Sunday, December 30, 2012

Health Care Tax Hikes For 2013 May Just Be Only The Beginning

Health Care Tax Hikes for 2013 May Be Just the Beginning



Posted 7:00AM 12/27/12 Posted under: Taxes, Personal Finance, Money and Politics
 
By Ricardo Alonso-Zaldivar

New taxes are coming Jan. 1 to help finance President Barack Obama's health care overhaul. Most people may not notice. But they will pay attention if Congress decides to start taxing employer-sponsored health insurance, one option in play if lawmakers can ever agree on a budget deal to reduce federal deficits.

The tax hikes already on the books, taking effect in 2013, fall mainly on people who make lots of money and on the health care industry. But about half of Americans benefit from the tax-free status of employer health insurance. Workers pay no income or payroll taxes on what their employer contributes for health insurance, and in most cases on their own share of premiums as well.

It's the single biggest tax break the government allows, outstripping the mortgage interest deduction, the deduction for charitable giving and other better-known benefits. If the value of job-based health insurance were taxed like regular income, it would raise nearly $150 billion in 2013, according to congressional estimates. By comparison, wiping away the mortgage interest deduction would bring in only about $90 billion.

"If you are looking to raise revenue to pay for tax reform, that is the biggest pot of money of all," said Martin Sullivan, chief economist with Tax Analysts, a nonpartisan publisher of tax information.

It's hard to see how lawmakers can avoid touching health insurance if they want to eliminate loopholes and curtail deductions so as to raise revenue and lower tax rates. Congress probably wouldn't do away with the health care tax break, but limit it in some form. Such limits could be keyed to the cost of a particular health insurance plan, the income level of taxpayers or a combination.

Many economists think some kind of limit would be a good thing because it would force consumers to watch costs, and that could help keep health care spending in check. Obama's health law took a tentative step toward limits by imposing a tax on high-value health insurance plans. But that doesn't start until 2018.

Next spring will be three years since Congress passed the health care overhaul but, because of a long phase-in, many of the taxes to finance the plan are only now coming into effect. Medicare spending cuts that help pay for covering the uninsured have started to take effect, but they also are staggered. The law's main benefit, coverage for 30 million uninsured people, will take a little longer. It doesn't start until Jan. 1, 2014.

The biggest tax hike from the health care law has a bit of mystery to it. The legislation calls it a "Medicare contribution," but none of the revenue will go to the Medicare trust fund. Instead, it's funneled into the government's general fund, which does pay the lion's share of Medicare outpatient and prescription costs, but also covers most other things the government does.

The new tax is a 3.8 percent levy on investment income that applies to individuals making more than $200,000 or married couples above $250,000. Projected to raise $123 billion from 2013-2019, it comes on top of other taxes on investment income. While it does apply to profits from home sales, the vast majority of sellers will not have to worry since another law allows individuals to shield up to $250,000 in gains on their home from taxation. (Married couples can exclude up to $500,000 in home sale gains.)

Investors have already been taking steps to avoid the tax, selling assets this year before it takes effect. The impact of the investment tax will be compounded if Obama and Republicans can't stave off the automatic tax increases coming next year if there's no budget agreement.

High earners will face another new tax under the health care law Jan. 1. It's an additional Medicare payroll tax of 0.9 percent on wage income above $200,000 for an individual or $250,000 for couples. This one does go to the Medicare trust fund.

Donald Marron, director of the nonpartisan Tax Policy Center, says the health care law's tax increases are medium-sized by historical standards. The center, a joint project of the Brookings Institution and the Urban Institute, provides in-depth analyses on tax issues.

They also foreshadow the current debate about raising taxes on people with high incomes. "These were an example of the president winning, and raising taxes on upper-income people," said Marron. "They are going to happen."

Other health care law tax increases taking effect Jan. 1:

- A 2.3 percent sales tax on medical devices used by hospitals and doctors. Industry is trying to delay or repeal the tax, saying it will lead to a loss of jobs. Several economists say manufacturers should be able to pass on most of the cost.

- A limit on the amount employees can contribute to tax-free flexible spending accounts for medical expenses. It's set at $2,500 for 2013, and indexed thereafter for inflation.
 

