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Health Network To Focus On The Latino Market By Launching CuidadoDeSalud.com and SeguroDeSalud.com

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Health Network (HealthNetwork.com), a leading healthcare marketing company with more than 15 million visitors to its websites annually, will be launching two Spanish-language websites in October: CuidadoDeSalud.com and SeguroDeSalud.com (Spanish translations of “health care” and “health insurance” respectively). Both sites are focused on increasing the enrollment of Latino Americans in health insurance and in providing features that alleviate concerns raised by critics that the government-focused websites are ineffective in reaching the Latino community.

Palm Beach Gardens, FL (PRWEB) September 29, 2014

Health Network (HealthNetwork.com), a leading healthcare marketing company with more than 15 million visitors to its websites annually, will be launching two Spanish-language websites next month: CuidadoDeSalud.com and SeguroDeSalud.com (Spanish translations of “health care” and “health insurance” respectively).

Both sites are focused on increasing the enrollment of Latino Americans in health insurance by providing features such as proprietary decision-making web tools, unbiased healthcare plan information, and dedicated Spanish-speaking health insurance agents. The sites will also provide features that alleviate concerns raised by critics that the government-focused websites are ineffective in reaching the Latino community. Both sites are scheduled to launch in October.

According to the Census Bureau, Latinos are the largest uninsured population group in the United States at 29%, which suggests that they are significantly underserved. In May the Department of Health and Human Services released the first national data on the ethnicity of enrollees in the Federally-run healthcare Marketplace, which reported that only 10% were Latinos, missing the enrollment target by over 30%.

With so many uninsured Latinos, the government developed an initiative to target Latinos, yet critics quickly pointed out that they are doing a poor and ineffective job. “The government has a Spanish-language version of its health insurance website, CuidadoDeSalud.gov, yet like its English-language counterpart it was plagued by problems. Its initial rollout was delayed by a couple of months, and then it was dogged by criticism that it was written in ‘Spanglish’" according to a recent USA Today article.

Latinos also have fears about deportation with Reuters reporting in December that “fear of immigration enforcement is a particular concern in Hispanic families where one spouse is a U.S. citizen or legal resident and married to an undocumented person, or where both parents are undocumented immigrants but their children have citizenship.” Reuters also referenced a comment by Daniel Zingale, the senior vice president at the California Endowment, who said “A lot of mixed-status families are afraid that if they enroll, that the government will come and divide up their family through deportation.”

Health Network is creating the Spanish-language websites to specifically address these concerns and to help significantly improve enrollment figures of Latinos during the next period of open enrollment, which starts on November 15th. Health Network is developing a sophisticated platform that will connect a database of licensed, Spanish-speaking health insurance agents with Latino consumers to help answer their questions over the phone, online or in-person. It’s also creating proprietary web tools to specifically help Health Network’s Spanish-speaking consumers find plans specifically designed around their needs.

"Latinos are severely underserved in the ACA landscape.” said Mike Schrobo, CMO of Health Network. “But with the innovative tools and unbiased information we’re providing within these flagship websites, we expect them to have an immediate and significant impact on helping Latino Americans obtain affordable healthcare for themselves and their families”.

Health Network believes that if Latino Americans were provided more choices with their enrollment options and more concern was paid to providing a meaningful Spanish-only experience, one that is not directly connected to Healthcare.gov or the Spanish-alternative CuidadoDeSalud.gov, enrollment numbers with this demographic would be significantly higher.

Health Network is unique in the health insurance industry since it’s not a licensed health insurance agency or brokerage company as this would require them to have a direct relationship with the Centers for Medicare & Medicaid Services (CMS), the government entity who is responsible for Healthcare.gov. By remaining unlicensed, Health Network is able to remain objective and focus on providing the best consumer experience possible.

Many Americans are unaware that in order to obtain subsidized healthcare under the ACA it isn’t necessary to go through one of the government exchanges, and according to Health Network, the private marketplace is quickly proving to be one of the best ways Americans can obtain coverage that is specifically matched to their medical and financial needs and that does not require them to register with a government exchange directly.

ABOUT HEALTH NETWORK
Health Network Group, LLC is a leading healthcare marketing company with 15 million visitors and nearly 100 million page views annually across its network of websites. Health Network’s mission is to provide a unique, consumer-first experience to help individuals obtain healthcare and improve their lives. It also respects consumer privacy and prevents the abuses by traditional industry companies of excessive personal data sharing. Learn more at HealthNetwork.com. Reported by PRWeb 1 day ago.

Auspicium CEO, Denise Cicchella, speaks at AHIA Annual Conference in Austin, Texas

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Denise Cicchella addresses crowd about Healthcare Fraud in 2013 and creative billing schemes that they should be including in their reviews.

Austin, Texas (PRWEB) September 29, 2014

Denise Cicchella, Auspicium CEO, was honored to be asked to speak at the 2014 Association of Healthcare Internal Auditors (AHIA) conference this year. Founded in 1981, the Association of Healthcare Internal Auditors (AHIA) is a network of experienced healthcare internal auditing professionals who come together to share tools, knowledge and insight on how to assess and evaluate risk within a complex and dynamic healthcare environment.

Denise spoke to the organization in 2013 about successful Transition Management of Hospital Construction Projects. The course was so well received, she was invited back to address the topic of Health Care Fraud for this years conference. Denise’s session was well attended with over 200 conference members present. Denise addressed fraud in the healthcare billing process and discussed such schemes as: ghost patients, unbundling of claims, identity theft (for use of stolen of fictitious medicare numbers), and others. The session was well received by participants who found the class engaging, entertaining, eye opening and thought provoking. Denise provided tips they could use in their every day work to go back and identify these schemes through audit and automated audit methods.

