Archive for the ‘Texas health insurance’ Category

Federal Government Denies Texas Health Insurance Waiver

Wednesday, February 1st, 2012

Here’s some news on the Texas health insurance front. Texas had applied for a waiver that would exclude it from the federal government’s law that imposes limits on overhead spending by health insurers. The law in question applies to the Medical Loss Ratio and was instated as part of ObamaCare.

Basically, the federal law mandates that health insurance companies “must spend a minimum of 80 percent of their revenue on payments for policyholders’ health care or improvement to their health coverage plans.” This might sound okay on the surface – more money going toward individual’s health care, and less money going toward executive salaries and overhead. But in reality, “overhead” also includes necessary and important items like employee training, education and liaising with doctor’s to better understand issues related to health. So by mandating an 80/20 medical loss ratio, the government is effectually limiting a health insurance carrier’s ability to perform actions that positively affect not only the company, but the consumer.

The consequence for spending more than 20 percent on such costs is a requirement to provide customers with rebates beginning in 2012. Texas was denied its waiver request because, according to officials from the U.S. Department of Health and Human Services, the state was unable to “prove that there would be destabilization of their insurance marketplace if it complied with this new regulation.”

As a result, it’s possible that Texas health insurance companies will be forced to pay out rebates worth $476 million to policyholders over the next three years.

Again, this sounds positive for consumers. But we’re not convinced that federal mandates are in the long term best interest of the people. By limiting health insurance carriers’ overhead costs, we can expect to see good programs like education and privacy protection reduced, since the law kills a carrier’s incentive to invest in such programs. The short sighted law requires health insurance companies to make business decisions based on federal regulations, rather than what’s best for consumers.

Tags: health insurance reform, Medical Loss Ratio, ObamaCare
Posted in Health Insurance News, Texas health insurance | No Comments »

Supreme Court to Debate Health Care Law

Tuesday, November 15th, 2011

Yesterday the nation’s highest court announced that it would hear challenges to the health care legislation that’s disrupted health insurance in Texas and across the country. After nearly two years of protests and complaints, this marks the most important episode in the legal battle against ObamaCare.

The primary issue to be disputed is whether the government has the power to require Americans to purchase health insurance by 2014 and to penalize those who don’t comply. Many pundits have noted that such an act is unconstitutional and steps outside the limits of regulating interstate commerce. But proponents of the legislation say that mandatory health insurance is the only way to implement coverage for the 30 million uncovered Americans.

According to USA Today, a group of 26 states, along with the National Federation of Independent Business and individual challengers, say that “if the law stands, it will mean new burdens for states and businesses.” They urged the justices to resolve the dispute quickly because of uncertainty about future business costs.

On the other side of the argument, the current administration stressed the law’s benefits, “including that more young Americans now have health insurance and that women can get mammograms and preventive services without out-of-pocket expenses.”

Earlier this year, a federal judge in Florida ruled the law unconstitutional, and four subsequent appeals have varied on their decisions. Two declared it constitutional and one found it unconstitutional, while another said that no challenge could be brought until a person was forced to pay the tax penalty.

Next year’s Supreme Court decision, which would supplant prior court findings, is likely to be handed down in late June, right before the 2012 Republican and Democratic conventions. Expect lots of posturing on both sides leading up to the hearings. In the meantime, don’t wait around to see what happens. Consumers will need affordable health insurance regardless of the decision. But if you do take the wait-and-see approach, we at least recommend a short-term health insurance plan or a high deductible plan with a low monthly premium so you’re covered should anything happen.

Tags: Health Care Reform, ObamaCare
Posted in Health Insurance News, Texas health insurance | No Comments »

Policyholders Weighing Texas Health Insurance Options in an Uncertain Market

Wednesday, November 2nd, 2011

As we get deeper into the ramifications of health care reform, we’ve noticed more and more insurance companies pulling out of the market. We noted last week that American Enterprise Group, parent company to World Insurance and American Republic, closed its individual major medical insurance business. This is just the latest instance in which insurance companies can’t maintain their businesses in the wake of ObamaCare. And while the closing of businesses is never a good thing, the real consequence is that thousands of consumers find themselves without health insurance.

One option to quickly regain coverage is to join your spouse’s employer plan, if possible. However, that alternative seems to be becoming less popular. These days, we’re fielding lots of calls from people whose employer plan rates have skyrocketed for both individual and family health insurance. Group insurers are facing higher costs in attempts to meet new health insurance regulations, and these costs are passed along to the customer. Because of this, individual health insurance plans are becoming attractive options for replacing costly employer plans.