Tuesday, December 18, 2012

BCBS Insurance Premiums SkyRocket W/ A 20% Increase In CA For 2013 - Recieved Your Rate Increase Letter Yet??

 

Blue Cross Blue Shield of California seeks rate hikes up to 20%

In filings with state regulators, Blue Shield is seeking an average rate increase of 12% for more than 300,000 customers. Consumer advocates say the firm should use its reserves to hold down rates.

 
December 13, 2012|By Chad Terhune, Los Angeles Times

Health insurer Blue Shield of California wants to raise rates as much as 20% for some individual policyholders, prompting calls for the nonprofit to use some of its record-high reserve of $3.9 billion to hold down premiums.

In filings with state regulators, Blue Shield is seeking an average rate increase of 12% for more than 300,000 customers, effective in March, with a maximum increase of 20%.
 
Some consumer advocates and healthcare economists say Blue Shield shouldn't be raising rates that high when it has stockpiled so much cash. The company's surplus is nearly three times as much as the Blue Cross and Blue Shield Assn. requires its member insurers to hold to cover future claims.

"Blue Shield is sitting on a huge surplus that is beyond what is required or necessary," said Laurie Sobel, a senior attorney for Consumers Union in San Francisco. "It should be used to hold down rate increases when it hits these extraordinary levels."

California officials can take into account an insurer's amount of surplus, among many other factors, when determining whether they think a rate increase is reasonable. Both the California insurance commissioner and the state Department of Managed Health Care are reviewing the company's proposed premiums, but neither agency has the authority to reject changes in rates.

Some other states limit how much surplus can be held by nonprofit health plans. Other regulators press nonprofit insurers to return more money to consumers and the community overall since their stated mission is to serve the public good. Washington's insurance commissioner has said the two big nonprofit Blue Cross and Blue Shield plans there hold enough surplus to allow a portion of it to be used to reduce rates.

At Blue Shield of California, based in San Francisco, reserves have jumped 77% since 2006 from $2.2 billion to $3.9 billion in September. That has outpaced the company's 19% growth in annual revenue since 2006.

Blue Shield said its reserves have nothing to do with rate increases, and that money has been put aside for the future benefit of its policyholders.

"Reserves are needed to ensure our members' claims can be paid no matter what," said Blue Shield spokeswoman Lindy Wagner. "We need them to protect against uncertainties like a pandemic or another crisis."

The company also expects higher costs from an influx of new customers under the federal healthcare law in 2014.

"It's a once-in-a-lifetime change in the healthcare market that will bring a lot of volatility, and we need higher reserves for that," Wagner said.

Even with these proposed rate increases, Blue Shield said, it expects to lose money in the individual insurance market in 2013.

The insurer said its medical costs for this segment of the business grew 10.6% and what it actually pays is rising 12.5% after adjusting for its portion after customer deductibles. The state's largest for-profit health insurer, Anthem Blue Cross, cited a similar jump in medical costs in seeking rate hikes as high as 25% for some individual policyholders, effective in February.
 
California regulators expect to finish their reviews of various company rate filings in the coming weeks.
 
The Department of Managed Health Care requires the health plans it oversees to maintain a minimum amount of reserves to cover claims. For Blue Shield, that minimum threshold was $218 million as of Sept. 30.
 
Insurers strive to be comfortably above any government threshold to avoid any concerns and to maintain the confidence of credit-rating firms.
 
Carl McDonald, a managed-care analyst at Citigroup, said reserves at nonprofit Blues plans across the country reached record levels last year and remain robust thanks to lower medical claims and stock market gains. By one measure, he estimated that Blue Shield of California had a risk-based capital ratio of 1,092% in 2011.
 
For comparison, the Blue Cross and Blue Shield Assn. requires its member insurers to hold reserves of at least 375% of risk-based capital. Nationwide, state regulators generally intervene if reserves dip below 200%.
 
McDonald said nonprofit health plans tend to amass more cash because they can't issue stock like their for-profit rivals and they have limited access to the debt markets. "But it's quite debatable whether Blues need to hold more than twice as much capital as is required," McDonald said in a recent report.
 
