Is overseas travel insurance policy issued by Insurance Companies of Ukraine and Belarus is Valid?

Is overseas travel insurance policy issued by health Insurance Companies of Ukraine and Belarus is Valid? Hindustan Times of Dec 25, 2008 has raised a very interesting question whether overseas travel health insurance policy issued by Insurance companies of Ukraine & Belarus is valid. IRDA has initiated information gathering exercise and we can expect some action in the coming weeks. We foresee this can be in the form of posing questions to the company which has been selling the products. We do not foresee any action against the Insurance co’s as these are not based in India. Points in favor of foreign insurance co are;

1.If Indians are permitted to buy air tickets worth any amount from Foreign airlines then why they should not have the freedom to buy Overseas Travel Insurance from a foreign company.
2.Many foreign insurance co’s (including a BUPA subsidiary )have been advertising in Indians press and selling Health Insurance for Indians living in India .According to information available to us no action was taken by IRDA against them.
3. Let the Indian Insurance co’s face the competition and come out with suitable products, pricing and service level. Point against foreign insurance co is;
Indian customers do not know about the financial strength of this co and it is the duty of IRDA to protect the interests of Indian Citizens. We will be pleased to have the comments from you.

Is overseas travel policy issued by Ukraine/Belarus insurance co's to indians valid

Hindustan Times of Dec 25,2008 has carried the news which raises the question whether Overseas Travel Policy issued by Ukraine & Belarus Insurance Companies to Indians valid.

IRDA has initiated information gathering exercise.

Points against the issue of such policies is;

1.Insurance co's not registered with IRDA.The co selling the products is not licenced by IRDA.

Points in favour of such policies are;

1.As Indians we are permitted to travel by any international airline

Portability of the Healthinsurance policy is coming

Yes,portability of the Healthinsurance policy is coming.It maens you can cahnge the insurance co when it comes to renewal.We feel this will be of help to those who are in the lower or younger age group.Even today this group has no difficulty.

The question arises -will it help those who are in 60+ age group.We doubt it will be so as the premium variation and different policies with respect to "No Claim Bonus" will be a stopping factor.

Indication that group health insurance rates will go up by 50%

We have been of the view that Individuals /families are neglected wherelse group health insurance policies are issued with better terms and lower rates.

The Economic Times od Dec 17,2008 has carried a news item according to which ratio of claims and servicing expenses to total premium figure of Group policies is 160%(Ref Mr Sandeep Bakhshi ,CEO, ICICI Lombard).

This news item also informs that where claims have been high the policies are being cancelled.

We are pleased to know that Insurance industry has started facing the truth and has started taking steps in the right direction.

Does Oriental insure someone who is 75+

We have received comments from some of our website surfers

Group Health Insurance Rates to go up in 2009

Many people wish to know whether the premium rates will go down in the year 2009.No indications are available as far as individuals /families are concerned.

It is becoming clear that Group Health Insurance policies have resulted in claims of over 130% and many Insurance co's are considering to increase the rates during 2009 by 30 to 40 %.

Unemployment Health Insurance

One of the most painful parts of losing a job is having to deal with replacing your health insurance. Most people feel unprepared to select and enrolling in this type of health insurance even though most of us will have a handful of interruptions in employer-provided health insurance over our full working career. Employer-provided health insurance expires on the last day of the month of termination of employment. Enrollment in an unemployment health insurance is never automatic and must be addressed within a short time after termination of employment.

Types of coverage

While unemployment compensation is provided through the government, unemployment health insurance is provided through commercial health insurance companies. The term "unemployment health insurance" is generic and therefore may refer to one of several available insurance programs. Some people who work for larger companies have the option of continuing their same health insurance for up to 18 months by paying the full cost of this coverage plus an administrative fee. This is commonly known as COBRA coverage. In some cases a similar program called "individual conversion coverage" is available. In either case the burden of enrollment and full payment of premiums is solely the responsibility of the terminated employee. Despite the obvious advantages in simplicity and continuity of coverage, few people can afford this option.

The most popular type of unemployment health insurance is short term major medical insurance. Despite the name, this insurance can span several years or longer and eligibility requirements are minimal¹. This insurance offers flexibility with high coverage limits. Policies can be renewed month-to-month from one month to six or twelve months. The two most important features of this coverage are that it is valid with all doctors and hospitals in the U.S. (no network required) and it provides a Certificate of Creditable Coverage² to be used with your next employer's health insurance policy. This is important because it ensures that the new coverage immediately takes over the cost of treating pre-existing medical conditions.

Specialty insurance can be used in specific situations and regular individual major medical insurance is suitable when it is unlikely that there will be other employment in the future and the applicant is financially stable.

Shopping Tips

Plan to enroll in a bare-bones coverage rather than a fully loaded policy. Most people avoid incurring voluntary medical expenses while they are not employed so this insurance is primarily designed to cover large unexpected medical expenses. Also, because of the uncertainty of unemployment, it is smart to select an insurance that is less expensive than you think you can afford.

Short term medical insurance is priced at about 1/3 of the cost of your former insurance or COBRA option. For a typical employee, this means that the total cost of the unemployment health insurance will be approximately the same as the amount you were contributing to the employer's health plan through salary-deductions³. Using his guideline, it may be psychologically comforting and aid in your personal financial planning to know that the total out-of-pocket cost of health insurance remains relatively constant from the period of employment to the period of unemployment.

All of the following insurance products provide strong protection against catastrophic losses and provide a Certificate of Creditable Coverage to ensure payment for pre-existing medical conditions on your next employer-provided health insurance plan. The price of the coverage varies and some products are better suited for specific situations. We suggest narrowing the list to two or three choices and then get online quotes for each product.

Use the online enrollment options available. This is faster and safer than a paper application and offers immediate confirmation of coverage.

Insurance Choices

All of the following choices are available a MedSave.com. They are grouped according to price range although price varies from one person to another based on location of residence, age, and sex.

Lowest cost unemployment policies - Celtic Insurance STM and UnitedHealthOne Golden Rule Insurance STM are often the least expensive insurance plans to cover a gap in group health insurance. Some of these plans keep cost down by using a "per cause" deductible rather than a single policy deductible.

Mid-range unemployment policies - Secure 3x12 (36 month) short term medical insurance, and Health Savings Account qualified health insurance for long term coverage.

Higher priced unemployment policies - Blue Cross, Aetna, Cigna, CelticCare

Special Situations

When specific medical conditions or circumstances exist then additional sources should be checked to determine the best coverage options. The special situations are: 1) when significant medical conditions, including diabetes, high blood pressure or high cholesterol exists, 2) applicant is a resident of MA, NJ, NY or VT, 3)non-US citizens, 4) residing in the U.S. les than a year, 5) previously declined for health insurance coverage, 6) applicant is overweight or 7) coverage is needed outside of the U.S. In all of these cases, see the article titles "Short Term Medical Insurance for Special Situations".

Individual help in selecting the best value insurance is available through OnlineAdviser at onlineadviser@short-term-medical-insurance.com.

Footnotes

¹ See the article "Am I Eligible for Short Term Medical Insurance" and "How Long Can I Be Covered by Short Term Medical Insurance" for details.

² See the article "Understanding a Certificate of Creditable Coverage" for more information.

³ This assumes that the average employee contribution for employer-provided coverage is about 40% of the total cost.

Recession impacts health insurance

An artice in Time (November 13, 2008) predicts that the number of uninsured Americans will rise sharply to above 50 million within the next few months. This pessimistic prediction assumes that many employers will drop their group health plans to combat the recession by the end of the 2008 calendar year and that many of these individuals will not obtain alternate health insurance on their own. The prediction also assumes that employers would drop health coverage altogether rather than switch to one of the low cost limited beneft plans now available. We see no reason to support these assumptions.

The number of uninsureds has actually decreased slightly over the past two years as more affordable insurance plans have been introduced to the market according to our "Covering the Unisured: 2008 Update" report. The cost of employer provided health insurance coverage for an employee without dependents is about $6,000 per year and COBRA coverage cost slightly more. But the cost of individually purchased short term medical insurance averages only about $1,800 per year. About 72% of Americans currently qualify for this type of low cost short term medical insurance. (Short term medical insurance is not available to the residents of four states or individuals with serious pre-existing medical conditions).

Given this viable and affordable alternate coverage possibility, it seems unlikely that more than an additional four million people would choose to go without any health insurance in 2009.

Golden Rule Web site temporarily closed for maintenance

Golden Rule Insurance Company, a national leader in innovative low cost health insurance, announced that its "E-store" will be closed for system maintenance over the weekend of Friday October 17, 2008 and will reopen at 8:00AM eastern time on Monday October 20. While direct self-serve online quoting, enrollment and some other functions may still be available during this weekend, MedSave.com will postpone customer service requests until Monday when all online functions are available to provide full enrollment support.

Golden Rule Insurance provides low cost short term medical insurance as well as a line of affordable long term renewable insurance policies for individuals and families in most states. See www.MedSave.com/goldenrule for more information.

Who killed health care" is a good reading

I have come across a book "Who killed health care" by Regina Herzlinger .Regina is a Professor in Harvard Business School and has covered various aspects of health care as well as health insurance industry in that country (USA).It is good to know that India is mentioned at various places in this book ,where health care of good level at a fraction of USA costs is possible.

If you are connected with Health Care,Insurance,Health Insurance industry then this book is a must for you.I forsee many things which had happened in USA will happen in India also over a period of time.

