WASHINGTON -- For the first time since the federal and state health insurance marketplaces opened in the early fall, the number of people who signed up for coverage in January exceeded the government's expectations for the month, bringing the overall total to about 3.3 million.
Reported by TwinCities.com 1 day ago.
Health insurance sign-ups top monthly forecast for the first time
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Personal Accident and Health Insurance in the Netherlands, Key Trends and Opportunities to 2017
MUMBAI, February 13, 2014 /PRNewswire/ -- Bharat Book Bureau presents Personal Accident and Health Insurance in the Netherlands, Key Trends and Opportunities to 2017. This report provides a comprehensive analysis of the personal accident and health insurance segment in the...
Reported by PR Newswire 1 day ago.
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States Still Low in Health Insurance Sign-ups
WASHINGTON— Most states are still lagging when it comes to sign-ups under President Barack Obama’s health care law, but an Associated Press analysis of numbers reported Wednesday finds a dozen getting ahead of the game.Huge disparities are emerging in …
The post States Still Low in Health Insurance Sign-ups appeared first on The Epoch Times. Reported by Epoch Times 1 day ago.
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Here's Why The Richest Nation In The World Still Can't Get Health Care Right
WASHINGTON -- Five years ago, U.S. President Barack Obama and his Democratic Party had a crazy idea that maybe the richest nation in the history of the world should do something to make its fragmented, inequitable and very expensive health care system a little better.
*So you Yanks finally got around to establishing universal health care? Welcome to the mid-20th century!*
Thanks, but that's not quite right. Even after the Affordable Care Act is more than a decade old, there will still be 31 million people who don't have health insurance. That's 25 million fewer uninsured than there would have been without the new law, but it's still a lot of people. Undocumented immigrants are left out of the health insurance exchanges and Medicaid. Some Americans can't afford insurance even when it's subsidized. Others will simply go without and choose to pay a tax penalty for remaining uninsured.
*But people must be happy and relieved to have guaranteed access to health coverage now, especially those too poor to afford it, right?*
Er, no. Pretty much from the start, the American public hasn't been happy about what's come to be known as Obamacare. The botched rollout last year of the biggest part of the law -- online marketplaces where people can shop for health insurance and receive government subsidies to help pay for it -- didn't help matters.
There's a big partisan divide, with liberals viewing the law more favorably and conservatives viewing it as, well, the worst thing that's ever happened. Overall, it's just not very popular, as these survey results show.
Source: Henry J. Kaiser Family Foundation
Worse, it's not popular among the very people it's supposed to help: those with no health insurance.
Source: Henry J. Kaiser Family Foundation
The Republican Party in Congress has made repealing the law a top priority since winning control of the House of Representatives in the 2010 elections, and Republican officials in individual states have fought the law at every turn, including filing a constitutional challenge that went all the way to the Supreme Court, which ultimately upheld the law.
*Then the American health care system must have been pretty amazing before Obama started mucking with it -- with high quality and low costs, right?*
Are you running for Congress? American politicians love saying the United States has the best health care system in the world. And it's partly true. American pharmaceutical and medical device companies as well as premier medical institutions develop groundbreaking treatments all the time. That's why rich foreigners come to places like the Mayo Clinic in Rochester, Minn., and Johns Hopkins Hospital in Baltimore (it's hard to imagine rich foreigners going to those places for any other reason).
But American exceptionalism has a dark side. A U.S. Census Bureau report found that in 2012, more than 15 percent of the population -- 48 million people -- had no health insurance, which means they had limited access to medical care and were at risk of facing crippling debt if they got sick or injured. African Americans and Hispanics lack health insurance at disproportionate rates, and the uninsured are more likely to be poor, under 35 years old and living in the south of the United States.
So those are your have-nots. It's not a perfectly pretty picture for the haves, either. America spends a ton of money on health care, and that spending has risen faster than the U.S. economy for decades, though it's slowed a bit in recent years -- which might have something to do with Obamacare.
Source: Health AffairsStudy after study demonstrates that Americans pay higher prices -- sometimes a lot higher -- for medical care than do residents of other developed countries.
Source: International Federation of Health PlansAnd what do we get for all the extra money we spend? Not better quality health care. The U.S. has worse life expectancy and infant mortality rates than other nations, and Americans are more likely to be obese and have diabetes. We don't talk about that at our Fourth of July cookouts.
*Now I'm stumped. Why is everyone so upset? Is Obamacare disrupting the health care enjoyed by those already covered?*
The truth is, most of the reforms affect only a tiny sliver of the health insurance market. Although the U.S. has a large number of uninsured residents, a majority of the population already had coverage, and nearly all of those people are going to keep the same coverage.
*
Where Americans Get Health Insurance
*
Source: U.S. Census Bureau data via U.S. Department of Health and Human ServicesThe Affordable Care Act will predominantly affect people who buy health coverage directly from an insurance carrier. About 3 percent to 5 percent of people -- or what amounts to 10 to 15 million people -- fall into this category. Insurers used to be allowed to reject applicants who had pre-existing medical conditions and charge higher prices for sick people, middle-aged customers and women. They can't do that anymore. However, these changes have unsettled those already participating in this market, in some cases by raising prices and in others by limiting the number of doctors and hospitals patients can use. So those folks are pretty angry.
The most common source of health insurance for Americans is employers, which provide benefits to more than 170 million workers and their dependents. Companies pick up the lion's share of the cost in most cases, and although workers forego higher wages in exchange for those benefits, it's also totally tax-free.
And despite the heated rhetoric from conservatives about the horrors of socialized medicine, more than one-in-five Americans are covered by government health care programs, according to the U.S. Census Bureau. Medicaid and the Children's Health Insurance Program cover about 60 million low-income people, and Medicaid is poised to grow by millions more under Obamacare.
Then there's Medicare, the health benefit for about 50 million retirees and people with disabilities. It's a single-payer, socialized, government-financed health care program. And yet, Americans revere it -- even those same conservatives who claim the (mostly private-sector-based) Obamacare will destroy the fabric of the nation.
Republicans like 2012 vice presidential nominee Paul Ryan love nothing more than socialized medicine -- when its name is Medicare.
*This seems like a big mess. What's going to happen?*
Republicans continue to assail the law and will likely use its shortcomings to hammer at Obama's Democratic Party in this year's congressional elections and the presidential contest just two years away.
The thing is, though, it'd be extremely difficult to put the toothpaste back in the tube. As of Jan. 1, millions of people are enrolled in private health insurance through Obamacare, and most are receiving federal subsidies. The soonest Republicans could gain control of the White House is January 2017 -- by which time even more Americans will be getting their health coverage from Obamacare. In the meantime, Obama certainly won't go along with ploys to gut the program. It is called "Obamacare," after all. Reported by Huffington Post 23 hours ago.
*So you Yanks finally got around to establishing universal health care? Welcome to the mid-20th century!*
Thanks, but that's not quite right. Even after the Affordable Care Act is more than a decade old, there will still be 31 million people who don't have health insurance. That's 25 million fewer uninsured than there would have been without the new law, but it's still a lot of people. Undocumented immigrants are left out of the health insurance exchanges and Medicaid. Some Americans can't afford insurance even when it's subsidized. Others will simply go without and choose to pay a tax penalty for remaining uninsured.
*But people must be happy and relieved to have guaranteed access to health coverage now, especially those too poor to afford it, right?*
Er, no. Pretty much from the start, the American public hasn't been happy about what's come to be known as Obamacare. The botched rollout last year of the biggest part of the law -- online marketplaces where people can shop for health insurance and receive government subsidies to help pay for it -- didn't help matters.
There's a big partisan divide, with liberals viewing the law more favorably and conservatives viewing it as, well, the worst thing that's ever happened. Overall, it's just not very popular, as these survey results show.
Source: Henry J. Kaiser Family Foundation
Worse, it's not popular among the very people it's supposed to help: those with no health insurance.
Source: Henry J. Kaiser Family Foundation
The Republican Party in Congress has made repealing the law a top priority since winning control of the House of Representatives in the 2010 elections, and Republican officials in individual states have fought the law at every turn, including filing a constitutional challenge that went all the way to the Supreme Court, which ultimately upheld the law.
*Then the American health care system must have been pretty amazing before Obama started mucking with it -- with high quality and low costs, right?*
Are you running for Congress? American politicians love saying the United States has the best health care system in the world. And it's partly true. American pharmaceutical and medical device companies as well as premier medical institutions develop groundbreaking treatments all the time. That's why rich foreigners come to places like the Mayo Clinic in Rochester, Minn., and Johns Hopkins Hospital in Baltimore (it's hard to imagine rich foreigners going to those places for any other reason).
