea to try.   Should is used for more aspirational goals that need additional technology, standards, and policies.

Massachusetts goes live with its statewide HIE this Fall, so it was very helpful that no new regulations are required by the PIN for Push transport models.    The new guidance is completely aligned with the Strategic and Operating Plan we already have in process to replace existing paper-based workflows with electronic workflows leveraging current consent models.

 

 

 

Business Health Insurance Information

Source(google.com.pk)
Business Health Insurance Information
Increasingly, more people are buying health insurance online because of the large number of offers featured on the Internet. There are many insurance providers that offer cheap health insurance quotes for those who are on a tight budget. However, finding the best plans available on the market is not as easy as it seems. Before you start searching for online health insurance providers, you should take into consideration a few things.Easy To Insure ME has the answers

The easiest way to obtain cheap health insurance quotes is to visit independent websites that allow customers to search for medical insurance online. Many of these websites provide a short form that you will have to fill in with information about your health condition, medical history, weight, height, age, gender, pre-existing conditions, lifestyle, drinking and smoking habits and more. Once you provide these details, you will receive cheap health insurance quotes based on your answers. If you provide accurate details, then you will obtain free quotes that meet your requirements.

Customers who use quote comparison websites usually receive cheap health insurance quotes from the best online health insurance providers. However, it is important that you research each and every company in order to find one that is financially stable and has a good reputation in the industry. Check if there are any customer complaints and search for unbiased information about the company you are interested in. Keep in mind that a reliable insurer will provide you with a custom health insurance quote designed to suit your particular needs.

As soon as you gather three to five cheap health insurance quotes, you will need to compare them side-by-side. Make sure you get these quotes from reputable online health insurance providers. Take into account the amount of coverage provided, as well as the rates that you will have to pay every month. Check if the policy covers pre-existing conditions, prescription drugs, medical emergencies, maternity services, routine examinations and surgical procedures. Ask about the limitations and exclusions of the policy.Kaiser Permanente is an integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser Permanente is made up of three distinct groups of entities: the Kaiser Foundation Health Plan and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the autonomous regional Permanente Medical Groups. As of 2006, Kaiser Permanente operates in nine states and the District of Columbia, and is the largest managed care organization in the United States.

Kaiser Permanente has 8.9 million health plan members, 167,300 employees, 14,600 physicians, 37 medical centers, and 611 medical offices. In its most recently reported year, the non-profit Kaiser Foundation Health Plan and Kaiser Foundation Hospitals entities reported a combined $1.6 billion in net income on $47.9 billion in operating revenues.

Each independent Permanente Medical Group operates as a separate for-profit partnership or professional corporation in its individual territory, and while none publicly report their financial results, each is primarily funded by reimbursements from its respective regional Kaiser Foundation Health Plan entity.This morning’s story about the problems small business owners face in complying with the ACA doesn’t surprise me.  My first gig as an economist, way back in 1979, was a summer internship at the Small Business Administration, where, among other things, I prepared an analysis of the impact of health insurance mandates on small firms.  It was a pretty rudimentary piece of work: I was just a grad student and had not yet studied how to do applied micro analysis.  Still, I was able to see the main story line.

Actually, I got two out of the three pieces of the story.  First, I saw that there are economies of scale in group health insurance, and without some form of organization above the firm level, small employers will pay a higher unit cost.  Second, and quantitatively more important, small firms in the US are substantially more labor-intensive on average, so an increase in labor costs hits them harder.  The third piece, which I missed at the time, is that wages are lower in the small business sector, so a mandated benefit of given cost will constitute a larger share of the wage bill.

I concluded that, from a small business advocacy standpoint, a national health insurance program like Canada’s would be preferable to a system of employer mandates.

Since then I’ve learned that some European countries, like Germany, have employer mandates, but they don’t have the size-bias effect that ACA is likely to have in the US.  To take Germany, for instance, there are two reasons for this.  First, the Germans do have publicly-organized insurance pools above the employer level, which deals with the economy of scale problem, and SME’s are neither more labor-intensive nor lower-wage than larger firms in the same industries.  In other words, Germany doesn’t have (in this respect) a dual economy problem that mandated health insurance intensifies.

But the US suffers tremendously from duality*—the division in the economy between larger, better-capitalized, more productive, higher-paying operations and smaller, less productive sectors that offer crummy jobs.  (It isn’t entirely a division between firms because some large firms have established their own internal “secondary” sectors.)  ACA should be examined in this context, especially since the administration hasn’t proposed any measures at all to reverse the trend toward greater duality, which is one of the underlying factors behind the growth in inequality.

Just to be clear, I think it is a big step forward for workers in the secondary labor market to be able to get health insurance; this will lessen, for them, the impact of duality.  At the same time, however, we should not be surprised if ACA puts a differential burden on small business.  In the US context this might be a good thing in some respects, since jobs in small enterprises are generally pretty bad, but there are other aspects of size-bias to consider.

Ultimately, however, this is a dual economy problem, not a health policy problem.

*Duality should not be taken literally.  It is not about discrete separation but rather the tendency for size to covary with productivity and other related indicators.  Despite its moniker, it refers to a continuum.Every now and again, a political pundit is required to stand up and admit to the world that he or she got it wrong.

For me, this would be one of those moments.

For quite some time, I have been predicting that Obamacare would likely mean higher insurance rates in the individual market for the “young immortals” and others under the age of 40.  At the same time, my expectation was that those who fall into the older age ranges would benefit greatly as their premium charges would be lowered thanks to the Affordable Care Act.