It is time for us to take corrective steps itself so that health care of poor people is not affected in the time to come .I know many poor people of Karol Bagh ,New Delhi who used to get treatment in Jessa Ram Hospital courtesy great Bhatia Family ,who were the trustees of this hospital.This hospital provided health care to Karol Bagh residents at practically no cost or fraction of the cost.Then this hospital became a part of leading hospital chain.Rates have gone up to market level.People remember Bhatia family.Hundreds of Bhatia's are needed to set up hospitals for those who are below the poverty line.

Regina has predicted that more and more US citizens will travel to India & Thailand for treatment.I wish beds are not made available to these foreigners at cost of Indian patients.It is time to add more and more hospitals ,medical collleges,nursing colleges in India.If the hospitality industry plans for hotel rooms and starts working towards the same we should also have a plan to add large number of hospital beds in next 5 years or 10 years.

West Bengal Govt is very liberal in attracting investment

West Bengal Govt is very liberal in attracting investment as they gave incentives to Tata Motors for Nano Project;
Land 645 acres or so for lease of Rs 1 crore /year
Electricity @ Rs 3 per kwh
Loan of Rs 200 crores @ interest rate of 1%

Now that Private sector is permitted to set up Medical Colleges can we expect the same benefit from West Bengal Govt .If yes they can attract 5 Medical Colleges in teh state and these can help the state with following;
Education
More Doctors
Better health care
Medical Tourism
More jobs for people

Other states can also take the lead.Decision taken in 2008 will be appreciated by the masses when the fruits will be reaped.

Health Policies of Life insurance co's collectRs 100 crores

We have the first data available on the health insurance policies premium collected by Life insurance co's and this figure is Rs 100 crores.This figure is small but we know that these products were introduced by most of insurance co's during this year only.

We are familiar with inflation figure which is released by govenment agencies from time to time .First figure which has become available for inflation in health care is 17%.This means that if you wish to maintain the coverage of your health care then at the time of policy renewal you should increase it by 20%.That makes sense.

In the event of no claim being made during the year the cumulative bonus of 5% increase being given by your insurance co is not at all sufficient.Choice is yours.

TPA's to expand in Tier 2 cities

According to a report of Financial Chronicle September 08, 2008 TPA's will be growing in Tier 2cities as more and more people are being insured in these cities.Till recently were having on an average service network of about 10-15 branches in the country, most of which being in state capitals. In contrast, the general insurance companies, which control nearly the entire health insurance product portfolio, are present in an average of 400 locations. This huge disparity requires TPAs to aggressively expand their operations to meet the needs of the burgeoning health insurance market, industry experts believe. Besides, implementation of various government-sponsored health insurance schemes such as RSBY (Rashtriya Swashthya Bima Yojana) demands enhancement of service administration capabilities from TPAs. One of the larger TPA players, MediAssist, is planning a major expansion in tier-ii cities, both in terms of number of centres and employees, and is also looking to service various government-sponsored health insurance schemes.Let us hope that expansion does not result in deterioration of the service level.
Labels: Service level, TPA's to expand in Tier 2 cities

One should not try to be smart with Insurance company...

One should not try to smart with Insurance company One should not try to smart with an Insurance company Ekta Elreja has come out with an interesting investigating story in 'Metro Now'' about how a smart person has been trying to cheat Insurance company with false claims.The story in brief is ;For those of us blessed with perfect health, taking out a health insurance policy seems like giving away money. Akash Sharma is one man who decided that it was time to make the insurance companies pay. Using different names, he swindled the ICICI Lombard General Insurance Company to the tune of several lakhs of rupees before being found out and arrested.But the icing on the cake of this fraud was that not only did he take out policies under different names, he also created a fictitious hospital to manufacture the papers required for a mediclaim. Imagine the shock of the vigilance official from ICICI Lombard who went to track down a Sympathy Hospital in Indira Puram in Ghaziabad (UP) only to find a three-storey house in its place.Akash’s scam was almost perfect. He had it all planned down to the last letterhead for 'Sympathy Hospital’ and the ‘pathology reports’ to buttress his claims. What he failed to account for was the vigilance checks carried out by the insurance company.“Initially we never suspected anything because the amount in the claims was always under Rs 50000. Had he made a big claim, he would have been put through greater checks and would have been required to submit more document. Between January and June of this spokesperson for ICICI Lombard General Insurance said.”Moral of the story is " Do not try to be samrt .You will be caught.Labels: Akash Sharma is caught, Metro Now, Sympathy Hospital
Labels: Akash Sharma is caught, Metro Now, Sympathy Hospital

Bench Marking is done for Cataract & Asthma by FICCI

Insurance companies have been worried about the payment they are making to the hospitals for treatment of insured clients.It is a common statement in India that moment hospital comes to know the patient is insured their billing meter starts moving at a higher rate.This point has attracted the attention of FICCI and they have been working on it.

Teena Jain has covered this in an interseting manner in Mint, published from New Delhi.

As health insurers struggle with issues related to inflated billing, the insurance and health committees of industry lobby Federation of Indian Chambers of Commerce and Industry (Ficci) are developing yardsticks to establish minimum standards of treatment and costs for some diseases.
These standards are expected to give some indicative lines to insurers for settling bills with hospitals. The committee has completed its benchmarking for cataract and asthma.
“Once guidelines are developed for all the diseases, it will help insurance companies in pricing their products, settlement of claim disputes and in packaging new kinds of products,” said Jyoti Viz, director of financial sector at FICCI.
When all the standards are available, the Insurance Regulatory and Development Authority will decide whether they should be made mandatory or left to the discretion of the companies, Viz added.
For the last six months, the committee has been developing these standards along with the regulator and the General Insurance Council, or GIC, an umbrella body of general insurers.
A senior official at a public general insurance company said some sort of arrangement with hospitals would be required to control costs through such protocols.
“The benchmarking can be successful only when underwriters commit that they will patronize only hospitals which accept these benchmarks for billing purposes. Apart from this, volumes generated by insurers from health insurance business need to increase manifold,” said Niraj Kumar, general manager of The Oriental Insurance Co. Ltd. “No standard has come to us so far.”
Cases against insurance companies, especially involving the health insurance segment, account for the highest number of cases in consumer courts.
After standards are available, FICCI will run them through medical associations to ensure their accuracy.

My comments on Shobhana Chadha news in Economic Times Sep 7,2008

Shobhana Chadha, has covered an interesting story in September 7, 2008 issue of
The Economic Times on HEALTH INSURANCE
BETTER SAFE THAN SORRY

Never let bad choices spoil your future. You surely cannot correct your past mistakes, but definitely secure future by taking right decisions now. Take, for instance, Ramakrishna Pandya who learned from a stumble. The 50-year-old PSU employee, despite covered under a health plan, had to shell out a hefty sum of Rs 2 lakh while undergoing treatment for a bypass surgery in a private hospital.

Pandya’s fault was that he had picked up a health insurance plan which had sub-limits imposed on room rent, doctors’ fee and diagnostics. He could have easily saved himself from such a huge financial loss if he would have opted for a right health insurance policy, which fulfilled his requirements. To make sure that you don’t suffer due to an inadequate cover, here’s an insight into how to select the right medical insurance.

How to choose

First and foremost, insurance experts advise you should make sure that the health policy you opt for provides the right kind of coverage, which is in line with your family history of ailments and professional hazards. It’s a daunting task, keeping in mind that there are a host of health insurance products available in the market that differs widely in coverage and cost.

Says Sanjay Datta, head, health and accident insurance services, ICICI Lombard: “Contact insurance companies call centre or ask your agent to show you policies from several insurers so that you can compare them. Make sure the policy protects you from large medical costs, and beware of single disease insurance policies.” According to Datta, there are some polices that offer protection for only one disease, such as cancer. Thus, if you already have health insurance, your regular plan probably already provides all the coverage you need. Do check for the coverage you have before buying any more insurance.

Must haves

The basic purpose of health insurance, according to health insurers, is to protect you against health problems that impact you financially. “Therefore, your plan must insure you for three major categories — critical illness, hospitalization and surgeries,” says Sitesh Prasad, vice-president, Tata AIG General Insurance. Another thing, points out insurance experts, you should look before buying a health plan is cashless facility, which gives you the freedom of not making any advance cash deposits in case of hospitalization.

Datta believes the cashless facility serves as a boon for those times when you need finance the most. You have to simply use your health ID card at any of insurance providers’ network hospitals to avail of cashless service. “It is important for you to know that all insurance companies do not provide this facility,” says Datta. According to insurance experts, an Rs 1 lakh plan for a 30-year-old that provides coverage for all the three categories (mentioned above) should result in premium of not more than Rs 3,000-5,000 a year.

Scan the riders

For starters, you must remember that not every disease comes under the purview of a health insurance plan. Generally, a health insurance plan covers major diseases or illnesses such as cancer, bypass surgery, myocardial infarction, kidney failure, paralysis and so on. But with a rider — they do not protect from illness/ injury existing before the inception of the policy for the first four years.

Other cases when you can not count on your health insurance are — allopathic treatment, pregnancy and childbirth-related diseases, cosmetic aesthetic and obesity related treatment; expenses arising from HIV or AIDS related diseases, use or misuse of liquor, intoxicating substances or drugs as well as intentional self-injury; any medical expenses incurred during the first 30 days of inception of the policy, except accidents; congenital diseases; war, riot and strike-induced hospitalization.