But American exceptionalism has a dark side. A U.S. Census Bureau report found that in 2012, more than 15 percent of the population -- 48 million people -- had no health insurance, which means they had limited access to medical care and were at risk of facing crippling debt if they got sick or injured. African Americans and Hispanics lack health insurance at disproportionate rates, and the uninsured are more likely to be poor, under 35 years old and living in the south of the United States.
So those are your have-nots. It's not a perfectly pretty picture for the haves, either. America spends a ton of money on health care, and that spending has risen faster than the U.S. economy for decades, though it's slowed a bit in recent years -- which might have something to do with Obamacare.
Source: Health AffairsStudy after study demonstrates that Americans pay higher prices -- sometimes a lot higher -- for medical care than do residents of other developed countries.
Source: International Federation of Health PlansAnd what do we get for all the extra money we spend? Not better quality health care. The U.S. has worse life expectancy and infant mortality rates than other nations, and Americans are more likely to be obese and have diabetes. We don't talk about that at our Fourth of July cookouts.
*Now I'm stumped. Why is everyone so upset? Is Obamacare disrupting the health care enjoyed by those already covered?*
The truth is, most of the reforms affect only a tiny sliver of the health insurance market. Although the U.S. has a large number of uninsured residents, a majority of the population already had coverage, and nearly all of those people are going to keep the same coverage.
*
Where Americans Get Health Insurance
*
Source: U.S. Census Bureau data via U.S. Department of Health and Human ServicesThe Affordable Care Act will predominantly affect people who buy health coverage directly from an insurance carrier. About 3 percent to 5 percent of people -- or what amounts to 10 to 15 million people -- fall into this category. Insurers used to be allowed to reject applicants who had pre-existing medical conditions and charge higher prices for sick people, middle-aged customers and women. They can't do that anymore. However, these changes have unsettled those already participating in this market, in some cases by raising prices and in others by limiting the number of doctors and hospitals patients can use. So those folks are pretty angry.
The most common source of health insurance for Americans is employers, which provide benefits to more than 170 million workers and their dependents. Companies pick up the lion's share of the cost in most cases, and although workers forego higher wages in exchange for those benefits, it's also totally tax-free.
And despite the heated rhetoric from conservatives about the horrors of socialized medicine, more than one-in-five Americans are covered by government health care programs, according to the U.S. Census Bureau. Medicaid and the Children's Health Insurance Program cover about 60 million low-income people, and Medicaid is poised to grow by millions more under Obamacare.
Then there's Medicare, the health benefit for about 50 million retirees and people with disabilities. It's a single-payer, socialized, government-financed health care program. And yet, Americans revere it -- even those same conservatives who claim the (mostly private-sector-based) Obamacare will destroy the fabric of the nation.
Republicans like 2012 vice presidential nominee Paul Ryan love nothing more than socialized medicine -- when its name is Medicare.
*This seems like a big mess. What's going to happen?*
Republicans continue to assail the law and will likely use its shortcomings to hammer at Obama's Democratic Party in this year's congressional elections and the presidential contest just two years away.
The thing is, though, it'd be extremely difficult to put the toothpaste back in the tube. As of Jan. 1, millions of people are enrolled in private health insurance through Obamacare, and most are receiving federal subsidies. The soonest Republicans could gain control of the White House is January 2017 -- by which time even more Americans will be getting their health coverage from Obamacare. In the meantime, Obama certainly won't go along with ploys to gut the program. It is called "Obamacare," after all. Reported by Huffington Post 23 hours ago.
↧
If Liberals Hate Job Lock, Why Do They Like Defined Benefit Pensions So Much?
Last week, when the Congressional Budget Office released a report saying that Obamacare's insurance subsidies would reduce people's inclination to work, liberals celebrated this as a victory over "job lock." And I agree: tying health insurance to work makes people more inclined to work, but that's not necessarily a good thing.
We don't want an economy where job-based health insurance discourages people from starting businesses or staying home to raise kids. We don't want a health care system that prevents people who can otherwise afford retirement from quitting their jobs at age 63. And more broadly, we shouldn't structure benefits in a way that makes people beholden to their employers and penalizes them for changing jobs.
But! Given all that, why are liberals often so keen on defined-benefit pension plans, which are explicitly designed to create job lock?
Here's how the typical defined-benefit plan works. First, it has a significant vesting period, and if you quit during that period you get no benefits at all. In 2010 reforms, New York State raised this vesting requirement from five years to ten. This creates job lock: Workers are captive to their jobs, waiting around for their benefits to vest.
Even after the vesting date, pension benefits accrue non-linearly, with accrual typically backloaded into the third decade of work. This creates more job lock, as workers have to stick around with the same employer until late in their careers when pension benefit accrual is actually generous.
In 2010, Robert Costrell and Michael Podgursky provided a bracing example from the Missouri Public School Retirement System. A teacher who starts work at age 26 can be expected to accrue a pension benefit worth a modest $100,000 by age 46. (That's a net present value of benefits, not an annual benefit amount.) But by age 56, his or her accrued pension benefits would soar above $600,000.
And then the teacher would face reverse job lock, with accrued pension benefits actually falling with every year worked. If that Missouri teacher worked all the way to age 65, his or her accrued pension benefit would fall to around $500,000, because the guaranteed annual payments don't rise fast enough to offset the fact that the worker's age of retirement keeps getting closer to death.
This system is designed to cause the teacher to work until his or her mid-50s and then quit, whether or not that's good for the teacher or the school system. This is job lock, and it's bad for mid-career entrants, people who would like to work until they die, parents who want to take a few years out of the workforce to raise children, and even full-career teachers who split their careers between two states (and therefore two pension systems).
The usual justification is that job lock is good for the employer: It helps a firm or government agency retain experienced workers once it has expended significant money and energy on training. That may be true in some fields, especially the military. But it's not a general principle. Teachers, for example, get up to speed quickly: Half their gains from experience come in the first year of teaching, and a teacher with five years of experience is on average as effective as one with 25 years.
Similarly to health policy, we should look for a retirement policy that promotes adequate saving without creating job lock. What would that mean? Well, let's start by looking through the key features of defined-benefit pension plans, and keep only the ones that are good.
*(1) Here's the best thing about defined-benefit pensions: They are supported by large, comingled investment funds*, and therefore have the benefit of professional management and economies of scale. 401(k) is a disaster for a number of reasons, but one big problem is that investors pay high fees because small accounts are costly to manage, and most individuals have no idea how to manage their own investments.
Felix Salmon is right: comingled funds are great. But you can have a comingled fund without any of the other trappings of a defined-benefit plan: You can have smooth accrual of benefits and you can have some or all of the investment risk borne by the plan participants, rather than by its sponsor. Galveston, Texas has a retirement plan like this.
*(2) Job lock is another key feature of traditional pension plans, and it's bad.* But it's easy to design a defined-benefit plan with no job lock. It's called a cash balance plan, and it works like this: for every year worked, a percentage of the worker's salary is credited to an account on his or her behalf, which then grows annually at a prescribed rate. As you work longer, your benefit grows proportionately, and there's no penalty for retiring early or late. Nebraska has a plan like this for public workers. Wells Fargo also had one when I worked there, and I left with a cool $7,000 balance after three years of work, which I then rolled into my IRA.
*(3) Traditional pensions shift investment risk away from retirees toward someone else.* This is desirable, to an extent. People with low and moderate incomes are not in a good position to bet their retirement on the stock market not crashing in the five years before they retire.
But, as I'll discuss below, the assumption of risk is costly, so we want to be targeted about it. This is a good reason for what I like to call vertical-hybrid retirement plans: A basic benefit with little risk to the retiree, and more risk loaded on the retiree as his or her wealth rises. We already sort of have a system like this: Social Security is a fairly flat benefit with no investment risk for the beneficiary, and other sources of retirement income are riskier. Employers could adopt a similar split: defined benefit accrual up to an annual cap, and riskier add-on accounts for higher paid workers.
But the biggest issue is the last one...
*(4) Defined-benefit plans often have a higher benefit value than defined-contribution plans.* This isn't universal; many university workers have high-value DC plans through TIAA-CREF, and federal employees have a split system where about half the value is on the DC side. But the average employer 401(k) match amounts to just 2.7% of salary, which is a key reason that 401(k) has not proved a sufficient substitute for traditional pensions.