Health care fraud costs the country tens of billions of dollars a year. It’s a rising threat, with national health care expenditures estimated to exceed $3 trillion in 2014 and spending continuing to outpace inflation. Recent cases also show that medical professionals continue, and may be more willing, to risk patient harm in furtherance of their schemes. As consumers, healthcare fraud costs us in the realms of increased health insurance premiums, standards of care and fraudulent payments from governmental sources such as Medicare and Medicaid.

Denise and Auspicium provide custom audit service and audit training solutions to many clients including healthcare, education, pharmaceutical, and other industries. Denise is a subject matter expert in the field of construction audit, project management and fraud examination. Reported by PRWeb 1 day ago.

New Book Offers Solutions to Prevent Needless Disabling: Living Abled and Healthy

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Christopher R. Brigham, MD and Henry Bennett author new book, Living Abled and Healthy: Your Guide to Injury and Illness Recovery, which tackles poor health outcomes and needless disability with innovative insights and specific solutions.

(PRWEB) September 29, 2014

Each day countless individuals face poor health outcomes and needless disability. A new book, Living Abled and Healthy: Your Guide to Injury and Illness Recovery, tackles these issues with innovative insights and specific solutions.

When we, as individuals, deal with injury or illness we face the risk of living diminished lives—even when we may not need to. Today’s approach to our health and the management of potential disability has lost an essential component: the importance of educating and empowering each of us to take greater control of our own health and well-being.

Living Abled and Healthy… reflects the commitment of Christopher R. Brigham, MD, internationally recognized preventive and occupational medicine physician and a leader in addressing issues in recovery, disability, and human potential, and Henry Bennett to improve healthcare outcomes. They recognize that knowledge, combined with a positive attitude, can help individuals get successfully through the complex maze of government, health, insurance and legal systems to achieve best-possible outcomes. This leads not only to better lives, it also reduces both healthcare and disability costs.

The book challenges the status quo. It offers practical, innovative, low-cost, and powerful solutions to change attitudes, minimize long-term health problems, and reduce needless disability. It offers guidance for selecting the best healthcare providers and when and how to involve lawyers. The importance of establishing positive relationships with such healthcare participants as claims adjusters, case managers, and employers is explained. Critically, the goal of assuring appropriate care and reducing risks from unnecessary medications and procedures is addressed. Access to the web-based resources at http://www.livingabled.com —including forms, agreements, and additional tools—is provided with the book.

“Living Abled and Healthy… is written for those of us dealing with injury or illness,” says Brigham. “The book is a must-read, as well, for healthcare and other professionals within the healthcare systems—physicians, adjusters, attorneys, employers, insurers, adjudicators, and others will find it informative."

Written over five years, and including contributions from internationally recognized experts, the book has already received accolades from judges, employers, healthcare providers, patient advocates, and others. Reported by PRWeb 1 day ago.

Kelsey National Corporation Observes 50th Anniversary

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Kelsey National Corporation, an experienced marketer and administrator of insurance products for individuals, corporations, and associations across the United States, is celebrating half a century of innovation and experience in the US insurance industry.

Los Angeles, CA (PRWEB) September 29, 2014

Much has changed in the US insurance industry over the past 50 years, and Kelsey National Corporation (KNC) is proud of its history on the front lines of this transformation. During this time, KNC has constructed an impressive legacy that includes extensive experience building online dental, health, vision, and other types of insurance marketplaces for employers, benefit consulting houses, and associations.

Kelsey and the US insurance industry have matured side by side over the past 5 decades. The industry as a whole has seen the days of single carrier solutions for employee groups disappear as the internet has enabled – and companies like KNC have perfected – multi-carrier comparison tools. Today, sites like those run by KNC are able to provide a vast number of options to consumers and employers, while delivering a range of choice that was unimaginable when Van R. Kelsey Sr. founded the company just 50 years ago.

In 1949, Van R. Kelsey Sr. started out selling life insurance door-to-door to individual consumers. He accepted a position as Division Manager for a major life insurance company in 1952. Within 2 years, he had started his own operations as Kelsey Insurance Consultants. In 1964, Van founded Kelsey National Corporation, which is celebrating its golden anniversary of business success in 2014.

Van Kelsey was among the first entrepreneurs to see the advantages of providing group insurance plans to businesses. This insight soon translated into a successful bid to also provide group benefits to the members of local, state, and eventually national insurance associations. Reflecting his extensive expertise in the insurance industry, Van served as President of both his state and national insurance associations.

Van led KNC for thirty years. Then, in 1994, his son, Mark Kelsey, took over the reins and steered the company toward the wild, wild web. Much as his father had identified the opportunities of post WWII America, Mark’s Presidency at KNC focused on tapping the potential for online technologies and ecommerce to help transform the way insurance products are sold in the 21st Century.

Under Mark’s leadership, KNC developed a broad range of consumer-oriented insurance web sites, including HealthInsurance.com, which empowers small businesses and individuals to make informed health insurance decisions, and DentalInsurance.com, an online exchange platform for dental insurance and discount dental plan comparison shopping. In addition, KNC today provides turnkey insurance exchanges for a wide variety of businesses, benefit brokers, and associations across the US.

Earlier this year, Avery Smith, who was KNC’s Director of Business Development for the past 7 years, became the third President in Kelsey’s 50-year history. In his time with Kelsey, Smith has been responsible for the creation of an online platform that helped thousands of Medicare participants easily purchase Part D Prescription Drug Coverage. Smith has also worked tirelessly to create a private exchange for part-time and seasonal employees to purchase health insurance, which eight Fortune 500 companies have endorsed. He was prominent in the creation of YourDentalExchange.com, a private exchange that helps seniors who are losing group coverage sign up for dental and vision insurance plans with no waiting periods.

