(BUSINESS WIRE)--Aetna (NYSE: ΑET) and WellStar Health System of Marietta, Ga. announced today that they have reached agreement on a three-year contract that provides access for Aetna’s Medicare Advantage members to the hospital’s facilities and physicians.
Under this new agreement, Aetna Medicare Advantage plan members will be able to receive covered services, at in-network rates, from WellStar facilities in the greater Atlanta area. Earlier this year, Aetna and WellStar reached agreement on a contract that applied to members of Aetna’s commercial plans. Aetna members also will be able to continue receiving covered services from WellStar physicians.
“Aetna is very pleased to expand its relationship with WellStar,” said Ramzy Elgomayel, Aetna’s vice president of network operations for Georgia. “WellStar has provided excellent care to our commercial-plan members for several years, and we’re delighted to be able offer in-network access to their facilities and providers for our Medicare Advantage plan members.”
“The expansion of the Aetna contract to cover the Medicare Advantage members further solidifies our relationship,” said Barbara Corey, senior vice president of managed care for WellStar. “We look forward to providing exceptional health care services to these members.”
Aetna provides health benefits to approximately 600,000 members in Georgia. Those members have access to a network that includes 80 contracted hospitals and more than 9,500 primary care physicians and specialists.
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Saturday, October 31, 2009
Friday, October 30, 2009
Policymakers Have Many Options to Make Social Security Both Solvent and More Adequate
/PRNewswire/ -- Social Security, the foundation of economic security for millions of America's seniors and working families, can be made more adequate and solvent for the long term, according to a new report released today by the National Academy of Social Insurance (NASI).
The report, Fixing Social Security: Adequate Benefits, Adequate Financing, outlines approximately 30 options for putting the program's finances into 75-year balance and more than 10 ways to make Social Security more adequate for those who rely on it. All options have long-range cost estimates from Social Security actuaries.
"Fixing Social Security is a manageable job. While Social Security does not need more money now, policymakers could act now to make funds available in the future when the money will be needed," said Virginia Reno, co-author of the report and Vice President for Income Security at NASI.
"We also need to consider the adequacy of Social Security benefits," said Janice Gregory, president of NASI. "Long-term shifts in private retirement plans are placing more risks on individual workers. Recent losses in jobs, home equity, and individual savings are weakening all other sources of financial security in retirement. Only Social Security has held its value. Yet benefits remain modest for all, and inadequate for some especially vulnerable populations."
Benefit adequacy options in the report target such financially vulnerable groups as:
-- The oldest beneficiaries (over 85 years);
-- Widowed spouses of low-earning couples;
-- Low-paid workers generally;
-- Workers with gaps in paid work due to childcare; and
-- Students in college or vocational school who have lost parental
support due to death or disability.
Other adequacy options would increase benefits across the board for current and future beneficiaries.
Options to balance Social Security's future finances include:
-- Lifting the cap (now $106,800) on the earnings from which workers and
employers pay Social Security taxes;
-- Broadening the base for Social Security taxes;
-- Scheduling modest rate increases in the future when funds will be
needed;
-- Dedicating progressive taxes to pay part of Social Security's future
cost; and
-- Gradually lowering some future benefits.
A recent survey conducted by the Benenson Strategy Group (BSG) for NASI and the Rockefeller Foundation found that Americans want to preserve and improve Social Security, even if it means paying higher taxes to do so. "Even before the recession, fear of an insecure retirement was among Americans' top economic concerns," said Danny Franklin of BSG. "Those fears have only intensified in the past year. Americans today are willing -- even eager -- to invest in the peace of mind that Social Security provides."
The NASI project receives support from the Ford Foundation's initiative on Economic Fairness and Opportunity and the Rockefeller Foundation's Campaign for American Workers.
The National Academy of Social Insurance (NASI) is a non-profit, nonpartisan organization made up of the nation's leading experts on social insurance. Its mission is to promote understanding of how social insurance contributes to economic security and a vibrant economy.
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The report, Fixing Social Security: Adequate Benefits, Adequate Financing, outlines approximately 30 options for putting the program's finances into 75-year balance and more than 10 ways to make Social Security more adequate for those who rely on it. All options have long-range cost estimates from Social Security actuaries.
"Fixing Social Security is a manageable job. While Social Security does not need more money now, policymakers could act now to make funds available in the future when the money will be needed," said Virginia Reno, co-author of the report and Vice President for Income Security at NASI.
"We also need to consider the adequacy of Social Security benefits," said Janice Gregory, president of NASI. "Long-term shifts in private retirement plans are placing more risks on individual workers. Recent losses in jobs, home equity, and individual savings are weakening all other sources of financial security in retirement. Only Social Security has held its value. Yet benefits remain modest for all, and inadequate for some especially vulnerable populations."
Benefit adequacy options in the report target such financially vulnerable groups as:
-- The oldest beneficiaries (over 85 years);
-- Widowed spouses of low-earning couples;
-- Low-paid workers generally;
-- Workers with gaps in paid work due to childcare; and
-- Students in college or vocational school who have lost parental
support due to death or disability.
Other adequacy options would increase benefits across the board for current and future beneficiaries.
Options to balance Social Security's future finances include:
-- Lifting the cap (now $106,800) on the earnings from which workers and
employers pay Social Security taxes;
-- Broadening the base for Social Security taxes;
-- Scheduling modest rate increases in the future when funds will be
needed;
-- Dedicating progressive taxes to pay part of Social Security's future
cost; and
-- Gradually lowering some future benefits.
A recent survey conducted by the Benenson Strategy Group (BSG) for NASI and the Rockefeller Foundation found that Americans want to preserve and improve Social Security, even if it means paying higher taxes to do so. "Even before the recession, fear of an insecure retirement was among Americans' top economic concerns," said Danny Franklin of BSG. "Those fears have only intensified in the past year. Americans today are willing -- even eager -- to invest in the peace of mind that Social Security provides."
The NASI project receives support from the Ford Foundation's initiative on Economic Fairness and Opportunity and the Rockefeller Foundation's Campaign for American Workers.
The National Academy of Social Insurance (NASI) is a non-profit, nonpartisan organization made up of the nation's leading experts on social insurance. Its mission is to promote understanding of how social insurance contributes to economic security and a vibrant economy.
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Thursday, October 29, 2009
New Report Highlights How Health Insurance Reform Will Reduce Costs for Small Businesses
HHS Secretary Kathleen Sebelius today released a new report, "Lower Premiums, Stronger Businesses: How Health Insurance Reform Will Bring Down Costs for Small Businesses." The report outlines the many ways health insurance reform will lower health care costs for small
businesses and is available now at www.HealthReform.gov.
"Small businesses drive our economy and create jobs, but they are struggling as health care costs continue to rise," Secretary Sebelius said. "The high cost of care is making it difficult or impossible for these businesses to offer care or grow their business. Health insurance reform will bring costs down and give small businesses the relief they need."
The report notes:
* Small businesses, the backbone of job creation in our economy,
are disproportionately burdened by the financial strains caused by
rising health care costs. On average, small businesses pay up to 18
percent more than large firms for the same health insurance policy. This
difference is due in part to high broker fees (which can be up to 10
percent of premiums), and health plan administrative costs that are
three times those in the large group market.
* In a recent national survey, nearly three-quarters of small
businesses that did not offer benefits cited high premiums as the
reason.
* Nearly half of workers covered by a small business employer have
insurance that limits the total amount the plan will pay for medical
care and nearly one in ten small business workers have a health plan
that does not offer prescription drug coverage.
* Workers in small firms are more likely to shoulder burdensome
out-of-pocket health care costs. Thirty-six percent spent more than 10
percent of their household income on out-of-pocket medical expenses in
2007, compared with 27 percent of workers in larger firms.
Health insurance reform will bring down costs for small businesses by creating a health insurance exchange, providing a small business tax credit, ending the "hidden tax" on small businesses that provide health insurance and preventing arbitrary premium hikes. Reform will also ensure Americans have stable, secure insurance coverage, limit out-of-pocket spending and eliminate caps on benefits.
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businesses and is available now at www.HealthReform.gov.
"Small businesses drive our economy and create jobs, but they are struggling as health care costs continue to rise," Secretary Sebelius said. "The high cost of care is making it difficult or impossible for these businesses to offer care or grow their business. Health insurance reform will bring costs down and give small businesses the relief they need."
The report notes:
* Small businesses, the backbone of job creation in our economy,
are disproportionately burdened by the financial strains caused by
rising health care costs. On average, small businesses pay up to 18
percent more than large firms for the same health insurance policy. This
difference is due in part to high broker fees (which can be up to 10
percent of premiums), and health plan administrative costs that are
three times those in the large group market.