Because Americans tend to be undersaved, a higher benefit value is desirable — so long as its cost is properly accounted for. Unfortunately, public sector pension plans hide the ball on cost by discounting future benefit payments at a 7-8% annual rate, effectively assuming that high equity returns will pay much of the cost of future benefits.
The oft-cited figure that public pension gaps in 2011 amounted to just 0.2% of GDP over 30 years is based on this error. That's the gap in the mean case where pension investment funds hit their return targets; above-normal returns could reduce that gap to zero, while weak returns would make the gap much larger. Unfortunately, that's not a wash; weak pension fund performance would be correlated with weak economic and fiscal performance, hitting governments with rising bills for pension fund contributions at exactly the same time that tax receipts fall and demand for government services rises.
In effect, by investing pension funds in risky equities and then guaranteeing fixed payouts, governments are providing costly insurance to pensioners, agreeing to make large fiscal transfers toward pension funds in the event of weak economic performance. An insurance company would charge you a great deal for the service of converting a 7% average return on investments into a 7% guaranteed return, as you can see if you price out an annuity, but the cost of that insurance shows up nowhere in the public accounts, until a recession hits and pension fund managers come to state legislatures with the news that taxpayer contributions must rise at the same time the overall state budget is strained, as happened in 2009-11.
That insurance cost does show up on pension accounts in the private sector: Regardless of how they invest their pension funds, private pension sponsors must discount future benefits at a rate that is tied to interest rates on safe bonds, reflecting the certainty with which they will have to pay out. That means General Electric records a much higher (and more accurate) cost for promising a $10,000 pension payment to a worker in 2030 than New York City would record for promising the same payout.
Quite relatedly, governments are more keen on the defined-benefit model than private companies are, because only the governments get to say they are eating a free investment lunch. And this gets to the core problem, other than job lock, with the way defined benefit pensions operate in the U.S. today.
Despite their backers' ideological differences, traditional pensions and 401(k) are built on the same fallacy: That we can set aside x% of GDP today in order to finance future consumption by retirees exceeding x% of future GDP, by investing those retirement funds in assets that rise in value faster than the economy as a whole grows. In both cases, those excess returns can only be achieved through investment risk, and that risk has to be borne somewhere: either by workers themselves, or by firms and state and local governments.
And for that reason, fixing the problem of retirement undersaving is going to require doing two fairly unpleasant things. One is admitting that retirement is expensive, and can't be paid for simply by relying on supernormal returns somewhere. If we want x% of GDP to consist of consumption by retirees, we should find a way to set aside x% of GDP as retirement savings.
The other is having the federal government play an increased role in retirement, because nobody else is in a good position to do it. State and local governments are ill-suited to guarantee pension benefits because they are supposed to balance their budgets annually. Firms have been getting out of the defined-benefit business for decades, as workers change jobs more often and federal rules requiring adequate funding have made pension plans less favorable to comapnies. And 401(k) itself is not working at all, with high fees, mismanaged investments, and not enough money being deposited.
With health policy, as liberal readers of the CBO report noted, the guiding vision should be to ensure individuals are adequately covered while separating labor market decisions from health decisions. The same goal should apply to retirement policy: Adequate saving, without making workers unduly dependent on or wedded to their employers. Only the federal government can make that happen.
Join the conversation about this story »
Reported by Business Insider 15 hours ago.
We don't want an economy where job-based health insurance discourages people from starting businesses or staying home to raise kids. We don't want a health care system that prevents people who can otherwise afford retirement from quitting their jobs at age 63. And more broadly, we shouldn't structure benefits in a way that makes people beholden to their employers and penalizes them for changing jobs.
But! Given all that, why are liberals often so keen on defined-benefit pension plans, which are explicitly designed to create job lock?
Here's how the typical defined-benefit plan works. First, it has a significant vesting period, and if you quit during that period you get no benefits at all. In 2010 reforms, New York State raised this vesting requirement from five years to ten. This creates job lock: Workers are captive to their jobs, waiting around for their benefits to vest.
Even after the vesting date, pension benefits accrue non-linearly, with accrual typically backloaded into the third decade of work. This creates more job lock, as workers have to stick around with the same employer until late in their careers when pension benefit accrual is actually generous.
In 2010, Robert Costrell and Michael Podgursky provided a bracing example from the Missouri Public School Retirement System. A teacher who starts work at age 26 can be expected to accrue a pension benefit worth a modest $100,000 by age 46. (That's a net present value of benefits, not an annual benefit amount.) But by age 56, his or her accrued pension benefits would soar above $600,000.
And then the teacher would face reverse job lock, with accrued pension benefits actually falling with every year worked. If that Missouri teacher worked all the way to age 65, his or her accrued pension benefit would fall to around $500,000, because the guaranteed annual payments don't rise fast enough to offset the fact that the worker's age of retirement keeps getting closer to death.
This system is designed to cause the teacher to work until his or her mid-50s and then quit, whether or not that's good for the teacher or the school system. This is job lock, and it's bad for mid-career entrants, people who would like to work until they die, parents who want to take a few years out of the workforce to raise children, and even full-career teachers who split their careers between two states (and therefore two pension systems).
The usual justification is that job lock is good for the employer: It helps a firm or government agency retain experienced workers once it has expended significant money and energy on training. That may be true in some fields, especially the military. But it's not a general principle. Teachers, for example, get up to speed quickly: Half their gains from experience come in the first year of teaching, and a teacher with five years of experience is on average as effective as one with 25 years.
Similarly to health policy, we should look for a retirement policy that promotes adequate saving without creating job lock. What would that mean? Well, let's start by looking through the key features of defined-benefit pension plans, and keep only the ones that are good.
*(1) Here's the best thing about defined-benefit pensions: They are supported by large, comingled investment funds*, and therefore have the benefit of professional management and economies of scale. 401(k) is a disaster for a number of reasons, but one big problem is that investors pay high fees because small accounts are costly to manage, and most individuals have no idea how to manage their own investments.
Felix Salmon is right: comingled funds are great. But you can have a comingled fund without any of the other trappings of a defined-benefit plan: You can have smooth accrual of benefits and you can have some or all of the investment risk borne by the plan participants, rather than by its sponsor. Galveston, Texas has a retirement plan like this.
*(2) Job lock is another key feature of traditional pension plans, and it's bad.* But it's easy to design a defined-benefit plan with no job lock. It's called a cash balance plan, and it works like this: for every year worked, a percentage of the worker's salary is credited to an account on his or her behalf, which then grows annually at a prescribed rate. As you work longer, your benefit grows proportionately, and there's no penalty for retiring early or late. Nebraska has a plan like this for public workers. Wells Fargo also had one when I worked there, and I left with a cool $7,000 balance after three years of work, which I then rolled into my IRA.
*(3) Traditional pensions shift investment risk away from retirees toward someone else.* This is desirable, to an extent. People with low and moderate incomes are not in a good position to bet their retirement on the stock market not crashing in the five years before they retire.
But, as I'll discuss below, the assumption of risk is costly, so we want to be targeted about it. This is a good reason for what I like to call vertical-hybrid retirement plans: A basic benefit with little risk to the retiree, and more risk loaded on the retiree as his or her wealth rises. We already sort of have a system like this: Social Security is a fairly flat benefit with no investment risk for the beneficiary, and other sources of retirement income are riskier. Employers could adopt a similar split: defined benefit accrual up to an annual cap, and riskier add-on accounts for higher paid workers.
But the biggest issue is the last one...
*(4) Defined-benefit plans often have a higher benefit value than defined-contribution plans.* This isn't universal; many university workers have high-value DC plans through TIAA-CREF, and federal employees have a split system where about half the value is on the DC side. But the average employer 401(k) match amounts to just 2.7% of salary, which is a key reason that 401(k) has not proved a sufficient substitute for traditional pensions.
Because Americans tend to be undersaved, a higher benefit value is desirable — so long as its cost is properly accounted for. Unfortunately, public sector pension plans hide the ball on cost by discounting future benefit payments at a 7-8% annual rate, effectively assuming that high equity returns will pay much of the cost of future benefits.
The oft-cited figure that public pension gaps in 2011 amounted to just 0.2% of GDP over 30 years is based on this error. That's the gap in the mean case where pension investment funds hit their return targets; above-normal returns could reduce that gap to zero, while weak returns would make the gap much larger. Unfortunately, that's not a wash; weak pension fund performance would be correlated with weak economic and fiscal performance, hitting governments with rising bills for pension fund contributions at exactly the same time that tax receipts fall and demand for government services rises.
