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HCR Update: Grandfathering and HealthCare.gov

Jul 22, 2010

Health Care Reform Update


July 9, 2010



Grandfathering allowed for most standard and non-standard plans 

As we recently communicated with you, the federal government has issued Interim Final Regulations for the grandfathering provision. Because there are advantages to grandfathering, we will grandfather most standard and non-standard plans in our portfolio. To help you better understand what this means to your clients, we've put together this Grandfathering Fact Sheet. It explains:

£     More about grandfathering

£     What changes can be made without losing grandfathered status

£     What changes will result in losing the grandfathered status  

This is an important provision for many individuals and group policyholders. You can expect more information about grandfathering, including how we will implement it. As always, please talk with your sales representative if you have any questions. 

 


New government website lets consumers compare insurance plans 

The U.S. Department of Health and Human Services (HHS) has just launched HealthCare.gov, a website designed to help individuals and small businesses compare both private and public health insurance plans. Through HealthCare.gov, consumers can find information on literally thousands of private and public health care products. 

Important note about how our products appear on the site

Please note that our products are listed under our legal entities - not our brand names, which may cause confusion. We're currently working with HHS to correct this matter, and we hope to have our familiar brand names appear on the website soon. Until then, please be aware of how our products are listed on the website, state by state: 

£     California: Blue Cross of California, Anthem Blue Cross Life & Health Insurance Company

£     Colorado: Rocky Mountain Hospital and Medical Service, Inc.

£     Connecticut: Anthem Health Plans, Inc.

£     Georgia: Blue Cross and Blue Shield of Georgia, Inc., Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.

£     Indiana: Anthem Insurance Companies, Inc. 

£     Kentucky: Anthem Health Plans of Kentucky, Inc.

£     Maine: Anthem Health Plans of Maine, Inc.

£     Missouri: RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC),

£     Nevada: Rocky Mountain Hospital and Medical Service, Inc.

£     New Hampshire:  Anthem Health Plans of New Hampshire, Inc.

£     New York: Empire HealthChoice HMO, Inc., Empire HealthChoice Assurance, Inc.,

£     Ohio: Community Insurance Company

£     Virginia: Anthem Health Plans of Virginia, Inc.

£     Wisconsin: Blue Cross Blue Shield of Wisconsin, Compcare Health Services Insurance Corporation  

In October, HealthCare.gov will also start including rate estimates for private insurance plans. We're working with the government to determine how small group information will appear in states with no community ratings.  

HealthCare.gov can be a valuable tool for your clients, which is why we're working hard to have our recognizable names appear on it soon. We'll keep you posted as more information becomes available to us. If you have any comments or questions, please talk with your sales representative.

Getting to the bottom of health care costs 

Did you know: Only three cents of every premium dollar is profit? 

On average, 87 cents of every premium dollar you pay is spent covering medical care and services that members receive like doctor visits, hospital costs, prescription drugs and more according to a PriceWaterhouseCoopers medical cost trend report for 2009. Another 10 cents funds services we provide like claims processing, enrollment and billing and provider credentialing. That leaves 3 cents of every premium dollar for profits. Kaiser Health news has reported that the combined annual profits of the top 10 health insurers are equal to just two days work of national health care expenditures or just 0.5% of the estimated $2.5 trillion the nation spent on health care in 2009.

 


This content is provided solely for informational purposes: it is not intended as and does not constitute legal advice. The information contained herein should not be relied upon or used as a substitute for consultation with legal, accounting, tax and/or other professional advisors.

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