* In a recent national survey, nearly three-quarters of small
businesses that did not offer benefits cited high premiums as the
reason.
* Nearly half of workers covered by a small business employer have
insurance that limits the total amount the plan will pay for medical
care and nearly one in ten small business workers have a health plan
that does not offer prescription drug coverage.
* Workers in small firms are more likely to shoulder burdensome
out-of-pocket health care costs. Thirty-six percent spent more than 10
percent of their household income on out-of-pocket medical expenses in
2007, compared with 27 percent of workers in larger firms.
Health insurance reform will bring down costs for small businesses by creating a health insurance exchange, providing a small business tax credit, ending the "hidden tax" on small businesses that provide health insurance and preventing arbitrary premium hikes. Reform will also ensure Americans have stable, secure insurance coverage, limit out-of-pocket spending and eliminate caps on benefits.
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Wednesday, October 28, 2009
Selecting Medicare Coverage: Four Considerations to Help Seniors Choose
/PRNewswire/ -- Open enrollment, the six-week period during which seniors can select healthcare coverage for 2010, begins Nov. 15. Health plans have begun sharing their costs and coverage, but making a choice can be a daunting task. Here are four considerations to help Medicare-eligible seniors select which Medicare coverage best meets their individual needs:
1. Understand the A, B, C and Ds of Medicare. There are four primary parts
to Medicare. Parts A and B cover hospital and medical expenses,
respectively. Parts C and D provide benefit and prescription drug
coverage through health insurance companies that are approved by
Medicare. Medicare Advantage plans include all of the coverage offered
by Parts A and B and can include prescription drug coverage under Part
D.
2. Compare costs. Premiums can range for $0 to hundreds of dollars per
month, depending upon the type of organization (nonprofit or
for-profit) and the type of coverage. Total plan costs include
premiums, co-payments and deductibles for everything from preventive
care to hospitalization.
3. Compare benefits and doctors. Does the plan have a large network of
doctors and specialists for you to choose from? Is your doctor and
preferred hospital in that network? Does the plan cover your
prescription medications?
4. Compare quality. Call the customer service number for the plans you're
considering. Does a live person answer the phone? Are they friendly,
helpful and knowledgeable? Does the plan offer value-added programs
that help you maintain or improve your health and independence? Does
the plan offer services to help your loved ones take care of you if
needed? Will the plan coordinate your care between doctors and
specialists?
Selecting Medicare coverage is an important decision, especially since Medicare rules indicate that members must maintain the coverage they've chosen for an entire year. Seniors currently enrolled in Medicare Advantage plans will soon receive letters from their health plans explaining any changes in coverage for 2010. "We recommend that people read this letter thoroughly to avoid any surprises in the coming year," said Tom Lescault, president of SCAN Health Plan Arizona. "Changes in government funding has forced many health plans to reduce benefits or increase costs. People need to make sure they are able to make informed decisions during open enrollment."
As part of an ongoing commitment to improving the lives of seniors, SCAN Health Plan Arizona is an exclusive sponsor of "Healthy Tips for Successful Aging" with ABC 15. Each week, the station airs 30-second health tips provided by SCAN. The health plan also is the exclusive studio sponsor for KOY radio and co-hosts "Senior Focus," a broadcast dedicated to senior-related issues.
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1. Understand the A, B, C and Ds of Medicare. There are four primary parts
to Medicare. Parts A and B cover hospital and medical expenses,
respectively. Parts C and D provide benefit and prescription drug
coverage through health insurance companies that are approved by
Medicare. Medicare Advantage plans include all of the coverage offered
by Parts A and B and can include prescription drug coverage under Part
D.
2. Compare costs. Premiums can range for $0 to hundreds of dollars per
month, depending upon the type of organization (nonprofit or
for-profit) and the type of coverage. Total plan costs include
premiums, co-payments and deductibles for everything from preventive
care to hospitalization.
3. Compare benefits and doctors. Does the plan have a large network of
doctors and specialists for you to choose from? Is your doctor and
preferred hospital in that network? Does the plan cover your
prescription medications?
4. Compare quality. Call the customer service number for the plans you're
considering. Does a live person answer the phone? Are they friendly,
helpful and knowledgeable? Does the plan offer value-added programs
that help you maintain or improve your health and independence? Does
the plan offer services to help your loved ones take care of you if
needed? Will the plan coordinate your care between doctors and
specialists?
Selecting Medicare coverage is an important decision, especially since Medicare rules indicate that members must maintain the coverage they've chosen for an entire year. Seniors currently enrolled in Medicare Advantage plans will soon receive letters from their health plans explaining any changes in coverage for 2010. "We recommend that people read this letter thoroughly to avoid any surprises in the coming year," said Tom Lescault, president of SCAN Health Plan Arizona. "Changes in government funding has forced many health plans to reduce benefits or increase costs. People need to make sure they are able to make informed decisions during open enrollment."
As part of an ongoing commitment to improving the lives of seniors, SCAN Health Plan Arizona is an exclusive sponsor of "Healthy Tips for Successful Aging" with ABC 15. Each week, the station airs 30-second health tips provided by SCAN. The health plan also is the exclusive studio sponsor for KOY radio and co-hosts "Senior Focus," a broadcast dedicated to senior-related issues.
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Tuesday, October 27, 2009
Overriding State Insurance Protections Should Not Be Part of Financial Re-Regulation Package, Writes Consumer Watchdog to Geithner, Frank
/PRNewswire/ -- Consumer Watchdog sent a letter to Treasury Secretary Geithner, House Financial Services Committee Chair Barney Frank, and Financial Services Subcommittee Chair Paul Kanjorski today, arguing that legislation intended to undermine state insurance protections (H.R. 2609) is inconsistent with the re-regulatory promise of the financial reform package. The bill will be marked up in the House Financial Services committee today.
"We are at a loss to understand why you have proposed a measure to deregulate the insurance industry by preempting state laws as part of the financial re-regulation package," wrote Consumer Watchdog. "Each version of the bill would restrict the ability of state lawmakers and regulators to protect insurance consumers by granting the Treasury Department and a new Federal Insurance Office the authority to preempt state laws and regulations on prudential matters on behalf of foreign insurance firms."
"This proposal is even more perplexing in light of the strong fight, on the part of both the administration and majority members of the Financial Services committee, to preserve states' ability to protect their citizens during the debate over the Consumer Financial Protection Agency," the letter continued.
As Assistant Treasury Secretary Michael Barr put it to the Washington Post last week:
"'Washington doesn't always know what's best'... He said the administration wanted to restore the right of states 'to protect their citizens with the rules that they think make sense.'"
"If Washington doesn't always know what's best for American consumers, why would you expect foreign diplomats and regulators to know what's best for American insurance policyholders?" asked Carmen Balber, Washington Director for Consumer Watchdog.
The letter concludes: "Wall Street firms are again riding high a year after the crash, but the rest of the country continues to suffer rising foreclosures, increased unemployment, and a dearth of credit. With American homes, jobs and businesses already on the line, now is hardly the time for Congress to place our insurance policies at risk as well."
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"We are at a loss to understand why you have proposed a measure to deregulate the insurance industry by preempting state laws as part of the financial re-regulation package," wrote Consumer Watchdog. "Each version of the bill would restrict the ability of state lawmakers and regulators to protect insurance consumers by granting the Treasury Department and a new Federal Insurance Office the authority to preempt state laws and regulations on prudential matters on behalf of foreign insurance firms."
"This proposal is even more perplexing in light of the strong fight, on the part of both the administration and majority members of the Financial Services committee, to preserve states' ability to protect their citizens during the debate over the Consumer Financial Protection Agency," the letter continued.
As Assistant Treasury Secretary Michael Barr put it to the Washington Post last week:
"'Washington doesn't always know what's best'... He said the administration wanted to restore the right of states 'to protect their citizens with the rules that they think make sense.'"
"If Washington doesn't always know what's best for American consumers, why would you expect foreign diplomats and regulators to know what's best for American insurance policyholders?" asked Carmen Balber, Washington Director for Consumer Watchdog.
The letter concludes: "Wall Street firms are again riding high a year after the crash, but the rest of the country continues to suffer rising foreclosures, increased unemployment, and a dearth of credit. With American homes, jobs and businesses already on the line, now is hardly the time for Congress to place our insurance policies at risk as well."
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Friday, October 23, 2009
Sebelius Releases New Report on Benefits of Health Insurance Reform for Women with Breast Cancer
As Americans mark breast cancer awareness month, Secretary of Health and Human Services Kathleen Sebelius today released a new report, Health Insurance Reform and Breast Cancer: Making the Health Care System Work for Women. The report details how health insurance reform will help women diagnosed with breast cancer and is available now at www.HealthReform.gov.
