Oscar, The Startup That's Trying To Shake Up Health Care, Just Raised $80 Million

May 14, 2014, 3:17 pm

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Oscar, the company dead-set on shaking up the broken health care industry, just announced an $80 million fundraise, bringing its valuation to nearly $1 billion.

Oscar officially launched in New York City in January of this year, after founders Kevin Nazemi, Joshua Kushner, and Mario Schlosser decided that they wanted to use technology to create a better, more consumer-friendly health insurance company.

The site is well-designed and easy to navigate, and tries to one-up traditional health insurance companies like Aetna and UnitedHealth by making bill paying a breeze and allowing members to consult with doctors over the phone at no additional charge. 

Forbes reports that the company currently has more than 16,000 customers who pay an average of $4,500 in annual fees — placing Oscar’s revenue at around $72 million, with a valuation of $800 million. 

The round was led by Joe Lonsdale of Formation8 and includes Khosla Ventures, General Catalyst Partners, and others, and Oscar plans to use the new funding to hire more employees and expand into different areas (right now it's only available in New York). 

Kushner, Oscar's CEO, also founded Thrive Capital, a VC firm that has funded big-names like Instagram, Warby Parker, Nasty Gal, and MakerBot.

*SEE ALSO: Amazon made this man phenomenally wealthy — now he might be hatching places to take it on*

Join the conversation about this story » Reported by Business Insider 6 hours ago.

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Pence to propose 2-tier insurance plan for poor

May 14, 2014, 4:55 pm

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INDIANAPOLIS – Low-income Indiana residents would have more health-insurance options, including some with no cost, under a two-tiered plan Gov. Mike Pence plans to unveil on Thursday. Reported by Journal Gazette 4 hours ago.

What to do if HealthCare.gov messed up your application

May 15, 2014, 8:16 am

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*What to do if HealthCare.gov messed up your application*

*Q. *My aunt tried to get health insurance through Obamacare and was told by a broker she wasn’t eligible because she didn’t have a credit record. She has always lived frugally and never took on any debt. Why would the health reform law deny coverage to people just because they don’t have a credit score?

*A*. Your aunt was done a huge disservice by the broker. She was fully eligible to buy insurance through her state’s exchange and should never have been told otherwise.

That’s the bad news. The good news is that even though open enrollment is over, people like her, who tried to enroll but were stopped by wrong information, computer problems, or other things beyond their control, are eligible for a Special Enrollment Period so they can get insurance right away instead of waiting until next year.

Your aunt fell afoul of a complicated process called “identity proofing,” meant to verify the applicant’s identity. When a person started an application, the health insurance marketplace would send an electronic query to Experian, one of the three big national credit reporting agencies. Experian’s computers would look up the person’s credit history and generate a series of questions that a real applicant would know the answer to but an impostor wouldn’t. It might ask the person to identify which of four addresses he or she used to live at, or the make of a car purchased with a loan.

But people like your aunt don’t have an Experian credit history to look up, said Sonal Ambegaokar, a senior attorney with the National Health Law Program, a nonprofit advocacy group, including “people coming out of foster care, recent immigrants, low-income people, older people who’ve never used credit, and recent graduates who don’t have a credit history yet.”

The absence of an Experian record stopped the application process cold—but, as the broker should have known—the marketplace provided an alternative means of ID proofing. Applicants  were supposed to be told to call the “Experian help desk” and receive instructions on how to mail in or upload identity documents. Once Experian verified them, it was supposed to notify the applicant within 7 to 10 days that he or she could continue on to enroll in a plan.

That didn’t always happen, it turns out. “ID proofing was not very well explained,” Ambegaokar said. “Applicants were told, 'We can’t verify your identity so we can’t proceed,' with no explanation of what the process was or what their other options were.”

Many people wrote me to say they had sent their documents in and were still waiting to hear back weeks or even months later. The government says that some sent in the documents without enough information to enable Experian to match it with their marketplace account.

While ID proofing was a major problem, it wasn’t the only one, Ambegaokar says. Many immigrants were unable to get the marketplace’s computers to verify their visa or green card, even though all their documents were fully in order—another glitch that stopped the application process cold.

If you have experienced any of these problems, here’s what to do.