In effect, by investing pension funds in risky equities and then guaranteeing fixed payouts, governments are providing costly insurance to pensioners, agreeing to make large fiscal transfers toward pension funds in the event of weak economic performance. An insurance company would charge you a great deal for the service of converting a 7% average return on investments into a 7% guaranteed return, as you can see if you price out an annuity, but the cost of that insurance shows up nowhere in the public accounts, until a recession hits and pension fund managers come to state legislatures with the news that taxpayer contributions must rise at the same time the overall state budget is strained, as happened in 2009-11.
That insurance cost does show up on pension accounts in the private sector: Regardless of how they invest their pension funds, private pension sponsors must discount future benefits at a rate that is tied to interest rates on safe bonds, reflecting the certainty with which they will have to pay out. That means General Electric records a much higher (and more accurate) cost for promising a $10,000 pension payment to a worker in 2030 than New York City would record for promising the same payout.
Quite relatedly, governments are more keen on the defined-benefit model than private companies are, because only the governments get to say they are eating a free investment lunch. And this gets to the core problem, other than job lock, with the way defined benefit pensions operate in the U.S. today.
Despite their backers' ideological differences, traditional pensions and 401(k) are built on the same fallacy: That we can set aside x% of GDP today in order to finance future consumption by retirees exceeding x% of future GDP, by investing those retirement funds in assets that rise in value faster than the economy as a whole grows. In both cases, those excess returns can only be achieved through investment risk, and that risk has to be borne somewhere: either by workers themselves, or by firms and state and local governments.
And for that reason, fixing the problem of retirement undersaving is going to require doing two fairly unpleasant things. One is admitting that retirement is expensive, and can't be paid for simply by relying on supernormal returns somewhere. If we want x% of GDP to consist of consumption by retirees, we should find a way to set aside x% of GDP as retirement savings.
The other is having the federal government play an increased role in retirement, because nobody else is in a good position to do it. State and local governments are ill-suited to guarantee pension benefits because they are supposed to balance their budgets annually. Firms have been getting out of the defined-benefit business for decades, as workers change jobs more often and federal rules requiring adequate funding have made pension plans less favorable to comapnies. And 401(k) itself is not working at all, with high fees, mismanaged investments, and not enough money being deposited.
With health policy, as liberal readers of the CBO report noted, the guiding vision should be to ensure individuals are adequately covered while separating labor market decisions from health decisions. The same goal should apply to retirement policy: Adequate saving, without making workers unduly dependent on or wedded to their employers. Only the federal government can make that happen.
Join the conversation about this story »
Reported by Business Insider 15 hours ago.
↧
↧
Covered California Kicks Off Regional Meeting at Loma Linda University Health to Get More San Bernardino County Residents to Sign Up for Affordable Health Coverage
LLUH, in partnership with Community Clinic Association of San Bernardino County, is one of 48 lead organizations that received grant awards from Covered California to help residents access affordable health coverage.
Loma Linda, CA (PRWEB) February 13, 2014
Representatives of community groups working to enroll more San Bernardino County residents for affordable health insurance through Covered California kicked off their first regional meeting on Wednesday (Feb. 12) at Loma Linda University Health (LLUH).
About 40 people, representing dozens of community groups, stakeholders, health organizations, elected officials, and local health officials, took part in the gathering, hosted by LLUH.
“One of the objectives of the regional meeting is to focus on increasing partnerships and collaboration within the region, and to share lessons learned from the first weeks of enrollment,” said Edith Lara-Trad, information officer at Covered California, and the regional coordinator for the effort.
“It is about the people who are in dire need of health coverage. We have 47 days to continue mobilizing our efforts and enroll them now. One focus is to use in-person assistance to maximize enrollment,” she said.
LLUH, in partnership with Community Clinic Association of San Bernardino County, is one of 48 lead organizations that received grant awards totaling $37 million from Covered California to help residents access affordable health coverage. Covered California is the state’s new health care insurance marketplace responsible for reaching out to 5.3 million Californians in need of individual insurance, many of whom may be eligible for financial assistance with the premiums.
“LLUH wants to ensure the residents of the Inland Empire are informed regarding the historic changes in our health care system and we are getting our residents the coverage they need to improve and maintain their health,” said Gerald Winslow, Ph.D., vice president for mission and culture at LLUH, and director of the Institute for Health Policy and Leadership, the organizational entity responsible for administering the grant.
The regional meeting provided opportunities for grantees, certified counselors, providers, community and health agencies, and elected officials to mingle and work in partnerships in existing enrollment events. Covered California partners and the health community have played an integral role to accomplish enrollment to many people thus far and Covered California is providing specific support to the community and partners to drive the regional effort.
Lara-Trad said the challenge is to encourage more people to enroll by March 31, which is the deadline for open enrollment and for obtaining premium assistance and guaranteed health coverage. She said, “We are focusing on key gaps. Latinos, African Americans, and other under-represented communities and young adults are especially targeted for enrollment.” More information is available at http://www.CoveredCA.com.
Rosie Salazar, Covered California certified counselor at Inland Behavioral Health Services, attended the event because she wanted to expand her network and get ideas for getting more people to sign up for health insurance.
“We are in a community where we deal with many homeless and low-income people,” she said. “We do not want them to be left out of affordable health care.”
Photo Caption: Edith Lara-Trad, information officer at Covered California, welcomes representatives from Inland community groups to the first Covered California regional meeting at Loma Linda University Health.
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About Loma Linda University Health (LLUH)
Loma Linda University Health includes Loma Linda University's eight professional schools, Loma Linda University Medical Center's six hospitals and more than 900 faculty physicians located in the Inland Empire of Southern California. Established in 1905, LLUH is a global leader in education, research and clinical care. It offers over 100 academic programs and provides quality health care to 40,000 inpatients and 1.5 million outpatients each year. A Seventh-day Adventist organization, LLUH is a faith-based health system with a mission "to continue the teaching and healing ministry of Jesus Christ."
About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits. Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information on Covered California, please visit http://www.CoveredCA.com. Reported by PRWeb 13 hours ago.
Loma Linda, CA (PRWEB) February 13, 2014
Representatives of community groups working to enroll more San Bernardino County residents for affordable health insurance through Covered California kicked off their first regional meeting on Wednesday (Feb. 12) at Loma Linda University Health (LLUH).
About 40 people, representing dozens of community groups, stakeholders, health organizations, elected officials, and local health officials, took part in the gathering, hosted by LLUH.
“One of the objectives of the regional meeting is to focus on increasing partnerships and collaboration within the region, and to share lessons learned from the first weeks of enrollment,” said Edith Lara-Trad, information officer at Covered California, and the regional coordinator for the effort.
“It is about the people who are in dire need of health coverage. We have 47 days to continue mobilizing our efforts and enroll them now. One focus is to use in-person assistance to maximize enrollment,” she said.
LLUH, in partnership with Community Clinic Association of San Bernardino County, is one of 48 lead organizations that received grant awards totaling $37 million from Covered California to help residents access affordable health coverage. Covered California is the state’s new health care insurance marketplace responsible for reaching out to 5.3 million Californians in need of individual insurance, many of whom may be eligible for financial assistance with the premiums.
“LLUH wants to ensure the residents of the Inland Empire are informed regarding the historic changes in our health care system and we are getting our residents the coverage they need to improve and maintain their health,” said Gerald Winslow, Ph.D., vice president for mission and culture at LLUH, and director of the Institute for Health Policy and Leadership, the organizational entity responsible for administering the grant.
The regional meeting provided opportunities for grantees, certified counselors, providers, community and health agencies, and elected officials to mingle and work in partnerships in existing enrollment events. Covered California partners and the health community have played an integral role to accomplish enrollment to many people thus far and Covered California is providing specific support to the community and partners to drive the regional effort.
Lara-Trad said the challenge is to encourage more people to enroll by March 31, which is the deadline for open enrollment and for obtaining premium assistance and guaranteed health coverage. She said, “We are focusing on key gaps. Latinos, African Americans, and other under-represented communities and young adults are especially targeted for enrollment.” More information is available at http://www.CoveredCA.com.
Rosie Salazar, Covered California certified counselor at Inland Behavioral Health Services, attended the event because she wanted to expand her network and get ideas for getting more people to sign up for health insurance.
“We are in a community where we deal with many homeless and low-income people,” she said. “We do not want them to be left out of affordable health care.”