"Thousands of women and their families are impacted by breast cancer," Secretary Sebelius said. "We are fighting for health reform that will help improve treatment for women with breast cancer and doing all we can to encourage women to take the simple steps that can help prevent this disease."
The new report highlights the problems in the health care status quo that significantly impact women who are diagnosed with breast cancer or are breast cancer survivors. The report notes:
* Breast cancer is the second leading type of cancer among women.
The disease will affect one in eight American women during their
lifetime, with treatment costs totaling $7 Billion in 2007.
* Breast cancer patients with employer-based insurance had total
out-of-pocket costs averaging $6,250 in 2007, higher than out-of-pocket
spending for patients with asthma, diabetes, chronic obstructive
pulmonary disease (COPD), or high blood pressure.
* Breast cancer patients, even when in remission, are unlikely to
find meaningful insurance coverage in the individual insurance market. A
full 11 percent of individuals with any cancer said they could not
obtain health coverage in the individual insurance market.
"Today, breast cancer patients incur thousands of dollars in debt, and breast cancer survivors struggle to get the affordable care they need," Sebelius added. "Health insurance reform will bring costs down, make care more affordable and prevent insurance companies from discriminating against breast cancer survivors."
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"Thousands of women and their families are impacted by breast cancer," Secretary Sebelius said. "We are fighting for health reform that will help improve treatment for women with breast cancer and doing all we can to encourage women to take the simple steps that can help prevent this disease."
The new report highlights the problems in the health care status quo that significantly impact women who are diagnosed with breast cancer or are breast cancer survivors. The report notes:
* Breast cancer is the second leading type of cancer among women.
The disease will affect one in eight American women during their
lifetime, with treatment costs totaling $7 Billion in 2007.
* Breast cancer patients with employer-based insurance had total
out-of-pocket costs averaging $6,250 in 2007, higher than out-of-pocket
spending for patients with asthma, diabetes, chronic obstructive
pulmonary disease (COPD), or high blood pressure.
* Breast cancer patients, even when in remission, are unlikely to
find meaningful insurance coverage in the individual insurance market. A
full 11 percent of individuals with any cancer said they could not
obtain health coverage in the individual insurance market.
"Today, breast cancer patients incur thousands of dollars in debt, and breast cancer survivors struggle to get the affordable care they need," Sebelius added. "Health insurance reform will bring costs down, make care more affordable and prevent insurance companies from discriminating against breast cancer survivors."
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Wednesday, October 21, 2009
Humana Will Cover H1N1 Vaccine for Members
(BUSINESS WIRE)--Humana Inc. (NYSE: HUM) today announced that the company will cover the administration cost of the H1N1 (swine flu) vaccine for all fully insured members including those members who have a benefit plan that excludes immunization coverage. All co-payment, coinsurance and deductibles will be waived for the administration of the H1N1 vaccination regardless of the preventative-services benefit currently provided in these members’ plans.
“The safety and well-being of our health plan members, country, communities and associates is of utmost concern to Humana,” said Lisa Weaver, M.D., Humana segment vice president, clinical strategies. “Our initial focus is to encourage the CDC-identified priority groups to get vaccinated.”
Humana is taking this step to support its members’ ability to get the vaccination. The company will continue to monitor and respond to guidance from the Centers for Disease Control and Prevention. For the most up-to-date H1N1 information, log on to their website: www.cdc.gov/h1n1flu/. To reach the CDC by phone call 800-CDC-INFO (800-232-4636) or email: cdcinfo@cdc.gov.
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“The safety and well-being of our health plan members, country, communities and associates is of utmost concern to Humana,” said Lisa Weaver, M.D., Humana segment vice president, clinical strategies. “Our initial focus is to encourage the CDC-identified priority groups to get vaccinated.”
Humana is taking this step to support its members’ ability to get the vaccination. The company will continue to monitor and respond to guidance from the Centers for Disease Control and Prevention. For the most up-to-date H1N1 information, log on to their website: www.cdc.gov/h1n1flu/. To reach the CDC by phone call 800-CDC-INFO (800-232-4636) or email: cdcinfo@cdc.gov.
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Tuesday, October 20, 2009
Sebelius, Mills Release New Report Insurance at Risk: Small Business Employees Risk Losing Coverage
Secretary of Health and Human Services Kathleen Sebelius and Small Business Administration Administrator Karen Mills today released a new report, Insurance at Risk: Small Business Employees Risk Losing Coverage. The report examines the health care status quo that has left
employees at risk of losing their insurance and underscores the financial difficulties small businesses face when providing health insurance to their employees. The complete report is available now at www.HealthReform.gov.
"More Americans who work for a small business have lost their health insurance coverage, and those who still have coverage have seen their costs go up," said Secretary Sebelius. "Health insurance reform will drive costs down and make it easier for small business owners to give
their employees the quality coverage they need."
"The cost of health insurance is the number one concern of small business owners. On average, small businesses pay 18 percent more than big businesses for the same health insurance policy. This has left small business owners in an untenable situation, having to choose between their employees, who are often like family to them, and the bottom line," Administrator Mills said. "Health care reform will provide small business owners with greater access to the affordable, quality coverage they want and need for themselves and their employees."
The report notes:
* Employees of small businesses are 50 percent more likely to lose
coverage as workers at large businesses. Half of workers in small firms
that do not offer health benefits remain uninsured.
* Premiums for employer-based health insurance have more than
doubled since 2000, rising three times faster than wages. As a result,
fewer small businesses provide coverage for their employees. In 2000, 57
percent of firms employing less than 10 workers provided coverage. In
2009, only 46 percent of similar-sized firms provided coverage.
* In one national survey, nearly three-quarters of small
businesses that did not offer benefits cited high premiums as the
reason, and on average small businesses pay up to 18 percent more than
large firms for the same health insurance policy. This is due in part to
high broker fees (which can be up to 10 percent of premiums) and health
plan administrative costs that are three to four times those in the
large group market.
Health insurance reform will stabilize health insurance coverage for Americans who work for small businesses. Health insurance reform will provide small businesses with tax credits to help them provide health insurance for their employees. This will make health care more affordable for small businesses and their workers, solidifying and strengthening employer-based coverage for years to come.
Health insurance reform will also create a health insurance exchange so Americans without access to affordable insurance on the job can compare prices and health plans and decide which quality affordable option is right for them. The exchange will also significantly reduce
administrative costs for small businesses by enabling them to easily and simply compare the prices, benefits, and performance of health plans.
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employees at risk of losing their insurance and underscores the financial difficulties small businesses face when providing health insurance to their employees. The complete report is available now at www.HealthReform.gov.
"More Americans who work for a small business have lost their health insurance coverage, and those who still have coverage have seen their costs go up," said Secretary Sebelius. "Health insurance reform will drive costs down and make it easier for small business owners to give
their employees the quality coverage they need."
"The cost of health insurance is the number one concern of small business owners. On average, small businesses pay 18 percent more than big businesses for the same health insurance policy. This has left small business owners in an untenable situation, having to choose between their employees, who are often like family to them, and the bottom line," Administrator Mills said. "Health care reform will provide small business owners with greater access to the affordable, quality coverage they want and need for themselves and their employees."
The report notes:
* Employees of small businesses are 50 percent more likely to lose
coverage as workers at large businesses. Half of workers in small firms
that do not offer health benefits remain uninsured.
* Premiums for employer-based health insurance have more than
doubled since 2000, rising three times faster than wages. As a result,
fewer small businesses provide coverage for their employees. In 2000, 57
percent of firms employing less than 10 workers provided coverage. In
2009, only 46 percent of similar-sized firms provided coverage.
* In one national survey, nearly three-quarters of small
businesses that did not offer benefits cited high premiums as the
reason, and on average small businesses pay up to 18 percent more than
large firms for the same health insurance policy. This is due in part to
high broker fees (which can be up to 10 percent of premiums) and health
plan administrative costs that are three to four times those in the
large group market.
Health insurance reform will stabilize health insurance coverage for Americans who work for small businesses. Health insurance reform will provide small businesses with tax credits to help them provide health insurance for their employees. This will make health care more affordable for small businesses and their workers, solidifying and strengthening employer-based coverage for years to come.
Health insurance reform will also create a health insurance exchange so Americans without access to affordable insurance on the job can compare prices and health plans and decide which quality affordable option is right for them. The exchange will also significantly reduce
administrative costs for small businesses by enabling them to easily and simply compare the prices, benefits, and performance of health plans.