Blue Shield said its reserve has grown at a slower pace since its pledge last year to limit profits to 2% of annual revenue and return millions of dollars to customers. The company announced that move after a consumer backlash to a bid to raise rates as much as 59% in 2011 that was later dropped.
Overall, the company said it has returned about $520 million to customers over the last three years because of the 2% limit on profits.
 
Kaiser Permanente, the state's largest nonprofit health plan, reported $16.3 billion in reserve on Sept. 30 in state filings. But Kaiser said that figure includes the value of buildings and equipment in its large network of hospitals and other medical facilities as well as reserves for that side of its business.
The Kaiser health plan is seeking to raise rates an average of 9% for 220,000 individual policyholders and dependents next month.
 
Larry Kirsch, a healthcare economist in Portland, Ore., who has studied surpluses at other Blue Cross and Blue Shield plans, said not enough regulators nationwide require nonprofit plans to justify their rationale for hoarding so much cash at a time when many consumers and small businesses are struggling to afford health benefits.
 
"There ought to be a reasoned analysis for when is enough," Kirsch said. "There always seems to be a 'sky is falling' story. I say prove it to me."
 
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Monday, December 10, 2012

WSJ Reports: Higher Premium Expectations For 2013

    More Health-Law Changes Coming in 2013

 
Health-care reform is here to stay—for the foreseeable future. So for the millions of Americans with health insurance at their workplaces, this fall's "open enrollment" period will be one of the most important in years.

Next year will see some of the many significant changes brought on by the Affordable Care Act, including easy-to-read plan summaries and caps on flexible spending accounts. The ability of health insurers to place limits on annual spending is also on its way out, while earlier reforms such as adding adult children to their parents' plans offer new options to consumers.

Most of the really big changes—including health-insurance exchanges and tax credits to help people buy coverage—aren't coming into play until 2014. Still, the provisions going into effect in 2013, along with those that have already been introduced, can affect any changes you might want to make to your health coverage.

And the presidential election is unlikely to change the landscape for people picking health plans this fall. If President Obama is re-elected, the changes stay. If GOP candidate Mitt Romney wins, getting rid of the law is unlikely to be a quick or easy process, given that the Democrats are expected to retain control of the Senate.

 
image
Lisa Haney
"This year's fall enrollment season is really the calm before the storm of health-plan reforms that will come in 2014," says Tom Richards, insurer Cigna's president in charge of reform implementation. "There is some uncertainty among employers because of the political dynamics they are watching, nevertheless they continue to move ahead to implement the changes that were part of reform."

Here are five things you need to know as you sift through your plan options over the next few weeks.

1. Higher Premiums

First, the bad news: You will likely be paying higher premiums next year, with 13% of companies planning to raise their employees' contributions to health-care costs by five percentage points or more, and 42% planning premium increases of one to five percentage points, according to a July survey of employers by benefits consultant Towers Watson TW +0.76%.

Some good news: The pace of that growth is slowing. Employer health-care costs are expected to rise by 5.3% in 2013, compared with 5.9% this year, according to the survey.

Premium increases have been held down thanks to the requirement that insurers give rebates to consumers if insurers spent less than 80% of premiums on medical care, says Cheryl Fish-Parcham, deputy director of health policy at Families USA, a health-care consumer group in Washington.
Some 13 million consumers got rebates worth $1.1 billion this year, according to the Obama administration.

2. Straightforward Summaries

The most visible change in your packet of insurance options for 2013 is a new form called a "Summary of Benefits and Coverage."

The health-care law requires plans to provide these as of last month. The summary is meant to be a simple, easy-to-read description of how a plan works, what it covers and doesn't cover—there is no fine print allowed. Every health plan must have one, allowing you to compare two different plans side by side.

The form also will include examples to show you what each plan would generally cover in two common medical situations, the normal delivery of a baby and Type-2 Diabetes.

"You can lay these things side by side and see what's the same and what is different," says Nancy Metcalf, senior program editor at Consumer Reports. "Not only 'What's the deductible?' but 'Are there things that don't apply to the deductible? Is there an out-of-pocket limit and are there things that don't apply to that limit, like copays?' "

The plan is also supposed to provide you with a new glossary of insurance lingo—words like deductible, coinsurance and copayment that consumers may not understand.

