Georgia Health Insurance 411

Archive for February, 2010

Have you lost track of a life insurance policy? Has a loved one passed away and you are not sure you have found any or all life insurance policies?

The folks at MIB may be able to help.

170 Million Records. The decedent’s name is searched against our Policy Locator database. It contains over 170 million records representing inquiries submitted on individually underwritten life insurance applications processed during the last fourteen years.

Largest Fraud Detection Service. The data is collected by MIB from virtually every North American carrier involved in life insurance.

Match Against Applications. It is important to note that a Policy Locator search provides notice of an application which may have resulted in policy issuance.

For $75 per search, this is a valuable tool

Those with ovarian cancer may have a new way to combat the disease. The WSJ reports that Avastin is showing promise in testing as a treatment for ovarian cancer. Avastin is already approved for colorectal, breast, lung and kidney cancers.

More good news.

Four years ago a 30 day dosage ran $8,000 per month. Now it is $600.

If it seems like Blue Cross is the favorite punching bag of Washington and the media, it is not just your imagination.  Anthem/Wellpoint, parent of several Blue Cross plans (including Blue Cross of Georgia), is catching most of the heat.

Frankly, most of the criticism is a cheap, political ploy that is more theatrics than substance. But now it seems the AJC has jumped on the bandwagon in attacking the Georgia Blue Cross plans.

Alex Sabbeth’s anger went through the roof when he recently received nearly a 72 percent increase in his health insurance premium.

He sees it as proof of the health insurance industry’s desire for profits.

“Out of a habit of greed, they are raising people’s rates,”

This is a fairly common reaction, but without basis in fact.

Sabbeth’s policy — with a $10,000 deductible — was with Blue Cross/Blue Shield of Georgia. He had been paying $241.99 a month. The company’s letter told him that the new rate would be $415.40 a month, a one-shot increase of 71.6 percent.

He had just turned 60 years old, and while he is in good health he does have noncancerous lesions removed from his face about once a year.

Depending on how long he has been with Blue Cross, the increase could be part of their “normal” routine. Having worked with BCBSGA for several years I know their policies tend to get fairly pricey from the third year on. They are generally not a company I recommend if one is going to need coverage for more than a couple of years.

Blue is one of the few carriers that still use 5 year age brackets which means a big jump in renewal rates for ages that end in 0 or 5.

And the skin lesions have nothing to do with his renewal.

Sabbeth is concerned that the insurance company is trying to drive him off with the increase. He’s already searching around for a new policy.

Searching for a new policy is the right thing to do as long as he is aware his pre-existing condition will affect any final offer from a new carrier. Depending on the details, and the carrier he picks, it may not be a major issue. But most folks don’t know how to navigate the process of searching for and finding a plan that covers what is needed and delivers real value.

At Georgia Insurance Shop we pre-screen all applications before they are ever submitted to the carrier for review.

The Obamahouse and media have seized on the WellPoint Blue Cross profits and are using the bully pulpit to drum up support for health insurance reform. ABC News provides some insight into the profit structure of WellPoint and for those who are paying attention, takes the hot air out of the Obama-Sebelius tag team attack.

Let’s take a look at the ABC News interview with WellPoint CEO Angela Braly.

Q: How does WellPoint make its money?

A: The Indianapolis insurer made about $4.7 billion in 2009, a total stoked by the $2.2 billion it received from the sale of a pharmacy benefits management subsidiary.

Outside that, WellPoint made most of its money through employer-sponsored group health insurance. It reported $2.4 billion in operating profit from that segment last year, which amounts to about 58 percent of its total earnings.

The insurer has said it gets only about 10 percent of its operating income from individual health insurance like the kind it sells in California.

For sure, $4.7 billion sounds like a lot of money to the average Joe.

But so does a $1.4 trillion dollar deficit. I don’t recall anyone complaining about that.

But I digress . . .

WellPoint made almost half their profit through the sale of a PBM subsidiary. MOST of their profit comes from employer group health insurance plans.

No one is complaining about that either. So what about those individual health insurance plans that have a target on their back?

Only 10% of their revenue, not profit, revenue, comes from the sale of individual health insurance.

The interview goes on to address why individual health insurance premiums in California will be increasing by double digits, and why businesses don’t set prices based on profits.

Interesting read.

At least for those with an open mind.

Or those who don’t have a personal agenda . . .

Dr. Daniel R. Lerom is listed in documents as having a long-standing sexual relationship with his Lakeland patient, listed only as “HK” in a lawsuit filed with Hillsborough County Circuit Court.

Each time they two had sex, documents say, the doctor would bill her Blue Cross Blue Shield Insurance for their “sessions.”

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No, it is not your imagination. If you are trying to buy health insurance in Georgia you are going to find it pricier and harder to qualify. Premiums for new health insurance plans are jumping 6% on a quarterly basis in some cases. Renewals on existing major medical coverage for individuals and families are trending at 20% in many cases. Group insurance plans for business owners are looking at 30% increases on renewals and new business rates are also higher.

