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Regence BlueShield settles class action suits for $6M, will now cover developmental disabilities

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Regence BlueShield, the largest health insurance company in Washington state, settled two class-action lawsuits last week for $6 million over its lack of coverage for neurodevelopmental disabilities therapies, such as autism treatments. The suits, filed in federal district court and King County Superior Court by the families of children with autism, makes Regence the final health insurer among the state's three largest to get taken to court over their lack of coverage for such disabilities. The… Reported by bizjournals 4 hours ago.

Triple-S Management Corporation Awarded Two Regions of Puerto Rico's Medicaid Program

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SAN JUAN, Puerto Rico, Oct. 15, 2014 /PRNewswire/ -- Triple-S Management Corporation (NYSE: GTS), the leading  managed care company in Puerto Rico, today announced that the Puerto Rico Health Insurance Administration (ASES by its Spanish acronym) issued a Notice of Intent to Award... Reported by PR Newswire 4 hours ago.

Here's Why We Might Be Heading Towards Another Government Shutdown Fight

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Here's Why We Might Be Heading Towards Another Government Shutdown Fight Fourteen Republican senators have written a letter to House Speaker John Boehner that sets stage for a budget showdown ahead of a government-funding deadline in December. The possibility has started to ruffle feathers in Washington weeks before the midterm elections and sparked fears of a government shutdown.

In the letter, which was spearheaded by Sen. Marco Rubio (R-Florida), the senators urged Boehner to prohibit any "unappropriated and unauthorized funds" from going toward a risk-corridor program of the Affordable Care Act. It could open the door to a replay of last year, when bickering over the healthcare law led to the first federal government shutdown in 17 years. 

A Senate Democratic leadership aide who spoke to Business Insider suggested Rubio, who is expected to launch a White House bid in 2016, was trying to compete with another likely presidential hopeful, Sen. Ted Cruz (R-Texas), who was widely seen as the architect of the last shutdown.

"The Rubio strategy seems like he’s trying out-Cruz his probable 2016 primary challenger," the aide said. "I’m not going to predict whether it will succeed because Republicans have done crazier things."

The stopgap spending bill needs to be passed by Dec. 11 to avert a shutdown and keep the government funded. 

Republicans have charged the risk-corridor program could serve as a potential "bailout" for insurance companies. The "risk corridors" in question aim to make it easier for insurance companies to transition to the new health-care system, largely by making it less financially risky for them to sell new insurance plans on the government exchanges established by the Affordable Care Act. 

The risk corridors are a temporary program scheduled to expire in 2016. Until then, the risk corridors are set up for the government to compensate insurance companies that have bigger costs than they expected while transitioning to the new system. This provision is designed to protect insurers that see an especially unhealthy pool of customers and end up with higher claims than they predicted. 

This program exists because, under Obamacare's unprecedented overhaul of the federal healthcare system, insurers' cost of providing health insurance to an expansive new slate of customers was hard to predict.

The Department of Health and Human Services has said the risk-corridor program's payments are "user fees" and the administration has the authority to oversee the program and its funds. But a recent decision from the non-partisan Government Accountability Office, which the Republican senators pointed to in their letter, held the funds for the risk-corridor program must be appropriated by Congress.

Because of the decision, some Republicans who oppose the risk corridors think the best way to prevent them is to block their funding in the stopgap spending bill. This forces Democrats to either abandon the program or face the prospect of another shutdown if the stopgap bill is unable to pass.

"Without that appropriation, any money spent to cover insurance company losses under the risk corridor program would be unlawful," the senators wrote in their letter to Boehner, adding, "Unfortunately, President Obama and his administration have exhibited their intent to disregard the law and ignore the Constitution."

"We must act to protect Congress’ power of the purse and prohibit the Obama administration from dispersing unlawful risk corridor payments providing for an Obamacare taxpayer bailout," the senators wrote.

A consensus is emerging, however, that Republicans would most likely only take this path if they fail to win a Senate majority. Insiders doubt they would move on the strategy if they know they will have a Senate majority on Election Day since they would be in a position to eliminate the risk corridors without a budget battle.

However, control of the Senate may remain unknown immediately after Election Day due to the potential for lengthy runoffs in Georgia and Louisiana. In this scenario, it's also unlikely Republicans would want to risk a high-profile confrontation with the potential for a shutdown. The GOP's image brutally suffered after last year's 16-day shutdown, which means lawmakers would be reluctant to provoke a similar fight if voters are heading to the polls for decisive runoffs. 