If you don't get this new paperwork from your employer, ask for it, says Ms. Metcalf.

3. FSA Limits

For 2013, the amount you can put into a workplace flexible spending account will be capped at $2,500. Previously, the limits, if any, were set by the employer.

FSAs let you set aside tax-free money that can be used to pay for qualifying out-of-pocket expenses, such as copayments for doctor visits and prescriptions. It can't be used for premiums. Go to the Internal Revenue Service website for a list of qualifying expenses (www.irs.gov).

Keep in mind that if you don't use the full amount that you set aside, you will lose it. So it's important to estimate your out-of-pocket expenses wisely.

4. Dependent Coverage

Dependent coverage has gotten a boost from the health-law provision, which took effect in 2010, allowing many adult children up to age 26 to remain on their parents' policies, says Karen Pollitz, senior fellow at the Kaiser Family Foundation, a health-policy nonprofit organization.

If you haven't already, consider adding qualified dependents to your plan.

Keep in mind that a few plans were grandfathered in—or exempted from the requirement—when the provision was enacted, if they made minimal changes to their existing design.

Also, be aware that companies are often not eager to pay for additional dependents if they aren't required to do so or if the insured has other options, such as a spouse who already has coverage as well. A Towers Watson survey conducted this summer found that 7% of employers are planning a significant reduction in subsidization of coverage for dependents next year, while 31% are considering doing so in 2014 or 2015.

5. Higher Spending Cap

If you suffer from a chronic or costly medical condition, it may come as some relief that annual limits on how much an insurer will pay for care will be going up next year—and on their way out—for many plans.

For 2013, the cap rises to $2 million, from $1.25 million this year. The cap goes away entirely in 2014.

Before the health-care law, health plans could set an annual limit on how much they would spend on your covered benefits.

Ms. Pollitz says people who will benefit most from this will be patients with expensive conditions and procedures, such as transplants.

Still, despite the higher limits, insurers can still limit services that aren't considered "essential."

CharlesSCHWAB Reports: HEALTH INS Premium Increases Projected For 2013

6.3% Health Premium Increases Projected for 2013 
 
 
10/4/2012 By Stephen Miller, CEBS
In 2012, U.S. companies and their employees saw the lowest health care premium rate increases in six years, according to an analysis by consultancy Aon Hewitt. The average health care premium rate increase for large employers in 2012 was 4.9 percent, down from 8.5 percent in 2011 and 6.2 percent in 2010. In 2013, however, average health care premium increases are projected to jump up to 6.3 percent.

Aon Hewitt's analysis showed that in 2012:
The average health care cost per employee was $10,522, up from $10,034 in 2011.
The employees' portion of the total health care premium was $2,204, up from $2,090 in 2011.
Average employee out-of-pocket costs, such as co-payments, co-insurance and deductibles, were $2,200, up from $2,072 in 2011.
2013 Costs Forecast

For 2013, average health plan premium costs per employee are projected to jump to $11,188, of which average employee contributions to the health plan premium would be $2,385. In addition, average employee out-of-pocket costs (co-pays, co-insurance and deductibles) would be $2,429.

Over the last five years, employees’ share of health care costs—including employee premium contributions and out-of-pocket costs—have increased more than 50 percent from $3,199 in 2008 to $4,814 in 2013, according to the analysis.

“Employers have seen some stabilization in employment levels, less severe impact of high cost claims, a general movement towards consumer-driven plans and greater clarity around the average cost impact associated with health care reform. As a result, 2012 premiums were offset to reflect the better than expected historical experience. For 2013, we expect premium increases to gravitate back to the 6 percent range,” said Tim Nimmer, chief health care actuary at Aon Hewitt, in a media statement.

Total Plan Premium Costs
Percentage Increase
Average Cost per Employee
Average Employee Premium Contribution
Average Employee Out-of-Pocket Cost
2013 (projected)
6.3%
$11,188
$2,385
$2,429
2012
4.9%
$10,522
$2,204
$2,200
2011
8.5%
$10,034
$2,090
$2,072
2010
6.2%
$9,246
$1,927
$1,761
2009
5.0%
$8,703
$1,797
$1,580
2008
5.3%
$8,290
$1,691
$1,508
2007
5.3%
$7,874
$1,567
$1,364
Source: Aon Hewitt Health Value Initiative database of large U.S. employers' health care costs.
 