Further, you should review the room and boarding cost thoroughly before you opt for a plan. Most of the insurance policies cap room and boarding costs at 1% of sum insured a day and at 2% a day for those in an intensive care unit. Thus, when you sign up on the dotted lines, do check if the insurer has assigned a substantial sum for these expenses.

There’s also a chance that your company is providing a health cover under a group plan. Group health insurance is a benefit that companies, private bodies and trusts provide to their employees or a homogeneous group of people and enables them to receive private medical treatment quickly and at low cost. However, what you must make sure is that you are adequately covered under a group plan. If you are not, then you should buy a health policy immediately. Remember, penny wise, pound wise!

Some of the points where I find contradictions are;

Pandya Case: If he is working for a PSU the he is covered under Medical Rules of the company, which are very liberal. Full costs are borne by companies like Indian Oil or NHPC .Even Helicopter evacuation of the employees is covered by NHPC ,if employee
is to be evacuated from a remote dam site to a metro for treatment. Even the best health Insurance policy does not cover Helicopter evacuation .If Pandya had to pay Rs 2 lakhs then it is not because of sub limits but may be because of under insurance i.e. he was not covered for sufficient amount.

Sanjay Dutta suggests contacting Company call centre or agent: If you contact company’s
Call centre they are ready to give their rates /policy details. They do not have competitors data or they don’t want to reveal it. This means that you do not get choice. Same way agent also is handling only 1 company and does not give comparative quote. It is always better to go to site like http://www.healthinsuranceindia.org or consult an Insurance brokerage firm which is handling products of all insurance companies.
Sanjay mentions Rs 3000 to Rs 5000 for a person 30 years old for sum assured of Rs 1 lakh.This is possible for Rs 1400 or even less in case of Reliance General.

Allopathic Treatment: there is no policy which does not permit Allopathic Treatment.
In fact treatments which are not covered are Homeopathy, Naturopathy, and Magneto therapy.
Treatment by Magneto therapy has been accepted in USA. Homeopathy is widely practiced in Germany .We even have Homeopathy colleges and hospitals in India then why we are not covering it under Health Insurance Policy. Is it that we under pressure of
Allopathic lobby? Let us see who makes the beginning.

We welcome BUPA decision to enter India

We are pleased to know that MAX has joined hands with BUPA and JV will be taking shape in the coming months.

We are hopeful that with BUPA entry we will be moving away from an era of traditional health insurance products to innovative products offering premium features, ofcourse with corresponding price increase.

International automobile companies are selling premium automobiles to the Indian customers/HNI customers with price ranging from Rs. 20 Lakhs to Rs. 550 Lakhs (insurance premium varying from Rs. 60000 to Rs. 15 Lakhs)

Is it not surprising that we have been selling Health Insurance Policy with sum assured of Rs. 5 Lakhs (rarely Rs. 10 Lakhs) and premium in the range of Rs. 10000 to Rs 15000

The person has his car insured for accidental repairs of Rs. 20 Lakhs or Rs. 80 Lakhs or even Rs. 200 Lakhs but he himself can go in for hospitalization of Rs. 5 Lakhs only.

In one of our blog we wrote that helicopter evacuation is not allowed as a payable expense in the policies being issued. Grand sum of Rs. 1000 is available for ambulance charges.Let us change with time.

Let us hope BUPA and some new entrants will change the rules of the game,

Health Insurance is the fastest growing segment of non life/general/health insurance industry of India

In 2005 when we brought out ''Best Guide to Buy Health Insurance'' in the form of book we had predicted that Health Insurance will emerge as an important segment of Indian non life insurance industry.

Even though we never thought that due to detariff the rates for Fire Insurance will go down by 85 to 90%-but we are pleased to note that during 2007 -2008 health insurance premium has grown from Rs 3300 crores to 5000 crores and with growth rate of 50% ,it has emerged as the fastest growing segment of Indian non life insurance industry.

We do hope this segment will now attarct the attention of top management and they will look into various aspects with a view to improve customer satisfaction.

Why are short term insurance rates falling?

With health care costs rising sharply, why are so many short term medical insurance plans lowering rates? The latest rate reduction was announced at MedSave.com by HPA Inc., the administraors for Secure STM, including the "3x12" 36 month short term medical plan and the new "Secure Lite" lower cost short term medical insurance.

In an inflaionary environment, rate decreases are usually triggered by a drop in medical care utilization. Evaluating utilization trends in health plans is a complicated topic even for those who have access to the best data. We don't; we are just speculating. Just for the sake of discussion, let's assume that utilization has declined in short term medical insurance in recent years. Why would that be?

The easiest explanation is the increase in policy deductible. The median policy deductible selected by buyers increased from $500 a few years ago to $1000 today. The largest increase in policy deductibles chosen is in the $2500 deductible option.

A person who is healthy enough to meet underwriting standards is unlikely to incur substantial medical expenses in excess of $1000 within the 3-4 month average lifespan of a short term medical insurance policy. Of course some do, and they are the reason that insurance is important. But a larger number of people simply do not incur a claim on the policy that exceeds a $1000 deductible.

Another explanation is that people are actually waiting for group insurance to kick in after the STM before going to the doctor. That makes sense and is the behavior we would expect. Perhaps we will eventually find that fewer people are using STM as a substitute for regular health insurance. Those people might have gravitated to limited benefit and other types of low cost health insurance.

Money Today June 26 issue has covered health Insurance

22 pages of well researched information in Money Today is welcomed by us as this shows that Health Insurance is getting the importance ,which it deserves.

The good thing is that we have got lot of response thro emails/phone calls and some of the readers of Money Today have raised very interesting and good questions.

We will like to share with Insurance companies that the most important feature the customers are looking for in Health Insurance is good Service.Price is important feature but it is definitely not the first point at time of decision making.

Large & strong companies should give 90 days notice and then withdraw any product

Recently we were informed by Reliance General that no more Health Insurance proposal under Gold should be accepted.Reason we are made to understand is that they are having heavy losses in this product.

In the case of silver those wishing to have sum assured of Rs 1 lakh will not be accepted by underwriting team.

Those lodging claim during the year whether claim is accepted or not will have difficulty at the time of renewal.They are warned that well in time thay should look for another insurance company.

Insurance intermediaries go on informing clients about various insurance products to clients.It becomes embarrassing to tell a client that now Reliance or such & such Insurance company has stopped accepting this proposal or has withdrawn this product or is not going to renew your policy as you had lodged a claim during the year.

Let us try to create a positive image of Insurance Industry,which is owned by really large & strong companies or corporate houses of the country.Can we expect that whenever they decide to stop any product they should give at least 90 days notice by releasing an ad in the press ?

Comments are invited.

Should premium be calculated on completed age or running age?

Should premium be calculated on completed age or running age basis?

Most of the Insurance Companies take completed age in calculating premium.

On Aug 16, 2007 New India Assurance Company Ltd. had switched over from completed age to running age concept.

At present this type of information is not advertised in the form of a statutory ad therefore no one comes to know about this.

Mr. B K Shah, a medical practitioner for Mumbai realized the difference due to change over at the time of renewal of his policy and took up matter with New India.

Rucha has written a nice news story on this in Times Business of May 16 and it is as follows;

Insurance firms calculate running age for premium

Senior citizens, who are already grappling with steep premium rate hikes, have yet another reason to be miffed with the controversial health insurance sector. In what could perhaps be a first instance of its kind, last year, a public sector insurer started calculating and charging premium on the basis of an insurance applicant’s running age, against the normal practice of completed age.

Mumbai’s B K Shah, himself a medical practitioner, discovered this when he applied for his Mediclaim policy renewal. “In a nutshell,” says Shah, “When I went for renewal at the New India Assurance Company in October, the policy showed up my age as 74, although it should have been 73....I was told that they had introduced a ‘running age’ concept.” Shah says he thus had to shell out a higher loading (increase) on the premium than if his actual age were taken into account. He paid Rs. 700 extra. “With this additional amount, my renewal premium rose to a total of Rs. 23,052 last year from Rs. 11,053 in 2006.” Subsequently, Shah made a right to information (RTI) application, which confirmed the company had shifted to this structure since August 16, 2007, “as a corporate decision”. Bimalendu Chakrabarti, CMD at New India Assurance, corroborates this development. The RTI document assured that as and when the policy was due for renewal, policyholders would be intimated along with premium calculation. Shah denies receiving any such intimation. The document also mentioned that “the product” was approved by the sectoral watchdog – Insurance Regulatory Development Authority of India (Irda). Shah now approached the Irda to verify the claim. “I received a ridiculous reply that the method of calculating age is an internal underwriting issue to be decided by the concerned insurer.” In the absence of Irda chairman C S Rao, who retired earlier this week, a detailed discussion on the subject was not possible. However, an Irda official admits that the regulator has not issued specific instructions in this regard. “Most companies follow (the concept of) completed age and one follows running age…Companies’ policies are disclosed in their documents.”
Another official adds, “In a detariffed market, the premium has to be decided by the insurance company.”
The ombudsman’s office too washes its hands of the issue. “This is not an area of dispute. We don’t look at issues such as age. We come into the picture only when a claim is denied.” says an official. Blaming this laxity for the situation, K S (Kaka) Samant, general secretary at the General Insurance Pensioners’ Association, Western Zone, says: “Since the Irda has not taken any objection, it is taken as a sign of approval.” The consumer organizations TOI spoke to said this was a case of commercial considerations overriding logic. As Mumbai activist Jehangir Gai asks, “Would someone who is 17 and running 18 be allowed to vote?”
Shah also made RTI requests to other public sector general insurers – Oriental Insurance Company, United India Insurance Company and National Insurance Company. They charge premium according to the applicant’s actual age.

