CNN: Health insurance for the under-26 crowd
Seattle Times: Hospitals care for hundreds of Medicaid patients others won’t take: “…hundreds of Medicaid patients in Washington state each year who — despite no longer needing hospitalization — have occupied hospital rooms for a month or longer while trying to find a nursing home or other facility to take them in.” A Seattle Times investigation has found at least 2,025 such cases from 2000 to 2008. Overall price tag: $461 million.
AP: Missouri to vote in August on health insurance mandate: Missouri is poised to become the first state to put a new federal health insurance mandate to a vote of its residents.
Regulator getting heat for Florida’s property insurance problems: Florida Insurance Commissioner Kevin McCarty is taking a beating over the health of the state's property insurance market, rising premiums in South Florida and other issues.
In wake of tornadoes, Okla. Insurance regulator declares emergency
Autism insurance bill moves forward in NC
Allstate to hire agents for 50 new offices in AZ
Rabu, 12 Mei 2010
Selasa, 11 Mei 2010
Insurance news: Insurer surpluses draw fire, WellPoint in the news, and don't forget the tax benefits if you keep your adult child on your health care
Spokesman-Review: Insurance firms' deep pockets under scrutiny
WSJ: War of words heats up between Obama, WellPoint
NYT editorial: The Anthem saga
Slate: Obama vs. WellPoint: How the insurance giant's bad behavior advances health reform
BusinessWeek: Keeping Junior on parents' insurance is a tax benefit (i.e. the cost is generally deductible from your income taxes)
L.A. Times: A healthcare subsidy for early retirees
USA Today: Staged accidents to bilk insurers increase sharply
USA Today: Many who lost jobs used COBRA subsidy, kept insurance
In wake of devastating gulf oil spill, liability spreads
WA Post: Some families face higher health premiums to insure adult children
AP: Premiums may undermine coverage guarantee for kids
WSJ: What defines a "grandfathered" health insurance plan?
WSJ: War of words heats up between Obama, WellPoint
NYT editorial: The Anthem saga
Slate: Obama vs. WellPoint: How the insurance giant's bad behavior advances health reform
BusinessWeek: Keeping Junior on parents' insurance is a tax benefit (i.e. the cost is generally deductible from your income taxes)
L.A. Times: A healthcare subsidy for early retirees
USA Today: Staged accidents to bilk insurers increase sharply
USA Today: Many who lost jobs used COBRA subsidy, kept insurance
In wake of devastating gulf oil spill, liability spreads
WA Post: Some families face higher health premiums to insure adult children
AP: Premiums may undermine coverage guarantee for kids
WSJ: What defines a "grandfathered" health insurance plan?
Jumat, 07 Mei 2010
Insurance news: Autism mandate in Mo., flood spurs anger against agents in Tenn., and sorry, no homeowner's coverage for bedbugs
A roundup of insurance news:
BusinessWeek: Missouri Senate passes autism insurance mandate: Bill: Some insurers must cover up to $45k/year of intensive therapy for autistic kids.
BusinessWeek: BP Spill biggest energy insurance loss in more than 20 years
NYT: Does homeowners insurance cover the (up to $70k) cost of eliminating bedbugs? (No.)
WP: Safety group urges highway agency to require antilock brakes on new motorcycles: Fatalities would drop by more than 1/3, report says.
Nationwide Insurance to hire 1,400
Allstate hiring 100 agents in FL in push to boost auto insurance business
Anger against Tenn. Insurance agents rises as flood waters subside: Lawsuit brewing against agents who never told residents about flood insurance.
$350m UnitedHealth settlement means payments for doctors, patients
BusinessWeek: Missouri Senate passes autism insurance mandate: Bill: Some insurers must cover up to $45k/year of intensive therapy for autistic kids.
BusinessWeek: BP Spill biggest energy insurance loss in more than 20 years
NYT: Does homeowners insurance cover the (up to $70k) cost of eliminating bedbugs? (No.)
WP: Safety group urges highway agency to require antilock brakes on new motorcycles: Fatalities would drop by more than 1/3, report says.