It is increasingly clear that I had it wrong.Yesterday, Covered California—the name given to the healthcare exchange created pursuant to the Affordable Care Act that will serve the largest population of insured citizens in the nation—released the premium rates submitted by participating health insurance companies for the four health insurance program categories (bronze, silver, gold and platinum) established by the Affordable Care Act, along with the catastrophic policy created for and available to those under the age of 30.

Upon reviewing the data, I was indeed shocked by the proposed premium rates—but not in the way you might expect.  The jolt that I was experiencing was not the result of the predicted out-of-control premium costs but the shock of rates far lower than what I expected—even at the lowest end of the age scale.

So, why the all too popular narrative that Obamacare would mean unaffordable healthcare premium costs for so many Americans?

Setting aside the never-ending nonsense peddled by the opponents of healthcare reform, everyone from the Congressional Budget Office to numerous private actuaries have warned that premium shock could be expected to set in once the public began to see the reality of what Obamacare would mean to their pocketbooks. And yet, the only real jolt to the system being felt by these public and private prognosticators today is utter amazement over just how reasonable the California prices have turned out to be.

How did the CBO and the actuaries get it so wrong?

As Jonathan Cohn of The New Republic correctly points out—

“One reason for the misplaced expectations may be that actuaries have been making worst-case assumptions, even as insurers—eyeing the prospects of so many new customers—have been calculating that it’s worth bidding low in order to gobble up market share. This would help explain why premium bids in several other states have proven similarly reasonable. “The premiums and participation in California, Oregon, Washington and other states show that insurers want to compete for the new enrollees in this market,” Gary Claxton, a vice president at the Kaiser Family Foundation, said via e-mail. “The premiums have not skyrocketed and the insurers that serve this market now are continuing.  The rates look like what we would expect for decent coverage offered to a standard population.”

Cohn is saying that, despite the political naysayers, the healthcare exchange concept appears to be working very well indeed in states like California, Oregon and Washington—the first states to publish the expected health exchange prices for purchasing coverage. These are also states that are actually committed to seeing the program work as opposed to those states whose leaders have a vested political interest in seeing the Affordable Care Act fail.

Keep in mind that the entire idea of the exchanges is to require health insurance companies to compete openly with one another by offering identical coverage programs in the three created classes—each offering insurance coverage that actually delivers meaningful protection to customers—and then openly disclosing the price each insurance company will charge for that policy.  Thus, shoppers can clearly see which company has the best price on an apples-to-apples basis.

For all the negative chatter about how including older and sicker Americans in the health insurance pools would drive up the price for younger participants in the pool less likely to be ill, what we are now seeing in states like California is that the desire on the part of the health insurance companies to increase market share—thanks to the large influx of customers as a result of Obamacare—is driving prices downward.According to the administration’s blog post, setting up the system to collect that information is taking too long, and without that information they can’t enforce the employer mandate.

What the announcement didn’t say is that without that information, they can’t enforce the individual mandate, either.

The individual mandate requires taxpayer to pay a penalty if they don’t obtain “qualified” coverage, but there are a number of exceptions. Primarily, taxpayers are exempt from the penalty if the lowest-cost coverage available to them requires them to pay more than 8% of their family income. Calculating eligibility for this exemption requires information from every employer of every family member, including the employee share of the premium for employer-sponsored coverage, whether the employee worked more or less than 30 hours per week, the amount paid by that employer, and whether the coverage is for the employee only, or the employee plus his or her family. That is precisely the information whose collection is delayed under the administration’s new rule.

Furthermore, little-noticed in the announcement is that the delay in the reporting requirement applies also to insurers – including those offering coverage in the exchange. During the delay, insurers will not have to report the names and social security numbers of people they cover – in other words, the list of people who don’t have to pay the penalty because they obtained exchange coverage.

Since neither employers nor insurers will have to report who is covered under their health plans, how is the IRS supposed to determine who has to pay the penalty for failing to obtain qualified coverage? They won’t – by the same line of reasoning that the administration applies to the employer mandate.

As the administration puts it, “We recognize that this transition relief will make it impractical to determine which employers owe shared responsibility payments (under section 4980H) for 2014. Accordingly, we are extending this transition relief to the employer shared responsibility payments. These payments will not apply for 2014.”

Likewise, this transition relief will make it impractical to determine which individuals have not obtained qualified coverage and as a result owe an individual penalty. Even if the administration chooses not to explicitly apply the same logic to individuals, as a practical matter they won’t be able to prove that any particular individual did not obtain coverage.

Indeed, the administration has already gone even further with last Friday’s “honor system” regulation. States and exchanges “may accept the applicant’s attestation regarding enrollment in an eligible employer-sponsored plan…without further verification.” In other words, they aren’t going to collect the information necessary to verify anyone’s eligibility – both for access to exchange coverage, and for the subsidies that will often go along with it – so they’ll just take the applicant’s word for it. (The regulation also applies the same “attestation” concept to age, citizenship, immigration status, income, or any other “factor of eligibility for which the electronic data source is unavailable.” Since determining eligibility for exchange coverage requires the same information as determining whether one owes the individual mandate penalty, that will have to be on the “honor system” as well.

It is striking that in just a few short years, the administration has overturned, waived, or delayed – either with or without statutory authority – almost every major component of their signature health reform bill. Since October 2011, the administration has indefinitely suspended the CLASS Act (voluntary federal long-term care insurance, later repealed by Congress), declared an early end to the federal high-risk pools, and now delayed
for at least a year the Small Business Health Options Program (SHOP exchanges, to make it easier for small employers to provide coverage), the Federal Basic Health Plan Option (FBHPO, low-cost coverage for those just over the income limit for Medicaid), the employer mandate, and now, perhaps, the individual mandate as well.

All that survives – for the moment – is government-run “exchanges” with heavy coverage mandates, limited choices, and high taxpayer-funded premium subsidies for a large portion of the population.