Tag Archives: Insure

Individual Health Insurance Rates Easy To Insure ME

If you are wondering who regulates the health insurance rates in America, the answer may surprise you. First, it all depends on whether you are buying for yourself, or your employer is providing this option for you and also what state you live in. We will break this down into state rate regulations and federal rate regulations. States do have a hand in making sure the claims filed by the people enrolled can be paid for, but the state puts more emphasis on plans charged to small employers (less than 50 workers) and to people who buy their health coverage individually. There is a reason for this: In most cases, a large employer (more than 50 employees) will be able to negotiate better rates for their employees, since there is a more varied range of health and unhealthy individuals. So, the government pretty much feels like the large companies can fight for themselves. Easy To Insure ME has the answers

Now for the smaller companies employing forty-nine people and less, and individuals who buy it on their own, they need more protecting. They have less leverage to bargain with. If an individual or smaller company has more expensive healthcare costs, the insurer’s desire to sell to this group has decreased. As a result, the insurer may quote health insurance rates at unreasonable prices. For this reason, most states have rate restrictions on premiums for this demographic, just so this doesn’t happen.

As far as federal regulation goes, there is no direct law or regulation that controls how much a company pays for its premium. But there are federal laws that protect individuals from being discriminated against, concerning their health conditions. The Health Insurance Portability and Accountability Act (HIPAA) ensures that employees and their dependents in similar situations with people (for instance, same job title, full time/part time, tenure at the company) in that same group cannot have different health insurance rates. Meaning you cannot be charged exorbitant rates as opposed to the person sitting in the office next to you – no matter what your health status is.

Another regulation is the Employee Retirement Income Security Act. This law is simple: it states that employers must act in the best interest of the participants and their dependents and must provide benefits responsibly. This also regulates protects health insurance rates because it prevents companies, large and small from acting selfishly by keeping its employees needs in mind.

In closing, rest assured that there are state and federal regulations in place that protect you from being singled out – whether you are buying health insurance yourself or your employer is responsible for it, you are protected.

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How Much Profit Can Health Insurers Make From Premiums Easy To Insure ME

The U.S. Department of Health and Human Services (HHS) has unveiled new requirements for how much health insurers must spend on medical care in comparison to non-medical items, such as advertising and overhead, under the new health reform law. Easy To Insure ME has the answers

Starting January 1, all health insurance plans will be required to spend a set percentage of their premium income on medical claims and quality improvement expenses. That percentage will be 80 percent for individual and small group plans, and 85 percent for larger groups. This split is known as the “medical loss ratio.”

Lynn Quincy is a Senior Health Policy Analyst for Consumers Union, the nonprofit publisher of Consumer Reports magazine. She serves as a consumer representative to the National Association of Insurance Commissioners, the group that created these standards.

Quincy said, “The term ‘medical loss ratio’ isn’t exactly consumer-friendly, but these new rules are very good for consumers. People are going to get better value for their premium dollars.

“The new rules seek to keep a lid on the non-medical expenses that are typically included in the insurance premiums we pay — things like executive pay, lobbying, and marketing.

“If a health plan spends too much on these non-medical items – relative to their spending on medical care – the plan has to reimburse its customers by paying them rebates.

“Looking at industry filings, many health insurers should not have trouble complying with these new standards. But for those insurers with excessive spending on non-medical items, the standards will provide a strong incentive to rein in those expenses.

“Plus, consumers will benefit from greater transparency in premium calculations. There will be new requirements that govern how insurers report their spending. These reports must be made public by HHS on its website. So in the future, it may not take a congressional investigation to see how much of your premium dollar is being spent on medical care.

“The goal of these requirements is not to generate rebates, but to drive insurers to spend less money on bureaucracy and more on health care. Consumers will benefit when their insurance choices include more insurers that are more efficient,” Quincy said.

Buying Individual Health Insurance Tips Easy To Insure ME

We all need to have health insurance, and for anyone who is are self employed, or are unable to obtain insurance from your employer, you will have to check into purchasing individual health insurance. Insurance on your own is normally much more expensive than when you get it from a business, so it pays to shop around and obtain the best coverage for you. Even though they are known as individual policies, they often can cover your spouse and kids as well. However, at the time you apply for a policy, there isn’t a guarantee that says you will end up accepted for an individual policy. If you have got certain health conditions, because the policy is medically underwritten, your insurer could deny your application, or add exclusions to your policy. There are several states that make this practice illegal, and this means that health insurers will have to provide you with a policy, whatever medicals problems there are. Easy To Insure ME has the answers

People who are older or who are in bad health, will have to pay higher premiums than those who are younger and in excellent health.

Knowing how health insurance is priced is among the most confusing elements of buying individual health insurance, so evaluating various companies and their rates might make a big difference in the amount you have to pay for health insurance.

In case you are trying to find individual health insurance, don’t let all of the confusion allow you to shy away from getting a policy. Even for people who are in great health, one accident could land you in economic peril without health insurance. Some questions to think about when buying individual health insurance are:

Do I wish to keep my existing doctor? If there is a doctor that you really like, this might determine whether an HMO or PPO plan is good for you. If you have an HMO, then you must use their doctors, but a PPO plan will allow you to use the physician that you pick.

Just how much will it cost me out of pocket, and just how much will my premiums be every month? Is it intelligent for me to pay more for lower out of pocket expenditures? For a comprehensive health plan that doesn’t have many out of pocket costs, an HMO might be what you are searching for. However, if you’re in your 20’s or 30’s, don’t have children, and have more money saved up, you can save money by only getting insurance for catastrophic illnesses. This will mean that you’ll have to pay out of pocket for virtually any tests or doctor visits.

How much health care will my family members need? Consider any services that may be needed by all your family members on a regular basis. If somebody has asthma in the family, will they need to go to an asthma specialist to regulate their illness?

When you can take some time to assess and consider the health insurance you and your family need, it can make purchasing individual health insurance much less difficult, and offer the health coverage you and your family need for a price that you’ll be able to live with at the same time.

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