Nationwide Insurance to hire 1,400
Allstate hiring 100 agents in FL in push to boost auto insurance business
Anger against Tenn. Insurance agents rises as flood waters subside: Lawsuit brewing against agents who never told residents about flood insurance.
$350m UnitedHealth settlement means payments for doctors, patients
Kamis, 06 Mei 2010
Health insurance help for early retirees to start June 1
The federal government announced plans to start its new reinsurance program for early retirees June 1 - several weeks ahead of the June 21 start date required by the Patient Protection and Affordable Care Act.
The new program will provide $5 billion, over the next three and half years, to both self-funded and insured employer health plans. The funds must be used to help lower the employer's own health costs, provide premium relief to their workers and families or a combination of both.
According to Health and Human Services Secretary Kathleen Sebelius, the number of large firms offering retiree coverage to its workers has dropped more than 30 percent over the last 20 years.
Beginning in late June, employers can apply for reimbursements of up to 80 percent of claims costs between $15,000-$90,000. Claims incurred between the start of the plan year (usually Jan. 1) and June 1 count towards the $15,000 threshold. But only claims that occur after June 1 are eligible for reimbursement.
We've posted some basic information on our health reform pages, but for more details go to www.healthreform.gov
The new program will provide $5 billion, over the next three and half years, to both self-funded and insured employer health plans. The funds must be used to help lower the employer's own health costs, provide premium relief to their workers and families or a combination of both.
According to Health and Human Services Secretary Kathleen Sebelius, the number of large firms offering retiree coverage to its workers has dropped more than 30 percent over the last 20 years.
Beginning in late June, employers can apply for reimbursements of up to 80 percent of claims costs between $15,000-$90,000. Claims incurred between the start of the plan year (usually Jan. 1) and June 1 count towards the $15,000 threshold. But only claims that occur after June 1 are eligible for reimbursement.
We've posted some basic information on our health reform pages, but for more details go to www.healthreform.gov
Seattle couple charged in insurance scheme
The owners of a Seattle construction company have been charged with multiple counts of theft for a scheme that investigators believe bilked insurance companies out of more than $470,000.
James Philo, 59, and Cheryl-Lin Philo, 45, owners of Philo Construction Company of Seattle, each face four counts of first-degree theft and 15 counts of second-degree theft. Arraignment is scheduled for May 11, 2010 in King County Superior Court.
“Fraud and inflated claims mean higher premiums for the rest of us,” said Washington state Insurance Commissioner Mike Kreidler. “In this case, employees and former employees were concerned about what they saw going on and stepped forward to report it.”
In December 2006, a major windstorm swept across Washington, knocking down trees and causing substantial damage to a numerous homes. The Philos hired subcontractors to remove many of those trees from customers’ homes.
In March 2007, a former employee contacted Kreidler’s office, saying that Philo was submitting inflated invoices to insurers. Other workers provided information as well.
An investigation by the agency’s Special Investigations Unit, working with more than 15 insurance companies, found that the Philos had been asking their subcontractors for two invoices for each job. The Philos paid the subcontractors the smaller amount, and then submitted the larger invoice to their customers’ insurance companies for reimbursement.
The markup averaged close to 30 percent, plus another 20 percent that insurers allow for profit and overhead. For example, a $2,150 bill from a tree service company was reported to the insurer as a $2,795 job. Once profit, overhead and sales tax were added, the Philos were paid a total of $3,649.
The Philos also created a fictitious company, Pro Line Construction Resources, to act as a subcontractor when they needed to support a particularly high estimate.
The criminal charges are based on 20 cases of double-invoicing, totaling $31,000 in overcharges to insurers. All told, state investigators documented more than 60 cases of apparent fraud, totaling which they believe represents $470,000 in overcharges.
James Philo, 59, and Cheryl-Lin Philo, 45, owners of Philo Construction Company of Seattle, each face four counts of first-degree theft and 15 counts of second-degree theft. Arraignment is scheduled for May 11, 2010 in King County Superior Court.