· Go back onto your state’s marketplace website and look up the call center number. If your marketplace is run by HealthCare.gov, the call center number is 1-800-318-2596.
· Call and explain your problem and ask for a Special Enrollment Period. Here's a list of "complex situations" that qualify.

“The service representative can go online and see where you got stuck in your application,” Ambegaokar said. “At that point, they have the authority to grant you a Special Enrollment Period.”

Got a question for our health insurance expert? Ask it here; be sure to include the state you live in. And if you can't get enough health insurance news here, follow me on Twitter @NancyMetcalf.

—Nancy Metcalf

*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2007-2013 Consumers Union of U.S.*

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United States: Why Shouldn't Smokers Pay More For Health Insurance? - Fisher & Phillips LLP

May 15, 2014, 7:51 am

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Employers are being stung by soaring health insurance premiums and desperately need to control their costs. Reported by Mondaq 13 hours ago.

Here's Why You Need About $7,000 Set Aside For Your Death

May 15, 2014, 9:33 am

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As the saying goes, only two things are certain in life: death and taxes.

Frankly, we don't like thinking about either.

But data from the National Funeral Director's Association says we had better start thinking about our mortality — at least, as it relates to our bank account.

According to the NFDA, the median price of an American funeral in 2012 was about $7,000. Even a "simple" cremation costs an average of $3,200 (although Fox Business points out that you can snag a cheap urn for about $20 at Costco).

Prices will just keep rising, if the past 50 years are any indication:

In a post on the blog Personal Capital, personal finance writer Holly Johnson recounts some of her experience working in a funeral home — namely, the costs. She writes:

… The cost of an average funeral doesn’t include cemetery expenses such as burial space, a burial vault, the opening and closing of a grave, or a headstone. When accounting for those expenses, the average cost for a traditional funeral rises dramatically, usually to somewhere between $9,000 and $12,000. I’ve even seen hundreds of families spend upwards of $15,000 or more over the years.

Johnson goes on to explain that many families are caught unawares by the costs of burying or cremating their loved ones, and some have to go into credit card debt to do it. "Now they are stressed over losing their loved one and having thousands of dollars in new debt," she says. She remembers families who were surprised that their loved one's life insurance either didn't cover the funeral costs or had lapsed, and families who had done nothing to plan for their inevitable demise.

Who wants to leave their family miserable and indebted? While we could caution 75-year-olds to start saving, it's a lot easier for a professional with at least one steady income stream to get ahead on savings than for a retiree. No one's saying you need an account marked "funeral" (that's bit morbid, even for the most responsible saver), but the numbers show that getting in the habit of putting money away today will benefit you to the very end.

Hat tip to Financial Samurai.

*SEE ALSO: 4 Signs You Picked The Wrong Health Insurance Plan*

Join the conversation about this story » Reported by Business Insider 12 hours ago.

New health cost controls get go-ahead from feds

May 15, 2014, 10:01 am

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There's a new health insurance term in the glossary, and it could mean thousands of dollars out of your pocket. Reported by Miami Herald 11 hours ago.

Employer health costs to rise nearly 9% this year, survey finds

May 15, 2014, 10:45 am

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Employer healthcare costs are expected to rise nearly 9% in 2014, a slight improvement over recent years, according to a new survey. However, that modest decline doesn't offer much relief to companies and their employees, who are seeing health insurance costs take a bigger bite out of their... Reported by L.A. Times 11 hours ago.

Research Report on Global Ambulance Services Market Trends and Forecast 2013-2019

May 15, 2014, 11:12 am

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Transparency Market Research Report added "Global Ambulance Services Market Analysis, Size, Share, Growth, Trends And Forecast 2019" to its database. Browse full report: http://www.transparencymarketresearch.com/ambulance-services-market.html.

Albany, New York (PRWEB) May 15, 2014

The ambulance service industry includes private and municipal operators who respond to medical emergency calls by providing transportation facility to the patients either by road, water or air. The services are not restricted only to en-route patients to a hospital, but also provide emergency medical care in the process. Ambulances are equipped with lifesaving equipment to provide emergency medical aid to the patient until reaching the hospital.

Browse the full report with request TOC at http://www.transparencymarketresearch.com/ambulance-services-market.html.