Costs by Plan Type

On average, Aon Hewitt forecasts that companies will see 2013 cost increases of 7.0 percent for health maintenance organization (HMO) plans, 6.1 percent for preferred provider organization (PPO) plans and 6.1 percent for point-of-service (POS) plans. From 2012 to 2013, the average cost per person for major companies is estimated to increase from $10,659 to $11,405 for HMOs, $10,433 to $11,069 for PPOs and $11,062 to $11,737 for POS plans.

Premium Costs by Plan Type
Year
HMO
POS
PPO
National
2013(projected)
$11,405
$11,737
$11,069
$11,188
2012
$10,659
$11,062
$10,433
$10,522
2011
$10,103
$10,657
$9,965
$10,034
2010
$9,353
$9,557
$9,212
$9,246
2009
$8,693
$8,864
$8,764
$8,703
2008
$8,193
$8,403
$8,388
$8,290
2007
$7,680
$8,062
$8,050
$7,874
Source: Aon Hewitt.

Cost Increases by Metro Area

In 2012, major U.S. markets that experienced rate increases higher than the national average included San Antonio (7.4 percent), San Francisco/Oakland/San Jose (7.4 percent), Los Angeles (7.2 percent) and Austin (6.5 percent). Conversely, Dallas (3.4 percent), Cincinnati (3.6 percent), Denver (4.5 percent), New York City (4.5 percent), Washington, D.C. (4.7 percent) and Philadelphia (4.9 percent) experienced lower-than-average rate increases in 2012.

Employer Actions Mitigate Costs

As the health care landscape shifts, employers are taking the opportunity to reassess their role as a health care benefits provider and subsidizer, while redefining their role in the health, safety and performance of their workforce. According to a 2012 Aon Hewitt survey of nearly 2,000 U.S. employers representing over 20 million U.S. employees and their dependents, most employers plan to continue sponsoring a medical plan for their employees. However, they are migrating from a traditional “managed trend” approach to a “house money/house rules” approach that integrates a pay-for-performance philosophy into their benefit programs. This strategy includes elements of:
Wellness and health programs that aim to improve the health of employees, reducing the amount and cost of care required, while minimizing work days missed due to illness. A growing number of employers are offering incentives and are beginning to link incentives to a result, as opposed to simply participating in a wellness program. In other cases, employers may require a health risk questionnaire, biometric screening and ongoing health coaching in order to be eligible for the richest plan or the highest employer subsidy.
Consumer-driven designs that expose employees to the direct cost of care up to a limit, encouraging more personal economic decisions about how to access care, how much care to use and what types of care to use. Aon Hewitt’s survey found that consumer-driven health plans (CDHPs) have become the second most common plan design offered by U.S. employers, with 58 percent of employers offering a CDHP in 2012.
Plan design strategies that encourage employees to consume less health care. Examples are plans that replace flat-dollar co-pays with percentage-of-cost co-insurance, migrate employees to generic prescription drugs and mail order refills for maintenance drugs, and levy surcharges for working spouses or additional dependents with coverage available elsewhere.
While still an emerging trend, a growing number of employers are interested in a corporate health care exchange model, which enables employers to manage the growth of their subsidy and allows employees to select from a greater set of health plan alternatives. While state-operated exchanges under health care reform will not be available to employers with more than 100 employees until at least 2017, organizations are exploring alternate health care models, such as corporate exchanges that allow employees to select from a greater set of health plan alternatives. Aon Hewitt found that more than 40 percent of employers are considering moving to a health care exchange model in the next three-to-five years.