Photo Caption: Edith Lara-Trad, information officer at Covered California, welcomes representatives from Inland community groups to the first Covered California regional meeting at Loma Linda University Health.
###
About Loma Linda University Health (LLUH)
Loma Linda University Health includes Loma Linda University's eight professional schools, Loma Linda University Medical Center's six hospitals and more than 900 faculty physicians located in the Inland Empire of Southern California. Established in 1905, LLUH is a global leader in education, research and clinical care. It offers over 100 academic programs and provides quality health care to 40,000 inpatients and 1.5 million outpatients each year. A Seventh-day Adventist organization, LLUH is a faith-based health system with a mission "to continue the teaching and healing ministry of Jesus Christ."
About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits. Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information on Covered California, please visit http://www.CoveredCA.com. Reported by PRWeb 13 hours ago.
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Most states lag in health insurance sign-ups
Most states are still lagging when it comes to sign-ups under President Barack Obama's health care law, but an Associated Press analysis of numbers reported Wednesday finds a dozen high-achievers getting ahead of the...
Reported by WTHR 9 hours ago.
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1 in 5 buyers of insurance under new law didn't pay premiums on time
WASHINGTON -- One in five people who signed up for health insurance under the new health care law failed to pay their premiums on time and therefore did not receive coverage in January, insurance companies and industry experts say.
Reported by TwinCities.com 9 hours ago.
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About 300,000 to have health insurance by end of March
An estimated 300,000 people are predicted to have health-insurance plans by the end of March when the individual insurance market closes for the year.
Reported by Seattle Times 6 hours ago.
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Estimated 300,000 to be insured by the end of March
An estimated 300,000 people are predicted to have health-insurance plans by the end of March when the individual insurance market closes for the year.
Reported by Seattle Times 7 hours ago.
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Health Connector has backlog of 50,000 paper insurance applications
About 50,000 health insurance applications, many filed by low-income Massachusetts residents, have yet to be processed by the state’s troubled insurance marketplace, officials disclosed Thursday, and it may take months to get all those people enrolled in subsidized plans.
Reported by Boston.com 6 hours ago.
Reported by Boston.com 6 hours ago.
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Featured Speakers Bring Big Data, Quality and Pricing Expertise to RISE Conference “Product Design, Pricing & Risk Adjustment on the Health Insurance Exchanges"
Mickey Dodge, Brian Tajlili and John Criswell as featured speakers in RISE Conference “Product Design, Pricing & Risk Adjustment on the Health Insurance Exchanges" in Las Vegas on February 17-18, 2014 will bring expertise to offer insight and strategies for Commercial data, quality, and pricing processes.
Las Vegas, NV (PRWEB) February 14, 2014
To be protected from adverse selection, payers must participate in the risk adjustment process. How they implement a risk adjustment strategy and the value of that solution is dependent on many things — data being the most significant. Being prepared to capture both traditional and new data sources will be a key differentiator to understand these populations and offer more insight into pricing.
Featured speakers Mickey Dodge, FSA, MAAA and Brian Tajlili, FSA, MAAA are Managing Actuaries from BCBS of North Carolina who will share lessons learned from 834s received to date, factors that affect risk scores and variables impacting transfer payments. John Criswell, MBA, CEO of Pulse8, a technology and analytics provider, will share strategies for using an advanced Big Data approach to enhance your probability of success with Risk Adjustment.
The RISE conference “Product Design, Pricing and Risk Adjustment on the Health Insurance Exchanges” is presented by Healthcare Education Associates as the only conference focused on the exchange’s unique challenges. It includes renowned speaking faculty from health plans, state exchanges and service providers who will share case studies and expert presentations to its audience of actuarial analysts, CEOs, CFOs, product development and benefit design executives. For more information and to register to attend, please go to http://www.frallc.com/pdf/H196.pdf and enter code HSM134 for a 15% discount off your admission rate. Reported by PRWeb 4 hours ago.
Las Vegas, NV (PRWEB) February 14, 2014
To be protected from adverse selection, payers must participate in the risk adjustment process. How they implement a risk adjustment strategy and the value of that solution is dependent on many things — data being the most significant. Being prepared to capture both traditional and new data sources will be a key differentiator to understand these populations and offer more insight into pricing.
Featured speakers Mickey Dodge, FSA, MAAA and Brian Tajlili, FSA, MAAA are Managing Actuaries from BCBS of North Carolina who will share lessons learned from 834s received to date, factors that affect risk scores and variables impacting transfer payments. John Criswell, MBA, CEO of Pulse8, a technology and analytics provider, will share strategies for using an advanced Big Data approach to enhance your probability of success with Risk Adjustment.
The RISE conference “Product Design, Pricing and Risk Adjustment on the Health Insurance Exchanges” is presented by Healthcare Education Associates as the only conference focused on the exchange’s unique challenges. It includes renowned speaking faculty from health plans, state exchanges and service providers who will share case studies and expert presentations to its audience of actuarial analysts, CEOs, CFOs, product development and benefit design executives. For more information and to register to attend, please go to http://www.frallc.com/pdf/H196.pdf and enter code HSM134 for a 15% discount off your admission rate. Reported by PRWeb 4 hours ago.
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NAIRO Delivers Key Information About the External Review Process Within the Health Insurance Marketplace
Issue Brief Tackles Pressing Questions About Health Reform and External Review
Portland, OR (PRWEB) February 14, 2014
Seeking to clarify the general uncertainty surrounding the launch of the Health Insurance Marketplace, the National Association of Independent Review Organizations (NAIRO) announces the release of a new Issue Brief that provides clarification on the external review processes available under the state and federal Marketplaces.
The Issue Brief, “External Review Options Available Under the Federal Facilitated and State Marketplaces,” discusses the elements of federal external review options, including State-Based Exchange Review Program, Federal External Review Program (FERP), Multi-State Plan Program (MSPP) external review program, and the Pre-existing Condition Insurance Program (PCIP) external review program.
“A lot of confusion exists for all stakeholders involved in the external review process for programs available within the new Marketplaces,” said Gib Smith, Executive Director of NAIRO. “This informative Issue Brief seeks to clarify the rules and expectations regarding external review for health plans, consumers, independent review organizations and other aligned service providers.”
As background, when using Marketplace-related healthcare services, a consumer may have a claim denied, which means that a particular healthcare service is either not medically necessary or not covered by the consumer’s health insurance plan. At this point, the consumer has the option to file an appeal. After exhausting the health carrier’s internal appeals process, the appeal moves to external review. As required by law, external review is conducted by independent review organizations (IROs), which serve an essential function by guaranteeing expert, unbiased medical review of appealed claims.
With the Marketplaces expanding health coverage to millions of Americans, and offering an entirely new platform for providing and obtaining health insurance coverage, many questions about important regulations have gone unanswered. NAIRO’s Issue Brief seeks to fill in the information gap with key guidance and insight for involved stakeholders.
Under PPACA, certain health plans must use IROs that are accredited by URAC or a similar nationally-recognized accrediting organization to manage their respective ACA Federal External Review Processes, including FERPs, MSPPs, and PCIPS. Within the healthcare industry, IRO accreditation is considered the gold standard for the companies providing external review services. Regardless of the venue, stakeholders within healthcare can utilize accredited IROs for internal and external appeals to ensure consistency, objectivity and accuracy when seeking medical review determinations.
The full Issue Brief is available here: http://www.nairo.org/news.php.
About NAIRO
NAIRO (The National Association of Independent Review Organizations) was formed by the majority of URAC-accredited IROs. The mission of NAIRO is to promote the quality and integrity of the independent review process at the internal and external levels. Utilizing the expertise of board-certified clinicians throughout the country, NAIRO members embrace an evidence-based approach to independent medical peer review, in order to help resolve coverage disputes between enrollees and their health plans. More information can be found at http://www.nairo.org. Reported by PRWeb 4 hours ago.
Portland, OR (PRWEB) February 14, 2014
Seeking to clarify the general uncertainty surrounding the launch of the Health Insurance Marketplace, the National Association of Independent Review Organizations (NAIRO) announces the release of a new Issue Brief that provides clarification on the external review processes available under the state and federal Marketplaces.
The Issue Brief, “External Review Options Available Under the Federal Facilitated and State Marketplaces,” discusses the elements of federal external review options, including State-Based Exchange Review Program, Federal External Review Program (FERP), Multi-State Plan Program (MSPP) external review program, and the Pre-existing Condition Insurance Program (PCIP) external review program.
