Wednesday, November 12, 2008

2009 HSA Contribution Limits

HSA contributions for 2009 ~ HSA contribution maximums (for January 1, 2009 effective dates) are not limited by either your plan's provider or your plan's deductible.

They are set & adjusted annually by the IRS:
$3,000 for individuals
$5,950 for families


Julia

Sunday, November 2, 2008

Presidential Healthcare Debate....

Barack Obama and John McCain couldn't disagree more on what is needed to fix the nation's health care system. Obama believes government still needs to be heavily involved in making sure people have insurance. McCain wants a system rooted in the free market.
read the complete OC Register article 11/2/08

Saturday, July 12, 2008

Medical bills take toll on personal finances

According to researchers at Harvard University, medical bills contribute to roughly half of all bankruptcies. They also say the chain of events leading to bankruptcy is often easy to trace – an unforeseen illness or accident that leads to the loss of a job, and with it, the double whammy of losing health insurance and income.

While most Americans will never file for bankruptcy, paying for health care is a source of worry for many.

The complete article was printed in the Orange County Register on 7/12/08.

Saturday, April 12, 2008

Have you ever been sick?

Friday, April 11, 2008
Have you ever been sick?
Insurers face increased scrutiny for picking apart clients' medical records and canceling policies after expensive treatment.
BY COURTNEY PERKES
The Orange County Register

Contact the writer: 714-796-3686 or cperkes@ocregister.com

Thursday, March 20, 2008

How to: Get Better Cheaper Health Care w/o Insurance

How to: Get Better, Cheaper Health Care Without Insurance (25 Tips, Tricks and Resources)
Published on Wednesday March 19th , 2008
By Christina Laun
Health care has been at the forefront of political and popular debate more than ever as costs continue to rise in the face of an unstable economy. With rising energy costs, falling real estate prices, and no national health care system, many people simply have to learn to do without the medical care they need. There are, however, ways to save on health care costs without having to sign up for a pricey insurance plan. Here are a few tips for saving your healthcare dollars, as well as a number of information sources for localized, low-cost healthcare.

Click Here for the complete article.

Julia

Monday, February 11, 2008

Little assurance for insurance firms

http://www.ocregister.com/news/ciga-williams-presentation-1976851-jacobson-board
BRIAN JOSEPH
Register columnistCAPITOL WATCHDOG bjoseph@ocregister.com
Comments 0 Recommend 0
SACRAMENTO – The California Insurance Guarantee Association may be the most important bureaucracy you've never heard of.
Founded under legislation in 1969, the association acts as a sort of insurance for insurance companies. If your provider goes broke, CIGA picks up your claim.

"Without CIGA, we would have been in an absolute financial disaster when the workers comp crisis hit," said Michael Mattoch, an executive with USAA Financial Services. He describes CIGA as crucial piece of California's infrastructure.

So would it worry you that CIGA is $1.6 billion in the red and plagued by infighting and potentially gross mismanagement?

http://www.ocregister.com/news/ciga-williams-presentation-1976851-jacobson-board

CIGA says it ran into trouble when the workers comp crisis forced it to pick up thousands of claims, but a recent audit by an Alhambra CPA suggests another culprit: misconduct.

In November, accountant John F. Williams made a PowerPoint presentation to the CIGA board that described an organization in disarray. He found contracts awarded without bidding, claims paid without review, a vendor the association should terminate "ASAP." Williams concluded that of $66 million spent on bill review fees, CIGA had overpaid $55 million.

"My jaw was on the table," said Dan Jacobson, an Orange County attorney who was appointed to the CIGA board by then-Insurance Commissioner John Garamendi in June 2006. "Before Mr. Williams' presentation, I had a sense there were some things that needed to be fixed at CIGA. I had no idea it was this horrible."

Williams, who was hired by CIGA management to conduct the audit, declined to speak with me, but I obtained a copy of his slideshow.
Marked "Confidential," the presentation states "contract negotiations [are]ad hoc, personal, and informal" and adds, "Some relationships have no contracts." It recommends that CIGA implement the most basic of procurement policies, such as bidding for services.

Williams' presentation also focuses on independent companies, or so-called "third-party administrators," employed by CIGA. Third-party administrators handle claims for CIGA and the slideshow suggests that not only did CIGA enter into bad agreements with them but also that some may have business relationships which could allow them to bleed CIGA.
The presentation states CIGA's "bill review fees are very high" because instead of paying the administrators a flat fee, they are paid a percentage of the savings they uncover.That practice is so questionable that Joe Coto, chairman of the Assembly Insurance Committee, is introducing a bill to outlaw it.

