Aetna Lowers Rates

Aetna lowers rates for major medical health insurance plans in Georgia by 16%! Consumers will see an immediate benefit as Aetna lowers rates for all under age 65 health insurance in Georgia.

Click here to compare your current rates to Aetna!

aetnaPrice their top selling Value $10,000 plan. Add dental for a few dollars more.

  • $40 office copay (primary care)
  • Generic drugs not subject to deductible.
  • Annual physical exam, no charge
  • Annual GYN exam, no charge

Other popular plans include Value $5,000, Open Access PPO $2500 and Open Access PPO $1500

Aetna lowers rates on popular HSA plans as well.

Check out these Aetna health insurance plans today.

Obamacare Casualties

Five more health insurance companies become casualties in the Obamacare war on consumers. Aetna, Cigna, Guardian, American Community and Pekin will all leave the individual major medical market in the next few months. Together, these 5 insurance companies cover about 10% of those with individual health insurance in the state of Indiana.

Obamacare sinking

As reported by the IBJ . . .

Their major complaint is about the new health law’s requirement that at least 80 percent of premiums be spent on medical bills. That new rule, known formally as a medical loss ratio or MLR, takes effect this year for all individual policies the insurers hold, not just new policies.

The insurers argue that the marketing and administrative expenses on individual policies are so high that they cannot transition so quickly to the new standard.

Even if they could make the change, policyholder services are already suffering due to downsized customer service departments. This means longer hold times and a greater chance of getting voice mail in lieu of a real person.

Many carriers have already shifted their customer service overseas to places like India and Pakistan where wages are lower.

Imposing loss ratio's on company's operating in a competitive market is stupid to say the least. If a carrier spends too much on themselves and it leads to an increase in premium rates they will lose market share.

The idiot's in DC look at pockets where market saturation is dominated by one or more carriers and claim this is proof positive that more regulation is needed. According to the report, Anthem Blue Cross has a 65% market share which politicians use to defend their position.

I look at the same thing and say they must be doing something right, delivering good value, or else their market share would be significantly less.

Golden Rule health insurance is number 2 in Indiana with 10% of the market.

If Blue Cross has 6.5x the market share of Golden Rule one must conclude that Blue delivers a better value than Golden Rule. Their pricing has nothing to do with how much, or how little, either carrier spends internally on administration.

So far Georgia is pretty much immune to the wholesale withdrawal by health insurance companies but our time is coming. I would not be surprised to see Aetna or Cigna pull out of Georgia before the end of the year.

Their products have failed to deliver good value for some time and the same can be said for Golden Rule who have been uncompetitive for over 3 years now.

Bob Vineyard at Georgia Insurance Shop is willing to help GA citizens find affordable health insurance for individuals, families and business owners.

Aetna Pulls Out

Aetna is withdrawing from the individual major medical market. They will no longer issue new policies and the status of existing policies cannot be determined. Aetna will probably renew those plans, or they may (at their option) simply non-renew.

This announcement impacts Indiana clients at this time but there is no reason to believe it will not extend to other states including Georgia.

They will continue to offer coverage through AARP.

Aetna has been a flaky carrier all along in this market so this comes as no surprise. Last year in Georgia they raised rates on some policyholders three times in a matter of months.

If you live in Georgia and have Aetna health insurance you should consider switching coverage now while you still can.

Georgia Insurance Shop can show you affordable plans with other health insurance companies that fit your needs and budget.

Out of Network Charges


Hartford managed care provider Aetna Inc. is suing six New Jersey doctors over medical bills it calls "unconscionable," including $56,980 for a bedside consultation and $59,490 for an ultrasound that typically costs $74, Bloomberg News reports.

The lawsuits could help determine what pricing limits insurers can impose on "out-of-network" physicians who don't have contracts with health plans that spell out how much a service or procedure can cost, the online news service said.

One defendant billed $30,000 for a Caesarean birth, and another raised his fee for seeing a critically ill patient in a hospital to $9,000 in 2008 from $500 the year before, the insurer alleges in the suits. The Caesarean price was more than 10 times the in-network amount Aetna quotes on its website.

"If these charges are accurate, consumers and purchasers should be outraged," said David Lansky, president of the San Francisco-based Pacific Business Group on Health, a coalition of health-insurance buyers that includes Chevron Corp., Walt Disney Co. and General Electric Co.

Lawyers for the doctors declined to comment on specific charges in the suits, and said their clients did nothing wrong, Bloomberg reports.


Obamacare – Another One Bites The Dust

Obamacare has led to one more health insurance company withdrawing from the market. This means less competition, fewer choices, higher rates. Aetna is pulling out of the Colorado market as of 2/1/2011. They will no longer offer health insurance for individuals, families or self employed in Colorado.

Aetna decided to withdraw from the small group health insurance market in Colorado last October (2010), so this is a natural progression.