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Thursday, October 15, 2009
Blue Cross and Blue Shield of Georgia to Provide First Dollar Coverage of H1N1 Vaccine for All Members
/PRNewswire/ -- Each year, influenza causes illness, hospitalizations and deaths, and severely strains the health care delivery system. This year, seasonal flu is complicated by the emergence and rapid spread of the H1N1 virus. In an effort to ensure that individuals and their families can take the appropriate actions to help protect themselves against the H1N1 virus, Blue Cross and Blue Shield of Georgia (BCBSGA) will cover the administration of the H1N1 vaccine without co-pay or deductible for all of its members. BCBSGA is also are encouraging self-insured employers to cover the cost of the vaccination for their employees.
"At BCBSGA, our priority is to ensure that our actions and communications support public health," said Dr. Bob McCormack, BCBSGA medical director. "Our goal is to keep our members as healthy as possible. We are committed to working with the CDC and HHS on an information campaign to ensure that members and the public are vaccinated to prevent H1N1, and if they develop H1N1 flu, they are treated effectively and appropriately."
Since a significant proportion of the vaccine is likely to be administered through non-traditional providers such as pharmacies, retail clinics and public health clinics, BCBSGA is currently working to complete agreements with these providers to increase access to the H1N1 vaccine. In addition, the antiviral medications Tamiflu and Relenza will move to an economical tier in plan formularies.
The CDC has recommended that certain populations receive the 2009 H1N1 vaccine when it becomes available. Initial prioritization includes pregnant women, people who live with or care for children younger than six months of age, children and young adults from 6 months to 24 years old, and people from 25 through 64 years old if they have chronic medical conditions that increase their risk of complications from influenza infection.
The CDC also recommends people take common-sense steps like washing your hands frequently; covering your mouth with your arm when you cough and sneeze; and staying home when you are sick to help protect others from the flu.
"The U.S. health care system has a responsibility to achieve maximal vaccination and effective treatment of H1N1 flu and its emerging risks, and we are eager to do our part to be sure that populations at high risk are immunized against this virus," said Monye Connolly, president, BCBSGA.
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"At BCBSGA, our priority is to ensure that our actions and communications support public health," said Dr. Bob McCormack, BCBSGA medical director. "Our goal is to keep our members as healthy as possible. We are committed to working with the CDC and HHS on an information campaign to ensure that members and the public are vaccinated to prevent H1N1, and if they develop H1N1 flu, they are treated effectively and appropriately."
Since a significant proportion of the vaccine is likely to be administered through non-traditional providers such as pharmacies, retail clinics and public health clinics, BCBSGA is currently working to complete agreements with these providers to increase access to the H1N1 vaccine. In addition, the antiviral medications Tamiflu and Relenza will move to an economical tier in plan formularies.
The CDC has recommended that certain populations receive the 2009 H1N1 vaccine when it becomes available. Initial prioritization includes pregnant women, people who live with or care for children younger than six months of age, children and young adults from 6 months to 24 years old, and people from 25 through 64 years old if they have chronic medical conditions that increase their risk of complications from influenza infection.
The CDC also recommends people take common-sense steps like washing your hands frequently; covering your mouth with your arm when you cough and sneeze; and staying home when you are sick to help protect others from the flu.
"The U.S. health care system has a responsibility to achieve maximal vaccination and effective treatment of H1N1 flu and its emerging risks, and we are eager to do our part to be sure that populations at high risk are immunized against this virus," said Monye Connolly, president, BCBSGA.
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Tuesday, October 06, 2009
Insurance Deregulation Is Not Financial Reform, Says Consumer Watchdog
/PRNewswire/ -- Consumer Watchdog called on Congress to reject legislation allowing the Treasury Department to use international agreements to override state insurance laws, including those requiring insurers to hold enough money to pay all claims. The proposal is under consideration in the U.S. House Financial Services Committee today.
"State insurance regulators made sure that insurance companies had enough money in the bank to pay policyholder claims and weather the financial storm. Congress should not give a political appointee the power to take away that authority on behalf of foreign insurance companies," said Carmen Balber, Washington Director for Consumer Watchdog. "This bill promotes insurance deregulation as Congress should be strengthening financial service sector regulation."
Download Consumer Watchdog's letter with Public Citizen and US PIRG here: http://www.consumerwatchdog.org/resources/FedInsOfc10-6-09.pdf
The proposal, a discussion draft amending H.R. 2609 offered by Rep. Kanjorski, would give the Treasury Secretary unilateral new authority to negotiate international insurance agreements on prudential issues, determine if state insurance laws are "inconsistent" with such an agreement, and then preempt those state laws. Safeguards intended to exempt specific state insurance laws from preemption do not go far enough to protect important consumer protections, wrote the groups.
The letter reads: "Never before has the U.S. government allowed a federal agency to unilaterally interpret or enter into international agreements on subject matter under the authority of the legislative branch, and then preempt states through rule-making on the basis that state policies are in contradiction to those agreements."
Consumer Watchdog also objected to the lack of consumer representation on the Financial Services witness panel today.
Rep. Kanjorski offered similar legislation last year, which was pulled back in the wake of AIG's dramatic collapse.
Download Consumer Watchdog's letter opposing last year's legislation here: http://www.consumerwatchdog.org/resources/HR5840.pdf
Download last year's letter from Public Citizen and US PIRG: http://www.consumerwatchdog.org/resources/HR-5840-letter-Consumer.pdf
The groups supported efforts to develop greater federal information and expertise in insurance but noted that the proposed legislation goes far beyond information gathering.
In California, where voters enacted the nation's toughest system of insurance regulation with Proposition 103, consumers are protected from unfair or excessive insurance rates, illegal surcharges and other abusive and discriminatory practices. Any move to federalize insurance regulation would jeopardize these consumer protections, said Consumer Watchdog.
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"State insurance regulators made sure that insurance companies had enough money in the bank to pay policyholder claims and weather the financial storm. Congress should not give a political appointee the power to take away that authority on behalf of foreign insurance companies," said Carmen Balber, Washington Director for Consumer Watchdog. "This bill promotes insurance deregulation as Congress should be strengthening financial service sector regulation."
Download Consumer Watchdog's letter with Public Citizen and US PIRG here: http://www.consumerwatchdog.org/resources/FedInsOfc10-6-09.pdf
The proposal, a discussion draft amending H.R. 2609 offered by Rep. Kanjorski, would give the Treasury Secretary unilateral new authority to negotiate international insurance agreements on prudential issues, determine if state insurance laws are "inconsistent" with such an agreement, and then preempt those state laws. Safeguards intended to exempt specific state insurance laws from preemption do not go far enough to protect important consumer protections, wrote the groups.
The letter reads: "Never before has the U.S. government allowed a federal agency to unilaterally interpret or enter into international agreements on subject matter under the authority of the legislative branch, and then preempt states through rule-making on the basis that state policies are in contradiction to those agreements."
Consumer Watchdog also objected to the lack of consumer representation on the Financial Services witness panel today.
Rep. Kanjorski offered similar legislation last year, which was pulled back in the wake of AIG's dramatic collapse.
Download Consumer Watchdog's letter opposing last year's legislation here: http://www.consumerwatchdog.org/resources/HR5840.pdf
Download last year's letter from Public Citizen and US PIRG: http://www.consumerwatchdog.org/resources/HR-5840-letter-Consumer.pdf
The groups supported efforts to develop greater federal information and expertise in insurance but noted that the proposed legislation goes far beyond information gathering.
In California, where voters enacted the nation's toughest system of insurance regulation with Proposition 103, consumers are protected from unfair or excessive insurance rates, illegal surcharges and other abusive and discriminatory practices. Any move to federalize insurance regulation would jeopardize these consumer protections, said Consumer Watchdog.
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Thursday, September 24, 2009
Contact GEICO for storm claims at 1-800-841-3000 or geico.com
(BUSINESS WIRE)--GEICO urges policyholders whose vehicles have been damaged in the recent Atlanta area flooding to report their claims as early as possible. To reach GEICO’s claims team at anytime, 24 hours a day, call 1-800-841-3000 or report the claim on www.geico.com.
“Our adjusters have been in Atlanta and the local areas all week assisting policyholders with damaged or flooded vehicles,” said Gary Musolf, head of GEICO claims in the region. “If you notice damage to your vehicle, contact GEICO right away so we can make arrangements to take care of your claim and get you back on the road.”
GEICO advises residents to heed all weather warnings and road closures. However, if driving is necessary, GEICO recommends these rain and flood driving tips to keep you safe:
* Heavy rain can make it difficult for other drivers to see you. Keep your headlights on and drive slowly, keeping your eyes out for on-coming traffic.
* If you see a large puddle or standing water, go around it or choose a different route. That puddle could be hiding a deep hole.
* Give yourself plenty of time to brake and do so gently in order to avoid hydroplaning.