After losing their insurance, most people jump on the Internet to research their options. Of course, given all the providers, plans and prices, this typically leads to confusion and frustration. Since there’s no need to tackle it alone, we always recommend that people work with a local health insurance broker who represents multiple insurance carriers. A broker can help you navigate your options and steer you toward an affordable health insurance plan that’s right for you and your family.

As a Texas health insurance broker, one of the first questions we get asked is, “What’s your fee?” The thing is, reputable brokers like Custom Health Plans have no fee. We are compensated by the insurance companies, which means we can offer guidance and advice and set you up with a new plan without charging you a cent. And since we represent multiple carriers, we’re not beholden to anyone. We’re on your side.

Plus, if you have questions about your plan or coverage options, we’re your liaison. Rather than calling an 800 number, listening to a hundred automated prompts and finally dealing with someone who doesn’t know you, your history or your health needs, you can call us. We’ll deal with the insurance companies; and again, there’s no fee for our services. And if you’re worried about rates, rest assured because health insurance rates are state regulated. This means that the quote you get from a broker is the same as the quote you’d get straight from the insurance carrier for an equal plan. But for that rate, you’re also getting the broker’s guidance, expertise and customer service – three things you can rarely expect to receive from a big insurance company.

As evidenced by business closings and daunting details in nearly every news report, ObamaCare has caused much uncertainty in the market. Even though most changes won’t go into effect until 2014 – and there’s a possibility of repeal – consumers should do their best to stay prepared. A lapse in coverage can be dangerous for you and your family, so we always urge consumers to maintain coverage in some capacity.

And remember, if you want help finding a plan or even just want some answers to your questions, we’re here to help. For fast, free quotes or assistance, visit www.customhealthplans.com or call 877-749-2241.

Tags: Affordable Health Insurance, Health Care Reform, Individual Health Insurance
Posted in Health Insurance News, Texas health insurance, Texas health insurance broker | No Comments »

Comparing Traditional Health Insurance to a Health Savings Account

Wednesday, August 17th, 2011

There are a handful of options for securing affordable health insurance, but depending on your personal health needs and budget, certain plans are better than others. When looking for a health insurance plan, it’s smart to know your options and the differences between plan types, so you can choose which plan is best for you or your family.

Traditional health insurance plans are often broken into the following categories –

Preferred Provider Organization (PPO) – A PPO is a plan that has agreements with a network of doctors, hospitals, and other providers who charge discounted fees for their services. As part of this network, your cost sharing typically results in lower prices than if you were to seek care outside of the network. Plans vary, but it’s common for PPOs to operate with monthly premiums, co-pays and deductibles.

Health Maintenance Organization (HMO) – An HMO generally requires individuals to choose a primary care physician from a list of providers partnered with the HMO. If you need to be referred for other services, the primary care physician will do so, but you typically can’t go outside the network. One drawback of this plan is that some HMOs only offer small networks of doctors, so you may have little say in choosing your health care provider, or you may have long wait times to see a doctor.

Point-of-Service Plan – This plan is like a combination of the two above. In a point-of-service plan, consumers generally must select a primary care physician from a qualified list, but they can seek care outside the network, or be referred to a doctor outside the network, and still maintain some coverage.

Significantly different from the plans detailed above is the Health Savings Account (HSA), perhaps the most innovative health insurance option available. HSAs offer members more control over their health benefits, while typically reducing premiums. By combining a high-deductible health plan with a tax-exempt saving account, individuals can cover their health care needs, including preventative care, wellness and even some alternative therapies. Health savings accounts are very flexible, allowing members to visit any doctor they choose. But to decrease out of pocket expenses, most provide a PPO network of doctors to choose from. This gives the consumer maximum flexibility to receive the care they need, when they need it, all while controlling short term costs and saving money for the future.

Choosing an affordable health insurance plan largely depends on the specific needs of the consumer. But whether you need an individual health insurance plan, a family health insurance plan or even something for your small business, arming yourself with knowledge about options – and then analyzing which plan’s benefits best suit your needs – will help to make the choice much easier.

Of course, if you need help sifting through the options and analyzing the results, just let us know. We’re here to help!

