Insurance Blog

Those Marvelous Rebates

The folks in LaLa land were greeted with this posting from the California Dept of Insurance. Seems the MLR rebates have been calculated and the results are in.

Blue Shield of California Life & Health Insurance Company: $10.8 million rebate to policyholders in the individual market; approximately 239,595 subscribers impacted; $45.15 average rebate per subscriber;
Kaiser Permanente Insurance Company: $277,034 rebate to policyholders in the individual market; approximately 21,823 subscribers impacted; $12.69 average rebate per subscriber;
Connecticut General Life Insurance Company (CIGNA):$3.4 million rebate to employers in the large group market; approximately 89,575 subscribers impacted; $37.70 average rebate per subscriber;
Anthem Blue Cross Life and Health Insurance Company: $1.3 million rebate to policyholders in the individual market; approximately 407,429 subscribers impacted; $3.16 average rebate per subscriber;
Aetna Life Insurance Company: $3.4 million rebate to employers in the large group market; approximately 84,428 subscribers impacted; $40.50 average rebate per subscriber;
PacifiCare Life and Health Insurance Company: $789,615 rebate to employers in the large group market; approximately 63,600 subscribers impacted; $12.42 average rebate per subscriber.

2700 pages, over 12,000 additional pages of regulations and interpretations so policyholders can get a refund ranging from $3 - $45.

I mean really?

Nobamacare

Nobamacare is a real possibility thanks to the Supreme Court Decision. If the states refuse to participate in key parts of Obamacare the law quickly becomes Nobamacare.

If any state declines to participate in the expansion, the Department of Health and Human Services (HHS) could strip that state of 100% of its Medicaid dollars. Every voter in that state would continue funding Medicaid through payroll taxes twice a month, but now would be subsidizing the other 49 states. Rejecting the expansion would thus be a political death wish for any governor or legislature.

This coercion is an unconstitutional violation of state sovereignty, so the Court struck down part of ObamaCare’s massive Medicaid expansion.

By rejecting Medicaid expansion, millions will have to forego the "free" health care entitlement.

Next, the states will need to refuse to create the exchanges. This forces HHS to establish them, paving the way for Nobamacare.

But there are no tax subsidies if HHS runs an exchange, so no incentive for people to flock to the exchanges; they’d pay full price. While many high-risk individuals would do so, it would still be vastly more expensive. Many will instead choose to pay the penalty (tax?) for violating the individual mandate.

Perhaps the rocket surgeons on Congress should have thought of that before writing this bill.

Since HHS-run exchanges have no subsidies, for states refuseing to create exchanges, no employer in that state will be subject to that penalty. This means business owners will band together to lobby their state not to set up exchanges.
This will create an unworkable patchwork nationwide, between states with semi-socialized medicine and healthcare costs spiraling out of control, versus those with private-sector medicine. Expect doctors, insurers, and providers to flock to these friendlier states, creating an increasingly unbalanced system. Then ObamaCare will start coming apart at the seams, and momentum will build to repeal and replace.

Sounds like a plan to turn Obamacare in to Nobamacare.

I like it.

Medicaid Patents Get Short Sheeted

Sixteen states impose a monthly limit on the number of drugs Medicaid recipients can receive and seven states have either enacted such caps or tightened them in the past two years, according to the Kaiser Family Foundation (KHN is a program of the foundation). The limits vary across the country. Mississippi has a limit of two brand-name drugs. In Arkansas adults are limited to up six drugs a month.

Since June, Alabama has had the nation’s stingiest Medicaid drug benefit after limiting adults to one brand-name drug. HIV and psychiatric drugs were excluded. On Aug. 1 the state will relax the limit to its previous level — four brand-name drugs — after the restriction saved more money than expected and the state received money as part of a settlement with a pharmaceutical company.

read more . . .

Pizza Getting Cold

A successful pizza restaurant owner wants to expand and open a new restaurant but is putting off plans because of Obamacare.

"I want to open a new restaurant, but without knowing how Obamacare will affect me, I can't make plans," Nichols said at a recent community forum in Beaumont on the new Patient Protection and Affordable Health Care Act.

With property purchased and blueprints drawn, Nichols said her building is now on hold because she can’t determine how to budget for Obama’s mandate.

New restaurant. More jobs.

Just what this economy needs.

Those who do not offer health insurance will have to pay a tax of $2,000 per employee.

Nichols has 85 Beaumont area employees set up on a private carrier insurance plan and matches the $90 a month each worker pays with $90 to cover the entire premium."

That's the cost if I continue to provide insurance. So I have two options, I can stop offering coverage and pay the $2,000 fine, or I could keep my number of staff under 50 so the mandate doesn't apply.

Hmmmm. Where have we heard this before?

She has been in the restaurant business for over 30 years “producing jobs for young adults.”

“Tens of thousands of kids have been sent to college, families have been started and careers have begun," Nichols added. "Now, a long and productive career is about to be destroyed by slavery instead of being rewarded with retirement."Nicholas said in 2011 she had to pay 87.49 percent of her income to federal income, state franchise tax, and property tax.

"Now add to that sales tax, phone tax, trash tax, water tax, gasoline tax, payroll tax and other taxes ad naseum," she continued.

