Health Insurance Rates to Be Reviewed in 2011

[longfisher]

You guys will recall that I repeatedly had to remind some here that the incredible rate increases we saw in group and individual / family health insurance rates in late 2010 were the nepharious workings of a greedy insurance industry trying to hike rates as much as they could before federal regulations came on line to help control those rates. Well, those regulations come on line in 2011 and here's a pretty good write-up of them from WAPO:

"Under the proposed regulation, which spells out the details of a key provision in the new federal health-care law, next year any insurer seeking a rate increase of 10 percent or more for an individual or small group plan would be required to file financial information justifying the raise with federal and state officials. (Beginning in 2012, the percentage rate increase that triggers the review will be adjusted for each state to reflect its particular market trends.)

State authorities would then analyze the data submitted by the insurer to determine if the increase is "unreasonable." If federal officials determine that a state lacks the resources or power to conduct such a review, the federal Department of Health and Human Services would step in to conduct it.

Either way, if a rate increase were found to be unjustified, that finding would be posted on both HHS's and the carrier's Web site along with the company's financial disclosures - including, for example, how much it is compensating top executives.

The law does not give federal officials the ability to reject the rate increase outright. However, administration officials say they believe that shining a spotlight on unreasonable increases could discourage insurers from moving forward with them."

Only when the Feds run the state exchanges will they be able to directly combat unreasonable rate increases like we saw in 2010. Most of the states have decided to run their own exchanges, so, the states would retain the right to regulate rates in those states. But costs are an issue for setting up departments to regulate those rates in states that maintain their own exchanges. So, the Feds made grants to those states of upwards of 250 million dollars to encourage them to do so.

IMHO, this is the most important cost control measure of health reform, although it targets only the insurance companies. The insurance companies are going to pay through the nose for hiking the rates so much in 2010 and blaiming it on Health Reform when exactly the opposite is true.

The Feds are steaming mad at the industry now. Frankly, I am too. Indeed, anyone who owns private insurance, group or individual / family, should be steamed at the industry for this particular theft and ruse. They simply took advantage of the situation of the regulations not being in place yet and lifted money from our wallets while blaming it on the reforms. CHEATS, THAT'S ALL.

Look for fireworks.

LF

[Curmudgeon]

No government control of healthcare there. Yeah, the Washington Post had it right, it's all a Republican lie ...

[FLATLINER]

longfisher
Crab mustard is good

Join Date: Jul 2009
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Posts: 855
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Occupation: Health & Life Insurance Sales



I think you should change all of the occurrences of "they" in your post to "WE"..

[longfisher]

longfisher
Crab mustard is good

Join Date: Jul 2009
Location: Spring, TX
Posts: 855
Boat: 21' Sea Pro WA Cuddy
Home Port: Freeport, TX
Best Catch: 42 lb. Kingfish, Heald Bank off Galveston, TX
Occupation: Health & Life Insurance Sales



I think you should change all of the occurrences of "they" in your post to "WE"..

...I'm an independent agent. I don't work for them. I have permission to sell their products when I think they're right for my customers. Otherwise, I don't.

I often go to absolutely extreme war with them when they mistreat my customers. Like denying claims when they shouldn't. Like when they offer something to my customers to stay on the membership roles and then renig. When they drop someones insurance coverage for bogus reason. THEN WE GO TO WAR.

Most of the time, I win by reminding them of the law. Once in a while I have to appeal on behalf of my customer to higheru ups. Most of the time I win there too. Once in a very long while I have to testify against them. I always win on those.

So, that brings me to a 100% win ratio on behalf of my customers. They absolutely hate that.

But there's not a single thing they can do about it. I have a contract that specifies that I can represent my customers as long as I remain within the law. I ALWAYS DO.

LF

[longfisher]

No government control of healthcare there. Yeah, the Washington Post had it right, it's all a Republican lie ...

I'm not referring to you specifically, Crud, when I say one can't have it both ways. I don't know what you may or may not have posted here about rising health insurance rates, perhaps you don't like them, perhaps you do for some strange reason, perhaps you've never voiced an opinion.

I'm referring to the general sense of this board in which there has been an enormous expression of both outrage that the rates have recently skyrocketed and misplaced blame of these outrages on Health Reform and, in particular, Obama.

So, here goes. One can't on the one hand complain about skyrocketing rates and on the other hand condemn regulation of those rates. It's hypocritical and it's partisan...not that this would ever stop a Republican swimming in a sea or ingnorance from doing this.

Furthermore, there's a significant difference between implementing consumer protections in any industry and running the industry. We have had consumer protections, some excelent examples are the those recently implemented for financial products, since the government began. Indeed, the Constitution explicitly lays down the circumstances in which the government can regulate commerce and, by extension, provide consumer protections. The very founding fathers provided for this role of govenment.