Our comments:

1. If all the Insurance Companies are following one definition/norm then why did New India decide to go it for new definition?

2. Should Insurance companies advertise in the form of a statutory ad so that customers as well as insurance intermediaries are made aware of this type of change?


Your feedback will be appreciated.

Punjab, Uttrakhand and Bihar also to cover health insurance of poor families

It is nice to know that more and more poor families are being covered under health insurance policies being issued by state governments and Insuarnce co's.

The contracts have recently been awarded by these states;

Punjab - New India Assurance co. Ltd.
Uttrakhand - United India Insurance Co. Ltd
Bihar - Oriental India Insurance Co. Ltd

The states which have already implemented this policy are Rajasthan, Haryana and Delhi. According to our information these states and concerned insurance co’s have started distribution of smart cards.

Bids are expected from the following states in the coming month or so;
Chhattisgarh
Goa
Gujarat
Jharkhand
Karnataka
Kerala
Maharashtra
Orissa
Tamil Nadu
Uttar Pradesh
West Bengal

The states where Indian Government is giving 90% subsidy are;

All North Eastern states
Jammu & Kashmir.


Mr. Anil Swarup, director general of labour welfare in the ministry of labour and the official in charge of implementing the scheme, said: “We are still in talks with Andhra & Madhya Pradesh governments, who have not taken steps for implementation of this scheme. We understand there are issues over committing 25% towards the premium. Andhra Pradesh already has a health insurance scheme. These states will not be covered in the first year.”

CT will offer coverage to high risk small businesses

Connecticut’s latest health insurance bill has now passed the state Senate and is expected to be signed by the Governor. The approval vote came late last night and today’s news is filled with praise for the “outstanding accomplishments” of the legislators. The new bill presents an entirely different approach to health insurance reform.

The law allows local municipal government employees and small businesses to join the state employee’s health insurance pool. Premiums are already about $2,000 per month for family coverage, (vs. a national average of about $1,200 for comparable coverage in large firms). Certainly this is not what we consider “affordable” but this is apparently far less than some CT municipalities are now paying for health insurance! Few small businesses could afford this coverage. Those that could foot the bill will cover only the owners or key employees. There is no economic reason to suggest that small businesses would use the plan to cover rank and file employees. Small businesses tend to pay far less for employee health benefits than larger firms and municipal governments.

The problem is that those who understand insurance principles realize that adverse selection under the new law will now drive the premium rates up in a spiral effect. That is ALWAYS the economic effect of opening up a guaranteed issue health plan to additional applicants on a voluntary basis. The state will now be effectively subsidizing the health care costs of local municipalities and the rlativley few affluent small business owners who have significant medical costs. The first may be commendable – but who would have expected the second result? Eventually the cost of coverage under this Connecticut insurance plan will be HIGHER than any other state's employee cost but LOWER than any other high risk insurance pool. It will be a highly effective method to distribute health care costs of a few among all the state's taxpayers.

Open enrollment health insurance pools are certainly not a new concept. This is the approach used in most states to cover high risk individuals despite the clear indications that those who need the insurance most can not afford it. Most states use open enrollment health insurance pools as a "last resort" coverage under federal HIPAA law for those who cannot find more afordable coverage. Connecticut's plan to combine the open enrollment plan with the taxpayer-funded state employees' health coverage is an interesting new approach.

Is the single payer issue dead?

The tide of public opinion about our nation’s health care woes has taken a sharp turn over the past two months. The movement to blame commercial health insurance – as exemplified in Michael Moore’s “Sicko” movie - has lost wind. While the health care problems remain exactly the same as before, fewer people are willing to blame health insurance companies. We still pay way too much for health care for less than ideal care. The prognosis remains that the problem will get worse before it gets better. But apparently we are beginning to realize that commercial health insurance system is more likely to be part of the solution rather than the root cause of the problem.

Support for an open market commercial competition in the health care business has increased. Most of the current legislative proposals for health care reform on a national and state level now incorporate the use of private health insurance companies.

Those who endorse a government controlled single payer health care system are outraged. Socialist-minded reformers have noticed the change and express frustration in many online publications this week. Some Americans hope for a single payer government-controlled health care system. One blogger titled his column “What’s Going On?” and expressed disgust with the sudden trend toward his state politician’s recent endorsement of commercial health insurance solutions. Another lawmaker in Oklahoma defended himself from attacks by health care reformers by taking a hard stance that proposed measures to expand coverage would simply be too expensive to justify the support of his constituents. On a national level, McCain’s health care proposals, previously regarded are tired and boring, are applauded by mainstream media this week.

So why are we seeing this sudden change in direction? Much of the change in attitude is attributable to the explosion of myths surrounding commercial health insurance. Three of the most popular myths about commercial health insurance companies are:
1 - The profits of health insurance companies boost our overall health care costs.
2 - Private insurance is more expensive than public insurance.
3- Commercial insurance practices are not in the public interest.

See http://www.slate.com/id/2190273/ We will likely see much more on this topic.

Contradiction between definition of a family

The Sixth Central Pay Commission (CPC) in its report has said, “Presently, the definition of family for the purposes of LTC includes parents and/or stepmother residing with and wholly dependent on the Government employee. Stepfathers residing with and wholly dependent on the Government employee are denied the benefit available to similarly placed stepmothers. The definition also places an unreasonable restriction in such of those cases where parents, despite not having any source of income and being totally dependent on the Government employees, continue to live in the native place. The parent in such cases are denied the option to travel to the place of posting of the Government official under LTC. The Commission, therefore, recommends that parents and/ or step parents (stepmother and stepfather) who are wholly dependent on the Government employee shall be included in the definition of family for the purpose of LTC irrespective of whether they are residing with the Government employee or not”.
The Sixth CPC has further said, “The definition of dependency is being linked to the minimum family pension for all purposes. Accordingly, all parents and/or step parents whose total income from all sources is less than the minimum family pension prescribed in Central Government and dearness relief thereon would be included in the definition of family for this purpose. The extant conditions in respect of other relations included in the family including married / divorced / abandoned / separated / widowed daughters shall continue without any change”.

Indian insurance industry is not ready to consider many of these relatives as the member of a family when it comes to issue the health insurance .We have instance where a mother wanted to take a policy for unmarried daughter of 27 yrs but the policy was refused as she is over 21 yrs.

It is in the interest of Insurance co’s to broadbase the definition of a family so that no of insured is increased , no of policies to be issued is reduced. This is the only way to be cost effective in handling the business.

Are Indian Pvt health Insurers blocking payouts ?

The Economic Times of May 6,2008 has carried part of the report released by USAID .The contents are ;

INDIAN health insurance is growing by 25% every year, it’s penetration is less than 0.02% of the GDP, yet there is no expertise on the sector, says USAID report.
The report, released on Monday, to study the impact of private life insurance on health coverage in India has said that the focus in India is on controlling claims pay-out by following strategies designed to minimise insured person’s ability to collect claims. “There is excessive emphasis on disqualification because of pre-existing conditions and post-claim underwriting”, it said. No wonder then, that it is one of the largest litigation areas for insurers. The report has suggested a slew of measures to improve the regulatory framework for health insurance.
For the regulator, Insurance Regulatory and Development Authority (IRDA), the report has a separate prescription for health insurance. Separate reserving rules should be considered for the different categories of health insurance, taking into account the short-term versus long-term nature of contracts, whether policies provide indemnity or assured benefits and the loss experience of varying health insurance products.
It has also asked IRDA to promulgate specific regulations for the sector. These include a minimum regulatory definition of pre-existing illness or condition to provide clarity in interpretation spelling out maximum “look-back” and “look-forward” periods. Further regulation is need to prohibit post-claims underwriting, making it mandatory for insurers to offer both group and individual policies among others.
Taking into account medical inflation, the report called for higher public health care spending. Effective primary care and prevention, safe maternity care and chronic disease management should be a part of public and private insurance, it said. “The burden of disease as measured by Disability Adjusted Life-Years could be reduced significantly if both health insurance coverage and publicly provided care included these services,” it said.
The country has a dismal record of even hospitalisation coverage – the basis for health insurance, it said. Quoting a recent census, it said only 1.7% of admissions were reimbursed and the average reimbursement was only Rs 258 (or 3.6% of the average hospitalisation cost of Rs 6,225).
Private insurers’ administrative cost are 40% of total premiums, double the target benchmark of 20%. Policy holders pay higher charges for healthcare services than those without insurance, because the mediclaim product has been modified in ways that make it less a program to control the cost of care and more a reimbursement target for providers.
The report forsees a more dynamic TPA market going forward, where TPAs could partner with insurer organizations. To encourage competition, it is recommended that mutual insurance companies and non-profit companies should be allowed to enter the market. Although IRDA can retain licensing TPAs, parts of regulation of TPAs should gradually come under the contractual relationships that insurers have with TPAs.

Our comments are;
We as an industry lack innovativeness.When an insurance co wants to develop a product they simply see the products of other co’s and try to copy the same.We suggest they should look at products from around the world and then come out with product.

Reliance stops health gold policy

Reliance has stopped issue of Health Gold Policy.They will continue to issue standard & silver policy.