“The safety of our policyholders and the quick and quality repair of their vehicles is our first priority during stressful times like these,” said Musolf.
GEICO (Government Employees Insurance Company) – as part of Berkshire Hathaway – is the third-largest private passenger auto insurer in the United States*. GEICO provides auto insurance coverage for 9 million policyholders and insures more than 16 million vehicles.
In addition to auto insurance, GEICO offers customers insurance products for their motorcycles, all-terrain vehicles (ATVs), boats, homes, apartments and mobile homes. Commercial auto insurance and personal umbrella protection and life insurance are also available.
As a member of the Berkshire Hathaway group of companies, GEICO is rated A++ for financial strength by A.M. Best Company and ranks at the top of several national customer satisfaction surveys. For more information, go to http://www.geico.com.
*A.M. Best 2008 market share data
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“Our adjusters have been in Atlanta and the local areas all week assisting policyholders with damaged or flooded vehicles,” said Gary Musolf, head of GEICO claims in the region. “If you notice damage to your vehicle, contact GEICO right away so we can make arrangements to take care of your claim and get you back on the road.”
GEICO advises residents to heed all weather warnings and road closures. However, if driving is necessary, GEICO recommends these rain and flood driving tips to keep you safe:
* Heavy rain can make it difficult for other drivers to see you. Keep your headlights on and drive slowly, keeping your eyes out for on-coming traffic.
* If you see a large puddle or standing water, go around it or choose a different route. That puddle could be hiding a deep hole.
* Give yourself plenty of time to brake and do so gently in order to avoid hydroplaning.
“The safety of our policyholders and the quick and quality repair of their vehicles is our first priority during stressful times like these,” said Musolf.
GEICO (Government Employees Insurance Company) – as part of Berkshire Hathaway – is the third-largest private passenger auto insurer in the United States*. GEICO provides auto insurance coverage for 9 million policyholders and insures more than 16 million vehicles.
In addition to auto insurance, GEICO offers customers insurance products for their motorcycles, all-terrain vehicles (ATVs), boats, homes, apartments and mobile homes. Commercial auto insurance and personal umbrella protection and life insurance are also available.
As a member of the Berkshire Hathaway group of companies, GEICO is rated A++ for financial strength by A.M. Best Company and ranks at the top of several national customer satisfaction surveys. For more information, go to http://www.geico.com.
*A.M. Best 2008 market share data
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Wednesday, September 23, 2009
Blue Cross and Blue Shield of Georgia Launches Zagat Health Survey Tool
/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGA) today announced the launch of the Zagat Health Survey tool, an online survey tool that will allow its members to share their physician experiences with other members throughout the state.
"Zagat is widely known and trusted for its ability to help people share and learn from other consumer experiences. By working with them we are able to create a trusted resource for our members that will actively engage them in sharing and using that information," said Monye Connolly, president of BCBSGA. "We are committed to providing our members with useful information to better help them navigate the health care system. Making information available, such as the patient experience information contained in the Zagat Health Survey, along with other quality and cost transparency information, is part of that commitment."
The Zagat Survey enables BCBSGA to address an unmet need for peer-to-peer interaction among health care consumers. The Zagat Health Survey tool provides a vehicle for members to review physicians based on a set of distinct criteria, creating a trusted resource to support informed member decision-making. The criteria are solely designed to reflect a consumer's experience with a physician and not to reflect the quality of care received. This tool not only helps members, but is also designed to assist doctors in understanding members' experiences.
The online survey tool allows consumers to review their doctor visits based on:
-- Trust - Confidence in the physician's approach
-- Communication - Physician's bedside manner, responsiveness and rapport
-- Availability - Convenience for making appointments and physician's
punctuality
-- Environment - Condition of the office, staff helpfulness, atmosphere
and amenities
Members are also asked whether they would recommend their doctor to others. The survey also features a comments section, allowing members to explain their ratings.
The online entry will display physician contact information, ratings on a 30-point scale for each of the four categories, and the percentage of members who recommend that physician. The most recent comments will be displayed first, and members will have the option to rate the usefulness of comments and report suspicious comments. BCBSGA members can complete the Zagat Health Survey by logging on to the secure member portal on the BCBSGA Web site.
"For physicians the Zagat survey tool can provide valuable, objective feedback on how their patients feel about them and their practice, information that often remains unknown," said Dr. Robert McCormack, medical director for BCBSGA. "For consumers, the survey can provide information to help them select a physician who is most likely aligned with their personal style and who will meet their health care needs. All-in-all, it is a viable mechanism that could very well change the way health care is measured and delivered throughout Georgia."
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"Zagat is widely known and trusted for its ability to help people share and learn from other consumer experiences. By working with them we are able to create a trusted resource for our members that will actively engage them in sharing and using that information," said Monye Connolly, president of BCBSGA. "We are committed to providing our members with useful information to better help them navigate the health care system. Making information available, such as the patient experience information contained in the Zagat Health Survey, along with other quality and cost transparency information, is part of that commitment."
The Zagat Survey enables BCBSGA to address an unmet need for peer-to-peer interaction among health care consumers. The Zagat Health Survey tool provides a vehicle for members to review physicians based on a set of distinct criteria, creating a trusted resource to support informed member decision-making. The criteria are solely designed to reflect a consumer's experience with a physician and not to reflect the quality of care received. This tool not only helps members, but is also designed to assist doctors in understanding members' experiences.
The online survey tool allows consumers to review their doctor visits based on:
-- Trust - Confidence in the physician's approach
-- Communication - Physician's bedside manner, responsiveness and rapport
-- Availability - Convenience for making appointments and physician's
punctuality
-- Environment - Condition of the office, staff helpfulness, atmosphere
and amenities
Members are also asked whether they would recommend their doctor to others. The survey also features a comments section, allowing members to explain their ratings.
The online entry will display physician contact information, ratings on a 30-point scale for each of the four categories, and the percentage of members who recommend that physician. The most recent comments will be displayed first, and members will have the option to rate the usefulness of comments and report suspicious comments. BCBSGA members can complete the Zagat Health Survey by logging on to the secure member portal on the BCBSGA Web site.
"For physicians the Zagat survey tool can provide valuable, objective feedback on how their patients feel about them and their practice, information that often remains unknown," said Dr. Robert McCormack, medical director for BCBSGA. "For consumers, the survey can provide information to help them select a physician who is most likely aligned with their personal style and who will meet their health care needs. All-in-all, it is a viable mechanism that could very well change the way health care is measured and delivered throughout Georgia."
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Analysis Shows Narrow Age Rating Would Raise Premiums by Nearly 50 Percent, Causing Many Young and Healthy to Forgo Coverage
/PRNewswire/ -- Allowing age adjustments more restrictive than 5 to 1 would cause dramatic premium spikes for the young and healthy in the individual insurance market, making coverage unaffordable for many according to a new analysis.
The Blue Cross and Blue Shield Association (BCBSA) released today new data, prepared by Oliver Wyman's Actuarial and Health and Life Sciences practice, showing that a 2 to 1 age rating ratio would increase premiums for the youngest and healthiest Americans in the individual market in many states by nearly 50 percent in the first year, relative to a 5 to 1 age rating ratio.
Currently 42 states permit health plans to vary premiums based on age by 5 to 1 or more -- the primary benefit being that premiums are kept affordable for younger individuals to encourage broad participation. If more restrictive age ratings are implemented, younger people would opt out of purchasing coverage. Oliver Wyman estimates that, over a five year period, more than 1 million younger members would leave the market, resulting in a 10 percent premium increase overall for individuals in some parts of the country.
"An affordable, sustainable insurance market requires broad participation across all age groups to maintain more affordable premiums. As this analysis shows, overly restrictive age rating regulations would hurt a large portion of those with individual coverage -- making coverage less affordable and undermining the key goals of healthcare reform," said Scott P. Serota, president and CEO of BCBSA. "To ensure the long-term sustainability of healthcare reform, we must strike the right balance on age rating to avoid disproportionately burdening one segment of the population over another. For this reason, we support a 5 to 1 age rating similar to what the vast majority of states permit today."
The Oliver Wyman analysis also finds that restricting age rating ratios to 3 to 1 would increase premiums in many states by as much as 30 percent for younger people, relative to a 5 to 1 ratio.
"Younger individuals are much more sensitive to the costs of health insurance compared to older individuals. The bottom line is that if premiums are too high, young and healthy individuals simply will not purchase insurance and their needed cross-subsidies for older, sicker people will be lost, increasing the cost of healthcare for everyone," Serota said.
