Once again the Supreme Court will decide whether the Affordable Care Act lives or dies. Defying expectations, the court announced Friday it has agreed to hear a case that challenges the heart of the law: subsidies that help people pay their insurance premiums. In about three dozen states, the federal government runs the online marketplaces...
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More Scrutiny Coming For Medicare Advantage, Obamacare
Federal officials are planning a wide range of audits into billing and government spending on managed health care in the new fiscal year, ranging from private Medicare Advantage groups that treat millions of elderly to health plans rapidly expanding under the Affordable Care Act. The Health and Human Services Office of Inspector General, which investigates...
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Different Types of Adjusters And Why They Are Needed
Many workers compensation carriers have several teams of adjusters. These usually consist of medical only adjusters, lost time adjusters, and so on. From time to time I see a high exposure claim team, where if a reserve is over a certain point it gets transferred to a team and they take it from there. Some...
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Joe Paduda Reviews GOP Win
With big wins in the Senate, House, and governors’ races, the GOP is poised to push its policies – here’s a brief review of potential moves. For the next two years the GOP will be in charge of Congress where it can do a lot to hamstring PPACA via budgeting procedures and incremental changes. Then, GOP...
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Post-election Health Wonk Review is up!
Thanks to Jennifer Salopek at Wing of Zock (love that name) – we have the first read of what may happen in DC come January. See the posts from Louise Norris and Jason Shafrin for insight on the subsidy calculation and the impact of the Cadillac plan tax – which will hit about 15% of us...
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Oregon to See Comp Costs Fall for Second-Straight Year
Good news has come for employers in the state of Oregon. Oregon workers compensation costs will decrease an average 5.3 percent in 2015, the Department of Consumer and Business Services (DCBS) announced. The department approved the average decrease in “pure premium,” which is the portion of the premium employers pay insurers to cover anticipated claims...
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Employers Can’t Skip Insurance Coverage For Hospitalization
Some employers said that leaving out hospital coverage helped protect low-wage workers from big deductibles. Closing what many see as a loophole that could trap millions of people in sub-standard insurance, the Obama administration said Tuesday that large-employer medical plans lacking hospital coverage will not qualify under the Affordable Care Act’s toughest standard. It also...
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Insurance Commissioners Also On a Few Ballots
The office of insurance commissioner is pretty far down the ballot and hardly noticeable compared with all the other high profile positions vying for voter attention. But 11 states have publicly elected insurance commissioners, though the post is only on ballots this November in California, Georgia, Kansas and Oklahoma. The only thing that could make...
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Asbestos pokes its long nose out from under the workers comp tent
Judgments in two recent court cases held that long-tail asbestos claims are not subject to the comp bar. A very good friend who spends most of his time dealing with asbestos claims for a very large carrier shared this with me in a recent email. Here’s how he put it: If this contagion were to...
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Insurance Industry Ranked Last in Simplicity Index
In an international survey evaluating how consumers perceive the simplicity and innovation of consumer brands, general insurance companies ranked the lowest of all 25 industries surveyed (24th in the U.S.) and health insurance companies ranked 25th (also 25th in the U.S.), according to Siegel+Gale, a global strategic branding firm, which just released its fourth annual...
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