The salient features of Gold were;

1Higher sum assured

2 Critical illlness also covered

We feel that this was a good policy but one can assume that this was not a profitable product and that is why it became necessary for them to withdraw this product.

A quetion before we the consumers is '' Should it be made mandatory for Insurance co's to release an ad informing the fact that they are withdrawing a specific product?''

Your comments are invited.

Insurance for college graduates

New data gathered by insurers shows that parents continue to be the driving force in a college graduate’s decision to buy short term medical insurance following graduation. Parents pay the premium in more than half of the short term medical insurance policies issues to those in the 21-24 age group. Without this parental financial support, a college graduate is four times more likely to go without medical insurance for a period of two months or more following gradation.

College graduates and their families are often surprised to learn how affordable health plans can be. MedSave.com, a leading provider of low cost medical insurance for college graduates, reports that the average cost of the six most popular health plans to young adults has dropped this year to for the first time in recent history. The price drop is due to the expansion of limited benefit plans rather than a reduction in overall health care costs.

But more health plan choices also means that there is more potential for selecting the wrong coverage. Not surprisingly, the least expensive health plans tend to be the most popular among young adults. This can lead to less than adequate protection. These health plans tend to provide up-front benefits for smaller medical expenses like doctors office visits but offer the least protection for catastrophic risks. It is important that college graduates choose the right plan for their own health situation. It appears that parents may be less likely to be involved in the selection of the insurance than in helping with the cost. Many college graduates are purchasing insurance for the first time and purchase trends indicate that some are making uninformed choices based solely on the cost of coverage or misperceptions of the risk/benefit aspects of insurance choices.

In most cases a high deductible short term medical insurance policy provides a young adult with the best protection at the lowest cost. Most college graduates and other young adults do not benefit financially by purchasing health insurance that covers routine health care like doctors office visits, lab tests and prescription drug costs.

Detriot business owners mirror national trends

A newly released survey of Detroit area businesses showed that while they are highly concerned with the effect of uninsured on their health costs, few support proposed legislation to require health insurance.

The results of this survey mirror those of other groups around the county. We want everyone to have health insurance, but we draw the line at requiring it by law.

The survey was conducted by John Bailey & Associates Inc. in preparation for the Detroit Regional Chamber of Commerce’s Mackinac Policy Conference. Surveyors found that 46% of members would vote “no” on the proposed constitutional amendment to require health insurance; 27% would vote “yes,” and 27% had no opinion or were undecided.

In Michigan, as in most other states, there are more low cost health insurance options available this year than at any time in the past. Yet without a requirement to carry insurance, about 16% of the population is uninsured and those with insurance wind up paying for the cost of health care for the uninsured.

Short term medical insurance in New York

New York residents face a triple threat when it comes to short term health insurance. First, the insurance products used in most states that are specifically designed for this purpose are not available in New York. Second, the coverage that is available is slow; often taking at least a month just to get through the manual application process. Third, the coverage is expensive. No pricing discount is recognized for the likelihood that this insurance will not be in force long enough to accrue catastrophic claims.

The easiest solution is to buy temporary insurance while staying in another state. Insurance issued in another state is valid in New York and allows treatment with any doctor or hospital in the U.S. There is no requirement that the address on temporary health insurance be your permanent residential address. Some New Yorkers residents purchase health insurance while staying at their out-of-state colleges, while at their second home in another state or while on vacation or visiting relatives. The insurance covers treatment while they are away from home as well as with the doctors and hospitals at home in New York. Almost all short term medical insurance is purchased online and most offer immediate download of the policy and insurance ID cards. Most insurance companies allow you to have the policy mailed back to a New York address if you will be returning from your trip soon.

The only other possible alternatives we can offer are:
1. Core Health Insurance – a limited benefit policy that does a fairly good job at mimicking the benefits of major medical insurance
2. International Medical Insurance - for individuals who are not permanent residents of U.S.
3. Inbound Immigrant Insurance – for individuals who have recently moved to the U.S.

If none of these options will work then it is especially important to explore all options to keep, extend or convert prior health insurance regardless of the higher cost.

Masschussets learns that "insurance is not health care"

A flood of articles in recent weeks discuss the difficulties triggered by Massachusetts' experiment in mandadted health insurance.

The Kaiser Founation published an excellent summry report at http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=51517 .

Several other states including California have declined similar proposals. Pols show that the majority of Americans do not wnt mandated health insuance, yet this provision remains a key provision in Hillary Clinton's campaign platform.

Health insurance in a recession

A new article titled "Health Insurance in a Recession" points out some general strategies that may prevent costly mistakes when making desicions about health insurance in financially difficult times.

great quote on nationalized health care

Nationalized health care will have: the compassion of the IRS, the efficiency of the postal service, the failure rate of government schools, the enforcement tactics of the Bureau of Alcohol, Tobacco, and Firearms, and all at Pentagon prices!
-- Albert V. Burns

Bloggers condemn Families USA Report

Families USA, a liberal lobbying group launched a nationwide media campaign this month to push its agenda of universal health insurance. The campaign is based on propaganda that the lack of health insurance is contributing to an increase in pre-mature deaths. The press releases titled “Dying for Coverage…” are prepared separately for each state in order to peak local interest manipulating statistics on the number of uninsured people on state by-state basis as the basis for calculating a number of deaths for maximum media impact. The problem is that the re is no factual basis for the mortality calculations or for jumping to the conclusion that health insurance is the controlling factor in cases of inadequate health care. The majority of information published on this topic would directly contradict the Families USA opinions.

Surprisingly, a large number of mainstream media reporters picked up on the press releases and published stories that present the opinions without checking the background. These are a few headlines that appeared around the country:

“Lack of health insurance can be lethal for Alaskans”, 4/12/08, Anchorage Daily News

““Report: 460 Hoosiers die each year due to lack of health coverage”, 4/5/08, Lafayette Journal & Courier

““Deaths tied to lack of insurer: 1,000 in N.C. died for want of health plan, study says”, 4/5/08, Winston-Salem Journal

““Report: Thousands die from lack of insurance; Several Missourians of working age with no coverage die each week, study shows”, Springfield News-Leader

Normally the mainstream media would recognize this type of press release as a political spin and ignore it. We do not know whether reporters simply took the easy route of writing their story by reproducing the press release without gathering additional information or whether perhaps the writers personally support the efforts of Families USA. Some of the reporters indicate that they are covering only the published report, and are not implying that their article is a balanced news report on the topic. In either case, it is clear that the newspapers readers were not been as easily fooled.

Public comments on Web sites are sharply critical of the campaign. These are a few comments (without citations) posted by boggers on the newspaper articles:

“Lack of insurance doesn't kill people. Lack of treatment, lack of living a healthy lifestyle, lack of exercise, lack of a healthy diet.....those things are much more likely to kill someone. It might take some effort to find insurance or health care, but it's available”.

“Uninsured who live a healthy lifestyle will lead longer, healthier lives without the side effects from the pharmaceuticals that modern medicine uses as a band-aid. Modern medicine does not attempt to find the cause of a medical condition, but only treats the symptoms”.

“merely having health insurance is no guarantee that you will be able to seek out treatment”.

“the affordability of health care is not directly related or controlled by employment status, income or insurance”.

"5 out of 6 people who die prematurely do have health insurance! What does that say about the importance of health insurance in causing deaths?"

We did not reproduce any of the more crudely worded criticisms but a strong majority of bloggers found the report objectionable. Other comments pointed out that we have long known that 80% of our nation's health care costs are directly tied to five behavioral factors – smoking, over-eating, lack of exercise, lack of stress management, and poor nutrition. There is no indication that there is any connection between health insurance and these five key behavioral issues. Other writers pointed out that no one in America who actively seeks treatment is denied basic health care – regardless of their ability to pay. Every state has adequate welfare type health care for those who are willing to spend their own money before requesting public assistance for medical expenses. Free basic medical treatment clinics and hospitals that provide free care based on demonstrated financial need operate in most geographical areas.

The consistency of the theme of the strong majority of these public responses indicates that Americans are increasingly aware that additional regulation of health insurance without addressing the underlying health care affordability issues is pointless and will only cause further harm. The most comprehensive public opinion studies including a massive survey by the AFL-CIO covered in U.S. News and World Report in March 2008 indicates that the majority do not support mandated health insurance or additional government intervention in health insurance.

At MedSave.com, we consider ourselves to be activists in the health care reform movement and we support the lobbying efforts of many reputable organizations like America’s Health Insurance Plans, Kaiser Foundation and Covertheuninsured.org and we would financially benefit from national health insurance reforms, but we feel that it is ethically necessary to distance ourselves from the intentionally deceitful strategies of Families USA. This type of propaganda will not help promote a solution to the national health care affordability crisis.

Health insurance scams in Maine

Maine Department of Insurance warns that consumer insurance scams increase during economic downturns. The logo above is designed to help inusrance buyers focus on verifying the legitimacy of dels that seem too good to be true. Consumers are also welcome to use the free independent OnlineAdviser service simply by emailing onlineadviser@medsave.com to verify the legitimacy of any suspected insurance plan. All of the low cost health insurance plans listed at MedSave.com at http://medsave.com/low-cost-health-insurance-listing/me.htm have been verified as legitimate legal plans in Maine.

1 in 9 people know "HSA"

The same study cited in the previous post indicates that only one out of nine people recognize that "HSA" stands for "Health Savings Account".