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The Blue Cross and Blue Shield Association (BCBSA) released today new data, prepared by Oliver Wyman's Actuarial and Health and Life Sciences practice, showing that a 2 to 1 age rating ratio would increase premiums for the youngest and healthiest Americans in the individual market in many states by nearly 50 percent in the first year, relative to a 5 to 1 age rating ratio.
Currently 42 states permit health plans to vary premiums based on age by 5 to 1 or more -- the primary benefit being that premiums are kept affordable for younger individuals to encourage broad participation. If more restrictive age ratings are implemented, younger people would opt out of purchasing coverage. Oliver Wyman estimates that, over a five year period, more than 1 million younger members would leave the market, resulting in a 10 percent premium increase overall for individuals in some parts of the country.
"An affordable, sustainable insurance market requires broad participation across all age groups to maintain more affordable premiums. As this analysis shows, overly restrictive age rating regulations would hurt a large portion of those with individual coverage -- making coverage less affordable and undermining the key goals of healthcare reform," said Scott P. Serota, president and CEO of BCBSA. "To ensure the long-term sustainability of healthcare reform, we must strike the right balance on age rating to avoid disproportionately burdening one segment of the population over another. For this reason, we support a 5 to 1 age rating similar to what the vast majority of states permit today."
The Oliver Wyman analysis also finds that restricting age rating ratios to 3 to 1 would increase premiums in many states by as much as 30 percent for younger people, relative to a 5 to 1 ratio.
"Younger individuals are much more sensitive to the costs of health insurance compared to older individuals. The bottom line is that if premiums are too high, young and healthy individuals simply will not purchase insurance and their needed cross-subsidies for older, sicker people will be lost, increasing the cost of healthcare for everyone," Serota said.
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Vice President Biden, Secretary Sebelius Issue New Report on Seniors and Health Insurance Reform
Vice President Joe Biden and Health and Human Services (HHS) Secretary Kathleen Sebelius today hosted a town hall meeting with seniors in Silver Spring, Md., and released a new report,
Health Insurance Reform and Medicare: Making Medicare Stronger for America's Seniors. The report, authored by HHS, outlines how health insurance reform will help seniors and answers key questions about President Obama's health insurance reform plan. The complete report is
available now at www.HealthReform.gov.
"We will protect seniors -- not burden them with out of pocket costs," said Vice President Biden. "The bottom line is, seniors will be better off under what we are proposing, and not a dollar from the Medicare trust fund will be used to pay for health insurance reform."
"Under health insurance reform, seniors will get better care and their health care costs will go down," said Secretary Sebelius. "Reform will strengthen Medicare, cut drug costs, and help ensure all seniors get the high-quality, affordable care they deserve."
The report highlights several problems in the current health care system and health insurance reform solutions such as:
* Preserving and strengthening Medicare.
According to the Medicare Trustees 2009 report, the Medicare Part A
Trust Fund will be exhausted by 2017. Health insurance reform will
extend the life of the Medicare Trust Fund by an additional four to five
years -- and delivery system reforms included in health insurance reform
have the potential to keep the Trust Fund solvent even longer into the
future. Health insurance reform will also reduce overpayments to private
plans and will clamp down on fraud and abuse to strengthen Medicare for
all seniors. Coupled with improvements in the quality of care, expansion
of the health care workforce, and reductions in out-of-pocket costs,
health insurance reform will ensure that Medicare will continue to
provide the high-quality, affordable coverage that America's seniors
deserve and expect.
* Cutting high prescription drug costs.
Prescription drug costs represent a significant expense for seniors.
While Medicare added a prescription drug benefit, this benefit includes
a coverage gap commonly called the "donut hole." In 2007, over 8 million
seniors hit the "donut hole." For those who are not low-income or have
not purchased other coverage, average drug costs in this coverage gap
are $340 per month, or $4,080 per year. Health insurance reform will
close the coverage gap in Medicare Part D over time, so seniors do not
have to worry about losing coverage for their drug costs. While the
closure of the coverage gap is phased in, health insurance reform will
also provide seniors with a discount of 50 percent on their brand name
medication costs in the coverage gap, saving thousands of dollars for
some seniors.
* Making preventive services free.
Many seniors do not receive recommended preventive and primary care,
leading to less effective and more expensive treatments. For example, 20
percent of women aged 50 and over did not receive a mammogram in the
past two years, and 38 percent of adults aged 50 and over have never had
a colonoscopy or sigmoidoscopy. Seniors in Medicare must pay 20 percent
of the cost of many preventive services on their own. For a colonoscopy
that costs $700, this means that a senior must pay $140 -- a price that
can be prohibitively expensive. Under health insurance reform, a senior
would not pay anything for a screening colonoscopy or other preventive
services. Reform will eliminate any deductibles, copayments, or other
cost-sharing for obtaining preventive services, making them affordable
and accessible.
* Ending overpayments to private insurance companies that cost all
Medicare beneficiaries.
The federal government pays private insurance companies on average 14
percent more for providing coverage to Medicare Advantage beneficiaries
than it would pay for the same beneficiary in the traditional Medicare
program. There is no evidence that this extra payment leads to better
quality for Medicare beneficiaries, and all Medicare beneficiaries pay
the price of these excessive overpayments through higher premiums --
even the 78 percent of seniors who are not enrolled in a Medicare
Advantage plan. A typical couple in traditional Medicare will pay on
average nearly $90 next year to subsidize private insurance companies
that do not provide their Medicare benefits. Health insurance reform
will eliminate excessive government subsidies to Medicare Advantage
plans, which could save the federal government, taxpayers, and Medicare
beneficiaries well over $100 billion over the next 10 years.
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Health Insurance Reform and Medicare: Making Medicare Stronger for America's Seniors. The report, authored by HHS, outlines how health insurance reform will help seniors and answers key questions about President Obama's health insurance reform plan. The complete report is
available now at www.HealthReform.gov.
"We will protect seniors -- not burden them with out of pocket costs," said Vice President Biden. "The bottom line is, seniors will be better off under what we are proposing, and not a dollar from the Medicare trust fund will be used to pay for health insurance reform."
"Under health insurance reform, seniors will get better care and their health care costs will go down," said Secretary Sebelius. "Reform will strengthen Medicare, cut drug costs, and help ensure all seniors get the high-quality, affordable care they deserve."
The report highlights several problems in the current health care system and health insurance reform solutions such as:
* Preserving and strengthening Medicare.
According to the Medicare Trustees 2009 report, the Medicare Part A
Trust Fund will be exhausted by 2017. Health insurance reform will
extend the life of the Medicare Trust Fund by an additional four to five
years -- and delivery system reforms included in health insurance reform
have the potential to keep the Trust Fund solvent even longer into the
future. Health insurance reform will also reduce overpayments to private
plans and will clamp down on fraud and abuse to strengthen Medicare for
all seniors. Coupled with improvements in the quality of care, expansion
of the health care workforce, and reductions in out-of-pocket costs,
health insurance reform will ensure that Medicare will continue to
provide the high-quality, affordable coverage that America's seniors
deserve and expect.
* Cutting high prescription drug costs.
Prescription drug costs represent a significant expense for seniors.
While Medicare added a prescription drug benefit, this benefit includes
a coverage gap commonly called the "donut hole." In 2007, over 8 million
seniors hit the "donut hole." For those who are not low-income or have
not purchased other coverage, average drug costs in this coverage gap
are $340 per month, or $4,080 per year. Health insurance reform will
close the coverage gap in Medicare Part D over time, so seniors do not
have to worry about losing coverage for their drug costs. While the
closure of the coverage gap is phased in, health insurance reform will
also provide seniors with a discount of 50 percent on their brand name
medication costs in the coverage gap, saving thousands of dollars for
some seniors.
* Making preventive services free.
Many seniors do not receive recommended preventive and primary care,
leading to less effective and more expensive treatments. For example, 20
percent of women aged 50 and over did not receive a mammogram in the
past two years, and 38 percent of adults aged 50 and over have never had
a colonoscopy or sigmoidoscopy. Seniors in Medicare must pay 20 percent
of the cost of many preventive services on their own. For a colonoscopy
that costs $700, this means that a senior must pay $140 -- a price that
can be prohibitively expensive. Under health insurance reform, a senior
would not pay anything for a screening colonoscopy or other preventive
services. Reform will eliminate any deductibles, copayments, or other
cost-sharing for obtaining preventive services, making them affordable
and accessible.
* Ending overpayments to private insurance companies that cost all
Medicare beneficiaries.