Democrats have already taken notice of Rubio's letter and have attempted to frame it as a strategy that could lead to a scene reminiscent of last year's shutdown. 

"Washington Republicans have already shown that they’re willing to shut down our government and hurt the middle class if they think it will help advance their ideological agenda," Josh Schwerin, a spokesman for the Democratic Congressional Campaign Committee, told Business Insider. "That’s why the choice is so clearly between Republicans who will use shutdowns as leverage or Democrats who want to jumpstart the middle class."

How likely it is Republicans will follow through on the strategy depends on who you ask. Democrats consider it a real possibility. Other analysts, observers, and aides think Rubio's letter is more about trying to both raise his personal profile and the profile of the risk-corridor program.

Goldman Sachs economist Alec Phillips speculated in a recent note that Republicans taking back the Senate would lead to an increase in fiscal confrontations between congressional Republicans and the White House ahead of key deadlines to fund the government and raise the debt ceiling.

"The result is likely to be less predictability regarding the process surrounding major fiscal deadlines. Since the confrontation between House Republicans and the White House over the debt limit in 2011, markets have gradually become inured to fiscal brinksmanship, as these debates have started to follow a predictable pattern," Phillips wrote.

"If Republicans win majorities in both chambers as polls currently suggest they might, that pattern seems likely to change, which could lead to renewed uncertainty ahead of future fiscal deadlines."

One Republican Senate aide, while refusing to comment on the potential strategy, told Business Insider, if Republicans take back the Senate, party leadership would be better served separating risk corridor-related legislation from the stopgap spending bill.

The aide described GOP-authored risk-corridor legislation as something that could attract some Democratic votes and pass both chambers. That way, Republicans will have put Obama, who would be forced with a decision about whether to sign or veto the bill, in a bit of a corner without flirting with a potential shutdown.

GOP leadership in both chambers, the aide told Business Insider, should prioritize "demonstrating the kind of competence" the aide said has not been seen from current Senate Majority Leader Harry Reid.

Join the conversation about this story » Reported by Business Insider 3 hours ago.

Massachusetts wins $13.9 million grant for Health Connector outreach

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Massachusetts has received $13.9 million from the federal government to help pay for outreach efforts necessary to transition more than 400,000 people from existing state health insurance to a revised one under the Affordable Care Act. The funding will help support the Health Connector’s direct mail, phone calls, training, advertising, public awareness events, and the services of Health Care for All. It was unclear how large the outreach campaign, and by extension the funding request, would have… Reported by bizjournals 3 hours ago.

Full Coverage Auto Insurance for Illinois Drivers Now Quoted Using Insurer Tool Online

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Full coverage auto insurance is now quoted for Illinois drivers using the Quotes Pros website at http://quotespros.com/auto-insurance.html.

Chicago, IL (PRWEB) October 15, 2014

American consumers who are seeking an upgrade to a standard insurance policy for any vehicle type can now use the Quotes Pros website for research online. The statewide system available is now searchable for full coverage auto insurance for Illinois drivers and motorists in nearby states at http://quotespros.com/auto-insurance.html.

The upgrade that now supplies access to full coverage policies and pricing this year has expanded the access to consumers when searching agencies in the U.S. The state locator format that is now supplied makes it easier for Illinois residents to find coverage pricing from nearly all insurers in the state.

"The price data that can be found through our system comes from selected companies that are quoting policies for motorists online," said a Quotes Pros source.

The insurer system that is designed for the public to use is maintained daily and updates are processed to provide more companies to consumers during insurer research. The full coverage policies that are accessible are in place alongside of the liability and collector plans most common for motorists.

"The database we're allowing consumers to access from our website has some of the most recognized state providers of coverage to help foreign and domestic auto owners," said the source.

The Quotes Pros company will maintain its system throughout the year with new providers as agencies are included for public research. Consumers in IL or other states now have the option of sorting through providers for life, motorcycle or health insurance at http://quotespros.com/motorcycle-insurance.html.

About QuotesPros.com

The QuotesPros.com company supplies agency data in the U.S. to consumers who are researching insurance costs on the Internet. The portal created for the public two years ago is now filled with national companies providing quotations for policies. The QuotesPros.com company helps to link consumers with the best companies in the coverage industry when considering purchasing policies. Reported by PRWeb 3 hours ago.

MNsure promises better website this year

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Shoppers on the MNsure health insurance exchange will encounter a much improved user experience when open enrollment begins next month, officials said Wednesday. Reported by TwinCities.com 2 hours ago.