Insurance survey reveals consumers' lack of understanding

A survey by Fleishman-Hillard Research indicates that almost twice as many people know the co-payment on their health insurance policy as the maximum out-of-pocket costs. The co-payment has little economic importance compared with the total out-of-pocket expense. The variance between different policies in their maximum out-of-pocket expenses is much more significant than the difference in co-payments. For example, policy co-payments range from $5 to $50, a difference of only $45. Maximum out-of-pocket range from $1,250 to more than $15,000. Obviously the out-of-pocket expense has more impact on the policyholder’s overall financial well-being. Yet only one in three people know the maximum out-of-pocket of their policy. Buyers who are aware only of the co-payment are more likely to make wrong policy selection decisions.

Racial differences in U.S. health care

Pointing out racial differences is always a touchy are, and health insurance should be no different. Two publications this past week pointed out sharp differences in medical insurance issues between African-Americans and white Americans.

An article in Penn State Live said that African-Americans under age 65 are three times more likely to be covered by Medicare than whites.

Health Affairs Policies Institute reported that “Minorities have, in general, equal or better mental health than white Americans, yet they suffer from disparities in mental health care.”

The differences are likely to be at least partly attributable to income differences between blacks and whites. But what really caught our attention and caused us to reference these publications is that they underscore and confirm the implication of numerous other reports from various source that seem to be saying that the typical uninsured person in America is a young adult middle-class working white person.

South Africa Supreme Court Approves Short Term Medical Insurance

The Supreme Court in South Africa ruled that short term insurers are allowed to sell medical insurance. The ruling has little bearing on citizens of the United States and other countires, however it appears possible that a similar legal contest could occur in the U.S. where state legislators show willingness to disallow this popular type of healh insurance within its borders. Some people question the authority of individual states to disallow an insurance that is considered a blessing by many people in most other states because of it affordability, liberal coverage and ease of use.

But because short term medical insurance buyers tend to be younger and healthier than those who pay much more for other types of medical insurance, some lawmakers want to level the playing field an have the younger healthier people pay the same insurance rate as the older less healthy people.

War on Affordable Health Insurance

A sampling of this week’s political headlines would lead a reader to believe that our nation’s War on Terror had been replaced by a War on Affordable Health Insurance. The most severely affected were Montana residents where Celtic Insurance Company announced a temporary suspension of new applications. The suspension applies not only to the low priced short term medical insurance but also to the popular renewable “CelticCare” and “CelticSaver” Health Savings Account plans for individuals and families. Because of the relatively small number of low cost health insurance carriers in Montana, the suspension will immediately affect the state’s insurance residents.

Celtic Insurance issued a statement saying “We are currently in discussion with the Montana Department of Insurance to gain new product approval for our filing. We are working closely with the Department to ensure a quick reentry into the Montana market.” The company gave no reason was given for the suspension but we presume that Montana’s notoriously difficult insurance regulatory system is to blame.

Another insurance product that covered emergency room treatment administered by Value Benefits was withdrawn from the market, according to the administrator, and was then quickly announced as reinstated in 22 states by the end of the week. As of today, “Value ER” policy is available only to residents of AK, AL, AZ, FL, GA, HI, IA, ID, IL, LA, MA, MI, MO, MS, NC, ND, NE, NM, OK, OH, PA, RI, SC, TN, VA, WI, WV, and WY . Emergency Room insurance has grown in popularity as the deductibles of most group health policies increased to eliminate any benefit in the event that immediate care is needed. This supplement insurance ensures that covered members won’t avoid treatment because of the cost when they need emergency care. A report released last month by the ALF-CIO showed that almost a third of Americans surveyed said that they had avoided necessary medical care due to the cost.

Announcements of proposed legislation in several other states including Pennsylvania and Florida drew fire for the effects it could have on eliminating more affordable coverage like short term medical insurance. An increasing number of states are considering laws that would have everyone purchase substantially the same type of insurance coverage. This type of legislation was enacted in New Jersey more than a decade ago and resulted in ridiculously high individual health insurance rates. More than half of the uninsured people in the U.S. qualify for health insurance and could afford coverage but are either unaware of the more attractive insurance choices or do not perceive the value of coverage. They tend to be uninsured for less than a year and find coverage in their next job or through some other means other than government paid coverage.

MedSave.com joined with other consumer advocate groups earlier this year in proclaiming that the proliferation of many new limited benefit health insurance plans meant that there were now more affordable health insurance choices to most people than ever before. Limited benefit health plans are used by large employers like Wal-mart to provide affordable health coverage for their lower income employees. These policies can be purchased by individuals to supplement other health insurance (for example, to lessen the risks of a $5,000 deductible health savings account policy) or may be used alone when no other insurance is available or affordable. Some limited benefit plans like Core Health Insurance do a reasonable job in bridging the affordability and coverage gap between today’s most common health plans and traditional major medical insurance.

The practice of regulating health insurance through legislation instead of dealing with the underlying cost of medical care continues to hurt consumers. It appears that our celebration of the increase in affordable health insurance choices available in the market might have been premature.

health insurance requirement for Texas college students

The Texas state legislature is considering a measure that would require all students at state-supported colleges and universities to have health insurance. About one in four of the state’s college students are uninsured. Some students who are already struggling with the cost of tuition and board are worried that the new requirement would put the cost of college out of reach.

If enacted, Texas would be the only state to single out college students for this requirement. The Commonwealth of Massachusetts has a new law that requires all residents to have health insurance. Similar proposals were defeated in California and other states. The most recent polls show that a slim majority of Americans are opposed to mandated health insurance coverage.

The state gives colleges the option of providing campus-based health coverage but does not require this service. Such plans are great for providing routine health care at a reasonable cost, but are inadequate for providing catastrophic care or medical care with other medical providers outside of the school location.

MedSave.com surveyed the major medical insurance carriers available in Texas and priced the coverage for an 18-22 year old living in several metropolitan areas of the state. While many full coverage health insurance plans would cost more than $3000 per year, at least one reputable insurance carrier offers catastrophic major medical insurance for less than $50 per month. The most affordable plans were offered by Celtic Insurance at www.celticenrollment.com. Celtic offers short term medical insurance than can be purchased in one semester (6 months) or one year policies and paid on a month-to-month basis. Longer term renewable policies are also available, but college students typically change insurance coverage too frequently for the renewable policy features to have much value. The cost of a policy with a high $5,000 deductible would be about $500 per year. Cost varies slightly with age, sex and location. Houston, Dallas and Austin areas have the state’s highest medical costs. Details, pricing, coverage options and enrollment are available directly online.

High deductible health insurance policies are becoming increasingly common in pace with the growth in popularity of Health Savings Accounts. A typical student health insurance policy has a deductible of $1000 or more, compared with a $500 deductible only five years ago.

Ideally, a college student would combine a university based health plan at a cost of about $350 per semester for routine care with a high deductible insurance plan at about $300 per semester for peace of mind that the best care would be available with any medical provider in the event of a serious accident or illness. The combined cost of providing full health coverage for a student would be slightly more than $100 per month. While this is substantial for a college student on a tight budget, it is significantly lower than the cost of health care for older adults. The national average cost of full coverage health insurance for adults is now more than $400 per month.

We conclude that as long as insurance coverage is available under $50 per month then the cost of minimal health insurance coverage would not likely be a financial impediment for the majority of Texas college students. We are concerned that the majority of health insurers are priced considerably higher and that market average prices may prevail in the longer term.

Massachusetts health insurance law unconstitutional

Two legal expert opinions in the Los Angeles Times conclude that the law requiring residents of Massachusetts to have health insurance is probably unconstitutional. No constitutional challenge has yet been brought to the courts but, if challenged, this approach would likley be struck down. Karl Manheim, law professor at Loyola Law School and Jamie Court of the Consumer Watchdog explain the legal difference between required auto insurance, which is constitutionally legal, and required health insurance which is not.

Uninsured in New Mexico

In New Mexico, the rate of uninsured is about 21% of the state population; significantly higher than the national average. State officials believe that a majority of the uninsured qualify for a cost-subsidized insurance plan that may cost about $35 per person per month. State administrators presume that many people do not know that they are eligible for coverage. Most of those who do not qualify for the cost-subsidized program are eligible for a number of commercial health insurance plans that cost less than $200 per person per month. Some of the short term medical insurance plans are more appropriate for season workers and the supplemental insurance plans are more likely to encourage basic and preventative health care visits because they require no deductible or co-pay. MedSave.com hosts a listing of low cost health insurance plans available in New Mexico.

We have long believed that consumer education campaigns are the most cost-effective method of reducing the number of uninsured in the United States. In New Mexico, however, the issue may be complicated by language and cultural barriers, as well as the requirement to prove citizenship for the cost-subsidized plans. (Commercial health insurance does not require citizenship but is usually more expensive than the state plan).

Americans Oppose Health Insurance Restrictions

Americans are calling for reforms in the health care system but increasingly want health insurance to be left as a free market system. In contrast, the largest portion of legislative initiatives throughout the country focuses on revising and restricting health insurance and leaves the rest of the health care system unchanged. Public opinion, at least judged by the trend of opinions posted on many news Web sites, shows increasing awareness of the distinction and intolerance of this political approach. The pattern of failures of legislative actions aimed at addressing health care costs - ranging from Health Savings Accounts to universal health insurance in Massachusetts – underscore the fact that addressing health insurance laws will not solve the health care crisis. Americans want to address the real underlying causes of high health care costs and want health insurance to remain an open market system with a range of individual choices.