“A lot of confusion exists for all stakeholders involved in the external review process for programs available within the new Marketplaces,” said Gib Smith, Executive Director of NAIRO. “This informative Issue Brief seeks to clarify the rules and expectations regarding external review for health plans, consumers, independent review organizations and other aligned service providers.”
As background, when using Marketplace-related healthcare services, a consumer may have a claim denied, which means that a particular healthcare service is either not medically necessary or not covered by the consumer’s health insurance plan. At this point, the consumer has the option to file an appeal. After exhausting the health carrier’s internal appeals process, the appeal moves to external review. As required by law, external review is conducted by independent review organizations (IROs), which serve an essential function by guaranteeing expert, unbiased medical review of appealed claims.
With the Marketplaces expanding health coverage to millions of Americans, and offering an entirely new platform for providing and obtaining health insurance coverage, many questions about important regulations have gone unanswered. NAIRO’s Issue Brief seeks to fill in the information gap with key guidance and insight for involved stakeholders.
Under PPACA, certain health plans must use IROs that are accredited by URAC or a similar nationally-recognized accrediting organization to manage their respective ACA Federal External Review Processes, including FERPs, MSPPs, and PCIPS. Within the healthcare industry, IRO accreditation is considered the gold standard for the companies providing external review services. Regardless of the venue, stakeholders within healthcare can utilize accredited IROs for internal and external appeals to ensure consistency, objectivity and accuracy when seeking medical review determinations.
The full Issue Brief is available here: http://www.nairo.org/news.php.
About NAIRO
NAIRO (The National Association of Independent Review Organizations) was formed by the majority of URAC-accredited IROs. The mission of NAIRO is to promote the quality and integrity of the independent review process at the internal and external levels. Utilizing the expertise of board-certified clinicians throughout the country, NAIRO members embrace an evidence-based approach to independent medical peer review, in order to help resolve coverage disputes between enrollees and their health plans. More information can be found at http://www.nairo.org. Reported by PRWeb 4 hours ago.
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Featured Session: Documentation and ICD-10 Implementation Presented by Dr. Paul L. Weygandt, Vice President Physician Services, J. A. Thomas & Associates
The American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) announce a featured session for its 2014 Conference: “Getting Paid for Innovation and High Value Outcomes: The Path to Cost Effective, Accessible Health Care for All”.
New Port Richey, FL (PRWEB) February 14, 2014
Friday, May 2, 2014
Disney’s Yacht & Beach Club Resort
Lake Buena Vista, Florida
8:00 a.m. to 5:30 p.m.
The ICD-10 conversion date is approaching…are you ready for October?
Who is affected? ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims.
Replacing the outdated ICD-9 coding system is daunting, but necessary. Don’t miss this featured session on May 2 to find out if you are ready.
Documentation and ICD-10 Implementation*
Paul L. Weygandt, MD, JD, MPH, MBA, CCS, CPE, FACPE , Vice President Physician Services, J. A. Thomas & Associates, Nuance Clinical Documentation Solutions Division
Dr. Paul L. Weygandt is Vice President Physician Services, J. A. Thomas & Associates (JATA now part of Nuance). In this capacity, he has developed approaches to physician documentation, assisting physician leaders in communicating the importance of accurate, legally compliant clinical documentation. Dr. Weygandt is a certified coder and an AHIMA-approved ICD-10-CM/PCS Trainer.
Don’t miss this informative session that will:· Employ strategies to engage physicians in a collaborative manner with clinical documentation improvement initiatives to improve quality of care, quality metrics and financial sustainability.
· Identify innovative and at times challenging ways to improve quality metrics through improved severity capture, focusing on the process of physician documentation.
· Engage physicians in the transition to ICD-10, enabling IT tools such as CAC while limiting physician, CDS, and coder rework.
*Topics are tentative and subject to change.
To read more about ICD-10 conversion from Dr. Weygandt in preparation for this session, please access the ICD-10 Monitor online resource link below.
http://icd10monitor.com/enews/vendor-news/itemlist/user/65-paulweygandtmdjdmphmbacpe?start=1
About ABQAURP
Established in 1977, ABQAURP (http://www.abqaurp.org) is the nation's largest organization of interdisciplinary health care professionals. We are committed to maximizing patient safety and the quality of health care provided to the public by maintaining a culture of educational and certification excellence and making it available to all health care professionals. Reported by PRWeb 4 hours ago.
New Port Richey, FL (PRWEB) February 14, 2014
Friday, May 2, 2014
Disney’s Yacht & Beach Club Resort
Lake Buena Vista, Florida
8:00 a.m. to 5:30 p.m.
The ICD-10 conversion date is approaching…are you ready for October?
Who is affected? ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims.
Replacing the outdated ICD-9 coding system is daunting, but necessary. Don’t miss this featured session on May 2 to find out if you are ready.
Documentation and ICD-10 Implementation*
Paul L. Weygandt, MD, JD, MPH, MBA, CCS, CPE, FACPE , Vice President Physician Services, J. A. Thomas & Associates, Nuance Clinical Documentation Solutions Division
Dr. Paul L. Weygandt is Vice President Physician Services, J. A. Thomas & Associates (JATA now part of Nuance). In this capacity, he has developed approaches to physician documentation, assisting physician leaders in communicating the importance of accurate, legally compliant clinical documentation. Dr. Weygandt is a certified coder and an AHIMA-approved ICD-10-CM/PCS Trainer.
Don’t miss this informative session that will:· Employ strategies to engage physicians in a collaborative manner with clinical documentation improvement initiatives to improve quality of care, quality metrics and financial sustainability.
· Identify innovative and at times challenging ways to improve quality metrics through improved severity capture, focusing on the process of physician documentation.
· Engage physicians in the transition to ICD-10, enabling IT tools such as CAC while limiting physician, CDS, and coder rework.
*Topics are tentative and subject to change.
To read more about ICD-10 conversion from Dr. Weygandt in preparation for this session, please access the ICD-10 Monitor online resource link below.
http://icd10monitor.com/enews/vendor-news/itemlist/user/65-paulweygandtmdjdmphmbacpe?start=1
About ABQAURP
Established in 1977, ABQAURP (http://www.abqaurp.org) is the nation's largest organization of interdisciplinary health care professionals. We are committed to maximizing patient safety and the quality of health care provided to the public by maintaining a culture of educational and certification excellence and making it available to all health care professionals. Reported by PRWeb 4 hours ago.
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PetFirst Announces Top Five Claims for 2013
Pet Insurance Reimbursement Totaling More Than $35,000 for Pet Emergencies
Jeffersonville, IN (PRWEB) February 14, 2014
PetFirst, the fastest growing pet insurer in North America, announces the top five claims for 2013. These claims are among the more than 58,700 claims filed in 2013 of which $5.6 million was reimbursed to pet parents.
According to INN (Insurance Networking News) pet insurance has been the fastest growing category in insurance sales in the US in recent years. That growth is expected to continue. PetFirst provides these great examples of why pet health insurance is so important:
Trapper, a mixed breed dog, became ill over the summer. His symptoms came on quickly and included being lethargic and not eating. His pet parents took him to the vet where he was diagnosed with Evans Syndrome – an autoimmune disease that can manifest in dogs and requires ongoing treatment including vet visits and lab work. Thanks to Trapper’s Lifetime pet insurance policy, not only is his condition covered for life, with no per incident limits, PetFirst reimbursed his family $10,000 for veterinary expenses.
Delilah is a 6 year old chocolate Labrador retriever. Delilah, like most labs, is curious about everything. Her curiosity ended in a trip to the vet for foreign body surgical removal, along with lab work, x-rays and a few days stay in the hospital. Delilah is well covered with the Lifetime pet insurance plan, which will cover multiple foreign body ingestions each year should this happen again. Today Delilah is doing just fine and her pet parent was reimbursed $9,821.27 for veterinary expenses.
MacDuff, an Airedale Terrier, suffered several injuries as a result of being hit by a car over the summer. MacDuff’s list of injuries included a fibular fracture (broken rear lower leg) along with swelling of the tissue in his leg. He also bruised the tissue in his lungs. The road to recovery required 10 days in the veterinary emergency hospital with several x-rays and a surgical procedure. MacDuff is well on the road to recovery and so are his pet parents who had MacDuff and their other Airedale Terrier covered on a Lifetime family plan insurance policy for multiple pets. The pet parents were reimbursement $8,511.13 for the veterinary expenses.