This year, the KNC team has given DentalInsurance.com a new, more user-friendly interface designed to make shopping for dental insurance and dental discount plans even easier for consumers, with a blog that has been given a facelift and a complete structural overhaul. Now, blog content and related oral health resources are easier for people to discover and use.

As the health, dental, and vision insurance industries continue to evolve within the U.S., Smith’s strategic plans for the future of KNC include expanding the company’s self-service exchange-type offerings, which today serve a variety of employers and benefits consultants, as well as associations of all sizes. “This is the most exciting time for the insurance industry in 50 years,” he said. “Health insurance reform and the empowerment of the individual through new technologies are changing not only the industry and our company but people’s lives. As we look to the future, we will continue to focus on building elegant and robust solutions for our partners, offering innovative products, and delivering the type of first-rate services and experiences that will keep Kelsey’s customers coming back.”

About Kelsey National Corporation
Based in Los Angeles, CA, Kelsey National Corporation (KNC – http://www.Kelsey.com) is an experienced marketer and administrator of insurance products for individuals, corporations, and associations across the United States. KNC offers unique solutions that can solve the paradigm of health care coverage for our partners by helping their members or employees make better insurance choices, including http://www.HealthInsurance.com, which empowers small businesses and individuals to make informed health insurance decisions, and http://www.DentalInsurance.com, an online exchange platform for dental insurance and discount dental plan comparison shopping. Reported by PRWeb 22 hours ago.

It's Not Your Imagination, Your Health Insurance Has Gotten Worse

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A quiet revolution happened to your job-based health benefits and you may not have noticed. It's happened gradually, but insurance looks a lot different than it did just 15 years ago: Americans are paying more and getting less.

That trend is only getting worse.

Gone are the days of deluxe health plans that simply paid employees' medical bills without questions or problems. Now, faced with their own rising health care expenses, employers are forcing more risk for big medical bills onto workers, and asking them to take a more active role in shopping for lower-cost health care than they have before.

Last year, when Amy Czerwinski learned she had breast cancer and would need a double mastectomy as well as seven months of chemotherapy, she was not in the best place to start bargain-hunting for care.

"This is a life-and-death thing," said Czerwinski, a 38-year-old accountant who lives in Hendersonville, Tennessee. "You go to the specialist, and they tell you who they would suggest. I would be afraid to shop around and get a cheaper oncologist."

And that highlights a key problem with putting the onus on patients to be smart shoppers for doctors: The spread of health insurance that makes us pay more money upfront has outpaced the spread of reliable, accessible information about prices and about the quality of medical services.

Health insurance companies and employers use buzzwords like "consumer-directed health plans" to describe these approaches to health benefits. Higher deductibles and other means of making patients pay more when they receive health care -- like "coinsurance" that requires consumers to cover a percentage of their bills rather than charging a flat copayment -- are a way for employers to save money.

The average annual cost of a single worker's insurance plan more than doubled between 1999 and 2013, rising from about $2,200 to around $5,900, according to a survey of employers published by the Henry J. Kaiser Family Foundation and the Health Research and Educational Trust last month. Over that same time, the average share of that cost paid by single workers inched up from 14 percent to 18 percent -- meaning employers are chipping in less, even as costs rise precipitously.

And in the past five years, another trend has rapidly spread: higher and higher deductibles, which require workers to pay cash upfront for their medical care before the insurance begins picking up a share of the bills. Between 2006 and 2013, the portion of single workers whose plans have deductibles of at least $1,000 jumped from 10 percent to 38 percent, according to the survey.

Deductibles are supposed to give patients a financial motivation -- what insiders call "skin in the game" -- to shop around for less expensive medical providers, and to reconsider treatments they may not need. When you're responsible for paying more of the bill, you're more likely to care about how much something costs.

In some key respects, these changes have been beneficial. In the old days, a patient had no reason to care how much a service or a drug might cost, because their health plan would cover almost all of it. This is one reason U.S. health care spending went up and up over the decades. And the switch to health insurance that requires patients to pay more of the total cost has contributed to a historic slowdown in national health spending and to slower growth in job-based insurance premiums in recent years.

That doesn't mean a whole lot when you get sick, though. Health insurance designed to make workers more cost-conscious also exposes them to big expenses when they need lifesaving care, as Czerwinski learned. "Your insurance won't even touch anything until you hit your deductible," she said.
Photo courtesy of Amy Czerwinski

Czerwinski racked up more than $15,000 in out-of-pocket costs as she struggled to meet the deductibles for her employer's health insurance while undergoing a double mastectomy and seven months of chemotherapy.

"You pretty much ignore the cost, because you just do," she said. "And then when you finally have to start opening the bills, it's kind of too late because you've already incurred the expenses." Her employer and the Patient Advocate Foundation, which referred HuffPost to Czerwinski, helped cover her expenses, she said.

A key element of the reasoning behind large deductibles and higher cost-sharing is that it will spur patients to become smarter consumers of health care who will do the research on which medical providers charge lower prices or have been proven to offer high-quality treatments.

But the facts that patients need in order to make informed choices are hard to find and complex to evaluate.

"I don't even know how you would do that," Czerwinski said. "I didn't even know that was an option."

And people facing high cost-sharing tend to skip not just expensive care they could do without, but also services they actually need, research shows.

There has been some improvement on this score, as health insurance companies, employers and other organizations are gathering and disseminating cost and quality information for patients to use. A growing number of health insurance companies, for example, are sharing these data with a nonprofit called the Health Care Cost Institute, which will publish them on its website next year.