These equipment are rugged, compact and have a short start time, being operated by medically trained professionals. With rising incidences of heart attacks, strokes and accidents, healthcare systems need to ensure proper and efficient on-site medical care. The advent of air ambulance services has helped the healthcare sector in the U.S market in responding to emergency calls in shortest lead time possible.

The global ambulance services market can be analyzed effectively based on different regions namely North America, Europe, Asia-Pacific and Rest of the World. U.S and Europe are the most developed markets for ambulance services owing to availability of advanced medical technology platforms supporting the efficient execution of novel medical technologies.

Free PDF brochure: http://www.transparencymarketresearch.com/sample/sample.php?flag=B&rep_id=1906.

North America has implemented air ambulance services realizing the need for reaching remote areas in short time. Moreover, air ambulance has been experiencing stable revenue growth in U.S. reinforced by increasing number of individuals covered by health insurance and graying U.S. population.

Demand for ambulance services is on consistent rise on account of rising road accidents and aging population. Besides, technological innovation in the medical equipment and telemedicine services will contribute to the growth of this industry. In addition, regulations focusing on providing immediate relief to patients and encouraging introduction of new technologies in ambulance services will bolster the industry demand.

Some of the major ambulance service companies include Acadian Ambulance Service, Inc., AirMed International LLC, London Ambulance Service NHS Trust, Air Methods Corporation, American Medical Response, Emergency Medical Services Corporation, and Rural/Metro Corporation.

This report provides comprehensive analysis of:· Market growth drivers
· Factors limiting market growth
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This report is a complete study of current trends in the market, industry growth drivers, and restraints. It provides market projections for the coming years. It includes analysis of recent developments in technology, Porter’s five force model analysis and detailed profiles of top industry players. The report also includes a review of micro and macro factors essential for the existing market players and new entrants along with detailed value chain analysis.

Reasons for Buying this Report:· This report provides pin-point analysis for changing competitive dynamics
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· It helps in understanding the key product segments and their future
· It provides pin point analysis of changing competition dynamics and keeps you ahead of competitors
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http://marketresearchmoz.wordpress.com/ Reported by PRWeb 10 hours ago.

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Don't Blame "Boomers" For Not Retiring

May 15, 2014, 11:44 am

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Submitted by Lance Roberts of STA Wealth Management,

Every month when the employment data is released there is an almost immediate debate that erupts over the Labor Force Participation Rate. Like any good boxing match, both sides take to their corners. Defenders argue the decline is primarily due to retiring "baby boomers" and demographic trends while opponents suggest that it is a sign that employment remains far weaker than headlines suggest.

As I discussed previously, recent employment increases, while encouraging have been little more than a function of population growth. As the population grows, incremental demand increases caused by that increase in population will create employment needs in areas most impacted by that population growth. This is why job formation has been primarily focused in retail, service and hospitality areas.  

The Census Bureau and Bureau of Labor Statistics provide some fairly comprehensive data about employment that can help us understand the current state of labor force participation. Is it really just an issue of masses of baby boomers retiring?  Or is it something potentially more structural in nature.

Let's start with the retirement of the boomer generation.  Recent statistics show that the average American is woefully unprepared for retirement. On average, 40% of American families are NOT saving for retirement, and of those who are, it is primarily about one year's worth of income.  Furthermore, important to this particular conversation, one-fourth of those at retirement age postponed retirement with only 18% being confident of having enough saved for retirement.

For the purposes of this analysis, I am going to exclude all of the "seasonal adjustments" that tend to be a focal point of many of the arguments and utilize a simple 12-month average to smooth the non-adjusted data.

With 24% of "baby boomers" postponing retirement, due to an inability to retire, it is not surprising that the employment level of individuals OVER the age of 65, as a percent of the working age population 16 and over, has risen sharply in recent years. 

This should really come as no surprise as decreases in economic and personal income growth was offset by surges in household debt to sustain the standard of living.  Notice that the surge in 65-year and older employment corresponds with the decline of prosperity in the chart below.

So, since we are now fairly certainly that a large number of individuals are working well into their retirement years due to financial reasons, what about employment participation for those of working age years 16-64.  The chart below shows the 12-month average of employment as a percentage of those individuals of working age.