And, that's a far cry, a very far cry, from taking over an industry and running it as if we lived in a socialist society. We don't. We never did, but perhaps during WWII when defense industries were all but nationalized. And, health reform as it ended up didn't start us on that long slide into socialism, despite what the zany right-wing says.

LF

[Curmudgeon]

Fair enough, Longdong, I'm not referring to you specifically, either. Many states have had it right for years, and closely control insurance rates. The industry tells 'em how much they absolutely have to have to survive, the insurance commission reviews the supporting documentation and decides how much of a rate change they can have - up or down. Works pretty well in my state, how it will work on a national scale is just scary.

I had pretty good insurance, then I turned 65, now I have Medicare and what my insurance morphed into (because I had Medicare). I now have less coverage at a higher cost! Really?

This is another part of Obamacare that Pelosi didn't want anyone to read. In four years the government will tell insurance companies what product they have to produce (remember, that also tells the consumer what they can have), and they will tell the industry what they can charge for it. And it will always look as if the government is the white knight saving us all from those dastardly providers. Except the only way to sell it is to subsidize the 'less fortunate' who cannot afford their own insurance. You know, from those who can to those who cannot? The bottom line is every one of us will be told what we can have, what we must have, and what we will pay for it. And what we want to or can afford will be meaningless. Let's hear it for socialized medicine, certainly makes my a woodie ...

Oh, yeah, insurance agents? They'll be useless as the last mammary ...

And, if you want to see how deceptive your government has become when they can't survive in the light of day? Look up 'Obamacare' on any of the popular search engines and see what ads pop up that you and I are paying for ...

[longfisher]

Oh, yeah, insurance agents? They'll be useless as the last mammary ...

Health insurance agents, particularly in the individual and family marketplace, may go the way of travel agents. It's certainly a possibility, maybe even a probability.

I won't care. I'm a general lines agent so I'm not captive to health insurance. It's just something that fit my one-time clinical background so it was easy.

Group health is still rockin' as are the sales of senior products. There's lots of work out there for folks like me who don't mind 'splain' things to folks.

That's our only real value, you know. We make the complex mess the insurers present simple enough for people to make informed decisions for themselve. And, we locate those peopel too so we incur marketing expenses the insurers don't have to.

It's really just that simple. As long as it's complex and as long as the insurers feel we bring something to the table we're gonna be here...except for health insurance.

LF

[FLATLINER]

As long as you can sleep at night, then go for it.

You are part of the problem, not the cure.

Oh yeah, to reply to the post above that you made, so if you are not a drug dealer, but someone that WORKS for a drug dealer, then its ok?

Not in my book.

Oh yeah, real classy with the name calling. Im not surprised tho.

Oh and before you jump on the "You are clueless" bandwagon as you do with everyone else here, I AM in Healthcare and I see what your parent companies do to patients every single day.

[marine4003]

as i novice on any type of insurance,i don't understand how the govt can tell people what they HAVE to purchase,and not tell the company's selling it what standards they have to adhere to,and what to charge, i do know one thing along a similar line..we had state farm for our veicle insurance even when we moved to NC from SC ,a while ago we received a letter from state farm stating we had been getting overcharged by 18% and by signing the letter agreed to allow SF to continue to overcharge ,or our property insurance would be cancelled..now thats blackmail any way you look at it..we told them to stuff it,and after being a SF customer for 12 years they didn't care..now were with farm bureau and have lowered our costs by half. Any company who does business by means of blackmail and veiled threats needs to be regulated,unfortunately the NC insurance board is comprised by former members of the insurance groups..Nice huh?

[longfisher]

As long as you can sleep at night, then go for it.

You are part of the problem, not the cure.

Oh yeah, to reply to the post above that you made, so if you are not a drug dealer, but someone that WORKS for a drug dealer, then its ok?

Not in my book.

Oh yeah, real classy with the name calling. Im not surprised tho.

Oh and before you jump on the "You are clueless" bandwagon as you do with everyone else here, I AM in Healthcare and I see what your parent companies do to patients every single day.

I report to no insurer. They dont' tell me what to do or what to sell.

Here's some examples that might help you understand.

Do you criticize the grocer who buys bananas from Dole when Dole plays social havoc in Central American economies and historically supported many coups?

Do you criticize Discount Tire for still selling Dunlop tires when they've had a poor history?

Do you withdraw all you money from the regional bank because the NY bankers raped the country?

There's that sort of distance between an independent agent and the insurance companies. We broker a product that's all. And, by law we have a fiduciary responsibility (that I take seriously) to put our customers needs first, and certainly above those of the carriers.

I do.

If you don't get it now then you're merely suffering from some sort of partisan paralysis of thinking.

LF