Sounds like Washington is a taxaholic.

Just say no to Obamacare.

Pinning Hopes on Promises

Georgia residents Liz Johnson and Robert Irby have diabetes and no health insurance. They had health insurance in the past . . . a high deductible plan with BCBSGA but they dropped it when the premium increased.

Johnson and Irby will be eligible for the state Pre-Existing Condition Insurance Plan, created for ‘’high risk’’ individuals like themselves. More than 1,000 Georgians with health conditions belong to this new health plan. The couple must be uninsured for six months before joining PCIP.

Johnson says she has looked into the PCIP and says, “It might be cheaper than what we had.’’

In addition, beginning in 2014, health plans will be barred from denying coverage to people with pre-existing conditions, and also won’t be able to charge them discriminatory premiums. And people with health problems and individual policies will be able to access private coverage through an insurance exchange, which should lower premiums for many consumers buying on their own

They are in fact eligible for PCIP. The premiums for the Standard option is $470 each.

Instead of signing up for PCIP they are "hoping nothing goes wrong".

PCIP is one area of Obamacare that actually works . . . as long as you sign up for it. Otherwise you live with the hope that your health won't change.

Limited Choice Under Obamacare

Obamacare is supposed to make health care and health insurance more affordable, give consumers more choices and provide free health care services.

Apparently the politicians in DC believe the public is both ignorant and gullible. In truth, there are at least 10 ways in which Obamacare LIMITS consumer choice.

"Free" preventive services are not really free. Everyone pays for these services in the form of HIGHER PREMIUMS.

Care to guess who decides which preventive services are essential?

The U.S. Preventive Services Task Force, a committee of experts chosen by HHS (Health and Human Services). In other words, non-elected officials are deciding the level and type of care you need.

We have discussed how the MLR (Medical Loss Ratio) is impacting health insurance by RAISING premiums and LIMITING choice. Seems it can also lead to the loss of HSA and HRA type plans.

since HSAs often cover most or all of participants’ routine medical expenses, the claims that a high-deductible health plan experiences are larger and may fluctuate significantly from year to year. According to one study, “For high-deductible and HSA plans to be viable, both from a consumer and carrier perspective under [Obamacare], an adjustment to the MLR formula for the impact of HSAs may be necessary.”[5] Otherwise, HSA plans may disappear, robbing consumers of an attractive and popular option.

We don't have to remind you that HSA and HRA plans actually make premiums AFFORDABLE for thousands of people that would otherwise go without insurance.

In addition to the IPAB (Independent Payment Advisory Board), a new government bureaucracy that decides what health services will be covered by insurance and which ones will not, a new CER (Comparative Effectiveness Research) entity will decide what type of care you can receive.

The list of 10 limits under Obamacare is available for review at this link.

Change you better believe in.

Alpha Protocol [PC Game]

Alpha Protocol

Developer: Obsidian Entertainment
Publisher: SEGA
Genre: Action RPG
Release Date: June 1, 2010 (US)

About Alpha Protocol

Loyalty carries a price and no one knows this more than agent Michael Thorton. A talented young agent cast out by his government, Thorton is the only one with the information needed to stop an impending international catastrophe. To do so means he must cut himself off from the very people he is sworn to protect. As players determine how to accomplish different objectives, the decisions made and actions taken in each mission will ultimately transform the type of secret agent Michael Thorton will become. Every choice the player makes as Michael Thorton will carry consequences for his future and the fate of the world.

Minimum System Requirements

OS: Windows XP/Vista/7
Processor: Intel Pentium 4 @ 2.0 GHz / AMD Athlon XP 2200+
Memory: 1 Gb
Hard Drive: 12 Gb free
Video Memory: 128 Mb
Video Card: nVidia GeForce 6800 / ATI Radeon X1600
Sound Card: DirectX Compatible
DirectX: 9.0c
Keyboard
Mouse
DVD Rom Drive

Recommended System Requirements

OS: Windows XP/Vista/7
Processor: Intel Core 2 DUO @ 2.5 GHz / AMD Athlon 64 X2 5400+
Memory: 2 Gb
Hard Drive: 12 Gb free
Video Memory: 512 Mb
Video Card: nVidia GeForce 9800 / ATI Radeon HD 2900
Sound Card: DirectX Compatible
DirectX: 9.0c
Keyboard
Mouse
DVD Rom Drive

Download Alpha Protocol – Direct Links

Part 01 – 700 MB

Part 02 – 700 MB

Part 03 – 700 MB

Part 04 – 700 MB

Part 05 – 700 MB

Part 06 – 700 MB

Part 07 – 700 MB

Part 08 – 700 MB

Part 09 – 700 MB

Part 10 – 700 MB

Part 11 – 700 MB

Part 12 – 700 MB

Part 13 – 700 MB

Part 14 – 700 MB

Part 15 – 402 MB

Crack

www.elj-games.blogspot.com

The Sims 3: Late Night [PC Game]

The Sims 3: Late Night

Developer: The Sims Studio
Publisher: Electronic Arts
Genre: Simulation
Release Date: October 26, 2010 (US)