As opposed to the Labor Force Participation Rate that is widely discussed following each labor report, this chart shows that the participation rate of 16-64 year olds remained fairly stagnant between 1988 and 2008 ranging from 71-74%. This stagnation is very much due to the structural shift in employment makeup. However, while employment participation for 16-64 year olds declined sharply in 2008 due to the financial crisis, it has only mildly recovered over the last 5 years.  It is here that the reality of job formation running at rates of population growth become clearly evident. 

When the monthly employment data is released individuals that have given up looking for work are considered to no long be part of the labor force (Not In Labor Force or NILF).  From 1977 through the turn of the century the 12-month average of the percentage of 16-64 year olds considered NILF, as a percentage of the total 16-64 aged population, had declined.  However, since the bursting of the tech bubble and the financial crisis the number the percentage of individuals that dropped out of the labor force has grown sharply.

What seems to be missed by the majority of employment analysis, in my opinion, is whether the economic viability for the average American has improved? The fact the social benefits as a percentage of real disposable incomes has risen to an all-time record certainly suggests that it has not.

It would seem to me that this would be a much more salient question considering 70% of economic growth in the domestic economy is driven by consumption.

While the debate over the *quantity* of employment is sure to continue in the months ahead, the real issue should be *quality*.  As I discussed recently in relation to the housing market:



"It is difficult to consider "buying" a home when full-time employment remains elusive.  *Full-time employment, which pays better wages and provides benefits, leads to increases in household formations and home ownership. A lack of full-time employment remains a major impediment to the recovery story."*



The problem is that while the Fed has achieved a 6.3% unemployment rate it is clearly a hollow victory. This fact was not lost on Janet Yellen recently when she pulled Fed policy away from the employment mandate suggesting "much more work needed to be done."  She is right. However, the problem is that Fed policy doesn't drive employment - employers drive employment which is only fostered through reduced regulations, taxes, and increased demand.

Bill Dunkelberg, NFIB Chief Economist, summed this up well when he stated recently:



"Small business confidence rising is always a good thing, but it’s tough to be excited by meager growth in an otherwise tepid economy. Washington remains in a state of policy paralysis. *From the small business perspective there continues to be no progress on their top problems:  cost of health insurance, uncertainty about economic conditions, energy costs, uncertainty about government actions, unreasonable regulation and red tape, and the tax code.**”*



Regardless of which side of the low labor force participation rate argument you stand on, it is hard to argue that it is simply a function of retiring "baby boomers." While political arguments are great for debate, it is the economics that ultimately drive employment. While the Fed has inflated asset prices to the satisfaction of Wall Street, as shown in the first table above, it has done little for the middle class. It is ultimately fiscal policy that will help business create employment, the problem is that businesses need less of it while government officials keep piling on more.

In the meantime, stop blaming "baby boomers" for not retiring - they simply can't afford to.

  Reported by Zero Hedge 10 hours ago.

Massachusetts health insurers blame Obamacare for $152M operating loss in Q1

May 15, 2014, 11:50 am

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The state's three-largest health insurers said a federal requirement to pay taxes and fees in support of the Patient Protection and Affordable Care Act, popularly known as Obamacare, resulted in a combined operating loss of $152 million in the first quarter. The federal law, which passed in 2010, imposes for the first time this year an annual fee on health insurance providers. According to federal law and disclosures made by local insurers, U.S. health insurers were compelled to book their full-year… Reported by bizjournals 9 hours ago.

Martha Coakley Asks Feds To Review GOP Opponent's Business Practices

May 15, 2014, 1:32 pm

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A Democrat running to be Massachusetts' governor asked federal securities regulators Thursday to look into an opponents' work with a venture capital firm.

State Attorney General Martha Coakley (D) asked the Securities and Exchange Commission to review whether Republican Charlie Baker violated any pay-to-play laws with a $25 million deal his firm, General Catalyst, made with New Jersey’s public pension fund. General Catalyst ultimately invested in a health insurance startup, Oscar Insurance, which Baker oversees.

The deal between the firm and the pension fund was made after Baker donated $10,000 to New Jersey's Republican State Committee, which is controlled by Gov. Chris Christie (R).

“[The SEC] should look at these allegations,” Coakley said, according to The Boston Globe. “They know best whether they have jurisdiction and whether they raise issues. But I would hope at least they would do a review of these allegations, to determine whether or not a further investigation is needed.”