Iris, a domestic short hair tabby cat, developed pancreatitis, a condition where the pancreas becomes inflamed and digestive enzymes escape causing damage to other organs including the liver. Iris’ condition was so sever is required hospitalization, testing and aggressive treatment. Today Iris is doing well and fully recovered from her illness. Thanks to their Lifetime Accident and Illness pet insurance plan through PetFirst, Iris’ pet parents received $4,513.82 reimbursement for the veterinary expenses.
Rocky, a Maine Coon breed cat, developed an obstruction of the urethra (the tube draining urine from the bladder out of the body). This condition required several x-rays and a surgical procedure to open the blockage. Rocky’s pet parents insured him with a PetFirst Preferred pet insurance plan. This particular plan the family chose reimburses up to $2,500 per incident, an amount that helped cover Rocky’s veterinary expenses.
Pet parents have several choices in tailoring the pet insurance plan that best fits their pet’s needs with PetFirst including selecting the reimbursement percentage, deductible amount and coverage limit. For more information on pet insurance and PetFirst, visit http://www.petfirst.com.
About PetFirst
PetFirst is the fastest growing pet insurer in North America offering easy-to-understand life-long coverage for dogs and cats. PetFirst’s comprehensive coverage is unique in the industry providing simplified policies with coverage for hereditary, chronic and breed-specific conditions with no per diagnosis limits. PetFirst offers pet insurance in all 50 states and the District of Columbia through animal welfare agencies, retailers, employers as well as other partners. PetFirst polices are underwritten by American Alternative Insurance Corporation (Munich Re) which is rated by A.M. Best as A+. Additional services are underwritten by Lloyd’s. For more information about PetFirst pet insurance, visit http://www.petfirst.com or call 877-894-7387.
-30- Reported by PRWeb 4 hours ago.
Jeffersonville, IN (PRWEB) February 14, 2014
PetFirst, the fastest growing pet insurer in North America, announces the top five claims for 2013. These claims are among the more than 58,700 claims filed in 2013 of which $5.6 million was reimbursed to pet parents.
According to INN (Insurance Networking News) pet insurance has been the fastest growing category in insurance sales in the US in recent years. That growth is expected to continue. PetFirst provides these great examples of why pet health insurance is so important:
Trapper, a mixed breed dog, became ill over the summer. His symptoms came on quickly and included being lethargic and not eating. His pet parents took him to the vet where he was diagnosed with Evans Syndrome – an autoimmune disease that can manifest in dogs and requires ongoing treatment including vet visits and lab work. Thanks to Trapper’s Lifetime pet insurance policy, not only is his condition covered for life, with no per incident limits, PetFirst reimbursed his family $10,000 for veterinary expenses.
Delilah is a 6 year old chocolate Labrador retriever. Delilah, like most labs, is curious about everything. Her curiosity ended in a trip to the vet for foreign body surgical removal, along with lab work, x-rays and a few days stay in the hospital. Delilah is well covered with the Lifetime pet insurance plan, which will cover multiple foreign body ingestions each year should this happen again. Today Delilah is doing just fine and her pet parent was reimbursed $9,821.27 for veterinary expenses.
MacDuff, an Airedale Terrier, suffered several injuries as a result of being hit by a car over the summer. MacDuff’s list of injuries included a fibular fracture (broken rear lower leg) along with swelling of the tissue in his leg. He also bruised the tissue in his lungs. The road to recovery required 10 days in the veterinary emergency hospital with several x-rays and a surgical procedure. MacDuff is well on the road to recovery and so are his pet parents who had MacDuff and their other Airedale Terrier covered on a Lifetime family plan insurance policy for multiple pets. The pet parents were reimbursement $8,511.13 for the veterinary expenses.
Iris, a domestic short hair tabby cat, developed pancreatitis, a condition where the pancreas becomes inflamed and digestive enzymes escape causing damage to other organs including the liver. Iris’ condition was so sever is required hospitalization, testing and aggressive treatment. Today Iris is doing well and fully recovered from her illness. Thanks to their Lifetime Accident and Illness pet insurance plan through PetFirst, Iris’ pet parents received $4,513.82 reimbursement for the veterinary expenses.
Rocky, a Maine Coon breed cat, developed an obstruction of the urethra (the tube draining urine from the bladder out of the body). This condition required several x-rays and a surgical procedure to open the blockage. Rocky’s pet parents insured him with a PetFirst Preferred pet insurance plan. This particular plan the family chose reimburses up to $2,500 per incident, an amount that helped cover Rocky’s veterinary expenses.
Pet parents have several choices in tailoring the pet insurance plan that best fits their pet’s needs with PetFirst including selecting the reimbursement percentage, deductible amount and coverage limit. For more information on pet insurance and PetFirst, visit http://www.petfirst.com.
About PetFirst
PetFirst is the fastest growing pet insurer in North America offering easy-to-understand life-long coverage for dogs and cats. PetFirst’s comprehensive coverage is unique in the industry providing simplified policies with coverage for hereditary, chronic and breed-specific conditions with no per diagnosis limits. PetFirst offers pet insurance in all 50 states and the District of Columbia through animal welfare agencies, retailers, employers as well as other partners. PetFirst polices are underwritten by American Alternative Insurance Corporation (Munich Re) which is rated by A.M. Best as A+. Additional services are underwritten by Lloyd’s. For more information about PetFirst pet insurance, visit http://www.petfirst.com or call 877-894-7387.
-30- Reported by PRWeb 4 hours ago.
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California takes down online health insurance exchange for small businesses
The nation’s most populous state has elected to temporarily shutter its new online health insurance marketplace for small business only four months after it launched, dealing yet another blow to a key element of the health care law meant to lower costs for employers.
Reported by Washington Post 35 minutes ago.
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Fact Checker: Democratic attack ad aimied at GOP candidate seeking to repeal Obamacare
“In North Carolina we put families first, but Senate candidate Thom Tillis sides with health insurance companies. He’d let them deny coverage for preexisting conditions and raise rates for women needing mammograms. Tillis supports a plan that would end Medicare as we know it and force seniors to spent up to $1700 more on prescriptions. He’s with the special interests, hurting North Carolina families.”
Reported by Washington Post 35 minutes ago.
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Health plans dont cover weight loss surgery
WASHINGTON (AP) - Like 78 million other Americans, MaryJane Harrison is obese. And like many critically overweight Americans, Harrison cannot afford to have weight loss surgery because her health insurance doesnt cover it.
Reported by MyNorthwest.com 12 minutes ago.
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Health plans don't cover weight loss surgery
The financial burden makes it nearly impossible for her to follow the advice of three physicians who have prescribed the stomach-shrinking procedure for Harrison, who is four-feet, 10 inches and weighs 265 pounds. Harrison's health insurance plan, provided by UnitedHealth, excludes coverage of any surgical procedures for weight loss. While the number of obese Americans persists at record levels, the number of patients undergoing weight loss surgery hasn't budged in a decade. Surgeons blame a combination of factors for the stagnating numbers, including the economic downturn and a social stigma against resorting to surgery to treat weight problems. Guidelines issued in November by the American Heart Association, the American College of Cardiology and the Obesity Society call on doctors to calculate a patient's body mass index — an estimate of body fat based on weight and height — each year, and recommend surgery for those who face the most serious health problems. Weight loss surgery is recommended for those with a BMI of 40 or those with a BMI of 35 who have other risk factors for heart disease such as diabetes or high blood pressure. The latest long-term studies show that the typical patient loses about 30 percent of their excess weight with the bypass procedure and 17 percent with the band after three years. Most insurers then require six to 12 months of doctor-supervised dieting, in which patients keep a journal of their eating habits and visit their physicians for regular weigh-ins and check-ups. America's Health Insurance Plans, the industry trade group, says companies are simply following federal guidelines that recommend surgery for "carefully selected patients" who have failed other methods. Dr. David Katz of Yale University's Prevention Research Center says a smarter approach lies in educating children and adolescents early on about healthy eating and exercise habits.
Reported by SeattlePI.com 7 minutes ago.
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The $20,000 tick bite
*The $20,000 tick bite*
After three years of suffering with pain so intense he couldn’t work, and undergoing three back surgeries, Gary Duncan, then 47 and living in Claremont, Calif., received a diagnosis of Lyme disease. To see doctors who specialized in Lyme, he and his wife, Holly, went out of their insurance plan’s network. They thought their preferred provider organization limited their out-of-pocket costs to $10,000 a year, which they were willing to spend to make Gary well. They didn't know they were on their way to a $20,000 tick bite.