Yet merely making the information available isn't enough, said David Newman, the institute's executive director. "Transparency in and of itself is not going to be the silver bullet. It can help," he said.

Employers who are shifting more responsibility for managing health care costs to workers should do more to make sure their employees understand how their benefits work and get them invested in the new way of doing things, said Julie Stone, the North America health and group benefits leader at Towers Watson, a consulting firm.

"There is an employer role to keep that front and center, and give examples and illustrate [that] it's in everybody's best interests, it's a win-win for the employer and the employee from a cost-management perspective," Stone said.

Czerwinski is now cancer-free, but she still worries about paying for the doctor visits and drugs she'll need to make sure the disease doesn't come back. And she's not confident her health benefits will keep up with her needs or stay on her family's budget.

"Insurance companies don't pay like they used to. And it's only going to get worse, and that's very scary because our salaries are not increasing at the same rate the insurance costs are increasing," Czerwinski said. "It didn't use to be this bad." Reported by Huffington Post 21 hours ago.

Health-Coverage Expansion Gets Tougher

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A nationwide effort to enroll consumers in health insurance under the Affordable Care Act this fall will be more complicated than it was for 2014. Reported by Wall Street Journal 17 hours ago.

LTCG CEO to Speak on Best Practices in Long Term Care Insurance Administration at NOLHGA’s 31st Annual Meeting

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LTCG CEO to Speak on Best Practices in Long Term Care Insurance Administration at NOLHGA’s 31st Annual Meeting EDEN PRAIRIE, Minn.--(BUSINESS WIRE)--Peter Goldstein, CEO of LTCG, has been invited to speak at the Annual Meeting of the National Organization of Life and Health Insurance Guaranty Associations, or NOLHGA, on October 9, 2014. Goldstein will share best practices in administering long term care insurance (LTCI) gained from his years of strategic leadership at LTCG, the recognized leader in business processing outsourcing for long term care. Under his direction, LTCG has become the largest provi Reported by Business Wire 19 hours ago.

Novitex Selected to Provide Client Communication Solution for ‘Path to Health’ Health Insurance Exchange Education and Enrollment Campaign

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Novitex Selected to Provide Client Communication Solution for ‘Path to Health’ Health Insurance Exchange Education and Enrollment Campaign STAMFORD, Conn.--(BUSINESS WIRE)--Novitex Enterprise Solutions, the industry-leading provider of the Integrated Document Life Cycle™ (IDLC™) in the Document Outsourcing market, has been selected by Tenet Healthcare to deploy the Connect platform, which will enable the healthcare services company and its 80 hospitals to standardize, personalize and accelerate the delivery of materials for its Path to Health education and enrollment campaign. Path to Health is a comprehensive initiative designed Reported by Business Wire 19 hours ago.

Clients Can Find Affordable Medical Insurance Online!

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Comparemedicalinsurance.info (http://comparemedicalinsurance.info/ ) announces a new blog post, “How to Find Affordable Personal Medical Insurance Online!”

(PRWEB) September 29, 2014

Comparemedicalinsurance.info has released a new blog post explaining how to find affordable medical insurance online.

Clients can now compare health insurance quotes to find the best individual medical plans. Having health insurance is very important as medical costs can be very high. A health insurance plan will cover a part of the insured’s medical expenses.

Comparing health insurance quotes can help clients find affordable plans. An individual policy is more expensive than a government funded plan, but the coverage is better.

Clients can compare plans online by completing a single form. The information is used by the search engine to select only relevant plans.

Comparemedicalinsurance.info is an online provider of life, home, health, and auto insurance quotes. This website is unique because it does not simply stick to one kind of insurance provider, but brings the clients the best deals from many different online insurance carriers. In this way, clients have access to offers from multiple carriers all in one place: this website. On this site, customers have access to quotes for insurance plans from various agencies, such as local or nationwide agencies, brand names insurance companies, etc.

Comparemedicalinsurance.info is owned by Internet Marketing Company.

For more information, please visit http://comparemedicalinsurance.info/ . Reported by PRWeb 17 hours ago.

Giving employees money to buy health insurance has tax implications

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Money given to employees to purchase their own health plans is taxable to both the worker and the organization unless the mon -More-  Reported by SmartBrief 16 hours ago.

Putting Your Health Insurance Where Your Mouth Is

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Open enrollment is fast approaching.

Last fall, I gave up my employer-based health insurance plan and jumped into New York's health insurance exchange.

Why give up a good health plan (that is partially subsidized by my employer) to become one more person searching for an unsubsidized plan?

The first factor was principle. While the Affordable Care Act fell far short of my expectations for improving America's health care system, it was a small step in the right direction. After years of emphasizing the importance of learning from the leading practices of other countries, I felt I should support this nascent system. As a healthy 41 year old, I was a "good bet" for any health insurance company and insurance pools need healthy people paying the full amount to balance out some of the negative selection.

The second factor was flexibility. By disconnecting health insurance from employment, I could make career decisions without having to add "where will I get health insurance?" to the equation.

This wasn't a financial decision. Monthly premiums were nearly identical for my employer-based plan and my exchange-selected Platinum Plan. My new plan was not as comprehensive and was not accepted by my primary care physician or my dentist. This was inconvenient but manageable. I combed through the health personnel directory, called my new insurer for some guidance, and found new providers.

Open enrollment is fast approaching.

Last year many people were afraid of taking the risk of jumping into the pool. Today we know the exchange is working. There are over 7 million paying customers, costs have come in lower than expected and the number of companies offering plans next year will increase.

