How much are health insurers spending on you?

Part of Health Care reform is an attempt to regulate how much health insurers spend on their policy holders. This is called a loss ratio and the reform legislation calls for an insurer to spend $0.80 per $1.00 in premium to pay claims and provide services. The other 20% would be for salaries, agent commissions, overhead, buildings and other administrative and non-claim expenses. For large companies, those with more than 100 employees, the ratio increases to $0.85/$1.00 in premium. Read here for more details http://money.cnn.com/2010/05/25/news/companies/medical_loss_ratio/index.htm?source=cnn_bin&hpt=Sbin Does this make sense to you? One study shows that only 7% of cost increases are contributed by administration costs (including insurance premiums). The leading contributors - Hospitals and Physicians http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358.

Here's a great example of discounts for medical services when one has health insurance. http://www.aetna.com/provider/data/ProviderNetwork.pdf . Sure it's an Aetna example, but it translates to other carriers as well. Basically when a provider agrees to join an insurance network, they also agree to the fee schedule. So a $150 list price office visit, gets discounted to $90. And a five-day hospital stay gets reduced from $25,000 to $8750. However, if your deductible is say $3000, you are only out of pocket $3000 on a 100% coinsurance plan.

A Healthy Statistic

So it's said that people, especially men, that are married are healthier, how about an update on that oft quoted "50% of marriages end in divorce statistic"? Check this out ...
http://www.time.com/time/magazine/article/0,9171,1989124,00.html?hpt=T2

Georgia joins lawsuit against Health Care Reform

Georgia joined 19 other states that are protesting the changes that Health Care reform requires of states. http://www.ajc.com/health/georgia-joins-states-suit-527563.html . Time will tell what this means. For the short term it looks like the Federal Government will be the source for the high risk pools mandated to be available in July 2010 by the Health Care reform legislation.

Large Companies consider dropping health benefits

Wow! Large companies dropping health benefits for employees? Looks like several considered it and in this article http://rawstory.com/rs/2010/0506/att-verizon-considered-dropping-health-insurance-employees/ it makes financial sense, but there are lots of other considerations, like employee moral, unions etc. We may see more of this.

Health Insurance Premiums UP

This confirms what I've been seeing with premiums starting in July 2010. Premiums are increasing. http://money.cnn.com/2010/04/23/news/economy/health_reform_insurers_react/index.htm
If you had a new plan, premiums should have been guaranteed for the first 12 months. Thereafter, carriers generally reassess rates on the anniversary date of the policy and generally hold premiums constant for the next 12 months. Some carriers increase rates on the policy anniversary, on birth dates and when changes are made to the plan. Carriers do have the option of raising premiums on a class of people, they can't single out a specific person or family for a rate increase. Often what a carrier will do is introduce a "new" plan and increase premiums across the board on the old plans.