They knew that every time an out-of-network doctor sent them a bill, their insurance would cover 60 percent. What they didn’t understand was that meant 60 percent of what their insurer deemed a “usual, customary, and reasonable,” or UCR, charge, which was often much less than the providers’ actual fees. So when a doctor charged them, say, $1,000, and the plan determined the UCR charge was $800, the plan paid only 60 percent of $800, or $480—not 60 percent of $1,000. Plus the plan had a $3,500 deductible. By the end of the year, the couple had paid more than $20,000 out of pocket.
You could similarly rack up big bills if the medical providers you use are not in your plan’s network. Your in-network providers have agreed to accept your insurance plan’s contracted rate. (You still must pay deductibles, co-insurance, and co-pays.) But providers who are not in your network can charge you whatever they think is reasonable and bill you for the balance not covered by your insurer, known as “balance billing.”
An obvious way to avoid stratospheric out-of-network charges is to not use out-of-network providers. But that’s not always possible. Many people receive out-of-network care without knowing it, says Cheryl Fish-Parcham, the deputy director of health policy at Families USA, a nonprofit consumer advocacy group.
Your insurer’s list of providers may be out-of-date, for example. Or you might have surgery at an in-network hospital but have out-of-network providers read your X-rays. “You may not even know their names until you get a bill,” says Karen Pollitz, a senior fellow at the Kaiser Family Foundation. Imaging and lab bills can be especially high, she adds; it’s not unusual for people to be charged 10 times what is set as the UCR price. If you have a long hospital stay, your bills could easily add up to thousands of dollars—or more.
Of course, going outside your network is sometimes unavoidable. For example, a hospital you are rushed to in an emergency might not be in your network. (There are some special protections for billing in an emergency. For more information, download a PDF of the Families USA Patients' Bill of Rights.) But, when possible, the choice should be up to you.
*Use our Health Law Helper interactive to get personalized information about health reform and insurance.*
-*Before treatment*-
*Familiarize yourself with your plan. *Ask your benefits department or insurer for the plan’s Summary of Benefits and Coverage. That is a standardized document that details the plan’s relevant features. Then call your plan and ask how it determines what it will pay for out-of-network care.
*Get a current network list. *Call and ask providers whether they are still in the plan before you make an appointment.
*Research the amount you’ll pay.* If you choose to go out of network, ask the provider’s staff how much he or she will charge before your visit. Try to negotiate prices in advance. Start by looking up the “fair” prices in your area for your test or procedure at Fair Health, Healthcare Blue Book, or both. Use the results as a basis for negotiating with the out-of-network provider, and get it in writing.
*Dig into the details. *If you have to undergo complex out-of-network procedures that aren’t listed on Fair Health or Healthcare Blue Book, ask the out-of-network provider for the billing codes for services to be performed. Also get the provider’s tax identification number and the ZIP code of where the service will be performed. Then call your insurance company with that information; they are obligated to tell you what they will pay. Then you can negotiate the balance with the provider.
-*After treatment*-
*Carefully review your bills.* If you receive an unexpected out-of-network bill from a doctor after surgery in a network hospital, for example, you might be able to get it reduced by negotiating after the fact, too. First, determine the typical price and ask the doctor to discount the fee. If that fails, complain to the hospital, your insurer, your employer, and your state insurance department or state health insurance consumer advocate. The National Association of Insurance Commissioners has links to every state's insurance department.
*Dispute incorrect charges.* If you find billing errors, notify your insurer. The procedure to file an appeal should be included in your billing. Healthcare.gov has more details on the dispute process for non-Medicare plans, including those offered by the Affordable Care Act exchanges. Medicare customers will find information on its appeal process on its site.
—Mandy Walker
This article also appeared in the March 2014 issue of Consumer Reports Money Adviser.
*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*
*Subscribe now!*
Subscribe to *ConsumerReports.org* for expert Ratings, buying advice and reliability on hundreds of products.
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Update your feed preferences Reported by Consumer Reports 4 days ago.
After three years of suffering with pain so intense he couldn’t work, and undergoing three back surgeries, Gary Duncan, then 47 and living in Claremont, Calif., received a diagnosis of Lyme disease. To see doctors who specialized in Lyme, he and his wife, Holly, went out of their insurance plan’s network. They thought their preferred provider organization limited their out-of-pocket costs to $10,000 a year, which they were willing to spend to make Gary well. They didn't know they were on their way to a $20,000 tick bite.
They knew that every time an out-of-network doctor sent them a bill, their insurance would cover 60 percent. What they didn’t understand was that meant 60 percent of what their insurer deemed a “usual, customary, and reasonable,” or UCR, charge, which was often much less than the providers’ actual fees. So when a doctor charged them, say, $1,000, and the plan determined the UCR charge was $800, the plan paid only 60 percent of $800, or $480—not 60 percent of $1,000. Plus the plan had a $3,500 deductible. By the end of the year, the couple had paid more than $20,000 out of pocket.
You could similarly rack up big bills if the medical providers you use are not in your plan’s network. Your in-network providers have agreed to accept your insurance plan’s contracted rate. (You still must pay deductibles, co-insurance, and co-pays.) But providers who are not in your network can charge you whatever they think is reasonable and bill you for the balance not covered by your insurer, known as “balance billing.”
An obvious way to avoid stratospheric out-of-network charges is to not use out-of-network providers. But that’s not always possible. Many people receive out-of-network care without knowing it, says Cheryl Fish-Parcham, the deputy director of health policy at Families USA, a nonprofit consumer advocacy group.
Your insurer’s list of providers may be out-of-date, for example. Or you might have surgery at an in-network hospital but have out-of-network providers read your X-rays. “You may not even know their names until you get a bill,” says Karen Pollitz, a senior fellow at the Kaiser Family Foundation. Imaging and lab bills can be especially high, she adds; it’s not unusual for people to be charged 10 times what is set as the UCR price. If you have a long hospital stay, your bills could easily add up to thousands of dollars—or more.
Of course, going outside your network is sometimes unavoidable. For example, a hospital you are rushed to in an emergency might not be in your network. (There are some special protections for billing in an emergency. For more information, download a PDF of the Families USA Patients' Bill of Rights.) But, when possible, the choice should be up to you.
*Use our Health Law Helper interactive to get personalized information about health reform and insurance.*
-*Before treatment*-
*Familiarize yourself with your plan. *Ask your benefits department or insurer for the plan’s Summary of Benefits and Coverage. That is a standardized document that details the plan’s relevant features. Then call your plan and ask how it determines what it will pay for out-of-network care.
*Get a current network list. *Call and ask providers whether they are still in the plan before you make an appointment.
*Research the amount you’ll pay.* If you choose to go out of network, ask the provider’s staff how much he or she will charge before your visit. Try to negotiate prices in advance. Start by looking up the “fair” prices in your area for your test or procedure at Fair Health, Healthcare Blue Book, or both. Use the results as a basis for negotiating with the out-of-network provider, and get it in writing.
*Dig into the details. *If you have to undergo complex out-of-network procedures that aren’t listed on Fair Health or Healthcare Blue Book, ask the out-of-network provider for the billing codes for services to be performed. Also get the provider’s tax identification number and the ZIP code of where the service will be performed. Then call your insurance company with that information; they are obligated to tell you what they will pay. Then you can negotiate the balance with the provider.
-*After treatment*-
*Carefully review your bills.* If you receive an unexpected out-of-network bill from a doctor after surgery in a network hospital, for example, you might be able to get it reduced by negotiating after the fact, too. First, determine the typical price and ask the doctor to discount the fee. If that fails, complain to the hospital, your insurer, your employer, and your state insurance department or state health insurance consumer advocate. The National Association of Insurance Commissioners has links to every state's insurance department.
*Dispute incorrect charges.* If you find billing errors, notify your insurer. The procedure to file an appeal should be included in your billing. Healthcare.gov has more details on the dispute process for non-Medicare plans, including those offered by the Affordable Care Act exchanges. Medicare customers will find information on its appeal process on its site.
—Mandy Walker
This article also appeared in the March 2014 issue of Consumer Reports Money Adviser.
*Consumer Reports has no relationship with any advertisers or sponsors on this website. Copyright © 2006-2014 Consumers Union of U.S.*
*Subscribe now!*
Subscribe to *ConsumerReports.org* for expert Ratings, buying advice and reliability on hundreds of products.
--------------------
Update your feed preferences Reported by Consumer Reports 4 days ago.
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