Many of my friends and acquaintances have jobs with employer-based health insurance. Many have been vocal advocates of the Affordable Care Act. They have talked about the need for America to improve its public health system. They have talked about the injustice of America's uninsured. They have talked about the fact that Americans pay far more for health care than other countries yet our life expectancy is below that of other wealthy countries.

It is time to talk less and do more. It is time to put your health insurance where your mouth is.

Open enrollment is fast approaching.

This fall I will again get health insurance on the exchange instead of through my employer. What about you?Follow Howard Steven Friedman Twitter, Facebook, Author page Reported by Huffington Post 15 hours ago.

What to do if you lose your health insurance

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*What to do if you lose your health insurance*

There are lots of ways to lose your health insurance. You can lose or quit your job, get a divorce, get kicked off your parent’s plan when you turn 26, move out of state, come to the end of your COBRA coverage, or have a plan that’s being discontinued. In the past, any one of those events could have meant disaster. Now, thanks largely to the Affordable Care Act and other health care reforms, you have more options. Still, there's a lot you need to know. Here are answers to the most common questions about losing your insurance.

-*Where can I get replacement insurance?*-

Through your state health insurance marketplace.  Anyone who needs health insurance can purchase coverage here. If you are not sure how to get started, run through our free interactive online tool, HealthLawHelper, which will point you in the right direction.

Once you register on the marketplace, you can find out whether you qualify for a financial help with your premiums, and out-of-pocket costs. You can then shop for and compare different plans and enroll in the plan of your choice right then and there. Learn more about selecting the right plan for you.

-*Do I have to go without insurance until the next open enrollment period?*-

No, you can get new insurance right away.

It is true that under normal circumstances you can’t purchase insurance on your own unless it’s open enrollment season, which this year runs from Nov. 15, 2014, through Feb. 15, 2015.

But if you are in any of the situations described above (plus several more), you can purchase replacement coverage on the marketplace at any time of year. What to do: log into or create an account on your state’s marketplace, then ask for what’s called a Special Enrollment Period. Once it’s confirmed, you’re free to shop for new health coverage.

-*What kinds of situations entitle you to this Special Enrollment Period?*-

Here’s the full list of “qualifying life events” that allow you to purchase new health insurance any time of year.

· Losing coverage from a job (quit or were laid off, doesn’t matter).
· Expiration of your current health plan, including COBRA.
· Coming to the end of your current plan’s contracted “plan year.”
· Aging off your parent’s plan when you turn 26.
· Losing coverage through a spouse because of death or divorce.
· Losing your student plan when you graduate.
· Moving to a new location outside your current plan’s service area.
· Getting out of jail.
· Moving back to the U.S. after having lived abroad.
· Becoming “lawfully present” in the United States. In general this means you are allowed to live in the United States on something other than a temporary tourist visa. Here’s a more detailed definition.
· Getting kicked off of Medicaid or CHIP because your income has gone up.
· Having a baby, adopting a child, or becoming a foster parent.

-*If I leave or lose my job, can’t I take COBRA?*-

Yes. For those who don’t know, COBRA is a law from the 1990s that requires most employers to allow departed employees (and their dependents) to stay on their old workplace health plans for another 18 to 36 months. Your COBRA plan will be the exact same plan you had at your old job.

The downside is you must pay the entire cost of the plan while on COBRA, including the part the employer used to pay. It can easily run to $700 a month or more for an individual and more than $1,000 a month for a family.

Starting from the day your regular employer coverage ends (it’s usually the last day of the month you left your job, but check to be sure), you have up to 60 days to decide whether or not to take COBRA.  If you sign up at any point during that period, your coverage will be retroactive, provided you pay the back premiums.

-*Which is better, COBRA or buying my own marketplace plan?*-

It depends. During your 60-day grace period you should definitely check out your options on the marketplace to see what kind of financial help you can get, and select some plans you think you might like. When you give your income information to the marketplace, you will also find out whether you may qualify for Medicaid for yourself or CHIP for your children. Then you can compare your marketplace options to the COBRA plan.

In most situations the marketplace plan will probably be cheaper than COBRA. But there are other things to consider, too:

· If it’s later in the year, you may have met your work plan’s deductible, whereas if you start a new plan, you’ll have to meet the new deductible from scratch. Be sure to take this into consideration when you run the numbers.
· If you are in the middle of treatment for a serious condition, check to see whether your providers take part in any marketplace plans.

-*Can I take COBRA and pick up a marketplace plan later?*-

Once you start COBRA, you have to keep it until the next open enrollment period or until the COBRA plan runs out, whichever comes first. So if you start COBRA in, say, March, you will have to keep it until open enrollment comes around. At that point you can replace it with a marketplace plan.

Get health insurance rankings

Click on the image at right for rankings of health insurance plans nationwide. Use the tool to:

· Choose a plan category such as private HMO or PPO, or Medicare HMO or PPO.
· Choose a state.
· Customize your search to compare plans' scores and their performance in measures such as consumer satisfaction and providing preventive services.

*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*

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Update your feed preferences Reported by Consumer Reports 14 hours ago.

Texas And Florida Expand Medicaid -- For Kids

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Republican lawmakers in Florida and Texas snubbed the Affordable Care Act’s Medicaid expansion for adults, but their states did broaden the program this year -- for school-age children.Those states were among 21 – including some big Democratic-led states, such as California -- that were required to widen Medicaid eligibility for children between the ages of 6 and 18 by 2014.  That little-known provision of the health law is a key reason hundreds of thousands of kids gained coverage in the state-federal health insurance program for the poor, according to a Kaiser Health News survey of a dozen states. 