Lower Claims Cost Increases Expected
Health plan per capita claims cost rates for 2013 are expected to decline, with projected claims cost increases dipping into single digits for most medical plans and all types of prescription drug plans, according to the 2013 Segal Health Plan Cost Trend Survey.
“While medical and prescription drug [claim cost rate increase] trends are projected to decelerate in 2013, we don’t know if deceleration is a long-term trend or a temporary result of current economic forces. We question whether medical care that is being delayed or avoided could lead to higher rates of undetected or untreated conditions in the future,” Edward A. Kaplan, senior vice president and national health practice leader at Segal, an HR consultancy, noted in a media statement.
Among the survey findings:
Almost all medical plan types are expected to experience claims cost rate increases under 10 percent (with the exception of fee-for-service/indemnity plans).
Pharmacy benefit claims cost trends are projected to be 6.4 percent, substantially below the double digit trends of a decade earlier.
Changes in the costs to plan sponsors can be significantly different from projected claims cost trends, reflecting such diverse factors as group demographics, changes in plan design, administrative fees, reinsurance premiums and changes in participant contributions, according to Segal.
To better control cost increases, Kaplan recommended that plan sponsors focus on:
Contracting with stable and cost-effective provider networks.
Implementing incentive-driven plan designs such as consumer-directed health plans.
Exploring ways to move providers to outcome-based compensation.
Using on-site and walk-in clinics for basic medical services.
Improving efforts aimed at early detection of disease, better control of chronic ailments and more effective wellness efforts.
-----
Other Health Care Cost Projections
Health care costs are projected to increase by 5.3 percent in 2013 (down from the 5.9 percent projected for 2012), according to Health Care Changes Ahead, an October 2012 research report by HR consultancy Towers Watson.
Without changes to medical and pharmacy plan designs, vendors, provider networks and other programs, the increase would have been 6.5 percent for 2013, Towers Watson found. Total per-employee costs are expected to be $11,507, representing an employer cost of $8,911 and an employee cost of $2,596.
Similarly, a June 2012 survey by the National Business Group on Health showed that the largest U.S. corporations expect health care premiums to rise 7 percent in 2013. In response, employers are eyeing a variety of cost-control measures including asking workers to pay a greater portion of premiums and sharply boosting financial rewards to engage workers in healthy lifestyles (see the SHRM Online article "Large Employers Expect Health Benefits to Increase 7 Percent in 2013.")

Stephen Miller, CEBS, is an online editor/manager for SHRM.

Tuesday, December 4, 2012

Wednesday, November 21, 2012

MUST READ!!! - Best Individual Health Insurance Policies

8 Keys to Picking the Best Individual Health Insurance Policy


Following these steps could save you tens of thousands of dollars if illness strikes.


Choosing the right individual health insurance plan just got a lot easier with the help of U.S. News’s Best Health Insurance Plans. Our user-friendly plan finder lets you zero in on a plan with the coverage you need at a price you can afford. To make a good choice and avoid some common traps, however, you need to keep a few basics in mind, starting with the meaning of such terms as premium, deductible, copay, and coinsurance. Then go through the checklist provided here, with your likely medical needs and how much you can pay a month as the backdrop. With the right insurance, you could save thousands, perhaps even tens of thousands, if you or a family member gets sick. 

1. Identify the “must-haves.” You can’t foresee a sudden injury or illness, but some medical needs can be anticipated. Maternity coverage, for example, is an obvious must-have if you’re starting a family, and not all policies offer it. If you have a family history of heart disease, you may want to make sure your coverage includes the cost of cardiac screening tests and cholesterol-lowering drugs. Under the Affordable Care Act, individual insurance plans must cover the full cost of more than two dozen preventive services for men, women, and children, including vaccinations and tests for high blood pressure, cholesterol, colon cancer, and diabetes, as long as they’re provided by a practitioner in the plan’s network.

2. Don’t overbuy. Would you buy a luxury car with a monthly payment as big as your mortgage? There’s not much point in thinking about a Cadillac insurance policy your budget can’t handle, either. If you’re relatively young and healthy, consider choosing a policy with a high deductible, the amount you must pay out of pocket before certain benefits kick in. A plan with a deductible of $5,000 or more is likely to cost you considerably less per month, and could save you money in the long run.

3. Check the network.
If you have a primary care physician and specialists you like, be sure they’re in the network of any plan you consider buying. Policies generally cover a lower share of the cost of out-of-network care—or none at all. For each plan U.S. News has rated, we supply links to the insurance company’s website. There, you should find a directory of doctors in the company’s network.