U.S. Says Consumers Must Renew Health Insurance Policies

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Officials said consumers should update information on their income and family size and should compare their current insurance with alternatives, which could offer better coverage at a lower cost. Reported by NYTimes.com 23 hours ago.

And now, Affordable Care Act's re-enrollment crunch begins

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The federal agency overseeing the Affordable Care Act insurance marketplaces started sending re-enrollment notices Tuesday night to the millions of people who purchased new coverage this year. And these consumers won't have a lot of time to act if they want to get a better deal on health insurance starting in 2015. Reported by TwinCities.com 23 hours ago.

MNsure promises better website, call center experiences this year

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Shoppers on the MNsure health insurance exchange will encounter a much improved user experience when open enrollment begins next month, officials said Wednesday. Reported by TwinCities.com 21 hours ago.

Corporate Whistleblower Center Urges Pharmacy Benefit Managers With Proof Their Company Is Overbilling Medicare/Medcaid To Call Them About A Recent Major Reward

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The Corporate Whistleblower Center is urging managers at a pharmacy benefit management company (PBM) to call them at 866-714-6466 if they have well documented proof the management company is involved in unjustly billing Medicaid or Medicare for pharmacy bills that should have been paid by a private insurance company, because this type of information can produce million dollar rewards, as was recently demonstrated. http://CorporateWhistleblowerCenter.Com

(PRWEB) October 16, 2014

The Corporate Whistleblower Center is urging managers or insiders at a pharmacy benefit management company to call them immediately at 866-714-6466 if they have proof a PBM is involved in knowingly billing Medicaid or Medicare for pharmacy bills that should have been paid by a private insurance company. As the Whistleblower Center would like to explain, this type of information from a insider can produce a million dollar reward.

In September of 2014 the Justice Department announced Caremark L.L.C., a pharmacy benefit management company (PBM), will pay the United States $6 million to settle allegations that Caremark allegedly failed to reimburse Medicaid for prescription drug costs paid on behalf of Medicaid beneficiaries who also were eligible for drug benefits under Caremark-administered private health plans. Caremark is operated by CVS Caremark Corporation, one of the largest PBMs and retail pharmacies in the country.

When an individual is covered by both Medicaid and a private health plan, the individual is called a “dual eligible.” Under the law, the private insurer, rather than the government, must assume the costs of health care for dual eligibles. If Medicaid erroneously pays for the prescription claim of a dual eligible, Medicaid is entitled to seek reimbursement from the private insurer or its PBM. A PBM administers and manages the drug benefits for clients who offer drug benefits under a health insurance plan.

Caremark allegedly served as the PBM for private health plans who insured a number of individuals receiving prescription drug benefits under both a Caremark-administered plan and Medicaid. According to the government, Caremark’s RxCLAIM computer platform allegedly failed to pay the full amount due on certain claims because it allegedly improperly deducted certain co-payment or deductible amounts when calculating payments. The government alleged that Caremark’s actions caused Medicaid to incur prescription drug costs for dual eligibles that should have been paid for by the Caremark-administered private health plans rather than Medicaid.

The Corporate Whistleblower Center says, "If you are a manager, or accountant at a pharmacy benefit management company, and you know your company is knowingly overbilling Medicaid, or Medicare for pharmaceutical products please call us at 866-714-6466 so we can carefully explain how federal whistleblower programs work. The most interesting part about a whistleblower with this type of information is there is not much gray area. The PBM either overbilled Medicaid, or Medicare, or they did not.

"If you possess this type of information we will help you package your information, and then we will get you to the best whistleblower attorneys in the nation. No other group in the nation offers a comparable service." http://CorporateWhistleblowerCenter.Com

In instance the PBM whistleblower will receive $1.02 million dollars.