While many of those kids were previously enrolled in another government insurance program, children are typically better off in Medicaid because it offers broader health benefits at lower cost to their families. The higher eligibility level was already in effect for children younger than 6.

California led the way, increasing Medicaid enrollment by 715,000 children age 6 to 18.  Five other states — Texas, New York, Florida, Georgia and Colorado — accounted for about 750,000 additional enrollees, according to data measuring growth through this summer.

Several other factors helped drive the increases:  Some of those kids might have been eligible under the old rule, but enrolled this year because of the focus on the health law’s open enrollment. California, meanwhile, shifted into Medicaid all kids previously covered by the Children’s Insurance Program (CHIP), the federal-state program that helps children from families with incomes too high to qualify for Medicaid but too low to afford insurance on their own. 

*More Kids Might Have Enrolled*

Consumer advocates say they welcome the expansion of eligibility to children in families making 138 percent of the federal poverty level, or $32,913 for a family of four— raised from the poverty level, or $23,850 for a family of four.

But they say more children would be enrolled had more states expanded the program for adults. That’s because parents who sign up themselves are more likely to sign up their kids.

“It’s a lost opportunity for Texas to cover the kids and teens, but not their parents.” said Anne Dunkelberg, associate director of the left-leaning Center for Public Policy Priorities in Austin, Texas.

Much attention has been paid to the 23 GOP-led states, including Florida and Texas, which have not expanded Medicaid for adults since the Supreme Court made that optional in 2012. Republican critics have said expansion would strain state budgets and increase dependency on government programs. Yet there’s been little publicity about the law’s mandatory Medicaid expansion for school-age children. 

One reason is that the change affected fewer than half the states — those that had not raised eligibility levels for school-age kids before the 2010 health law passed.  The law required states to expand by 2014. California, Colorado and New York started earlier.

In addition to those three and Texas and Florida, the other states that broadened eligibility for children in Medicaid are Alabama, Arizona, Arkansas, Delaware, Georgia, Kansas, Mississippi, Nevada, North Carolina, North Dakota, Oregon, Pennsylvania, Tennessee, Utah, West Virginia and Wyoming. Eleven of these states expanding kids’ coverage opted against expanding it for adults, after the Supreme Court gave them that option.

*Many Kids Shifted From CHIP*

In most of those states, between half and two-thirds of the children joining Medicaid were previously covered by CHIP. About 562,000 children were expected to shift from CHIP to Medicaid as a result of the law, according to a study by the Georgetown Center for Children and Families.

Experts say the benefits are generally richer in Medicaid. For instance, families had to pay monthly premiums for their kids’ CHIP coverage in six states that expanded Medicaid for children —Alabama, Arizona, Delaware, Florida, Georgia and Utah, according to Joan Alker, executive director of the Georgetown program.

“Having [to pay] premiums depresses enrollment” in CHIP, she said.

Medicaid requires that children receive comprehensive services, including physical exams, immunizations, laboratory tests and dental, vision, and hearing services. CHIP benefits are not as broad in some states.

Still, state officials and advocates in California and Pennsylvania worry that families may have to find new doctors for their kids because Medicaid does not have as many participating providers as CHIP in some places.

“It’s a mixed bag, as Medicaid has lower costs but possibly fewer providers,” said Kelly Hardy, senior director of health policy for the California advocacy group, Children Now.

But Hardy said the expansion makes life easier for parents who will no longer have to deal with having one child in CHIP and another in Medicaid because income eligibility varied by age. Siblings in different programs might have different benefits, provider networks and cost-sharing.

Unlike Medicaid expansion for adults, the federal government is not paying the full cost of expanded eligibility for the first three years. Instead, states will get the higher federal matching rate for CHIP—about 71 percent of the costs.

*‘Welcome Mat’ Effect*

In Texas, nearly 2.9 million children were signed up for Medicaid as of August 2014—up about 254,000 school-age kids from December 2013. In the same period, Texas’ CHIP enrollment fell by nearly 160,000. 

“There is no doubt we are seeing a welcome mat effect,” involving children who were previously eligible but not enrolled and who were signed up because of the publicity about the ACA’s open enrollment, said Dunkelberg of the Center for Public Policy Priorities.

In Florida, enrollment of school-age children in Medicaid rose by 137,000 this year, which included more than 62,000 kids who transferred from the state’s CHIP program, according to Florida Healthy Kids Corp., the nonprofit that runs CHIP in the state. That switch saved families money, since they previously had to pay a $15- or $20-a-month premium for CHIP coverage.

In Georgia, meanwhile, Medicaid enrollment for school-age kids rose by 81,000 to about 632,000 since last December. At same time, the state’s CHIP enrollment fell by about 25,000.

Georgia Medicaid Director Jerry Dubberly said the state did little to publicize the expansion for children. He attributes the higher enrollment to the change in eligibility, along with a reduction in dropouts as a result of the need to renew coverage for children only once a year under the health law.

Pennsylvania officials won federal approval to delay shifting children from CHIP to Medicaid until the end of the year because of concerns that families would have to find new doctors. About 32,000 children in that state’s CHIP program now qualify for Medicaid. 

Still, the number of Medicaid-enrolled children over six in Pennsylvania rose by about 18,000 this year to 668,000, which could include children who were uninsured or who switched from private insurance.

Officials in Florida, Georgia and Texas discount concerns about the availability of providers.

Greg Mellowe, policy director of the consumer group, Florida CHAIN, said he hopes the expansion of Medicaid to tens of thousands of children doesn’t go unnoticed by state lawmakers.