Tags: Health Insurance Plans, health savings accounts
Posted in Health Savings Account (HSA), Individual Health Insurance, Texas health insurance | No Comments »

State Workers Denied Texas Health Savings Accounts

Friday, August 12th, 2011

Health savings accounts (HSAs) have surged in popularity in recent years and are the fastest growing health insurance option in the private market. It’s easy to see why, as health savings accounts put cost controls into the hands of consumers and offer many tax advantages. So why are they not an option for state workers?

According to Texas Watchdog, it’s because House Bill 1766, which would for the first time have offered health savings accounts as an option for state employees, was killed before making it out of committee in this past legislative session. At the helm of opposition was Andy Homer, director of government relations for the Texas Public Employees Association. He testified that health savings accounts have no benefit for his group and that not a single one of his members had asked for one.

Homer says that “HSAs only appeal to young, healthy employees and people who make a good deal more than the average state employee,” and that because of the high deductible, people with HSAs tend to ignore preventative care. His statements are in direct opposition to many prevailing thoughts on the role of HSAs in health care.

“Everywhere we’ve seen health saving accounts take off we’ve seen the cost curve bend down considerably,” said Texas state representative and doctor, John Zerwas. “My big concern in all of this, the primary thing that needs to happen in health care is for consumers to have some skin in the game, to go out and be rational buyers of health care.”

Zerwas’ sentiments make sense. Because of natural market forces and competition, a cost-conscious consumer creates cost-conscious doctors, hospitals and pharmaceutical companies. This in turn can lower overall health care expenses across the board.

“I think it is the single most cost-effective health care plan on the market,” said Joanna Antongiovanni, president of the Texas Association of Health Underwriters. “High-deductible insurance plans combined with an HSA should be at the center of our nation’s efforts to expand health insurance coverage. Participants have an incentive to avoid paying for unnecessary services because they keep the money they don’t spend.”

Perhaps the lack of interest by Texas state employees and their representatives is due to poor communications of the benefits of an HSA. Some people are turned off by the corresponding high deductible, but between tax savings, consumer control and the ability to rollover unused funds to the following year, a health savings account is actually a terrific way to save money.

It’s worked in Indiana. When first introduced in 2006, only four percent of the state workforce enrolled in a health savings account. That number has since swelled to 85 percent, and cost savings estimates show that the HSA program may have saved taxpayers as much as $23 million last year alone. Now imagine those cost savings applied to Texas, which boasts a state workforce eight times the size of Indiana’s.

The fact is, there are many options for securing affordable health insurance, but a health savings account is the only one that puts cost controls into the hands of consumers. And when that happens, everyone wins — consumers, taxpayers and the state. HSAs have proved popular on the individual health insurance market. Hopefully Texas will soon implement an options for state workers as well.

Tags: Affordable Health Insurance, health savings account, Texas health insurance
Posted in Health Insurance News, Health Savings Account (HSA), Texas health insurance | No Comments »

Legislators Measure Texas Health Care

Thursday, February 17th, 2011

The 2011 edition of Texas on the Brink was released today. The study, which began in 2003 and is performed by the Texas Legislative Group, measures the state of health insurance in Texas, health care, education, quality of life and more. Unfortunately for Texas, we didn’t fare so well, particularly in regard to how many residents have Texas health insurance.

Below are some findings from the study, with 1^st representing the highest percentage and 50^th representing the lowest percentage.

Percent of population that’s uninsured – 1^st
Percent of uninsured children – 1^st
Percent of low income population covered by Medicaid – 49th
Percent of population with employer-based health insurance – 48th
State government health expenditures as percent of the gross state product – 43rd
Per capita state spending on mental health – 50th
Per capita state spending on Medicaid – 49th
Percent of population that is physically active – 36th
Health care expenditures per capita – 44th

Once again Texas ranks last in the number of its citizens who have health insurance. Last year’s United Health Foundation study also found Texas to rank last in health insurance rates. Some of this can be attributed to the economy. After all, health insurance can be costly. But what many people don’t realize is that not having health insurance can be significantly more expensive, as emergency medical care and unanticipated operations can leave consumers hundreds of thousands of dollars in debt.

Texas also ranks poorly in the number of residents with employer-provided health coverage. Even if your employer doesn’t offer coverage, there are still plenty of options in the private market. A Texas health insurance broker can walk you through your options, which include a range of individual Texas health insurance plans and family health insurance plans. Regardless of what you choose, being insured is always a good thing. It’s a sound investment, and one that ensures you and your family are protected, both medically and financially, should health issues arise.