“Fraud and inflated claims mean higher premiums for the rest of us,” said Washington state Insurance Commissioner Mike Kreidler. “In this case, employees and former employees were concerned about what they saw going on and stepped forward to report it.”
In December 2006, a major windstorm swept across Washington, knocking down trees and causing substantial damage to a numerous homes. The Philos hired subcontractors to remove many of those trees from customers’ homes.
In March 2007, a former employee contacted Kreidler’s office, saying that Philo was submitting inflated invoices to insurers. Other workers provided information as well.
An investigation by the agency’s Special Investigations Unit, working with more than 15 insurance companies, found that the Philos had been asking their subcontractors for two invoices for each job. The Philos paid the subcontractors the smaller amount, and then submitted the larger invoice to their customers’ insurance companies for reimbursement.
The markup averaged close to 30 percent, plus another 20 percent that insurers allow for profit and overhead. For example, a $2,150 bill from a tree service company was reported to the insurer as a $2,795 job. Once profit, overhead and sales tax were added, the Philos were paid a total of $3,649.
The Philos also created a fictitious company, Pro Line Construction Resources, to act as a subcontractor when they needed to support a particularly high estimate.
The criminal charges are based on 20 cases of double-invoicing, totaling $31,000 in overcharges to insurers. All told, state investigators documented more than 60 cases of apparent fraud, totaling which they believe represents $470,000 in overcharges.
Rabu, 05 Mei 2010
Insurance news: New coverage for some adult kids, Hawaii insurance fees up, and Paris pioneers insurance for subway scofflaws
Auburn Reporter: Some health plans covering adult kids early
AP: Health coverage extensions for young not universal: "These voluntary extensions come with a host of qualifications. Whether your child gets one also can depend on your employer."
WP: Quicker coverage sought for federal workers’ adult children: "Lawmakers introduced a measure Tuesday that would allow the Office of Personnel Management to extend health-care coverage to the adult children of federal workers before the new federal health-care law takes effect next year. Several health insurance companies plan to extend health-care coverage to adult children up to age 26 starting in June, but current federal law prohibits OPM from doing the same for workers in the Federal Employees Health Benefits Program."
Hawaii boosts insurance fees to help offset its budget shortfall "One insurance bill, SB 2159, raises the fee insurers pay to obtain copies of a driver’s record, from $7 to $20. HB 1985 doubles more than 30 other fees that are paid by insurance companies, agents, brokers, adjusters and other insurance entities. HB 2600 requires insurance companies to put systems in place to pay premium taxes monthly rather than quarterly, which has been the long-standing practice, according to the Property Casualty Insurers Association of America."
HHS: Sebelius calls on governors and insurance commissioners to re-examine any WellPoint health insurance rate increases in their states (Includes text of letter)
NM Insurance Chief Resigns After Blue Cross Flap
Health insurance ministry members pay claims directly to other believers: "Masters, who lives in Fort Lauderdale, Fla., is part of a growing number of Americans who are members of faith-based "health sharing ministries" where members directly pay for each others' medical bills."
Pharmacist sentenced to 4 years for defrauding insurance company (Iowa case)
(Houston TV station) Saving Cents: Buy car insurance by the mile: "There’s a first-of-its-kind auto insurance company in Texas that sells coverage by the mile. The company is called MileMeter, and is based in Dallas. The policies are great for people who live close to their jobs, those in the military who leave a car behind that is unused, retirees who do not drive much and those with a second car or truck that rarely leaves the garage."
(MI) Wayne County assistant prosecutor to tackle only arson-for-hire cases: "A state insurance coalition has raised enough money to pay an assistant Wayne County prosecutor to handle nothing but arson-for-hire cases."
NPR: Don’t pay your fare on the subway? There’s insurance for that: "Groups of free riders on the Paris Metro have created informal insurance pools that pay the fine when riders get caught. The groups call themselves mutuelles des fraudeurs -- fraudster mutuals. The fraudsters pay into a into a central fund. Then, whoever gets caught riding for free can draw from the fund to pay the fine, which starts at about $75."