4. Know your share of the costs.
This isn’t crystal-ball gazing. Plans are required to state how much you’ll pay out of pocket, through flat fees called copays and through coinsurance, a form of “cost-sharing” in which you pay a percentage of a medical service. When you’re sick, seemingly small copays can add up. And an expensive procedure could leave you obligated to pay thousands in coinsurance.

5. Make sure your drugs are covered.
You’ll want to make certain that the plan’s formulary, or list of covered medications, includes those you take regularly, especially if they are expensive. Or at least make sure the plan has a great alternative for prescription drugs.

6. Look into annual limits on coverage and services.
Thanks to health reform, annual dollar limits on coverage will disappear entirely in 2014. For now, any individual policy you buy cannot impose a limit of less than $1.25 million, an amount that will rise to $2 million on September 23, 2012. But the Affordable Care Act still allows plans to impose limits on services not deemed “essential” and, in some cases, to obtain a waiver allowing them to retain an annual limit.

7. Factor in your dependents.
If you have children under age 26 without health insurance coverage through an employer, the law permits them to be on your insurance. Policies also can no longer exclude kids under age 19 from coverage because of pre-existing conditions.

8. Walk through several plans.
It only takes a few minutes to review the main benefits associated with each plan, and some plans that look appealing at first glance may turn out to have cost-sharing features that could burden you with heavy medical costs. Each plan rated by U.S. News displays this information on a single page on usnews.com. A live person will walk you though the messier details if you contact the National Association of Health Underwriters, which can put you in touch with licensed local agents and brokers.

Article via: http://health.usnews.com/health-news/health-insurance/articles/2012/08/07/8-keys-to-picking-the-best-individual-health-insurance-policy

Saturday, November 17, 2012

INSURANCE Companies THANK FAST FOOD FOR YOUR HEALTH ISSUES!!!!! A Must Read!

DID YOU KNOW??? Study Shows:           Insurance companies hold billions in fast food stock
Researchers say there's a "potential disconnect" between insurance companies' mission and unhealthy food options.


Researchers say there's a "potential disconnect" between insurance companies' mission and unhealthy food options.
 
 
The fast-food industry has long been under fire for selling high-fat, high-calorie meals that have been linked to weight gain and diabetes, but the financial health of the industry continues to attract investors -- including some of the leading insurance companies in the U.S., a new study reports.
According to Harvard Medical School researchers, 11 large companies that offer life, disability, or health insurance owned about $1.9 billion in stock in the five largest fast-food companies as of June 2009.

The fast-food companies included McDonald's, Burger King, and Yum! Brands (the parent company of KFC and Taco Bell). Companies from both North America and Europe were among the insurers, including the U.S.-based Massachusetts Mutual, Northwestern Mutual, and Prudential Financial.
The researchers say insurance companies should sell their fast-food stock or use their influence as shareholders to make fast food healthier, by pressuring big restaurant chains to cut portion sizes or improve nutrition, for instance.

There's a "potential disconnect" between the mission of insurance companies and the often-unhealthy food churned out by companies like McDonald's, they write.

"The insurance industry cares about making money, and it doesn't really care how," says the senior author of the study, J. Wesley Boyd, M.D., an assistant clinical professor of psychiatry at Harvard Medical School, in Boston. "They will invest in products that contribute to significant morbidity and mortality if doing so is going to make money."

Boyd and his colleagues used a database that draws on financial filings and news reports to estimate the fast-food investments of the 11 companies. Their findings appear in the American Journal of Public Health.

Massachusetts Mutual and Northwestern Mutual -- which both offer life, disability, and long-term care insurance -- owned $367 million and $422 million in fast-food stock, respectively, much of it in McDonald's, the authors report. Prudential, which offers life insurance and long-term disability coverage, held $356 million in fast-food stock, according to the study.

Insurance companies disputed these figures. Andrea Austin, the assistant director of corporate relations for Northwestern Mutual, in Milwaukee, says the company's investment in fast-food companies is only about $250 million, and was at the time the study was conducted. That amounts to about one-fifth of 1 percent of the company's portfolio, she adds.