A new survey called “2008 Health Care for America Survey” sponsored by the AFL-CIO of 260,000 mostly middle income respondents showed that one third of Americans skipped needed health care because of the high cost. The decision does not appear to be connected to whether or not they had health insurance. This is in contradiction to the primary arguments for universal health insurance.

This week’s U.S. News and World Reports (3/25/08) says “"There is a lot of data that suggests that those who do have private health-care coverage are very satisfied," said (the executive vice President of Americans Health Insurance Plans). One survey found that "87 percent of respondents with private insurance said their health-care coverage gives access to good medical care at an affordable cost".

This blog covers reports on many of the state reform proposals as reported by various media and we find that an increasing number of commentators are in tune with the theme “keep the government out of health care” and “let a market economy prevail in health insurance”. Writers in online forums are increasingly concerned that pending or proposed legislation may restrict access to low cost health insurance plans like short term medical insurance and supplemental limited benefit health insurance that are now available through cost-conscious consumer Web sites like MedSave.com.

One of the well-phrased comments in this theme was published today in The Cente Times newspaper quoting Keith Richardson, 46, of Clarion, Pennsylvania; pastor of the First Baptist Church of Clarion running for the 5th Congressional District. “We have to look to the root causes for increases in medical costs, such as lawsuit abuse and excessive governmental intervention. I’d seek reforms that curb lawsuit abuse, such as capping punitive damages in most cases, or making plaintiffs in frivolous suits responsible for costs. I’d oppose any attempts to nationalize health care insurance. Free-market, private- sector forces are key to efficient and competitive health care and insurance systems. More government involvement means higher costs, greater waste, lower efficiency and reduced quality of health care. Just ask anyone from Canada who gladly pays extra to get health care in the U.S.” Based on recent trends of published opinions on the topic of health care reform, we beleive Mr. Richardson's position now represents the general opinion of the majority of Americans.

Although we see a lack of confidence in the U.S. health care system overall, there is growing indication that Americans oppose the increased regulation of health insurance as a solution to the problem.

New India starts sale in health insurance by offering 5% to 10%discount

New India starts sale in health insurance by offering 5% to 10% discount

Various Insurance companies increased the premium by following each other.There has been heartburn and criticism in blogs,press & electronic media.Even IRDA had to issue the instructions in this regard.

It is nice to know that New India has announced the following discount structure for those going in for renewal of the policy without making any claim in the current year.

Mumbai 10%
Delhi/Bangalore 7.5%
Rest of India 5%

We feel there is scope in management of the hospital expenses,negotiating for rates for surgeries,going in for special rates for the rooms/icu's. Let GIC(General Insurance Council) play a leading role in bringing down the hospital expenses and pass on the benefit to clients/customers.

Let IIM or ISB be given the assignment to undertake the study /research paper on the profitability of the hospitals/ loss of Insurance co's so that corrective steps can be initiated.

health insurance help for college students

An article in the 3/23/08 Pittsburgh Post Gazette says that some students at one Pennsylvania community college are staying in school just for the health insurance and not really pursuing an education. Since Pennsylvania has most affordable health insurance options than almost any other state, wouldn’t it make sense for the school to promote the use of free services like OnlineAdviser at MedSave.com that specializes in matching people up with the best health low cost insurance plan?

Student health insurance costs from $600 a year for a healthy student on a popular short term plan like American Health Shield to about $3,000 per year for a person on a group plan. There are cost-subsidized plans for low income applicant that cost even less. Most healthy Pennsylvania college students simply enroll in least expensive major medical plan they can find like those listed at www.short-term-medical-insurance.com on a semester-to-semester basis but there are a wider range of choices for students with special insurance needs. But even in the worst case, that’s more than the cost of tuition for a student who isn’t really interested in the course of study.

Additional resources for students:
Student Health Insurance Tips
Health Insurance Options for Graduating Students
MedSave.com Expands Support for Graduating Students
See more at http://www.medsave.com/articles.htm

Massachusetts wrestles with underfunded health plan

Massachusetts is now kicking some members out of the state health insurance pool citing the costs were “significantly more” than expected. People enrolled in the health plan pay only part of the cost and the rest is paid by the state. Participants contribution varies according to income. Both the state’s cost and the enrollees premiums are expected to rise more than 10% this year. Those removed from the price-subsidized state plan will be required to purchase commercial medical insurance. Few of the least expensive commercial health insurance plans are available in Massachusetts according to MedSave.com, a national leader in affordable health insurance.

The situation will only get worse since the plan does not have adequate protections against over-utilization. In time, health care inflation in Massachusetts will likely exceed national averages. New Jersey, California and other states looking to enact universal health care – note that Massachusetts-style is not the way to do it.


http://www.boston.com/news/local/articles/2008/03/21/state_health_plan_underfunded/

Wall Street feels the effect of insurance laws

Another wave of Wall Street workers will be looking for new jobs in the wake of the Bear Sterns takeover this week. The Wall Street Journal reported that Bear Stern employees expect further downsizing in coming months. J.P. Morgan Chase expects to layoff additional employees this week after releasing about 6% of its work in November 2007. Lehman Brothers, Morgan Stanley and Citicorp have also recently released employees. Despite the high income stereotype of Wall Street, not all of these people can afford a layoff. Many of these workers live paycheck to paycheck, just as in other industries. Our article “Surviving a Layoff” with practical tips on basic financial planning during a job change is accessed as often by Wall Street area workers as in any other part of the country.

In addition to the challenge of making ends meet without a paycheck, these employees now face the added cost of paying for their own health benefits until they land another position with employer-paid health care. These employees have the choice of keeping their existing health plan through COBRA or enrolling in alternate coverage.

Most of the lower paid Wall Street workers living in New York State or New Jersey will find few affordable health insurance alternatives due to restrictive insurance laws in those states. The simple and inexpensive type of short term medical insurance used to fill gaps between jobs is not available in either New York or New Jersey. COBRA coverage and similar alternatives are expensive – more than $1,200 per month for any type of family coverage. Those who opt to go without any coverage may compound the problem by triggering a little-known provision in federal law that requires them to satisfy a new six month waiting period even after their new employer-provider health insurance is in effect.

A smaller number of Wall Street executives commute to the city from distant suburbs. Residents of Connecticut, Rhode Island and Pennsylvania will have it easier during their layoff. Not only will these workers get a temporary reprieve from the daily commute to Manhattan, they will also find that there home state of residence makes a wide range of temporary health insurance options available at a fraction of the price paid by their NJ and NY neighbors. Web sites like MedSave.com list high quality short term major medical plans on a state by state basis. The cost is under $400 per month for family coverage in most parts of the country – a manageable issue for most households.

The difference in the cost of health insurance - $400 vs. $1,200 – means a whole lot more when you are out of work and trying to make ends meet until the next secure job comes along. We believe that is past time to tell the legislatures in New York and New Jersey that their residents need the same options as their neighbors in surrounding states.

Utah health insurance reform

MedSave.com supports these health care reform bills that were signed by the Utah’s governor this week:
* HB47 authorizes the Utah Department of Health to adopt standards for the electronic exchange of medical records.
* HB326 allocates almost $5 million over two years to ensure Utah's Children Health Insurance Program (CHIP) will cover all eligible children who apply. In the past, kids have been turned away because of lack of money.
* HB364 requires state departments of Education, Health and Workforce Services to promote enrollment in CHIP, Medicaid and another state program that subsidizes private insurance.
* HB301 requires the insurance industry to cover more people who were previously considered uninsurable.

The currently available and affordable short term medical insurance plans will continue to be available, as well as expended eligibility for the more expensive universal health insurance plans.

IRDA ASKS PSUS NOT TO FORCE ELDERS TO SWITCH TO NEW HEALTH PLANS Mumbai, March 17, 2008The Economic Times (Delhi edition) The Times of India (Delhi edition)
Insurance regulator Insurance Regulatory and Development Authority (IRDA) has asked state-owned insurance companies not to force senior citizens to switch to a new health insurance plan with lower benefits at the time of renewal of policies. The regulator has reiterated that insurers cannot raise rates on mediclaim policies by more than 50-75% of the previous year’s premium, following an adverse claims experience. With complaints pouring in from senior citizens, the regulator has set up a special cell to look into their complaints. The regulator has appointed R Srinivasan as officer on special duty, in charge of the cell based at IRDA’s Hyderabad office. Senior citizens who have problems with their mediclaim renewal can contact this special cell. The IRDA panel on health insurance issues faced by senior citizens mooted the idea. Senior citizens’ association has been clamouring for a special cell, given that health insurance accounts for over 15% of non-life premium. The IRDA panel had also recommended a health insurance pool under the aegis of IRDA to take over high risks cases, including the ones whose renewal premium is hiked by over 40%. A similar pool exists for motor third-party liability insurance. IRDA is yet to take a view on the pool for rejected health insurance covers. Incidentally, the regulator had put a similar cap on rates for third-party liability insurance a couple of years ago, even after it was decided to increase rates by over 100%. In a circular to public sector insurance companies, the regulator said that PSUs have already revised the premium rates in respect of mediclaim policies in April 2007. “The authority received several complaints from senior citizens that renewal premiums charged to them were exorbitant. The authority, therefore, advised all the public sector general insurance companies that: The loading of premiums if justified for renewals of mediclaim policies issued to senior citizens shall not exceed 50-75% of the premiums charged prior to the revision.” IRDA has also said, “Senior citizens shall not be compelled by the insurance companies to migrate to other health insurance products, if it is to the disadvantage of senior citizens. The above instructions are applicable to renewal cases only. The authority has now created a separate cell to attend to the grievances of senior citizens in respect of non-renewals or exorbitant increases in premium of mediclaim policies of public sector general insurance companies,” the circular said.

