insurance issues,Principles & Solutions and tips *trik tax

Friday, 29 March 2019

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Association Health Plans, an alternative for sole proprietors and small businesses to avoid the many pitfalls of the Affordable Care Act, have been dealt a mighty blow. In a ruling late yesterday Judge John Bates sided with eleven states and D.C. agreeing that the DOL's definition of what constitutes an employer under AHP's does not meet the employer relationship under ERISA.

Under ERISA there are ways to have a bona fide AHP however the rule set forth by the DOL under President Trump vastly expands this definition.

In a 43 page opinion Judge Bates sided with the plantiffs on several different points including: economic harm and increased regulatory burden.

Yes, the plantiffs are saying they will lose tax revenue from ACA, have increases in uncompensated care, and will also suffer from increased regulatory burden.

While this is a definite hit to AHP's, it should be noted that the DOL is very likely to ask for a stay and to appeal this decision.

As for the 11 states and D.C., well, they feel like winners. By winning they are screwing small businesses and sole proprietors all across the country out of affordable alternatives that limit them to ACA plans that government says are best.

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Thursday, 28 March 2019

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Okay, maybe one: Methinks the folks at TriHealth need to lighten up a bit.

What am I talking about?

Well, FoIB Holly R recently sent us this tip:

"TriHealth is suing a company known for sexually explicit gag-gifts after receiving one of their products anonymously."

The 'gift' was sent to a family practice office in Cincinnati.

The best part, though, is imagining the poor law clerk who had to type this into the lawsuit:

"Nothing about the package warned it was a spring-loaded d--- bomb"

No kidding?

Carlos Danger was unavailable for comment.

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Insurance Tips and trik auto insurance, auto insurance quotes, auto insurance companies, auto insurance florida, auto insurance quotes online, auto insurance america

Responding to Tuesday's ObamaCare "success" post, co-blogger Mike made some extremely salient points, and I wanted to make sure that they were more easily accessible. Regarding the report's noting that "Among all consumers in the 39 states that use the HealthCare.gov platform, the average premium before application of the tax credit was $612,” Mike explains:

"The 2019 average of $612 is 1.5% less than the 2018 average number of $621.

It appears the average reduced because fewer people ended up selecting the Silver plan for 2019, and more people selected the Bronze plan.

Click the link to the CMS report, scroll down to the end of Table 2 to find the enrollment by metal plan. You’ll notice that while Bronze selections rose in 2019, Silver selections decreased. These changes are presented as (%) which don’t give the full picture when the base - the overall number of selections - changes. So I converted the (%) to numbers of plan selections in each year.

The result clarifies that in 2019 there were about 76,000 more selections in the Bronze plans and 553,000 fewer selections in the Silver plans. This is evidence of people dropping their Silver plan, or migrating from the more-expensive Silver plan to the less expensive Bronze plan. Both types of selections help explain how the “average” premium before APTC could have reduced from 2018 to 2019.

Keep in mind no one pays a premium that is “averaged” between a Bronze and Silver plan.

But CMS does not provide the year-over-year change in premium for just the Bronze plan and just the Silver plan. Those answers would help to explain why so many people decided to migrate away from the Silver plan - or drop it entirely."

In other words:

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Wednesday, 27 March 2019

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Courtesy of FoIB MisHum, another of our frequent reminders about the wonders of government-run health "care" (eg MedicareForAll):

"The sister of a woman who spent some of her final hours waiting in a New Brunswick emergency room says she believes the wait contributed to her death."

Ya think?

The poor woman sat in the waiting room for almost half a day, even though she had obvious signs of respiratory distress and other symptoms of what turned out to be acute kidney failure.

The 58 year old ~~woman~~ victim, Marianne Porter, leaves behind 3 children, but apparently no outstanding medical bills because: hey, free!

And worth every loonie.

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Insurance Tips and trik auto insurance, auto insurance quotes, auto insurance companies, auto insurance florida, auto insurance quotes online, auto insurance america

Regular readers may recall a series of posts we did a decade or so ago about the tragic death of young Nataline Sarkisyan. Folks interested in the backstory can find it here). Eventually, her distraught family hired a prominent legal beagle who sued the insurer (tangentially) involved.

Eventually, the story faded from public view, but co-blogger Mike just reminded me that we have a connection to the recent Avenatti/Nike case: (alleged) unindicted co-conspirator Mark Geragos.

It was Mr G whom Nataline's parents hired to sue Cigna for "emotional distress:"

"It's a win-win for the lawyers and activists: regardless of whether she prevails, this has rekindled the controversy and gotten Mr Geragos and the "Americans for Change" folks free publicity."

Interesting coincidence.

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Tuesday, 26 March 2019

Insurance Tips and trik auto insurance, auto insurance quotes, auto insurance companies, auto insurance florida, auto insurance quotes online, auto insurance america

Some highlights:

* Approximately 11.4 million consumers selected or were automatically re-enrolled in an Exchange plan during the 2019 OEP

(This is a net decrease from last year)

* Nationally, 24 percent of consumers with a plan selection during the 2019 OEP were new to the Exchange

(This is a net decrease of almost 30%)

* Among all consumers in the 39 states that use the HealthCare.gov platform, the average premium before application of the tax credit was $612

(This is, believe it or not, also a decrease: of $9.00)

The full report available here.

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Insurance Tips and trik auto insurance, auto insurance quotes, auto insurance companies, auto insurance florida, auto insurance quotes online, auto insurance america

Entirely possible, of course. Our friend Holly R sent us the link to this story:

'Small Businesses Could See Employees' Health Claims under SB9

Business owners with less than 100 workers would be allowed to see data on employees' health claims under SB9 (M. Huffman), with identifying information made anonymous, which could improve their bargaining position with insurance companies, Cleveland.com reports. The bill passed the Senate last week.'

While this is interesting, I;m trying to figure out the point:

After all, for ACA-compliant small group plans, we have the wonder Community rating system whereby the overall health of the group (or its individual employees) is irrelevant.

And self-funded and AHP/MEWA-type plans are fully underwritten, so carriers get fresh, up-to-date medical info on everyone.

And since these plans tend to be "off the shelf" anyway, what possible "leverage" would a given employer actually have with or without this information?

'Tis a puzzler.

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