Baker has insisted he was unaware that General Catalyst had raised money from New Jersey's pension fund.

“Charlie has been completely transparent about this contribution and his association with General Catalyst,” Baker campaign spokesman Tim Buckley told the paper.

Part of the controversy over the investments stems from Baker's ambiguous role at General Catalyst. He is called an “executive-in-residence” and is also listed as a partner. While Baker has denied that he is a partner or employee of the firm, he identified himself as one on campaign finance documents.

Both Coakley and Baker have run statewide campaigns before. She lost to former Sen. Scott Brown (D-Mass.) in 2010, while Baker lost the gubernatorial race to Deval Patrick (D) that same cycle.

To become the gubernatorial nominee, Coakley must first best a field of other Democratic candidates, including state Treasurer Steve Grossman, former homeland security official Juliette Kayyem, former federal heath care administrator Don Berwick and biopharmaceutical executive Joseph Avellone. Reported by Huffington Post 8 hours ago.

Senate OKs bill to diversify Covered California

May 15, 2014, 2:17 pm

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The state Senate has approved a bill to diversify the board overseeing Covered California, the state's health insurance exchange. Reported by Miami Herald 7 hours ago.

A Possible GOP Presidential Candidate Found A Way To Expand Health Insurance - Without Calling It Obamacare

May 15, 2014, 3:15 pm

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A Possible GOP Presidential Candidate Found A Way To Expand Health Insurance - Without Calling It Obamacare Reported by ajc.com 6 hours ago.

A Possible GOP Presidential Candidate Found A Way To Expand Health Insurance — Without Calling It Obamacare

May 15, 2014, 3:15 pm

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Indiana Gov. Mike Pence, a Republican whose name has recently been thrust into 2016 presidential speculation, unveiled on Thursday a plan to expand health-care coverage to low-income people in Indiana. 

Pence is opposed to the Affordable Care Act and has rejected the law's expansion of the federal Medicaid program. The coverage expansion in Indiana is a nod to Obamacare's Medicaid expansion, but Pence attempted to cast it in terms more palatable to conservatives. 

Overall, he's attempting to walk a fine line between earning hundreds of millions of dollars in federal support and maintaining support from fellow conservatives. Pence said his plan, an upgraded version of the Healthy Indiana Plan, will balance the two by requiring patients applying for coverage to take more personal responsibility for their insurance. 

Pence's office said the strategy, which would replace the traditional Medicaid program for people ages 19 to 64 with incomes up to 138 percent of the federal poverty level, would provide coverage to more than 350,000 Hoosiers.

This would help alleviate what is known as the "coverage gap" in the state. Overall, according to the Kaiser Family Foundation, more than 4.8 million Americans sit within the gap of having incomes too high to qualify for traditional Medicaid coverage but too poor to qualify for subsidies through insurance plans under the exchanges.

But Pence took pains to make clear what he sees as a clear distinction between his plan and expanding Medicaid. 

"From the beginning of my tenure as Governor, we have been saying 'no' to the Affordable Care Act in Indiana. We refused to set up a state-based exchange, and we have made it clear that we will not expand traditional Medicaid," Pence said in announcing the plan Thursday. 

"Medicaid is not a program we need to expand. It is a program we need to change. Nobly created 50 years ago to help the poor and those with disabilities access quality health care, Medicaid has morphed into a bureaucratic and fiscal monstrosity that does less to help low-income people than its advocates claim."

Pence's plan flows with many other red-state or Republican-governor coverage expansions. Hoosiers with incomes below the federal poverty level can either pay a small monthly premium or be dropped to a more basic level of coverage without dental and vision benefits. Those making above the poverty level must pay a monthly premium or be dropped from the coverage for at least six months.

Here are the three basic tiers:

· HIP Plus — This is the highest level of coverage, which requires monthly contributions of between $3-$25.
· HIP Basic — A lower level of coverage that only requires co-payments, not monthly contributions.
· HIP Employer Benefit Link — This type of coverage aids Hoosiers in payments for private plans through their employers. Pence said it would "encourage the use of private insurance options."

Pence now plans to submit a final waiver proposal to the federal government to harness billions of dollars of federal money. He is expected to do that by the end of June, after the state holds hearings and the two required "comment periods."