PA health insurance reform

A message to Pennsylvania Governor Ed Rendell: Making more cheap health insurance at taxpayer expense is not the answer.

Over half of the uninsured in Pennsylvania are between the ages of 24 and 35, are generally healthy and come from middle income households. They will be uninsured for less than a year, on average, and will find coverage without government help, thank you very much. If they really wanted health insurance coverage, they could find it at a price of their morning lattes at Starbucks. MedSave.com, a leader in low cost health insurance nationwide, lists more than a dozen high quality health insurance plans priced well under $200 per month in Pennsylvania for this age group. The Kaiser Foundation, the U.S. Census reports, GAO publications and private insurance industry studies consistently show that availability and affordability are not primary obstacles to coverage in Pennsylvania.

Take a clue from the state’s CHIP program to see that increasing public funding does not result in a proportional increase in the number of people covered. The state’s needy already have adequate coverage through your welfare programs and those with chronic medical conditions need your help with managing the high out-of-pocket cost of their care, not with finding health insurance.

If you really want to increase the number of insured Pennsylvanians to satisfy your powerful health care industry backers (although we are not convinced this is even a worthwhile goal), then simply require residents to show proof of coverage of health insurance coverage in order to gain employment or qualify for any type of government program or to receive a tax refund. You would accomplish a whole lot more for a lot less public expense.

NJ introduces harmful health insurance proposal

New Jersey’s legislature is considering pulling the trigger again. Individual residents will be the repeat victims. More than a decade ago the lawmakers took an ill-advised law that dictated the coverage to be included in all New Jersey health insurance policies. In effect, this consumers options to about six choices, generically labeled, “Plan A”, “Plan B”, “Plan C”, “Plan, D”, “Plan E” and “HMO”. More recently Health Savings Account options were made available. The intent was to simplify the selection process for New Jersey residents who were not smart enough to make intelligent decisions when buying their own health insurance. The legislative initiative was a disaster.

In the years since this restrictive legislation was passed, New Jersey soared to the highest health insurance prices in the nation. Most insurance companies withdrew from the market and those few that remained do not even advertise their products or employ agents to sell them. The number of uninsured in New Jersey is among the highest in the nation, despite the state’s relatively affluent population. The uninsured are typically middle income who could easily afford health insurance in most other states.

Many New Jersey residents hoped that lawmakers had learned a lesson and would refrain from further radical attempts to regulate the market. But apparently the legislature is poised to pass additional restrictive legislation that would require every New Jersey resident to buy health insurance. Despite strong adverse public opinion and the lack of success in other states hat have tried similar measures, the law is promoted by powerful health care industry and big business lobbyists. The health care industry would benefit from expanded insurance as an additional source of funding. Employers would benefit because the pressure to provide group coverage would be reduced.

The bill will be revealed today – Saint Patrick’s Day, according to an article in The Philadelphia Inquirer. It appears that the luck of the Irish may fade for New Jersey residents.

States with free market health insurance approach have more affordable health insurance choices in 2008 than ever before according to MedSave.com, a company that specializes in low cost health insurance. None of these affordable health insurance plans are available to New Jersey residents. Many New Jersey residents feel that they should have the right to buy the affordable health insurance plans that are available to their neighbors in Pennsylvania and Delaware. New Jersey residents are encouraged to tell their legislators that the real answer is to avoid this drastic new legislation, remove the excess market restrictions and return to a free market system used in most other states.

It simply makes no sense to require New Jersey residents to buy health insurance while at the same time denying them the option of purchasing the most popular insurance plans at rates that are comparable to those available in the rest of the nation.

Spring Break Travel Requires Medical Insurance

College students are not the only ones who get to enjoy spring break. March and April have become popular travel times for families across the country and adults who need a break from the long northern winters. The weather is mild and prices are low in some of the most popular destinations. International travel has become increasingly popular this time of year as prices for worldwide hotspots can be more competitive than some U.S. destinations.

Regardless of whether your destination is in one of the states or overseas, it makes sense to spend a few minutes to become familiar with the travel insurance options that are available for only a few dollars a day. If your trip is sponsored by an organization, then proof of medical insurance is often required before departure. Many people do not realize that their regular health insurance provides inadequate coverage while hey are travelling.

For short trips outside the U.S. Liaison International is the best choice. You can add complete trip insurance including lost luggage protection with Round Trip insurance. Coverage can be issued immediately for as short as five days. The cost for a short trip is typically under $20 per person.

For trips within the U.S. any of the reputable short term medical insurance plans listed at short-term-medical-insurance.com or MedSave.com will provide immediate emergency coverage while you are travelling. Unlike other insurance plans, these policies provide the same coverage throughout the United States, with any doctor or hospital and do not require the use of a network provider.

Another approach is to add supplemental coverage like 24 Hour Accident insurance from Value Benefits. This overlaps the primary health insurance and provides additional cash to cover expenses incurred in the event of an unforeseen medical problem. This coverage applies at home as well as while travelling.

The Group Insurance Myth Exposed

The myth of the price efficiency of group health insurance persists despite overwhelming evidence to the contrary. Another major news agency published an article that said purchasing health insurance “in bulk”, through employers or small business associations, would certainly save us money. Past presidential candidates have even cited the potential savings of group health insurance pools in their campaign platforms to control health care costs. The Bush administration previously supported this approach during the past presidential election but backed off after they learned that the market facts do not support this conclusion. Some organizations continue to push for group insurance pools for political reasons without supportive economic data. The Des Moines Register reported this week at http://www.desmoinesregister.com/apps/pbcs.dll/article?AID=/20080315/NEWS/803150335/-1/NEWS04 that some politicians contnue to support an program that allows small businesses to purchase group health insurance through larger associations despite more than a year of evidence tht few employers see value in such an approach. Making more of this inefficient type of health isnurance available is simply not the answer.

The Kaiser Foundation, a leading source or research data on health insurance plans, reports that employers spend an average of $380 per month for single employee coverage and more than $1000 per month for family coverage.

How many individuals who purchase their own health insurance pay more than $1000 per month for family coverage? If you buy your own health insurance, how much doe your coverage cost in comparison to the published cost of group health coverage? Very few people - probably less than 5%, according to several health insurance industry sources – pay more than the amounts published by Kaiser for their individual health insurance. In fact, the average price of health insurance purchased by self-employed people and other individual customers is less than half of the cost of the insurance cited by employers.

How to individual buyers achieve such great savings that large employers cannot accomplish? A close look at fundamental economics provides the answer.

First, individual insurance is not subject to “mandated benefits” included in group health insurance. This means that individual buyers can customize the insurance for their specific needs. A 50 year old couple, for example might be able to trim $200 per month from their health insurance premium because they no longer need to purchase coverage to cover maternity expenses. On the flip side, a younger person may find insurance that is age-rated to reflect the lower medical risks of their age group. By customizing the coverage to their specific needs, individual buyers achieve lower pricing than is available to group insurance buyers. Mandated benefits that may be important to include in coverage for “the masses” may not apply to individual buyers.

Second, individuals have proven to be more resourceful shoppers. Web sites like MedSave.com specialize in low cost health insurance. One of the primary methods is to simply purchase insurance that expires after a period of time – usually 6 to 36 months. This short term medical insurance is priced at 25% to 40% less than equivalent coverage that has longer renewability provisions. Individual buyers know that they will re-shop health insurance every year and that there is a high probability that long term guarantees are not needed because they change insurance plans more frequently.

Third, there is a wider range of coverage amounts and premium pricing available to individuals. In the past, all health insurance policies provided about the same amounts of maximum potential benefits. Now with the expansion of limited benefit health insurance policies, maximum coverage is available, for example in amounts from $50,000 to $5,000,000. Other policies offer the option of limiting the amount of specific coverage. For example, some low cost policies provide a benefit of $75 for a doctor’s office visit or $1000 per day for hospital coverage. This may not cover the entire amount of the medical cost, but it certainly makes the insurance much more affordable. The trade off means that more low priced insurance options are available to the individual buyers can select a plan that fits their budget.

Fourth, the individual health insurance markets have largely embraced the Internet to make pricing immediately available to everyone. Group health insurance, in contrast, is still priced by manual efforts of human underwriters. It is very difficult or sometimes impossible to compare pricing data across a large number of insurance carriers. The pricing of group health insurance – and therefore the market itself - is simply less efficient than the individual insurance market.

Finally, group insurance is required to cover everyone, regardless of health problem. Individual health insurance is designed for specific risk classes. Most people qualify for preferred risk classes. Those with serious ongoing medical problems are typically routed to state high risk pools where the costs are subsidized with public finds. These high risk plans emphasize managed care approach for known medical conditions rather than insurance for unknown medical costs. Again, the net result is that the overall price is lower for the majority of buyers and the only risk of the few who face higher risks are spread among a larger market.

The net result is that individuals have proved to be more efficient shoppers of their own health insurance than their employers and their state legislators. The basic economic principle that market efficiency increases as market restrictions decrease proves to be valid once again. Most individuals can purchase high quality health insurance for about $200 per month and family coverage is still available for under $500 per month.