Tags: Texas health insurance, Texas health insurance plans
Posted in Health Insurance News, Texas health insurance | No Comments »

The Economics of Health Care Reform

Monday, January 31st, 2011

texas health insurance Proponents of health care reform have promised that it will provide affordable health insurance in Texas and across the country. There’s no doubt that the new legislation will help certain individuals, but what often goes unsaid is that health care reform will also hurt a large percentage of the people that it’s intended to protect. According to John Goodman of the National Center for Policy Analysis, much of this is owed to the “top down” practice of implementing health care reform.

“Top down” means that reform starts with a goal or an idea, and the individuals in charge attempt to impose this idea onto all the people below. Top down thinking doesn’t consider what the masses want. It ignores the fact that people will act in their own self interest, rather than in the interests of the government’s collectivist vision.

John Goodman writes: “Almost everybody in health policy thinks you can have a plan designed by people at the top that will work, even though every doctor, every nurse, every hospital administrator and 310 million patients all have an economic self-interest in defeating the plan.

Below, Goodman notes some examples that he believes will play out, as people act in the interest of their own health and finances.

Thirty-two million otherwise uninsured people will try to double their consumption of medical care.
Almost everyone with private insurance and all Medicare enrollees will try to increase their consumption of preventive services, promised without deductible or copayment.
With no increase in supply, doctors and patients will face a huge rationing problem.
There will be up to 900,000 additional emergency room visits and the time price of care (rationing by waiting) will jump substantially
Patients whose plans pay below-market rates, including the elderly, the disabled and poor families on Medicaid, will be pushed to the rear of the waiting lines.

Goodman goes on to note that Congress passed a law that encourages middle and upper income families to have more insurance than they want or need. Assuming this segment of society utilizes the insurance they were forced to buy, they’ll in effect make access to health care more difficult for the poorest and most vulnerable segments of society. So whether consumers are looking to purchase health insurance in Texas or anywhere else, the top down methods used to expand our access to health care will actually hinder adoption by the people who need it most.

Tags: Affordable Texas health insurance, Health Care Reform, health insurance reform
Posted in Health Insurance News, Texas health insurance | No Comments »

Politician Proposes Texas Health Insurance Exchange

Tuesday, January 18th, 2011

texas health insurance exchange Following the March 2010 passage of health care reform, health insurance in Texas and across the country was dramatically changed. One big change that affects how consumers buy health insurance in general involves publically run exchanges on both the federal and state level. Rather than just buying insurance from private companies, whether through an employer or on your own, these exchanges would allow people to purchase government-backed health insurance policies.

Texas has been slow to react, as the state generally dismisses health care reform as an abuse of government power and one that negatively affects the nation’s economic well being. But one politician is attempting to create a Texas-run exchange rather than subject Texans to the federal plan options. State Representative John Zerwas, a republican from Katy, TX, wants to create a Texas health insurance “connector,” or simplified insurance market, that would supersede our state’s adherence to the federal plan.

“My opposition to the federal health care reforms is no secret, and I continue to support Attorney General Greg Abbott’s efforts to have the law declared unconstitutional,” said Zerwas. “But the ‘connector concept’ has been around for decades and did not originate with Obamacare…Quite frankly, it is something that we should consider on its own merits regardless of the fate of the federal reforms.”

The state-run market would, in theory, make it easier for consumers to compare standard coverage plans, and also help to dole out federal subsidies to low income individuals and families in need of affordable Texas health insurance.

Zerwas’ plan would supplement, not replace, the private Texas health insurance market. He says that major lobby groups comprised of doctors, hospitals and big businesses endorse the program, which would be overseen by board members ranging from health professionals to consumers and businesses.

It’s yet to be seen how all this will play out, but establishing state control over the exchange may be a better option than leaving it in the hands of the federal government, which to this point has not engendered much confidence in its handling of health care policies.

Tags: Affordable Texas health insurance, Health Care Reform, Health Insurance Exchanges
Posted in Health Insurance News, Texas health insurance | 1 Comment »

2010 Health Insurance: Year in Review

Saturday, January 1st, 2011

texas health insurance year in review Over the course of 2010, many measures were passed that significantly affected health insurance in Texas and across the country. Below we take a look back at some of these monumental changes.