Austin also disagrees that the company's fast-food investments represent a disconnect with its mission. "We have to determine what's going to give our policy owners value," she says. "We have to make sure we fulfill our obligations to them, and to do that we invest in a wide variety of industries. It's that diversification that enables us to return value to them."

In an e-mail, MassMutual spokesman Mark Cybulski called the study's findings "absolutely incorrect" and said that as of December 31, the company's holdings of fast-food-related stock amounted to just $1.4 million, which represents less than one-hundredth of 1 percent of the company's $86.6 billion in cash and total invested assets.

Austin says she has "no idea" why the figures differ and says that Northwestern Mutual doesn't use subsidiaries.

Theresa Miller, the vice president of global communications for Prudential Financial, said in an e-mail that she could not discuss the specifics of the company's portfolios. But she noted that the investments in the report are within index funds, and that "a large portion" are managed on behalf of third-party clients.

MassMutual, Northwestern, and Sun Life (another insurer mentioned in the report) have contested Boyd's findings in the past. Last year Boyd led a similar analysis, published as a letter to the editor in the New England Journal of Medicine, that found that seven insurance companies held some $4.5 billion in tobacco-company stock. Then, too, Cybulski said that MassMutual's holdings were just a fraction of what Boyd and his colleagues claimed.

According to Boyd, the discrepancy in his figures and those cited by MassMutual may be due in part to two factors: Insurance companies may invest in fast-food stocks through subsidiaries over which they have limited oversight (and therefore may not consider them direct investments), and some of the investments may be in index funds, a type of mutual fund tied to the collective performance of a large group of stocks, such as the S&P 500, which may include those of fast-food companies.

The database used in his analysis provides only the aggregate of a company's holdings, Boyd says.
Austin says she has "no idea" why the figures differ and says that Northwestern Mutual doesn't use subsidiaries.

Boyd and his co-authors emphasize that fast food -- unlike cigarette smoking -- can be safe in moderation.

However, a growing body of research has linked frequent fast-food consumption to weight gain, obesity, and type 2 diabetes.

As a result, the study notes, several cities and towns have restricted fast-food restaurants via zoning laws. And under the health-care legislation passed by Congress in March, chain restaurants will have to post calorie information on their menus, as is already required in New York City.

In their 2009 paper on tobacco, Boyd and his colleagues suggested that insurance companies profit twice over by investing in tobacco stocks, since they can charge higher premiums to smokers and also profit if the stock rises. A similar dynamic may be at work with fast food, according to Boyd.

"They can charge you more for life insurance if you have these negative health outcomes that people have as a result of eating fast food," he says.

But investing in unhealthy industries such as fast food and tobacco isn't necessarily a win-win for insurers over the long term, especially for health insurers, says Sara N. Bleich, Ph.D., an assistant professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.

"Health insurance companies get profits if they invest in tobacco and fast food, [but] these are some of the top drivers of mortality in the country," says Bleich, who researches obesity policy but was not involved in the current study.
 
"They are essentially killing off their consumer base, so it's not a sustainable model in the long-term. Long-term goals should be consistent with health, because that ensures a large population from which to draw consumers."

Robert Zirkelbach, the press secretary for America's Health Insurance Plans, a national association representing health insurers whose Web site lists three of the companies named in the study, declined to comment on the specifics of the study. "Our industry is strongly committed to prevention and wellness," Zirkelbach said in a statement.

"Health insurance companies are doing things across the country that are working to address obesity, to promote prevention, and to encourage people to live healthier lifestyles."

Gigi Kellett, the director of the anti-tobacco campaign of Corporate Accountability International, a Boston-based watchdog group, says that both tobacco and fast food are inappropriate investments for insurance companies.

"Tobacco remains the leading cause of preventable death around the world, and there is growing research that diet-related diseases could soon surpass tobacco," she says. "It's irresponsible for insurance companies to invest in companies that make people sick."

Corporate Accountability International recently launched a "Retire Ronald" campaign to pressure McDonald's to discontinue the Ronald McDonald clown character and rein in its marketing to children, Kellett adds.
For her part, Bleich says that while health insurance companies, specifically, should be encouraged to divest their fast-food investments, encouraging self-regulation and competition in the fast-food industry may be a more effective way to make the industry healthier.