The presentation adds that a couple of the third-party administrators are affiliated with the very vendors billing CIGA. That means, effectively, that the same companies billing CIGA are also ensuring that the bills are accurate.

http://www.ocregister.com/news/ciga-williams-presentation-1976851-jacobson-board

"It seemed to validate my concerns raised at my first Investment and Audit Committee meeting when I discovered that they were not auditing the billing and substantive case handling of their compensation defense firms," said Steve Testan, a founder of a national workers comp defense firm who was appointed to the CIGA board by Assembly Speaker Fabian Núñez in June 2007.

"As to the entirety of Williams' presentation, I was shocked. The association is dealing with public assessment monies."
Testan and Jacobson, two of newest members of the 13-member board, were obviously troubled by Williams' report, but say the board's chair and vice chair and CIGA management have blocked them from doing anything about it.
http://www.ocregister.com/news/ciga-williams-presentation-1976851-jacobson-board

In letters to numerous state officials, including Núñez, Insurance Commissioner Steve Poizner, Attorney General Jerry Brown and Orange County Sen. Lou Correa, Testan and Jacobson allude to "Herculean efforts … undertaken by the powers that be" to prevent them from speaking with Williams and add that CIGA may have paid more than $200 million in unaudited legal fees.

One letter concludes that the actions of CIGA leadership suggest "waste and mismanagement" if not "something more sinister."
The infighting has become so fierce that the vice chairman, Jim Sevey, even asked Jacobson to resign after Jacobson raised concerns about a potential conflict of interest involving CIGA's legal counsel. Jacobson declined.

http://www.ocregister.com/news/ciga-williams-presentation-1976851-jacobson-board
"When I've tried to access simple information that I need to perform my job – like Mr. Williams' phone number – I've been met with a management brick wall," Jacobson said.

I can understand their frustration. I tried to attend a CIGA meeting last week at the high-rise Bankers Club of San Francisco, but I was thrown out almost as soon as I arrived.
I had barely removed my coat and sat down when the executive director, Wayne Wilson, glared at me from across the room. Who are you? he demanded as he loomed over my chair. This meeting is private, he said.
I explained that I thought I should be allowed to stay because CIGA was established under statute, its members are appointed by elected officials and it's funded by assessments on California insurance policies.

Wilson didn't care about my reasons and didn't care when I identified myself as a Register reporter. He wanted me gone.

My research had indicated there is some disagreement over whether open meetings laws apply to CIGA, so I asked Wilson to cite the authority for making me leave. He refused, then told me to get out.
I later spoke with Wilson after he returned to CIGA headquarters in Glendale. He told me there are "substantial question marks surrounding" Williams' presentation and suggested that the auditor didn't fully understand CIGA.

http://www.ocregister.com/news/ciga-williams-presentation-1976851-jacobson-board
For example, he said CIGA doesn't bid for services because when an insurer goes bankrupt it has to react quickly.
"You can't stop paying benefits to an injured worker," Wilson said. "That's one of the issues Mr. Williams never got a grip on."
Wilson dismissed allegations of overspending as one man's opinion and added that the claims of some CIGA critics may prove to be "over the top."
"There's nothing sinister … going on," he said. "The board is actively and aggressively working on issues that have been identified."
I also tried to speak with Jim Sevey, the vice chairman, and with Chairwoman Linda R. Smith, but both referred me to Wilson.

Not everyone is silent, however. At the same meeting where I was tossed, Testan announced that he had offered his resignation to Núñez because of "irreconcilable differences" with certain board members.
"Information uncovered during my tenure … suggests that CIGA, to put it mildly, has some very serious issues to deal with," Testan wrote in a letter to Núñez. "Californians need a properly functioning CIGA."
Sen. Correa, meanwhile, has taken an interest in CIGA. Last week, he asked the Joint Legislative Audit Committee to launch an investigation.

"This is scary stuff," said Correa, a Democrat who represents Santa Ana. "This thing makes its living off an assessment on businesses. I only hope that they're applying best business practices," he said.