Simple rules for a whistleblower from the Corporate Whistleblower Center:· Do not go to the government first if you are a major whistleblower. The Corporate Whistleblower Center says, “Major whistleblowers frequently go to the federal government thinking they will help. It’s a huge mistake.”
· Do not go to the news media with your whistleblower information. Public revelation of a whistleblower’s information could destroy any prospect for a reward.
· Do not try to force a government contractor or corporation to come clean to the government about their wrongdoing. The Corporate Whistleblower Center says, “Fraud is so rampant among federal contractors that any suggestion of exposure might result in an instant job termination, or harassment of the whistleblower. Come to us first, tell us what type of information you have, and if we think it’s sufficient, we will help find the right law firms to assist in advancing your information.”
· The Corporate Whistleblower Center wants to emphasize there are high quality whistleblowers in every state including California, New York, Florida, Texas, Massachusetts, Maryland, Rhode Island, Virginia, Ohio, Pennsylvania, West Virginia, Tennessee, North Carolina, Georgia, Alabama, Louisiana, Missouri, Michigan, Indiana, Iowa, Illinois, Wisconsin, Minnesota, Nebraska, North Dakota, Kansas, New Mexico, Colorado, Utah, Arizona, Nevada, Idaho, Washington, and Alaska.

Any type of insider or employee who possesses significant proof of their employer or a government contractor defrauding the federal government is encouraged to contact Corporate Whistleblower Center anytime at 866-714-6466 or via their web site at http://CorporateWhistleblowerCenter.Com

For attribution purposes please refer to the September 2014 United States Department of Justice press release on this matter. http://www.justice.gov/opa/pr/caremark-will-pay-6-million-resolve-false-claims-act-allegations

Case number: The case is captioned United States ex rel. Well v. CVS Caremark, Inc., Civil Action No. SA:11-CV-00747 (W.D. Tex.). Reported by PRWeb 19 hours ago.

A Partnership to Provide Financial Assistance to People Coping With Cancer

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Continuing their ongoing commitment to the community, Triage Cancer and Fifth Season Financial have teamed up to spread the word about an option for people coping with cancer to regain some financial stability.

White Plains, New York (PRWEB) October 16, 2014

Continuing their ongoing commitment to the community, Triage Cancer and Fifth Season Financial have teamed up to spread the word about an option for people coping with cancer to regain some financial stability.

According to the Institute of Medicine, “the cost of cancer care…is rising faster than many sectors of medicine— having increased to $125 billion in 2010 from $72 billion in 2004… making cancer care less affordable for patients and their families and are creating disparities in patients’ access to high-quality cancer care.” While the changes brought about by the Patient Protection and Affordable Care Act (ACA) are a step in the right direction of providing adequate health insurance coverage for individuals, people still end up in devastating financial situations after a cancer diagnosis. Perhaps they had to take time off from work for treatment and recover, or they were unable to go back to work, and therefore, their income has been reduced. Additionally, there are co-payments and other out of pocket costs associated with a cancer diagnosis. One recent survey of patients with health insurance found that in an attempt to deal with the financial distress: “70% of patients reduced leisure activities, 48% withdrew savings, and 18% sold possessions.”

“We’re proud to work with Triage Cancer in helping families navigate the myriad of health and financial issues they face when confronted with cancer, “ said Adam Balinsky, President of Fifth Season Financial. “We see first-hand how relief of financial pressures can have a measurable positive effect on a cancer patient’s medical prognosis.”

Through this unique partnership, Triage Cancer and Fifth Season Financial hope to provide people coping with cancer a viable option to deal with the financial strain a cancer diagnosis can cause, while at the same time, ensuring that people’s loved ones are taken care of in the event of their death.

“We hear from people all over the country that the status of their financial health makes them feel hopeless and overwhelmed. Which is why partnering with Fifth Season Financial made so much sense. Through this partnership we can help spread the word to people coping with cancer that there may be an option other than depleting one’s savings or declaring bankruptcy, while still providing their loved ones with something upon their death,” said Joanna Morales, CEO of Triage Cancer.

For more information about Triage Cancer’s work and upcoming events, please visit: http://www.TriageCancer.org. For more information about Fifth Season Financial and the “Loans for Living” program, visit http://www.fifthseasonfinancial.com.

About Fifth Season Financial, L.P.
Fifth Season's mission is to partner with persons facing advanced stage diseases in order to help them regain control over their financial situation. The need for financial help and access to discretionary funds for people with advanced stage diseases is overwhelming. Fifth Season has partnered with more than 300 patients and their families’ and provided over $50 million of loans through their “Loans for Living” program. For more information about Fifth Season Financial and the “Loans for Living” Program, please visit http://www.fifthseasonfinancial.com.

About Triage Cancer
Triage Cancer is a national, nonprofit organization providing information and resources on the full spectrum of cancer survivorship issues to patients, survivors, caregivers, advocates, and healthcare professionals, through a national Speakers Bureau, educational events, and online tools. Triage Cancer also offers an educational blog at http://www.TriageCancer.org/blog. Reported by PRWeb 17 hours ago.

