Search Results for: stop-loss

Marketplace IT Glitches: The Sky Is Not Falling

Posted by

…Children’s Health Insurance Program—through the marketplace. Achieving the vision for marketplaces as a seamless one-stop shop for obtaining coverage will largely depend on new IT systems that operationalize numerous policy and logistical decisions, provide real-time eligibility assessments, enroll people in appropriate coverage, and ensure premiums are paid correctly. Getting these systems right—under very tight deadlines—is an enormous task. Like all…

Delay the Individual Mandate? Why That’s a Bad Idea.

Posted by

…a sicker risk pool – and the higher claims costs for insurers. Because it’s too late in the year for insurers to recalculate and re-file their premium rates for review, they could be exposed to significant losses and it could even threaten their solvency. The bottom line? An attempt to delay the individual mandate is tantamount to an attempt to…

Waiting for Medicare: The ACA Will Help Fill the Gap

Posted by

…job. Her doctor told her she should stop working permanently because of the severity of her symptoms. But Karen was hoping to put off that day, and worked as long as she could before taking a second short-term disability leave. It was during that time that she came to terms with the difficult reality of her condition. MS is a…

Why Should Health Insurance Exchanges Drive Higher-Quality Health Care?

Posted by

…for Improving Maternal and Infant Health Outcomes to “identify specific opportunities and strategies to provide better care, while reducing the cost of care for mothers and infants covered by Medicaid/CHIP.” States are beginning to alter their Medicaid payment policies to discourage elective deliveries: Texas stopped paying for them altogether, while Washington State began paying a bonus to hospitals that met…

Diane Rehm Show Takes a Look at Workplace Wellness Programs

Posted by

…workers to get the care they need. Yet we don’t have evidence that financial incentives delivered as higher health plan costs really work. It’s one of the areas a recent Rand report notes needs more research, noting, “Employers overwhelmingly expressed confidence that workplace wellness programs reduced medical costs, absenteeism, and health related productivity losses. But at the same time, only…

New Report: States Going Above and Beyond to Create Sustainable Exchanges and Deliver Choice and Value to Consumers

Posted by

…in every state by October 1, 2013. Exchanges are intended to address the current barriers to affordable and adequate health coverage in the individual and small-group markets by providing a seamless, one-stop experience for individuals to apply for financial assistance, compare health plans, and enroll in public or private coverage. Similarly, Small Business Health Options Program (SHOP) exchanges are designed…

Breaking Down the NAIC’s Comments

Posted by

…rate review processes and medical loss ratio requirements, as well as participate in state reinsurance and risk adjustment programs. However, the NAIC went on to identify 10 areas of continued concern, including essential health benefits, appeals, and the proposed process for dispute resolution, among others. Essential health benefits. Citing concerns about the risk of adverse selection, the NAIC objected to…

100 Days to “Launch”: What a Formerly Controversial Health Program Can Teach Us

Posted by

People, stop wringing your hands and roll up your sleeves. On Sunday, we’ll be just 100 days from the first day of open enrollment in new, high quality and affordable health insurance coverage options. As we barrel towards the finish line, pundits and policymakers have been quick to question whether we can actually pull it off. There’s not enough time,…

As Self-Funding Remains Hot Topic in Press, States Begin to Take Action

Posted by

…666) regulating the sale of stop-loss insurance. The legislation, which is currently before the governor, establishes minimum attachment points for stop-loss policies. The minimum specific attachment point – which represents the minimum dollar amount where the stop-loss issuer begins paying for claims incurred by a covered individual and the employer’s liability ends – is set at $20,000 while the minimum…

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.