I don't think we've heard the last of this. Stay tuned.
Brian Joseph covers Capitol issues for the Register. His Capitol Watchdog column focuses on government practices. To reach him, call 916-449-6046 or e-mail bjoseph@ocregister.com.
http://www.ocregister.com/news/ciga-williams-presentation-1976851-jacobson-board

Thursday, January 31, 2008

HealthCare Partners joins BC Select HMO network

HealthCare Partners joins
Blue Cross Select HMO network
Effective January 1, 2008, HealthCare Partners officially joined the Blue Cross Select HMO provider network alongside its other prestigious partners.
Giving members access to an extensive network of excellent, contracted providers and quality, cost effective coverage is always a top priority within the Select HMO network, and the inclusion of HealthCare Partners helps attain this goal. A multi-specialty medical group dedicated to the well-being of members and their communities, HealthCare Partners has more than 40 convenient medical offices, including five urgent care centers and hundreds of affiliated medical offices located throughout the Greater Los Angeles and Orange County area. By giving members access to more than 800 Primary Care Physicians, the addition of this medical group will help retain existing business while also attracting new members.
HealthCare Partners has long been a participating medical group with Blue Cross. This change expands our relationship and makes this marquee group available to our Select HMO members. HealthCare Partners is currently available on ProviderFinder.

Wednesday, January 30, 2008

PacifiCare accused of widespread violations.

PacifiCare accused of widespread violations
It could face $1.3 billion in penalties for allegedly mishandling claims.
The Associated Press

SAN FRANCISCO – Health insurer PacifiCare could face as much as $1.3 billion in penalties for allegedly handling claims unfairly following its takeover two years ago by UnitedHealth Group Inc., state officials said today.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care
California regulators investigated and uncovered at least 130,000 alleged violations of state laws and regulations regarding payments for medical care, California Insurance Commissioner Steve Poizner announced in a statement.
A maximum penalty of $10,000 applies to each violation, which include wrongful denials of covered claims, incorrect payments, lost documents and delays in handling claims.
"After years of broken promises to California regulators, it became crystal clear that PacifiCare simply could not or would not fix the meltdown in its claims-paying process," Poizner said.
Minneapolis-based UnitedHealth purchased Cypress-based PacifiCare for $9.2 billion in January 2006. More than 3 million Californians were added to UnitedHealth in the deal. The company now has about 27 million enrollees nationwide.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care
UnitedHealth officials said problems occurred when the company tried to make too many changes too quickly.
"The pace of the transition may have resulted in some physicians and other care providers experiencing inconsistent service in the past," spokesman Tyler Mason said.
PacifiCare had already disclosed many of the issues raised by regulators prior to the investigation and was taking "aggressive steps" to make improvements, Mason said.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care
PacifiCare was also fined $3.5 million by California's Department of Managed Health Care over the alleged violations.
Department of Insurance investigators reviewed PacifiCare claims processed between July 2005 and May 2007 following complaints from patients and doctors, Poizner said.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care
The maximum fine will apply only if authorities prove all the violations and show they were committed as part of a deliberate scheme.
UnitedHealth's regional chief executive David Hansen said the "vast majority" of the violations were administrative errors that did not harm PacifiCare members. More than 80,000 of the violations, he said, stemmed from not sending health care providers letters acknowledging that claims were received, even though most of those claims were paid on time, he said.
http://www.ocregister.com/news/claims-pacificare-violations-1969293-unitedhealth-care

Wednesday, January 2, 2008

Blue Cross of CA to become Anthem Blue Cross

Blue Cross of California to become Anthem Blue Cross

Starting April 1, 2008, Blue Cross of California will begin to do business as Anthem Blue Cross, taking on a trusted brand name that symbolizes quality for millions of consumers across the country.

This means Blue Cross of California products and services will be offered under the Anthem Blue Cross brand. Blue Cross of California’s affiliate, BC Life & Health Insurance Company, will also adopt the Anthem brand and change its name to Anthem Blue Cross Life and Health Insurance Company.

The brand change to Anthem will apply to our complete product portfolio, including medical, dental, vision, life, employee assistance programs and behavioral health services.

The Anthem brand, used by 11 other health plans across the country, is well recognized and known for quality, affordable health care coverage. With a strong reputation in the market as a trusted choice for consumers, the Anthem brand name embodies the same consistency, strength, security and stability as the Blue Cross of California name.

Stay tuned for more information as it becomes available.

Julia