Plight of the Living Dead: What to Do If You're Officially RIP

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Plight of the Living Dead: What to Do If You're Officially RIP Filed under: Credit, Banking, Consumer Ally, Social Security, Consumer Issues

*Fer Gregory/Shutterstock*

In just a few weeks, the dead will walk the streets. Zombies, ghouls and vampires will mingle with the living. We'll give them candy, smile, and then sleep peacefully, knowing that they're fictional.

But beware: There are actual real live dead people walking around America right now. Every day. Thousands of them. And you could be the next to join their ranks.

These troubled undead are suffering from a horror that's nearly as scary as zombie-hood, and almost as hard to recover from.

They've been declared deceased by their banks, their creditors, and sometimes, by their government. It happens a lot more often than you'd probably guess -- unless it has happened to you. Out of the 2.8 million U.S. death reports received each year by the Social Security Administration, one in 200 is incorrect, averaging 38 mistaken deaths a day, according to CNN Money. And unfortunately, a quick call to your bank or the SSA likely won't resolve the issue.

Whenever someone in this country is declared dead, a quiet machinery goes to work behind the scenes. Government agencies, banks and businesses reclassify the deceased in their files, a move intended to prevent hackers from running amok on people's finances postmortem. Databases like the Social Security Administration's Death Master File lock down your Social Security number, name, birth and death dates and final ZIP code.

But what if you're one of the 1,000 people mistakenly declared dead by a creditor every month? Or one of the 14,000 people wrongly declared dead each year by the Social Security Administration. Or misidentified as deceased by your bank, which then blocks you from conducting your daily financial business.

Then, my friend, you'll have to battle your way back to life.

*How Do Banks and Creditors Falsely Report Your Death?*

Victims of false death reports sometimes make the news, as they suffer from the consequences of human or technological error for years on end.

"The error can take place from either a person hitting the wrong button or from a computer glitch that reports the account is deceased," said Alexis Moore, cyber-crime expert and author of "Cyber Self-Defense." When that happens, it can affect other entities that track your identity, such as the Internal Revenue Service, the Department of Motor Vehicles and licensing agencies. Consider these cases:

· Kimberly Haman filed a federal lawsuit in February after trying for more than a year to prove she was alive to her bank and Equifax (EFX). Her "deceased" status caused the Missouri resident a great deal of trouble in refinancing her mortgage and getting a credit card.
· Bank of America (BAC) mistakenly designated customer Arthur Livingston as dead for three years, despite his account being active on a daily basis. Because of that, the South Carolinian couldn't get a mortgage.
· Laura Brooks of Virginia, according to CNN Money, realized she had been falsely declared dead in 2000 when she stopped receiving her disability checks and her rent and loan payments were bounced.

"Many times folks don't realize it until they get denied credit or have an account closed," Moore said. "Getting through to security departments and those who can help them correct the issue is nearly impossible because those that work in financial institutions, for the IRS and credit bureaus don't understand or realize the query is about the person being falsely reported dead."

So what can you do if this happens to you?

*6 Steps to Clear Your Name and Prove You're Alive*

1. *Find the source of the mistake.* A county clerk's office, health insurance company or family member could be the reason for an incorrect death report. Confirm whether a death certificate has been issued. If so, you'll have to provide documentation and have the certificate amended. Moore recommends gathering your financial records, tax returns, birth certificate and social security card during this initial stage.
2. *Inform Equifax, Experian (EXPN) and TransUnion of the error. *"Credit reporting companies must investigate the items in question -- usually within 30 days -- unless they consider your dispute frivolous," the Federal Trade Commission says.
3. *Keep a record of all correspondence regarding your claim.* It's important that you document every phone call, letter sent and online inquiry as the process unfolds. Noting the date and time of your conversations, claim numbers and names of representatives who assist you will help you keep all parties accountable throughout the investigation.
4. *Follow up with the entity that falsely claimed you were dead.* The Motley Fool recommends being clear about what you want fixed and the potential reason for the mistake.
5. *Request lost benefits or take legal action.* If you didn't receive your Social Security benefits due to this error, you have a right to those funds. Legal action can be taken against companies unwilling to provide you with that back pay. And this kind of error can cost a victim big time, in the form of bounced check fees and lost income. At the least, the Motley Fool recommends attaching a letter to your credit file explaining this error for future reference.