“While Florida continues to have the option to reject expansion for adults in the legal sense,” he said, “this is yet another reminder that doing so isn't sensible or justifiable in any other sense.”
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente. Reported by Huffington Post 15 hours ago.

Improving the 'Patient Experience' By Eliminating the Big Insurance Company

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Health care provider organizations that are working directly with employers like Boeing -- and cutting out the insurance company middlemen -- believe they can do more than save money for those employers. They're confident they can also improve both health care quality and service for workers and their families in ways that insurance companies cannot.

Employers are starting to realize that insurers might not be, as they have claimed, "part of the solution" to achieving a more patient-centered health care system. In fact, in some ways they have been part of the problem.

Providence-Swedish Health Alliance, a not-for-profit, hospital-based accountable care organization (ACO), will soon be providing both coverage and care to many Boeing employees, along with UW (University of Washington) Medicine -- without an insurance firm. Officials at Providence-Swedish told me Boeing chose to work with them directly in part because of the firm's desire to ensure their employees had a "better patient experience." While cutting costs and improving quality of care were priorities, improving service and reducing hassles that have become synonymous with insurance company interactions was equally important to Boeing.

So Providence-Swedish has committed to a number of assurances and is even establishing a "concierge center" for Boeing employees. Among other things, the ACO has promised same-day or next-day appointments for urgent primary care visits and acute care, proactive support for preventive care and chronic disease management. The hub for all of this will be the concierge center, which patients can reach by phone, email or the Web.

While Boeing is contracting directly with Providence-Swedish and UW Medicine, the ACOs will have their own deals with insurance companies to provide back room services like claims processing. Dr. Joe Gifford, CEO of the Providence-Swedish ACO, told me his organization is working with Blue Cross of Illinois for that work. The federal government works with insurers in the same way to handle claims for Medicare beneficiaries.

Gifford also told me he's in discussions with a number of other employers in the region that could result in similar deals -- and even some that will include insurance companies, to some extent. And he noted that government entities, including Medicare and state governments, are following a similar path.

It's a path that leads to what is often referred to as value-based care, a term that encompasses a spectrum of arrangements. What is common to all of the arrangements is a movement away from paying doctors and hospitals for individual treatments and diagnostic tests. In the deal with Boeing, for example, the aerospace company has given the ACOs a budget to provide all the care Boeing employees and dependents are likely to need in 2015.

In that sense, he said, "Boeing is treating us like an industrial supplier... and we are fully accountable" for costs and outcomes. That means that the ACOs will by necessity need to focus on keeping patients healthy and managing chronic conditions in the most cost-effective ways so as to prevent complications and reduce unnecessary hospitalizations.

Other hospitals are also taking on responsibilities that once were the complete domain of insurance companies. One example: the Community Hospital of the Monterey Peninsula in California, which earlier this year began offering its own Medicare Advantage plan to serve area seniors through a subsidiary called Aspire. "We think we can do a better job of meeting local needs than having a national company come in and tell us how to do it," the company's CEO, Scott Kelly, told the Monterey County Weekly.

This trend is not new. Many hospitals in the 1980s began operating their own HMOs to compete with insurance companies, but most of them failed, in large part because they didn't have the actuarial and claims management expertise in-house they needed to stay solvent.

Learning from past mistakes, many of the hospitals and physician-led groups that are moving back into the health insurance market are hiring companies like Chicago-based Valence Health, a fast-growing firm that offers services ranging from claims adjudication to patient care coordination to more than 120 hospitals nationwide.

The number of employees at Valence has doubled to 325 over the past two years and is expected to grow by another 500 within five years. According to Kevin Weinstein, Valence's chief marketing officer, that growth has been fueled by the movement away from fee-for-service medicine to value-based care in which health care providers are finding they have no alternative but to be more accountable for both cost and quality.

While the Affordable Care Act has been a catalyst for much of this change, employers like Boeing and other big payers of health care, including federal and state governments, will continue to drive it. Reported by Huffington Post 13 hours ago.

Improving the "Patient Experience" By Eliminating the Big Insurance Company

0
0
Health care provider organizations that are working directly with employers like Boeing --and cutting out the insurance company middlemen-- believe they can do more than save money for those employers. They're confident they can also improve both health care quality and service for workers and their families in ways that insurance companies cannot.

Employers are starting to realize that insurers might not be, as they have claimed, "part of the solution" to achieving a more patient-centered health care system. In fact, in some ways they have been part of the problem.

Providence-Swedish Health Alliance, a not-for-profit, hospital-based accountable care organization (ACO), will soon be providing both coverage and care to many Boeing employees, along with UW (University of Washington) Medicine--without an insurance firm. Officials at Providence-Swedish told me Boeing chose to work with them directly in part because of the firm's desire to ensure their employees had a "better patient experience." While cutting costs and improving quality of care were priorities, improving service and reducing hassles that have become synonymous with insurance company interactions was equally important to Boeing.

So Providence-Swedish has committed to a number of assurances and is even establishing a "concierge center" for Boeing employees. Among other things, the ACO has promised same-day or next-day appointments for urgent primary care visits and acute care, proactive support for preventive care and chronic disease management. The hub for all of this will be the concierge center, which patients can reach by phone, email or the Web.

While Boeing is contracting directly with Providence-Swedish and UW Medicine, the ACOs will have their own deals with insurance companies to provide back room services like claims processing. Dr. Joe Gifford, CEO of the Providence-Swedish ACO, told me his organization is working with Blue Cross of Illinois for that work. The federal government works with insurers in the same way to handle claims for Medicare beneficiaries.

Gifford also told me he's in discussions with a number of other employers in the region that could result in similar deals--and even some that will include insurance companies, to some extent. And he noted that government entities, including Medicare and state governments, are following a similar path.