March 2010

Health Care Reform Passes
Despite no Republican support and tenuous public support, Democrats used their majority and a political tactic called reconciliation to jam the bill through Congress. In the final roll call, no House Republican voted for the bill, and 34 House Democrats voted no.

April 2010

America Says “Repeal That Bill”
Shortly after the health care reform bill was passed, a Rasmussen Reports poll showed that 58% of Americans favored repealing the bill. Stated reasons included frustration with how Democrats handled the measure, and worry that it would be a severe financial burden for America.

May 2010

Corporations Consider Dropping Health Insurance Coverage
Under Obama’s new law, many businesses can save money by dropping employee health insurance and paying fines instead. Reports showed that companies, including Dallas-based AT&T, were calculating the benefits of potentially discontinuing their health insurance programs, which would leave thousands of workers uninsured.

August 2010

America’s Introduction to “Medical Loss Ratio”
As people began to digest the new law, reports showed that much of the bill hinged on how health insurance companies met something called a “medical loss ratio.” This meant that 80 to 85 percent of a health plan’s premiums must be spent on what the government considers to be “medical services” or “activities that improve health care quality.” In effect, this law gave the government the power to force private companies to make business decisions based on regulations rather than on what’s best for the company or its customers’ health.

September 2010

Good News for Those with Pre-existing Conditions
Starting in September, all health plans were prohibited from dropping an individual’s coverage because he got sick. Children fared even better, as those under 19 years of age with pre-existing conditions could not be denied coverage by insurers.

ObamaCare Forces Texas Health Insurance Companies to Close
The cost burden of ObamaCare forced many health insurance companies to close up shop, including Grand Prairie-based National Health Insurance Company. It said that it could no longer offer insurance policies because of the company’s inability to meet requirements of the health care bill.

November 2010

Republicans Gain Ground in Midterm Elections
The Republicans won a sweeping victory in the House, one that political analysts called a referendum against the Obama administration. Republican leaders stated their desire to repeal ObamaCare, and to start fresh with a new plan that lowers costs and raises quality.

It’s yet to be seen what 2011 has in store, but if it’s anything like 2010, it will certainly be interesting. Here’s hoping for a productive, prosperous and healthy new year. Cheers!

Tags: Health Care Reform
Posted in Health Insurance News, Texas health insurance | No Comments »

A Dummy’s Guide to Buying Individual Texas Health Insurance

Tuesday, December 14th, 2010

Whether we get it from our employer or the individual market, we all need to obtain and maintain a Texas health insurance plan. If you can’t rely on your workplace to offer a quality health insurance plan, then it pays to shop around the individual Texas health insurance market to see what plans are available, and at what prices. Below are some tips on finding and buying a health plan on your own.

Choose your preferred type of plan – There are PPOs, HMOs, health savings accounts and more. All those acronyms can sound confusing, but they’re just descriptors identifying a particular type of plan. One good factor in determining which plan type is best for you is whether you have an existing doctor you wish to keep. If yes, then a PPO plan will allow you to stick with that doctor. An HMO will dictate which doctors you can see.

How much do you want to pay each month? – Health plans can be very flexible in pricing. If you pay more each month, then your out-of-pocket costs for doctor visits and prescriptions will be lower. But if you’re generally healthy, then you might opt for higher out-of-pocket costs to save you money on your monthly premiums.

Who needs coverage? – Are you looking to obtain coverage for just yourself or your family too? An individual health insurance plan is a bit of a misnomer, as it can cover more than just one person. Of course, it costs more to cover a family than one person, but it’s worth it to ensure your spouse and kids are covered should health issues or an emergency occur.

For personalized support in choosing an individual health insurance plan, consider enlisting the services of a Texas health insurance broker. A broker can walk you through various plans and options, and it’s all free to you, as a broker’s fee is paid by health insurance carriers, not individual consumers.

Tags: Individual Texas Health Insurance
Posted in Individual Health Insurance, Texas health insurance | No Comments »

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Archive for the ‘Texas health insurance’ Category

Federal Government Denies Texas Health Insurance Waiver

Supreme Court to Debate Health Care Law

Policyholders Weighing Texas Health Insurance Options in an Uncertain Market

Comparing Traditional Health Insurance to a Health Savings Account

State Workers Denied Texas Health Savings Accounts

Legislators Measure Texas Health Care

The Economics of Health Care Reform

Politician Proposes Texas Health Insurance Exchange

2010 Health Insurance: Year in Review

A Dummy’s Guide to Buying Individual Texas Health Insurance

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