In addition to higher rates, underwriting of health insurance for individuals and families is getting tougher and taking longer. Health insurance companies are almost routinely requesting doctors records before making a decision on your application and in some cases are refusing to approve coverage if you have not had a physical exam in the last 12 months.

Medical conditions that in the past were either considered a “standard” risk or elicited a nominal upcharge in premiums are now become major stumbling blocks.

We have entered a “hard” market for health insurance.

Many of the economic factors that affect businesses in the mainstream are filtering down to health insurance companies. All health insurance companies are seeing a noticeable drop in enrollment and those who are applying for health insurance are generally in poor health. Those who have individual or family health insurance are dropping coverage altogether if they consider themselves healthy.

What is left on the books are generally those who are sicker which raises claim costs relative to premium income.

Toss in the folks who opted for COBRA that normally would not have if not for the ARRA subsidy and the health insurance companies have a mess on their hands.

Insurance companies that cater to the group health insurance market are seeing participation in COBRA plans double or more. While that block was never profitable, it is even less so now and is gradually becoming a larger portion of their overall block.

In spite of what you may hear from the media and politicians, profits are being squeezed and the only way to maintain financial solvency is to increase premiums and when allowed, tighten underwriting criteria.

Here in Georgia we are seeing rates on the rise and it is becoming more difficult to get an individual or family health insurance policy issued. I would estimate at least 90% of health insurance applications are either denied or issued at something other than standard rates. Some carriers have told us they are rejecting 40 – 50% of applications for coverage.

A lot of those people come to me for assistance. Not too long ago I would review a risk profile for a prospective client, pre-screen that profile with a handful of health insurance companies, and then we could make our choice.

I still do that but I am also finding that I have to submit an application to two or three insurance companies before we get an acceptable offer.

Until the economy turns around, and it is not showing any signs of doing so, anyone looking to buy affordable health insurance in Georgia will be disappointed in how difficult it has become. No amount of rhetoric or tax dollars from Washington will cure our problems until consumers and business owners have confidence in the future of the economy.

When consumers have confidence and the ability to make purchases other than the basic necessities, businesses will start to hire and expand. We don’t have a credit crisis, we have a confidence crisis. All of this is spilling over to drive up the cost of health insurance which only serves to fuel political flames.

We still have the ability to help clients find affordable health insurance in Atlanta, but it is just getting more difficult every day.

We work with clients to help them find affordable medical insurance in Atlanta Georgia and show them how to become smart shoppers when it comes to prescription medication. As a general rule, if you want to save money overall, prescription coverage and Rx copay’s don’t play well together. When a health insurance company is reviewing your application they evaluate the cost of treating the illness as well as the cost of any medication.

Here is a clue.

If you are taking a prescription drug that is advertised on TV you are probably paying too much.

Paying too much in higher health insurance premiums, and paying too much for a medication that can treat your problem for a lot less. Consumer Reports illustrates this in their comments on a popular drug used to treat BPH (benign prostate hypertrophy). Many doctors prescribe a widely advertised drug Flomax to help men who have a “going” problem.

Flomax is an alpha-blocker and a recent report indicated there is no single alpha-blocker that is better or safer than another. Flomax will set you back as much as $250 per month but a careful shopper can find it at about half that price.

But a generic alpha-blocker such as Doxazosin is less than $10.

If you are looking for a Georgia health insurance plan with a copay, and are taking Flomax, you should consider the impact that will have on your final rate. It would not be unusual for a health insurance company to increase your premiums by $100 per month to cover the additional risk of Flomax.

Opting for a different plan that does not have a copay could save you $150 per month (when compared to a comparable copay plan). Add in the additional savings of switching to a generic alpha-blocker and your premium savings could easily be $300 per month.

There are many different ways to make health insurance in Georgia more affordable and this is just one of those ways.

If you have health issues, and need life insurance in Georgia, a new plan is now available for individuals up to age 85. The most unique benefit of this plan is the FULL FACE AMOUNT is available upon issue. No requirement to wait up to 3 years before the full amount is payable.

Here are just some of the conditions that would normally result in a decline for life insurance that can be approved under this new plan.

• Cancer, if not diagnosed or treated in the past 12 months
• Heart conditions, if not treated or diagnosed in the past 24 months
• Diabetes, if there are no complications and, if insulin dependent, insulin use began after age 40
• Most with Lupus, MS or Parkinsons will be accepted
• Hepatitis C if not diagnosed or treated within 24 months

Liberal build tolerance. BMI up to 40 can be acceptable.

There are no occupation questions. Missionairies, miners, crop dusters and other hazardous occupations are acceptable.

There are no physical exams or blood work required.

If you have had trouble buying life insurance in Georgia, contact us about this plan underwritten by an “A” rated life insurance company.