Existing major medical policyholders will be offered one 12 month renewal before their coverage with Aetna terminates.

Aetna is still under a cloud imposed by CMS (Center for Medicare Services) and is enjoined from offering Medicare Advantage plans anywhere in the United States. This sanction has lasted for a year with no indication it will be lifted any time soon.

As for now, Aetna has not indicated they will withdraw from the individual major medical market or small group market in any other states, including Georgia. Given their relatively small market share we would not be surprised in seeing them systematically withdraw from other states over the next few months.

If you live in GA, and have Aetna coverage for individual major medical or small group coverage, now might be a good time to consider making a change.

Employer group health plans can move at any time without loss of coverage.

Individuals in GA are not as lucky. Only those who can pass underwriting will be able to move to a new health insurance company. Do not drop your Aetna coverage until you have secured new coverage from a new health insurance company. Do not make application with a new health insurance company until you have had your medical conditions pre-screened by a competent Georgia health insurance agent.

Georgia Insurance Shop represents all the major health insurance companies in GA and will be glad to review your current coverage, offer side by side comparisons, and assist in finding the most affordable health insurance plan available to you.


Aetna Will Probably Abandon the Individual Major Medical Market

Aetna has made another stupid move that will most likely cause them to abandon the individual major medical market in the next 18 months. Always a pain in the butt to deal with and customer service that is really cuss-tomer service.

Their latest move will put their very small block of individual major medical business into a death spiral.

Obamacare is taking its' toll on the individual health insurance market, leading to fewer choices and higher premiums. Parent's looking for children's health insurance have almost no options except to add them on as a dependent to their own plan.

Obamacrap has also killed the maternity benefit as an option in Georgia.

Last week Aetna sent a notice to agents that compensation will be cut drastically. New business comp is half what it was before. As if that wasn't enough, they also are cutting existing comp on in force renewal business by 70%.

The result will be agents will be forced to abandon Aetna as a resource for new business (no big loss there) and will move as many healthy clients as possible to new health insurance companies leaving Aetna with only the sick people.

Aetna's block of business will deteriorate to the point that premiums will be insufficient to cover claims, leading to larger and larger rate increases going forward. The policyholder's left behind will be held captive with no place to go and few options. Either they will have to pay the higher premium or drop coverage and go without for at least 6 months until they can get into Obama's PCIP program.

This is just another stupid carrier trick.

Wedding Postponed for Health Insurance

The Washington Post reports a bride to be in North Carolina has postponed her wedding until she can obtain health insurance. According to the Post:

Rachelle Friedman was paralyzed from the chest down after one of her bridesmaids shoved her into a pool just a month before her June wedding to her college sweetheart.

Things can get rowdy sometimes and this is definitely tragic, but so is going without health insurance. As Marlin Perkins might say, "Just as a mother bear protects her cubs, protecting your finances from loss is accomplished with a health insurance policy".

They told ABC News that their combined income as a married couple would be too high to qualify for Medicaid payments. Friedman needs the state and federally funded health coverage to pay for her constant care and rehabilitation.

We don't know how old this woman is, nor anything about her finances before the accident. Nor do we know if her parents could have provided health insurance for her either separately, or as a dependent on their plan. This moment of revelry has changed her life, probably forever and now they are expecting the taxpayers to pay for her care.

Affordable Health Insurance in Georgia

Health insurance does not have to be expensive, especially for young people. Georgia Insurance Shop has several clients under the age of 30 that are covered by excellent health insurance plans for less than $150 per month and some less than $100. For $3 to $5 per day you could have a major medical insurance plan from Blue Cross, Humana, Cigna, Aetna or other health insurance companies. Ask for a competitive rate quote today.

Trickle Down Effect of Obamacare

Hurricane Obamacare is a category 5 storm that will make landfall in January, 2014 but already we are feeling the effects of the feeder bands buffeting the country. On Monday HHS confirmed that the MLR (medical loss ratio's) as defined in Obamacrap would go into effect in 2011 without modification. We explored some of the impact of this MLR in yesterday's post.

But the MLR is much more insidious than just limiting the amount health insurance companies can spend on overhead. It is a jobs killer. 

Already several smaller health insurance companies have either exited the market or have announce they will soon leave. More will follow.

Giants like Aetna, Humana and others have already slimmed down by laying off hundreds of workers that service their health insurance block. Many of those are still unemployed and more will follow over the next few months.

These layoffs affect their ability to service prospective and existing clients. Already those of us on the front line have seen a noticeable impact on the ability to secure answers to service issues or have problems handled in a timely fashion.

Agent commissions are due to be cut drastically in January of 2011. Some say this is a good thing, but all that glitters is not gold.

Agents are 1099 employees and as such, cost the health insurance company nothing until a service is performed. The carriers do not pay our rent, or insurance or salaries. We pay all of that from our revenue.