The federal government pays private insurance companies on average 14
percent more for providing coverage to Medicare Advantage beneficiaries
than it would pay for the same beneficiary in the traditional Medicare
program. There is no evidence that this extra payment leads to better
quality for Medicare beneficiaries, and all Medicare beneficiaries pay
the price of these excessive overpayments through higher premiums --
even the 78 percent of seniors who are not enrolled in a Medicare
Advantage plan. A typical couple in traditional Medicare will pay on
average nearly $90 next year to subsidize private insurance companies
that do not provide their Medicare benefits. Health insurance reform
will eliminate excessive government subsidies to Medicare Advantage
plans, which could save the federal government, taxpayers, and Medicare
beneficiaries well over $100 billion over the next 10 years.
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Thursday, September 17, 2009
New Report Outlines Importance of Health Insurance Reform for Young Americans
HHS Secretary Kathleen Sebelius today released a new report, Young Americans and Health Insurance Reform: Giving Young Americans the Security and Stability They Need. The report highlights the vulnerability young adults face in the current health care system and the urgent need for health insurance reform. The complete report is available at www.healthreform.gov.
"More and more young adults wake up the day after their nineteenth birthday or on graduation day and find themselves uninsured," said Secretary Sebelius. "I've seen this problem first-hand. When my son graduated, he faced the challenge of finding health insurance. Unfortunately, too many of his peers are forced to go without the care they need. Health insurance reform will help insure young Americans have access to the affordable health care they need and deserve."
While seventeen percent of adults (those aged 30-64) are uninsured, thirty percent of young adults do not have health insurance. When young adults lose access to their parents' health insurance, they find it increasingly difficult to afford the high cost of health insurance.
Young adults are often less likely to work for employers who offer health insurance benefits. Nearly half of young people work part-time, and part-time workers are less likely to be offered coverage. Young people are also more likely to work for smaller firms, which tend to offer less coverage. Among young adults working in firms of fewer than 50 employees and who had coverage in 2006, one in four lost that insurance in the following two years - more than twice the rate of older adults.
The report also shows that 33 states allowed insurance companies to charge unrestricted premiums based on age, health status and even gender. In some states, a 22-year-old woman can be charged twice as much for her premium than a 22-year-old man.
The health care status quo is significantly impacting young Americans. In a recent survey, two-thirds who had gaps in healthcare admitted to forsaking health care because of costs including skipping recommended tests and treatment and neglecting to fill a prescription. Even with cost-saving measures, more than one-third of all young adults with coverage report having problems paying medical bills.
Health insurance reform would ensure young adults have access to quality, affordable health coverage, deter mounting health problems and ensure young people are not left with crushing medical debt after an accident or illness. Capping out-of-pocket expenses, co-pays and
deductibles while limiting arbitrary premium increases would provide affordable health care options for young adults as well.
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"More and more young adults wake up the day after their nineteenth birthday or on graduation day and find themselves uninsured," said Secretary Sebelius. "I've seen this problem first-hand. When my son graduated, he faced the challenge of finding health insurance. Unfortunately, too many of his peers are forced to go without the care they need. Health insurance reform will help insure young Americans have access to the affordable health care they need and deserve."
While seventeen percent of adults (those aged 30-64) are uninsured, thirty percent of young adults do not have health insurance. When young adults lose access to their parents' health insurance, they find it increasingly difficult to afford the high cost of health insurance.
Young adults are often less likely to work for employers who offer health insurance benefits. Nearly half of young people work part-time, and part-time workers are less likely to be offered coverage. Young people are also more likely to work for smaller firms, which tend to offer less coverage. Among young adults working in firms of fewer than 50 employees and who had coverage in 2006, one in four lost that insurance in the following two years - more than twice the rate of older adults.
The report also shows that 33 states allowed insurance companies to charge unrestricted premiums based on age, health status and even gender. In some states, a 22-year-old woman can be charged twice as much for her premium than a 22-year-old man.
The health care status quo is significantly impacting young Americans. In a recent survey, two-thirds who had gaps in healthcare admitted to forsaking health care because of costs including skipping recommended tests and treatment and neglecting to fill a prescription. Even with cost-saving measures, more than one-third of all young adults with coverage report having problems paying medical bills.
Health insurance reform would ensure young adults have access to quality, affordable health coverage, deter mounting health problems and ensure young people are not left with crushing medical debt after an accident or illness. Capping out-of-pocket expenses, co-pays and
deductibles while limiting arbitrary premium increases would provide affordable health care options for young adults as well.
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Senate Finance Committee Plan Goes Far To Achieve Reform But New Taxes Raise Affordability Concerns
/PRNewswire/ -- Scott P. Serota, president and chief executive officer of the Blue Cross and Blue Shield Association (BCBSA), issued the following statement regarding the chairman's mark released yesterday by Chairman Max Baucus (D-MT) and members of the Senate Finance Committee:
"We strongly support healthcare reforms that expand coverage to everyone, improve quality, and rein in costs. This chairman's mark achieves many of these goals.
"The mark addresses many necessary insurance reforms, the foundation of which is a proposal advocated by BCBSA to guarantee coverage to everyone, regardless of pre-existing conditions. We commend Chairman Baucus for including in his mark a personal responsibility requirement to obtain and maintain coverage -- the linchpin to making insurance reforms work.
"We also support the mark's age rating provision which allows discounts to young people to encourage them to purchase coverage. Age rating provisions in other bills would preclude these discounts and would result in major premium increases to young people causing many to forgo coverage. Making insurance affordable for young people, who account for as much as 40 percent of those without insurance, is critical to reducing the number of uninsured and will help to lower the cost of health insurance for everyone, including older Americans.
"We strongly support the goal of making coverage affordable. However, we are greatly concerned that burdensome new taxes and fees aimed at insurers and other healthcare industry stakeholders would severely undermine the reforms that the chairman's mark aims to achieve. These unprecedented new taxes would make coverage much less affordable for individuals, their families, and employers.
"We look forward to continuing a vigorous and productive discussion with the Senate Finance Committee. This is a once-in-a-generation opportunity to achieve meaningful and sustainable change in our healthcare system, and BCBSA will continue to advocate for reforms that expand access to everyone, improve quality, and rein in costs."
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"We strongly support healthcare reforms that expand coverage to everyone, improve quality, and rein in costs. This chairman's mark achieves many of these goals.
"The mark addresses many necessary insurance reforms, the foundation of which is a proposal advocated by BCBSA to guarantee coverage to everyone, regardless of pre-existing conditions. We commend Chairman Baucus for including in his mark a personal responsibility requirement to obtain and maintain coverage -- the linchpin to making insurance reforms work.
"We also support the mark's age rating provision which allows discounts to young people to encourage them to purchase coverage. Age rating provisions in other bills would preclude these discounts and would result in major premium increases to young people causing many to forgo coverage. Making insurance affordable for young people, who account for as much as 40 percent of those without insurance, is critical to reducing the number of uninsured and will help to lower the cost of health insurance for everyone, including older Americans.
"We strongly support the goal of making coverage affordable. However, we are greatly concerned that burdensome new taxes and fees aimed at insurers and other healthcare industry stakeholders would severely undermine the reforms that the chairman's mark aims to achieve. These unprecedented new taxes would make coverage much less affordable for individuals, their families, and employers.
"We look forward to continuing a vigorous and productive discussion with the Senate Finance Committee. This is a once-in-a-generation opportunity to achieve meaningful and sustainable change in our healthcare system, and BCBSA will continue to advocate for reforms that expand access to everyone, improve quality, and rein in costs."
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Tuesday, August 25, 2009
Aetna and WellStar Renew Agreement
(BUSINESS WIRE)--Aetna (NYSE: AET) and WellStar Health System in Marietta, Ga., announced August 24 they have reached an agreement on a three-year contract renewal.
Under this new agreement, Aetna members will continue to receive covered services, at in-network rates, from WellStar facilities in the greater Atlanta area. Aetna members also will be able to continue receiving covered services from WellStar physicians.
“Aetna is happy to announce this renewal” said Ramzy Elgomayel, Aetna’s vice president of network management for the Atlanta area. “WellStar Health System has provided valued care and services to our commercial-plan members.”
"WellStar is pleased to reach a new three-year agreement with Aetna. We look forward to seamlessly continuing the long standing relationship that we have had with Aetna. As a not-for-profit organization, and one of the top integrated health systems in the country, WellStar is committed to meeting the ongoing health care needs of our community and will continue to invest in and deliver high quality health care services," said Barbara Corey, senior vice president of managed care.
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Under this new agreement, Aetna members will continue to receive covered services, at in-network rates, from WellStar facilities in the greater Atlanta area. Aetna members also will be able to continue receiving covered services from WellStar physicians.
“Aetna is happy to announce this renewal” said Ramzy Elgomayel, Aetna’s vice president of network management for the Atlanta area. “WellStar Health System has provided valued care and services to our commercial-plan members.”