It's a path that leads to what is often referred to as value-based care, a term that encompasses a spectrum of arrangements. What is common to all of the arrangements is a movement away from paying doctors and hospitals for individual treatments and diagnostic tests. In the deal with Boeing, for example, the aerospace company has given the ACOs a budget to provide all the care Boeing employees and dependents are likely to need in 2015.

In that sense, he said, "Boeing is treating us like an industrial supplier... and we are fully accountable" for costs and outcomes. That means that the ACOs will by necessity need to focus on keeping patients healthy and managing chronic conditions in the most cost-effective ways so as to prevent complications and reduce unnecessary hospitalizations.

Other hospitals are also taking on responsibilities that once were the complete domain of insurance companies. One example: the Community Hospital of the Monterey Peninsula in California, which earlier this year began offering its own Medicare Advantage plan to serve area seniors through a subsidiary called Aspire. "We think we can do a better job of meeting local needs than having a national company come in and tell us how to do it," the company's CEO, Scott Kelly, told the Monterey County Weekly.

This trend is not new. Many hospitals in the 1980s began operating their own HMOs to compete with insurance companies, but most of them failed, in large part because they didn't have the actuarial and claims management expertise in-house they needed to stay solvent.

Learning from past mistakes, many of the hospitals and physician-led groups that are moving back into the health insurance market are hiring companies like Chicago-based Valence Health, a fast-growing firm that offers services ranging from claims adjudication to patient care coordination to more than 120 hospitals nationwide.

The number of employees at Valence has doubled to 325 over the past two years and is expected to grow by another 500 within five years. According to Kevin Weinstein, Valence's chief marketing officer, that growth has been fueled by the movement away from fee-for-service medicine to value-based care in which health care providers are finding they have no alternative but to be more accountable for both cost and quality.

While the Affordable Care Act has been a catalyst for much of this change, employers like Boeing and other big payers of health care, including federal and state governments, will continue to drive it. Reported by Huffington Post 13 hours ago.

Bidding war for NMHIX ad contract begins, but some NM firms abstain

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Two New Mexico advertising firms said Monday they will definitely bid on the $6.2 million New Mexico Health Insurance Exchange's advertising contract, and a third said it is considering a bid. Three local firms also said they won’t pursue the contract. Joan Griffin, owner of Griffin & Associates in Albuquerque, said she bid on the original $7.2 million contract in 2013 and that her firm is in the process of preparing a bid for the new contract. “I think it is important that the Health Insurance… Reported by bizjournals 13 hours ago.

Can a Company Reimburse Employees Who Buy Their Own Health Insurance? Maybe

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Can a Company Reimburse Employees Who Buy Their Own Health Insurance? Maybe Reported by ajc.com 13 hours ago.

Swiss voters reject state-run health insurance system

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Swiss voters on Sunday shot down a plan to shift to a state-run health insurance system, opting to stick with their all-private scheme. Reported by FOXNews.com 12 hours ago.

MCNA Receives URAC Claims Processing Accreditation

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MCNA has been awarded Claims Processing Accreditation from URAC, a leading Washington, DC-based health care accrediting organization that establishes quality standards for the health care industry. MCNA is the first dental plan to receive this accreditation from URAC.

Fort Lauderdale, FL (PRWEB) September 29, 2014

MCNA has been awarded Claims Processing Accreditation from URAC, a leading Washington, DC-based health care accrediting organization that establishes quality standards for the health care industry. MCNA is the first dental plan to receive this accreditation from URAC. It will serve as an important framework by which the company can pursue the continuous improvement of its claims administration business processes through benchmarking against nationally recognized standards.

"Becoming accredited illustrates our commitment to meeting the exacting standards and industry best practices set forth by URAC. We are very proud of this milestone," said Shannon Turner, Vice President of Operations.

MCNA's claims administration processes are supported by DentalTrac™, the company's proprietary, enterprise-wide management information system (MIS). Recognizing that claims processing is central to the success of the Medicaid, Medicare, and CHIP programs that MCNA serves, the company's experienced leaders and staff ensure accuracy and efficiency throughout the business process while maintaining strict adherence to the requirements and rules established by the Health Insurance Portability and Accountability Act (HIPAA). With this achievement, MCNA has taken steps to further develop its core value of continuous quality improvement and protect the interests of all stakeholders, including plan members, network providers, and partner agencies across the country.

"By applying for and receiving URAC accreditation, MCNA has demonstrated a commitment to quality healthcare," said URAC President and CEO Kylanne Green. "Quality healthcare is crucial to our nation's welfare and it is important to have organizations that are willing to measure themselves against national standards and undergo rigorous evaluation by an independent accrediting body."

URAC, an independent, nonprofit organization, is a well-known leader in promoting healthcare quality through its accreditation, education, and measurement programs. URAC offers a wide range of quality benchmarking programs and services that model the rapid changes in the healthcare system and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire healthcare industry. For more information, visit http://www.urac.org.

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MCNA is a leading dental benefit management company committed to providing high quality services. We serve approximately 4 million Medicaid and CHIP members in Texas, Louisiana, Florida, and Kentucky. For over 20 years, we have been committed to improving the overall health of our members by making sure they get great dental care, and service they can trust. At MCNA, we care about your smile. More information can be found at our corporate website, http://www.mcna.net. Reported by PRWeb 12 hours ago.

'Sticker shock' of health insurance renewals

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Higher premiums, lower reimbursements, high deductibles bite medical practices' bottom lines

 
 
 
 
 
 
 
  Reported by Delawareonline 8 hours ago.
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