Already it is anticipated that half the agents who are working the health insurance market will leave. That number may be low. The rest have already decided they can no longer afford to provide a high level of client service due to the fact our compensation will be cut in half and in many cases even more than that.

This lack of "free" service will shift the burden back to the home offices who are already trying to do more with less staff. If you think customer service is bad now, just wait.

It will also lead to increased complaints about the responsiveness of the health insurance companies. Complaints that will filter to state agencies who have also cut staff due to lack of state funds.

Health insurance will become a self service commodity. Some think that is a good thing. Some believe insurance companies should not profit from health care. They point to executive compensation packages, total profits and stockholders and blame them for the high cost of health insurance.

But in doing so they ignore the facts.

Executive compensation will be mostly unchanged although some will inevitably lose their job as departments are cut or eliminated. If profits suffer too much those carriers that remain in the business will withdraw, leaving less competition and higher premiums.

For what it is worth, the profit margin on health insurance averages 3%. If you look at what is commonly quoted as an average health insurance premium of $350 per month per individual then if there were $0 profits premiums would decline by about $10.

And how will stockholders be impacted?

Well, it depends.

You need to realize that stockholders are mostly retirement plans. Roughly 80% of all publicly traded stocks are held by employee retirement plans. In spite of all the media attention on Wall Street "fat cats" and their massive stock holdings, most stock is held by Joe and Mary Lunchpail. When stocks take a hit the little people suffer.

We touched on some of the issues of the MLR in yesterday's post but the impact on businesses, both large and small, is quite far reaching.

Starting in 2011 health insurance companies will have to track premiums, claims, and administrative fee's and provide a year end accounting on how much was spent on each item. This report will go to HHS but most likely also to the IRS.

If the health insurance company failed to meet the mandated MLR they must issue refund checks, and 1099's, to all covered participants. That cost will be factored into their overhead which means even less for customer service.

The checks that go out to businesses are quite complicated. Starting in 2012 business owners will start to receive refund checks for premium overcharges if things go as planned. The money received by the business means a possible amended business tax return, but it also means each business must pro-rate the refund over each individual that was a plan participant during the year and issue refund checks to those individuals.

If the premium was deducted by the employee on a pre-tax basis that means an amended return for them, and even more work for the IRS.

So far it seems as if the only winners in this deal is the IRS.

These checks and the headache that goes with this grand scheme will hit in 2012, which coincidentally happens to be an election year . . .

I wonder how many voters, already disenchanted with what they have seen of Obamacrap and who voiced their opinion at the polls a few weeks ago will return in November of 2012 and throw the bums out?

Hurricane Obamacrap has not yet made landfall but already the disruptive forces of this category 5 storm are being felt.

Georgia Health Reimbursement Arrangement's

Individual health insurance in Georgia and HRA's (Health Reimbursement Arrangement) just got a big boost. Georgia insurance code, Section 33-51-7 as amended specifically allows individual health insurance plans to be funded through an HRA and will not be subject to Georgia small group health insurance laws.

Federal guidelines for HRA's can be found in IRS Publication 69.

You may enjoy several benefits from having an HRA.

  • Contributions made by your employer can be excluded from your gross income.
  • Reimbursements may be tax free if you pay qualified medical expenses. See Qualified medical expenses, later.
  • Any unused amounts in the HRA can be carried forward for reimbursements in later years.

In addition to the above, individual health insurance policies are not subject to expensive COBRA rules and regulations.

The ability to carry over unused funds from one year to the next makes the HRA more attractive than the "use it or lose it" rules under an FSA.

If you are a business owner in Georgia that is burdened by excessive rules that apply to group health insurance plans, you might want to consider a Health Reimbursement Arrangement and individual health insurance policies.

Affordable Major Medical Insurance in Georgia

Georgia Insurance Shop specializes in major medical plans for individuals and families. We represent all major Georgia health insurance companies including Blue Cross, Humana, Cigna, Kaiser, Aetna and more.

Eat Twinkie's, Lose Weight

Lose weight and lower cholesterol by eating from the vending machine. CNN reports that Mark Haub, professor of nutrition at Kansas State University ate Twinkie's, Nutty Bars and powdered donuts for 10 weeks.

The result?

His body mass index went from 28.8, considered overweight, to 24.9, which is normal. He now weighs 174 pounds.

Haub's "bad" cholesterol, or LDL, dropped 20 percent and his "good" cholesterol, or HDL, increased by 20 percent. He reduced the level of triglycerides, which are a form of fat, by 39 percent.

I eat pretty much anything I want but do have a bit more variety. Not sure the wife would agree to letting me go on a diet of sugar but if the results were there . . .

Affordable Health Insurance in Georgia

For those with a healthier lifestyle, Georgia Insurance Shop has health insurance rates available instantly online. Compare all major health insurance companies including Cigna, Blue Cross, Humana, Kaiser, Aetna and more.