"WellStar is pleased to reach a new three-year agreement with Aetna. We look forward to seamlessly continuing the long standing relationship that we have had with Aetna. As a not-for-profit organization, and one of the top integrated health systems in the country, WellStar is committed to meeting the ongoing health care needs of our community and will continue to invest in and deliver high quality health care services," said Barbara Corey, senior vice president of managed care.
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Sunday, August 09, 2009
New State-by-State Reports Show How Health Insurance Reform Will Benefit All Americans
HHS Secretary Kathleen Sebelius August 7 released Stable and Secure Health Care for America, a series of new state-by-state reports outlining how health insurance reform will improve health care for all Americans. Sebelius announced the availability of the new reports as part of a
Webcast -- "Health Insurance Reform: What's In It For You?" -- where Sebelius and top HHS officials took questions from the American people and discussed the importance of health insurance reform. The new reports are available at www.HealthReform.gov.
"These reports show how health insurance reform will help Americans save money, get better care, strengthen their insurance if they already have it, and afford insurance if they don't," said Sebelius. "Every American will benefit when we pass health insurance reform."
The reports released today show reform will:
* Lower health care costs;
* Increase health care choices by protecting what works and fixing
what's broken; and
* Assure quality, affordable care for all Americans.
Friday's reports are the second in a series of state-by-state reports on health care across the country. Earlier this summer, Sebelius released The Health Care Status Quo in Your State, a series of state by state reports on the current state of health care in America. The reports are
available at http://www.healthreform.gov/healthcarestatus.html.
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Webcast -- "Health Insurance Reform: What's In It For You?" -- where Sebelius and top HHS officials took questions from the American people and discussed the importance of health insurance reform. The new reports are available at www.HealthReform.gov.
"These reports show how health insurance reform will help Americans save money, get better care, strengthen their insurance if they already have it, and afford insurance if they don't," said Sebelius. "Every American will benefit when we pass health insurance reform."
The reports released today show reform will:
* Lower health care costs;
* Increase health care choices by protecting what works and fixing
what's broken; and
* Assure quality, affordable care for all Americans.
Friday's reports are the second in a series of state-by-state reports on health care across the country. Earlier this summer, Sebelius released The Health Care Status Quo in Your State, a series of state by state reports on the current state of health care in America. The reports are
available at http://www.healthreform.gov/healthcarestatus.html.
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Monday, August 03, 2009
BCBSGA Announces Decision to Cover H1N1 Vaccine Administration
/PRNewswire/ -- Blue Cross and Blue Shield of Georgia (BCBSGA) announced today that it will offer coverage for the administration of the H1N1 (swine flu) vaccine when it becomes commercially available to the general public. The vaccine administration will be covered for members whose benefit plans provide coverage for vaccines.
BCBSGA will also continue coverage of seasonal flu vaccine administration for those whose health plans offer vaccine coverage. The U.S. Centers for Disease Control and Prevention has stated that the H1N1 vaccine is not intended to replace the seasonal flu vaccine. Seasonal flu and H1N1 vaccines may be administered on the same day, according to the CDC.
The decision to cover the H1N1 vaccine administration is based on formal recommendations announced this week by the CDC's Advisory Committee on Immunization Practices. ACIP recommended initial prioritization for those administering the vaccine for five key populations, including:
-- pregnant women,
-- people who live with or care for children younger than six months of
age,
-- health care and emergency services personnel,
-- children and young adults from 6 months old to 24 years old, and
-- people from 25 through 64 years old if they have chronic medical
conditions that increase their risk of complications from influenza
infection.
ACIP also provided guidance regarding high risk groups to be targeted in the event of a significant shortage of vaccine as well as recommendations for the rest of the general population if the supply of vaccine exceeds the needs of the target groups.
BCBSGA's immunization policy decisions are based on recommendations issued by ACIP and other nationally recognized organizations. ACIP is composed of 15 experts in fields associated with immunization who provide advice and guidance to the U.S. Department of Health and Human Services and CDC on the most effective means to prevent vaccine-preventable diseases.
Vaccine administration is covered for members whose benefit plans provide coverage for vaccines. Policyholders should confirm their specific benefits by calling the toll-free telephone number listed on their insurance card.
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BCBSGA will also continue coverage of seasonal flu vaccine administration for those whose health plans offer vaccine coverage. The U.S. Centers for Disease Control and Prevention has stated that the H1N1 vaccine is not intended to replace the seasonal flu vaccine. Seasonal flu and H1N1 vaccines may be administered on the same day, according to the CDC.
The decision to cover the H1N1 vaccine administration is based on formal recommendations announced this week by the CDC's Advisory Committee on Immunization Practices. ACIP recommended initial prioritization for those administering the vaccine for five key populations, including:
-- pregnant women,
-- people who live with or care for children younger than six months of
age,
-- health care and emergency services personnel,
-- children and young adults from 6 months old to 24 years old, and
-- people from 25 through 64 years old if they have chronic medical
conditions that increase their risk of complications from influenza
infection.
ACIP also provided guidance regarding high risk groups to be targeted in the event of a significant shortage of vaccine as well as recommendations for the rest of the general population if the supply of vaccine exceeds the needs of the target groups.
BCBSGA's immunization policy decisions are based on recommendations issued by ACIP and other nationally recognized organizations. ACIP is composed of 15 experts in fields associated with immunization who provide advice and guidance to the U.S. Department of Health and Human Services and CDC on the most effective means to prevent vaccine-preventable diseases.
Vaccine administration is covered for members whose benefit plans provide coverage for vaccines. Policyholders should confirm their specific benefits by calling the toll-free telephone number listed on their insurance card.
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Thursday, July 16, 2009
Isakson, Dodd Introduce Legislation Requiring Child Care Providers to Disclose Insurance Status
U.S. Senators Johnny Isakson, R-Ga., and Chris Dodd, D-Conn., both members of the Senate Health, Education, Labor and Pensions Committee, today introduced legislation that would require child care providers to disclose whether they have liability insurance.
The legislation was prompted by the story of Anthony DeJuan Boatwright, also known as Juan. In 2001, when he was 14 months old, Juan fell into an unattended bucket of mop water at his child care center in Augusta, Ga. As a result of the accident, Juan has remained semi-comatose and dependent on a ventilator for the past eight years. The center where Juan was injured was licensed, but not insured. At the time, there was no provision in place to let parents know the insurance status of child care providers.
“I hope the Senate will quickly pass this straight-forward, bipartisan legislation to simultaneously honor young Juan and provide parents with much-needed information about child care facilities,” Isakson said. “Juan’s mother Jackie deserves considerable credit for her efforts to ensure all parents know whether or not their child care provider is insured.”
“As the father of two young daughters, I understand the need for parents to be well informed when making decisions about child care,” said Dodd. “This bill will help to protect children and give parents peace of mind. I’m proud to support this important legislation, and look forward to future opportunities to improve the quality of and access to child care in this country for children, families, and providers.”
Specifically, the Anthony DeJuan Boatwright Act would require child care providers that receive Child Care and Development Block Grant funds to disclose whether or not they carry liability insurance for the operation of their facility. The bill also would require that states recommend such coverage in their licensure process.
Senators Saxby Chambliss, R-Ga., and Roland Burris, D-Ill., also are co-sponsors of the bill. A companion bill passed in the House of Representatives on June 2, 2009.
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The legislation was prompted by the story of Anthony DeJuan Boatwright, also known as Juan. In 2001, when he was 14 months old, Juan fell into an unattended bucket of mop water at his child care center in Augusta, Ga. As a result of the accident, Juan has remained semi-comatose and dependent on a ventilator for the past eight years. The center where Juan was injured was licensed, but not insured. At the time, there was no provision in place to let parents know the insurance status of child care providers.
“I hope the Senate will quickly pass this straight-forward, bipartisan legislation to simultaneously honor young Juan and provide parents with much-needed information about child care facilities,” Isakson said. “Juan’s mother Jackie deserves considerable credit for her efforts to ensure all parents know whether or not their child care provider is insured.”
“As the father of two young daughters, I understand the need for parents to be well informed when making decisions about child care,” said Dodd. “This bill will help to protect children and give parents peace of mind. I’m proud to support this important legislation, and look forward to future opportunities to improve the quality of and access to child care in this country for children, families, and providers.”
Specifically, the Anthony DeJuan Boatwright Act would require child care providers that receive Child Care and Development Block Grant funds to disclose whether or not they carry liability insurance for the operation of their facility. The bill also would require that states recommend such coverage in their licensure process.
Senators Saxby Chambliss, R-Ga., and Roland Burris, D-Ill., also are co-sponsors of the bill. A companion bill passed in the House of Representatives on June 2, 2009.
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