Medical Malpractice Insurance Rates are on hold

Medical Malpractice Insurance rate are on hold, as insurance commissioner Jones requested a review of the new rates.
In a statement published this week, Jones said, that "unlike health insurance where I do not have the authority to reject excessive rates, the Insurance Commissioner does have the authority to regulate the rates of medical malpractice insurance paid by doctors, surgeons, clinics and other health prociders. We have found that recent loss ratios - the percentage of premium dollar spends on claims- of many medical malpractice insurers are low. Low loss ratios are one indication that premiums may be too high."

This might be the one of the first step to control the sharp increase of health care. If insurance rates for malpractice are lower maybe than charges of doctors and hospitals rate do not have to increase as much as they have done in the past.

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The Sandwich Generation -

BlUE SHIELD REJECTS COMMISSIONER JONES REQUEST TO DELAY RATES

Read this article - Blue Shield's behavior is unbelievable!

Blue Shield of California defies state insurance commissioner over rate hikes

The Los Angeles Times

Defying California’s new insurance commissioner, Blue Shield of California has refused to delay controversial health insurance rate hikes for 60 days that prompted an uproar among customers who are seeing successive increases over the last five months of up to 59%.

The nonprofit San Francisco-based insurer said it would submit its latest increase — effective March 1 and averaging 15% — for review by an outside expert. It pledged to issue refunds to customers if errors are found in its paperwork.

Insurance Commissioner Dave Jones immediately condemned Blue Shield’s move, saying the company acted on its own without consulting him. Jones discounted Blue Shield’s characterization of its action as “unprecedented,” noting that a new state law requires all insurance rate hikes to undergo scrutiny by outside actuaries.

Jones, however, has limited authority to stop rate increases. He can only do so in cases where an insurer spends less than 70% of premium income on healthcare expenses. (more)

This entry was posted on Saturday, January 15th, 2011 at 3:53 am and is filed under health News,insurance companies. You can follow any responses to this entry throu

"Child Only Health Insurance Policy "big disappointment in CA

After Blue Shield rate increase disaster, now the "child only health insurance policies" are another disaster for California residents.

In the last quarter of 2010 with the exception of Blue Shield no insurance carrier offered anymore child only policies for children under 19 years, due to the fact that accordingly to the healthcare reform they had to accept all children, even the unfortunate one's with severe health problems. Than the insurance commissioner threatened, if the carriers would not offer child only policies, the carriers would be banned for 5 years in the CA market.

Now most carriers have an open enrollment window for "child-only policies" for children under 19 years, which most carriers offer from January 1st to February 28th of 2011.

After investigating the individual insurance plans, I can only find PPOs plan with very high deducible Anthem, Aetna offers a $3500 deductible Plan. Blue Shield , Cigna offers a $ 5000 deductible -Healthnet and Anthem are offering also a HMO but rates are higher than any available PPO plans.

Before the Healthcare reform we were able to offer insurance PPO plan with $ 500 and $ 1000 deductible - these plans were very affordable for children. They are not existing anymore and this creates a hardship for all families in CA.

I do understand the insurance carrier having to protect themselves from the financial loss of huge claims for children with health problems, but it is not fair that all CA children cannot find suitable policies.

I will not offer a child policy with a deductible of $ 3500 or $ 5000, it is to easy for children to get sick and have to go to the emergency. Just to open the door of an emergency room cost $ 500, Parents should not take this risk!

Please offer more insurance plans for children under the age of 19 years.

The CA State should support the insurance companies with the unhealthy children in CA, and not just demand that the insurance companies carry the burden of the unhealthy children.

Our children are our future and we must make sure that they are protected!

Last year we could offer plans of

BLUE SHIELD RATE INCREASE DELAYED BY INSURANCE COMMISSIONER JONES

CA insurance commissioner Jones is requesting Blue Shield to hold off on rate increase for the planned increases of January and March increases.

Please read this article, which has been published by the insurance commissioner Jones. http://www.insurance.ca.gov/0400-news/0100-press-releases/2011/release002-11.cfm

I hope this will happen as some of my client have increase of 59 % for the Vital Shield plans.

When the old insurance commissioner Poizner had put Anthem on hold Blue Shield was one of the only carrier to be able to offer individual insurance policies last quarter of 2011,

With almost no competition insight Blue Shield must have had a record breaking quarter!

So please help your policyholders and stop this rate increases!

What is Medical Loss Ratio, and how does it hurt your agent in 2011.

The "Medical Loss Ratio" is the amount that an insurance company pays for claims divided by the premiums that people paid for insurance . A claim is a bill for medical items or services. For example, if an insurance company pays an average of 80 cents in claims for every dollar it collects in premiums, then its medical loss ratio is .80.

"Administrative Cost" is the flip side of the medical loss ratio. Administrative cost is the difference between what an insurance company collects in premiums and what it pays for claims. Administrative cost pays for claims processing, underwriting, marketing, utilization review, building up reserves, general management, and profit. Administrative cost is often shown as a percentage of the premium and ranges from 5% to 50% or more. For example, if an insurance company pays 20 cents for administrative cost for every dollar it collects in premiums, then its administrative cost is 20%.

A low administrative cost generally means that an insurance company is efficient. Consumers get more dollars of covered services for the premiums they pay. However, there is a bigger picture. A better measure of efficiency is how much health insurance contributes to people's health for the premiums they pay. This is not always the same as the most dollars of services paid per premium dollar. Some administrative costs can help you to get more for your money. For example, some administrative costs are used to help an insurance company negotiate lower prices for services or to develop programs to improve your health. Company "A" that pays $100 per x-ray may have lower administrative costs than company "B" that pays $60 per x-ray, but company "B" may provide more health for your premium dollar.

The Health Care Reform dictates that in 2011 the Medical Claim Loss Ratio in the individual market can not be higher than 0.80 and for large groups 0.85. As a result insurance companies have reduced the agent commission in half for the the individual market starting in 2011. This means we have to work twice as hard to earn the same amount of money.

This is a hardship for any agency and will cause us to reduce staff and not to hire employees. We will be able to survive but will reduce any expenditure we can avoid.

I wonder if we would tell any public employee, we are cutting your salary in half, what would happen. Although we agent are associated with NAHU, we were not able to help ourselves as we are to small a number to play any role.

It is a pity because we are the liaison to the consumer, who needs us more than ever to find an affordable health insurance coverage.