"Plan on this becoming a second full-time job because that is what it takes to overcome being falsely reported deceased," Moore said. "Often clients will also require licensed attorneys and law enforcement involvement, depending upon the individual's circumstances. This is worse than what identity theft victims experience because, when reported deceased, the accounts get archived and shut down, making it difficult to reestablish."

*Precautionary Steps to Take*

There isn't much you can do to prevent a credit bureau from confusing you with someone with a similar name or identification number. However, there are some steps you can take to prevent this error from occurring due to your own inattention.

· Widows should request a copy of both their own and their spouses' credit reports after a death to make sure that everything checks out, as a mistake could occur due to marital association of information, TransUnion Vice President Clifton O'Neal suggests.
· Exercise caution when filling out medical discharge paperwork. It was a mistake on those forms that led to Bea Cohen being falsely reported dead for years, impairing her ability to obtain credit. One would hope that a hospital would check over the forms for inaccuracies, but human error can occur on both ends.
· You're allowed one free credit report each year from the three major bureaus. Cycle through them every four months, and you'll have a better chance of catching a problem with your records before it inhibits your life.

 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 16 hours ago.

Hillary Clinton stumps in Kentucky for Grimes

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Hillary Rodham Clinton urged Kentucky voters to send Democratic candidate Alison Lundergan Grimes to the Senate to protect the state's 521,000 Kentuckians who have health insurance through the Affordable Care Act. (Oct. 16)

 
 
 
 
 
 
 
  Reported by USATODAY.com 15 hours ago.

Obamacare is Silent regarding Insurance Charges

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Obamacare is Silent regarding Insurance Charges There are many who plan to avail Obamacare but they are facing a dilemma of sorts. Health security rates will surely increase after the November 4th elections. The booking for health insurance on the... Reported by I4U News 15 hours ago.

She The People: Better than a pink ribbon: Laws protect breast cancer patients from losing jobs, benefits

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Pink ribbons galore and funny games on Facebook may “raise awareness” of breast cancer in October, but women facing that diagnosis need more substantial help.

Such as not having to worry about their jobs — or losing their health insurance benefits — while they’re undergoing treatment. Reported by Washington Post 13 hours ago.

Zane Benefits Releases New Information on Selecting the Right Broker

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New Information on Finding the Right Broker for Small Businesses

Park City, UT (PRWEB) October 16, 2014

Today, Zane Benefits, the #1 Online Health Benefits Solution, published new information on tips for finding the right broker for small businesses and startups.

According to Zane Benefits, with open enrollment 2015 exactly one month away, many small businesses are exploring their health insurance options. However, making a decision about healthcare benefits can be difficult without the proper guidance and education. Deductibles, out-of-pocket maximums, advanced premium tax credits-- there are a lot of terms to know in order to make an informed decision.

While the individual health insurance Marketplaces have made it easier to compare health insurance options, many small businesses and their employees are not comfortable selecting a plan on their own. As open enrollment for 2015 approaches, it has become evident that employees and small businesses need the assistance of brokers for health insurance advice.

The article contains tips on hiring the right health insurance broker for small businesses.

Click here to read the full article.

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About Zane Benefits
Zane Benefits, the #1 Online Health Benefits Solution, was founded in 2006 to revolutionize the way employers provide employee health benefits in America. We empower employees to take control over their own healthcare, while helping employers recruit and retain the best talent. Our online solutions allow small and medium-sized businesses to successfully transition to a health benefits program that creates happier employees, reduces costs and frees up more time to serve their customers. For more information about ZaneHealth, visit http://www.zanebenefits.com. Reported by PRWeb 13 hours ago.

Mitch McConnell, Alison Lundergan Grimes Spar Over The Uninsured, Flub Facts

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The following post first appeared on FactCheck.org.
Sen. Mitch McConnell and Democrat Alison Lundergan Grimes disagreed at their Oct. 13 debate on how many Kentuckians had gained health insurance through the state exchange. McConnell disputed that the state website has insured 521,000 people. Grimes, meanwhile, said those half a million people had insurance for the first time.

More than half a million people have signed up for coverage through the Kynect website for both private insurance and Medicaid, but Grimes is wrong to say they were all previously uninsured. Through the end of the open-enrollment period, 75 percent of Kentuckians who had signed up for coverage indicated they had been uninsured prior to gaining insurance through Kynect. That’s according to numbers provided to FactCheck.org by the state Cabinet for Health and Family Services.