AP: Health coverage extensions for young not universal: "These voluntary extensions come with a host of qualifications. Whether your child gets one also can depend on your employer."
WP: Quicker coverage sought for federal workers’ adult children: "Lawmakers introduced a measure Tuesday that would allow the Office of Personnel Management to extend health-care coverage to the adult children of federal workers before the new federal health-care law takes effect next year. Several health insurance companies plan to extend health-care coverage to adult children up to age 26 starting in June, but current federal law prohibits OPM from doing the same for workers in the Federal Employees Health Benefits Program."
Hawaii boosts insurance fees to help offset its budget shortfall "One insurance bill, SB 2159, raises the fee insurers pay to obtain copies of a driver’s record, from $7 to $20. HB 1985 doubles more than 30 other fees that are paid by insurance companies, agents, brokers, adjusters and other insurance entities. HB 2600 requires insurance companies to put systems in place to pay premium taxes monthly rather than quarterly, which has been the long-standing practice, according to the Property Casualty Insurers Association of America."
HHS: Sebelius calls on governors and insurance commissioners to re-examine any WellPoint health insurance rate increases in their states (Includes text of letter)
NM Insurance Chief Resigns After Blue Cross Flap
Health insurance ministry members pay claims directly to other believers: "Masters, who lives in Fort Lauderdale, Fla., is part of a growing number of Americans who are members of faith-based "health sharing ministries" where members directly pay for each others' medical bills."
Pharmacist sentenced to 4 years for defrauding insurance company (Iowa case)
(Houston TV station) Saving Cents: Buy car insurance by the mile: "There’s a first-of-its-kind auto insurance company in Texas that sells coverage by the mile. The company is called MileMeter, and is based in Dallas. The policies are great for people who live close to their jobs, those in the military who leave a car behind that is unused, retirees who do not drive much and those with a second car or truck that rarely leaves the garage."
(MI) Wayne County assistant prosecutor to tackle only arson-for-hire cases: "A state insurance coalition has raised enough money to pay an assistant Wayne County prosecutor to handle nothing but arson-for-hire cases."
NPR: Don’t pay your fare on the subway? There’s insurance for that: "Groups of free riders on the Paris Metro have created informal insurance pools that pay the fine when riders get caught. The groups call themselves mutuelles des fraudeurs -- fraudster mutuals. The fraudsters pay into a into a central fund. Then, whoever gets caught riding for free can draw from the fund to pay the fine, which starts at about $75."
Selasa, 04 Mei 2010
Wind damage in Eastern Washington -- what does your insurance cover?
High winds caused significant damage yesterday in parts of Eastern Washington, with winds gusting up to 60 miles an hour.
Every time this happens, our office gets calls from people wanting to know what damage their homeowners/auto/business insurance covers. (We're the Washington state agency that regulates insurance.)
Here are a few common questions:
Am I covered if my car was damaged by falling limbs? If your car was damaged, that damage should be covered under the comprehensive coverage in your auto insurance policy. (If you opted for comprehensive coverage, that is. Some people, to save money, just get liability coverage.)
My yard is covered with branches from the storm. None of them hit the house or my fence, so there's no property damage. But would the cleanup costs be covered in this case? Sorry, probably not. Standard homeowner's policies typically only pay for such cleanup if your property was actually damaged. In other words, your home, garage, fence, etc. would probably have to first be damaged by the debris for the insurer to pay to remove it. Standard policies don't cover the loss of trees or shrubs because of wind.
My business has an awning over the sidewalk, and it's been damaged by the wind. Is it covered? Probably, but check with your agent or insurer to be sure, since business insurance can vary a lot. Also, many business policies have business interruption coverage, which can be very useful if a covered loss forces you to close the business. But there are often deductibles or other limits, so they may not apply if the business interruption is for just a few days.
Click here for a lot more storm-related Q&As re: insurance.
Also: If you have damage and have questions or problems with your insurer (and live in Washington state), call our consumer affairs hotline at 1-800-562-6900. It's not a phone tree; it's staffed by live people.
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