The Obama administration must then approve the waiver. Though the administration didn't immediately signal its intentions, one official referenced the administration's collaboration with Arkansas on its "private option" expansion.

"Just like we worked with Arkansas and other states on a unique plan, we look forward to doing the same with Indiana once they submit a formal proposal," the official told Business Insider.

In a statement, Department of Health and Human Services spokesperson Emma Sandoe said the administration was "encouraged" by the developments on Thursday. If approved, Indiana would be the 27th state, along with the District of Columbia, to expand coverage for people who would have been covered under the law's Medicaid expansion.

"We are encouraged by Indiana and Governor Pence’s commitment to helping cover more of the state’s uninsured population through the Healthy Indiana program and look forward to seeing his proposal," Sandoe said.

"The Medicaid coverage expansion provides federal funds to cover 100% of the cost of newly eligible beneficiaries for the first three years and no less than 90% after that. In Indiana, it would mean coverage for thousands of additional Hoosiers."

Join the conversation about this story » Reported by Business Insider 6 hours ago.

Special enrollment launched for COBRA holders

May 15, 2014, 3:25 pm

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California's health insurance exchange has launched a special enrollment drive for people covered under COBRA. Reported by SignonSanDiego 6 hours ago.

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Missouri Backs Criminal Checks for Health Advisers

May 15, 2014, 4:57 pm

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Missouri passes measure requiring criminal background checks for health insurance navigators Reported by ABCNews.com 4 hours ago.

Health Insurers have Enrolled and Effectuated Over 400,000 Lives Through ACA Federal and State Based Marketplaces Using the Softheon Marketplace Connector Cloud (MC2)

May 15, 2014, 4:27 pm

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STONY BROOK, N.Y., May 15, 2014 /PRNewswire/ -- Softheon, Inc., a proven leader in health insurance marketplace integration and business operations, has announced that as of May 12, 2014, over 400,000 enrolled lives have been effectuated through ACA Federal and State Based... Reported by PR Newswire 5 hours ago.

Recording seems to refute claims made by Anthem

May 15, 2014, 7:17 pm

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We've all heard stories about health insurance companies refusing to budge after denying a claim, often asserting that the policyholder was in the wrong. David Cienfuegos said his wife was told by Anthem Blue Cross that his doctor was part of the insurer's coverage network, but then was... Reported by L.A. Times 2 hours ago.

Democratic Candidate Imagines Insurance Exec Dance Party Over Obamacare Repeal In New Ad

May 16, 2014, 2:51 am

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"Insurance executives" boisterously dance on tables, guzzle Champagne and throw bills in the air as a Democrat running in a competitive House race imagines how the industry would react to a repeal of the Affordable Care Act.

Former Minnesota state Rep. Mike Obermueller (D) is demonstrating that Democrats are increasingly confident with rhetoric around the health care law as he launches a television ad that criticizes his Republican opponent's repeated attempts to vanquish the law.

In the raucous spot, which was first shared with The Huffington Post and will begin airing Friday, Obermueller highlights comments the six-term Rep. John Kline (R-Minn.) made concerning October's federal government shutdown.

“Obamacare is a continued disaster," Kline says. "We had a tactic. We said, 'OK, we're going to let the government shut down' ... so we let the government shut down for 16 days … under these conditions that you defund it or you delay it all. We voted again and again and again and again and again.”

Kline called the Affordable Care Act "indefensible" in March.

“It’s time to hold Congressman Kline accountable for taking $430,000 from the health insurance industry and then voting to allow them to deny care for preexisting conditions, drop coverage for those who get sick, and even charge women more than men,” Obermueller said in a Friday statement accompanying the ad's release. “I’m devoted to fixing the problems with the Affordable Care Act, but we can’t go back to letting the insurance industry do whatever they want, and that’s a big difference between John Kline and me.”

A Democratic source said the ad will air on prime-time cable in Minneapolis as well as online.

Although President Barack Obama carried Minnesota's 2nd District in 2008 and 2012, Kline defeated Obermueller by 8 percentage points in 2012. Reported by Huffington Post 19 hours ago.

Cost-control plan for health care could cost you

May 16, 2014, 3:51 am

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Washington — You just might want to pay attention to the latest health insurance jargon. It could mean thousands of dollars out of your pocket. Reported by detnews.com 18 hours ago.