During the debate, McConnell said he would be fine with continuing the Kynect website, even though he opposes the Affordable Care Act (around the 34:30 mark). He said it was a “state decision” and the state “can continue it if they’d like to,” though Kentucky would “have to pay for it.” When asked by moderator and TV journalist Bill Goodman if he’d continue Kynect, McConnell said, “Yeah, I think it’s fine to have a website.”

It’s a website that Goodman then noted had “also insured 521,000.” McConnell said, “No, it hasn’t.” Later, when Goodman said 85,000 of those had private insurance, McConnell asked: “How many of them, though, got insurance after having policies canceled?”

We don’t know how many had received cancellation notices from their insurance companies because their plans didn’t meet the Affordable Care Act’s minimum benefit requirements, and then decided to purchase coverage through the Kynect website. But we do know that some of those who signed up through Kynect — 25 percent — said they had been previously insured.

A Gallup poll released in August found Kentucky had experienced the second largest drop in the percentage of uninsured among the states from 2013 to mid-2014. Kentucky’s percentage of uninsured went from 20.4 percent to 11.9 percent, a drop of 8.5 percentage points, second to only the decline in Arkansas, according to the telephone survey.

Grimes, however, echoed a common Democratic talking point in assuming that all those who got coverage through the exchange were newly insured. She said: “We have over half a million Kentuckians who for the first time ever are filling prescriptions. They are going to the doctor and they’re getting checkups. I will not be a senator that rips that insurance from their hand. I will work to fix the Affordable Care Act.”

The state Cabinet for Health and Family Services told us that between Oct. 1, 2013, and April 15, 2014 — the open enrollment period — 413,410 Kentuckians enrolled in health coverage through Kynect. Of those, 330,615 qualified for Medicaid coverage and 82,795 bought private insurance. Three-quarters of all those signing up indicated they had been uninsured prior to getting coverage through the website.

That would mean that as of April 15, there were about 310,000 uninsured Kentuckians who were covered through Kynect. The total enrollment number is now more than 521,000. If the 75 percent figure remained constant, then there would be about 391,000 previously uninsured people who now have coverage. Reported by Huffington Post 13 hours ago.

The Abortion Conversation We Need To Have

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Abortion. We need to talk about it. I know, sometimes it seems as if we talk of little else, so perhaps I should say we need to talk about it differently. Not as something we all agree is a bad thing about which we shake our heads sadly and then debate its precise degree of badness, preening ourselves on our judiciousness and moral seriousness as we argue about this or that restriction on this or that kind of woman.

We need to talk about ending a pregnancy as a common, even normal, event in the reproductive lives of women -- and not just modern American women either, but women throughout history and all over the world, from ancient Egypt to medieval Catholic Europe, from today's sprawling cities to rural villages barely touched by modern ideas about women's roles and rights. Abortion takes place in Canada and Greece and France, where it is legal, performed by medical professionals, and covered by national health insurance, and also in Kenya, Nicaragua, and the Philippines, where it is a crime and a woman who terminates a pregnancy takes her life in her hands. According to anthropologists, abortion is found in virtually every society, going back at least 4,000 years. American women had great numbers of abortions throughout our history, when it was legal and when it was not.

Consider this: At the beginning of the nineteenth century effective birth control barely existed and in the 1870s it was criminalized -- even mailing an informational pamphlet about contraceptive devices was against the law and remained so until 1936. Yet the average number of births per woman declined from around 7 in 1800 to around 3.5 in 1900 to just over 2 in 1930. How do you think that happened?

We need to see abortion as an urgent practical decision that is just as moral as the decision to have a child -- indeed, sometimes more moral. Pro-choicers often say no one is "pro-abortion," but what is so virtuous about adding another child to the ones you're already overwhelmed by? Why do we make young women feel guilty for wanting to feel ready for motherhood before they have a baby? Isn't it a good thing that women think carefully about what it means to bring a child into this world -- what, for example, it means to the children she already has? We tend to think of abortion as anti-child and anti- motherhood. In media iconography, it's the fetus versus the coat hanger: that is, abortion kills an "unborn baby," but banning it makes women injure themselves. Actually, abortion is part of being a mother and of caring for children, because part of caring for children is knowing when it's not a good idea to bring them into the world.

We need to put abortion back into its context, which is the lives and bodies of women, but also the lives of men, and families, and the children those women already have or will have. Since nearly 1 in 5 American women end their childbearing years without having borne a child (compared with 1 in 10 in the 1970s), we need to acknowledge that motherhood is not for everyone; there are other ways of living a useful, happy life.

We need to talk about abortion in its full human setting: sex and sexuality, love, violence, privilege, class, race, school and work, men, the scarcity of excellent, respectful reproductive health care, and of realistic, accurate information about sex and reproduction. We need to talk about why there are so many unplanned and unwanted pregnancies -- which means we need to talk about birth control, but also about so much more than that: about poverty and violence and family troubles, about sexual shyness and shame and ignorance and the lack of power so many women experience in bed and in their relationships with men. Why is it such a huge big deal to ask a man to wear a condom? Or for a man to do so without being asked? Why do so many women not realize they are pregnant until they are fifteen or twenty or even twenty-five weeks along, and what does that say about the extraordinary degree of vigilance we demand women exercise over their reproductive systems? And speaking of that vigilance, what about the fact that some 16 percent of women, according to a Brown University study, have experienced reproductive coercion in at least one relationship -- a male partner who used threats or violence to control a woman's contraception or pregnancy outcomes -- with a remarkable 9 percent experiencing "birth control sabotage," a male partner who disposed of her pills, poked holes in condoms, or pre- vented her from getting contraception. One-third of the women reporting reproductive coercion also reported partner abuse in the same relationship.4 Behind America's high rate of unintended pregnancy -- almost half of all pregnancies -- and high rates of abortion lies a world of hurt.

We need to talk about the scarcity of resources for single mothers and even for two-parent families, and the extraordinary, contradictory demands we make upon young girls to be simultaneously sexually alluring and withholding: hot virgins. We need to talk about blood and mess and periods and pregnancy and childbirth and what women go through to bring new life into the world and whether deep in our hearts we believe that those bodies mean women were put on Earth to serve and sacrifice and suffer in a way that men are not. Because when we talk about abortion as a bad thing, and worry that there's too much of it, sometimes we mean there's too much unwanted pregnancy and that women and men need more and better sex education and birth control, and sometimes we mean there's too much poverty, especially for children and their mothers, but a lot of the time we mean a woman should have a good cry, and then do the right thing and have the baby. She can always put it up for adoption, can't she, like Juno in the movie? And that is close to saying that a woman can have no needs, desires, purpose, or calling so compelling and so important that she should not set it aside in an instant, because of a stray sperm.

Abortion has been legal across the United States for more than four decades. More than a million abortions are per- formed every year -- some 55 million since 1973, when Roe v. Wade became the law of the land. A few facts: By menopause, 3 in 10 American women will have terminated at least one pregnancy; about half of all US women who have an abortion have already had a prior abortion; excluding miscarriages, 21 percent of pregnancies end in abortion. Contrary to the popular stereotype of abortion-seeking women as promiscuous teen- agers or child-hating professionals, around 6 in 10 women who have abortions are already mothers. And 7 in 10 are poor or low-income. Abortion, in other words, is part of the fabric of American life, and yet it is arguably more stigmatized than it was when Roe was decided.

Excerpted from "Pro: Reclaiming Abortion Rights" by Katha Pollitt. Pro copyright © 2014 by Katha Pollitt. Published October 14, 2014, by Picador USA. All rights reserved. www.picadorusa.com/proTo buy a copy of Pollitt's book head over to Amazon. Reported by Huffington Post 12 hours ago.

Affordable Health Benefits Await Millions Of Uninsured

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RICHARDSON, Texas, Oct. 16, 2014 /PRNewswire/ -- Blue Cross and Blue Shield of Texas (BCBSTX) today launched a statewide education effort to help more than 6.2 million uninsured Texans find affordable health insurance options and begin to benefit from important medical services that... Reported by PR Newswire 12 hours ago.

A.M. Best Affirms Ratings of Philadelphia Financial Group, Inc. and Its Insurance Subsidiaries

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A.M. Best Affirms Ratings of Philadelphia Financial Group, Inc. and Its Insurance Subsidiaries OLDWICK, N.J.--(BUSINESS WIRE)--A.M. Best has affirmed the financial strength rating of A- (Excellent) and the issuer credit ratings (ICR) of “a-” of the two domestic life/health insurance subsidiaries of Philadelphia Financial Group, Inc. (PFG): Philadelphia Financial Life Assurance Company and Philadelphia Financial Life Assurance Company of New York. Concurrently, A.M. Best has affirmed the ICR of “bbb-” of PFG. All companies are headquartered in Philadelphia, PA. PFG is a subsidiary of Tipt Reported by Business Wire 12 hours ago.
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