technology insurance

Health Insurance Premiums - What insurance carriers don't tell you.

2008-08-08T21:23:00.001-07:00

A Northern California newspaper reported today that insurance companies are indicating that their average 2008 health insurance premiums will increase on average 10%.

We disagree. Although statistically this may be accurate, the truth is that our office has seen rates in California and Texas averaging 20-27% this year. One national Health provider has sent a number of our clients premium increases of 40-65%. Most increases will become effective in July (for new business) or at the policyholders 6 month anniversary or 1 year anniversary.

What you are not hearing from the insurance industry is that these future rate increases do not include age increases or policy age banding changes. The most common method of age banding is to have a single rate for individuals between age 35-40, etc. This year a number of insurance companies have eliminated "age banding" and are now charging a tier rate, meaning you will receive age change increases, at birthday 35, 36, 37, 38, 39, 40. Insurance providers are also charging higher rates for women, a perfectly legal practice, as their actuarial staff supports these increased rates with a higher utilization of services and more medical conditions.

What should you do?

First, start with running an instant health insurance quote online two to four times a year. Online brokers have the most up to date rates and you can compare your policy against other companies best plans available in your state. It takes less than 5 minutes.

With this information, plan a potential exit strategy if your premium rates become unaffordable. Insurance companies usually notify you in advance of their intention to increase premiums. If you decide to switch carriers, you should have ample time to apply and be approved with a new company prior to receiving any actual rate changes. This policy is also good to avoid any potential gap in coverage. Another tactic is to change plans within your current health insurance companies product portfolio. This is valuable if you have on going medical conditions or serious pre-existing conditions.

Take time to design a health insurance program that meets your family or businesses needs. This is a serious financial commitment, especially if you select the wrong plan.

Anthem California introduces 12 month rate guarantee

2008-08-08T21:22:00.000-07:00

If you own private health insurance, there is a good possibility that you could see three rate increases in 12 months. The first increase can be at 6 month's, another on your birthday and a third on the 12 month anniversary.

Anthem Blue Cross of California has recently modified their renewal process that could effectively save you money annually. Members now enjoy 12-month Anniversary Date rate guarantees. Anthem Blue Cross is pleased to announce that we're introducing Anniversary Rating for California Individual clients in the following products: SmartSense, Tonik and Lumenos®. With the Anniversary Rating methodology/model, premium and age adjustments happen at the same time - in the member's "Anniversary Month."

To compare your present insurance rates with Anthem of California, visit Quotebroker.com and receive a free instant health insurance quote for yourself, family or business. This website allows you to shop the insurance marketplace, using the same technology industry quoting system that was previously only available to insurance companies and industry insiders. Shop, compare insurance benefits, premiums and apply for an affordable health insurance plan online.

Affordable Healthcare for Texas

2008-08-08T21:21:00.002-07:00

Santa Clarita, CA (PRWEB) July 22, 2008 -- Quotebroker Insurance Services is expanding their Southwest Region territory by making their affordable health insurance products available to citizens in the State of Texas. Quotebroker specializes in providing free health insurance quotes and high risk medical plans for those who have difficulty obtaining affordable health insurance.

They provide insurance at competitive rates for individuals, families, groups, and associations, and are pleased to make their coverage available to the citizens, businesses, and other organizations in Texas for the first time.

Since Quotebroker is an independent online insurance brokerage firm and not owned by any insurance company, they are able to provide their clients with objective information about different insurance products, such as personal insurance plans, long-term care insurance, retirement planning, life, health, disability income protection, and a wide range of other insurance plans for individuals, groups, associations and their members in Texas, Arizona, California, and Nevada.

By providing free online insurance quotes, Quotebroker's prospective clients are able to choose from a variety of different affordable health insurance plans, weigh their benefits and coverage options, and select the health insurance that best serves the particular needs of their situation. This system saves their clients time, money, and greatly simplifies the process of choosing affordable health insurance.

With insurance costs rising for families, organizations, businesses, and individuals across the Southwest, there's never been a better time to reevaluate insurance coverage and conduct some comparison shopping to get the best coverage for the best rates. Quotebroker's free health insurance quotes provided on their website allow people to weigh their options at a glance from the comfort of their homes and make informed decisions on the type and amount of coverage they need.

Any persons, businesses, or organizations in the states of California, Arizona, Nevada, and now Texas who want to get the most competitive rates on several different kinds of insurance are encouraged to call Quotebroker toll-free at 800-783-0802 or visit their website at www.QuoteBroker.com, for a free health insurance quote.

Healthy Families Program for Kids

2008-08-08T21:21:00.001-07:00

The California Healthy Families program provides comprehensive, low cost health insurance, dental and vision coverage to children under age 19.

To qualify for the program, the child(ren) must:
** Live in California
** Are US citizens or qualified immigrants
** Are not enrolled in nor eligible for no-cost Medi-Cal
** Were not covered in the past 3 months in employer-sponsored insurance
** Meet certain family income guidelines (very liberal) Medi-cal is for the poor

Monthly premiums depend on the familiy size and health plan selected. Monthly premiums will range from $4 to $15 per child, but will not exceed $45 per family. There are No Deductibles.

Co-payments are low: $5 for office visits, ER and prescription drugs. Well visits and all well baby care under 24 months of age, have no copays. Family out-of-pocket copayment maximums for a benefit year are a low $250.

Program Benefits include:
* Office Visits
* Prescription Drugs
* Laboratory work and x-ray services
* Health exams and check-up's
* Hospital and ER services
* Immunizations
* Well-baby care
* Mental and Substance abuse services
* Vision and Dental coverages

These plans are offered by California's most popular carriers, which may vary by county.

For a free brochure or application, simply contact QuoteBroker at (661) 702-1755

Uninsureable? California Health Insurance Options

2008-08-08T21:20:00.001-07:00

There is still hope for individuals that can not qualify for Health Insurance. The Major Risk Medical Insurance Program (MRMIP) offers limited health insurance benefits to California residents who are unable to purchase health insurance due to a pre-existing medical condition. If you have a pre-existing condition and are not eligible for COBRA, Cal-COBRA, or HIPAA, then you can apply to MRMIP as a last resort to obtain health coverage.

MRMIP provides health care coverage through contracted health insurance companies and health plans. MRMIP is partially subsidized; however, qualifying participants must pay a portion of the premium, which is costly.

As a result of California legislation there is a 36-month limit for participation in MRMIP. At the end of this period, MRMIP enrollees are given a one-time opportunity to purchase guaranteed issue health coverage through any indemnity policy, PPO, or HMO currently offering individual health coverage in California. Eligible MRMIP participants who are “disenrolling” after the 36-month period have 63 days to apply for individual health coverage. Ninety days prior to the disenrollment, MRMIP participants receive a notice of disenrollment and 45 days prior to disenrollment, participants are mailed a Certificate of Program Completion that enables them to obtain individual health coverage.

All participating indemnity insurance companies, PPOs, and HMOs who offer comprehensive individual medical coverage in California are required to offer a Standard Benefit Plan that is substantially the same as the health coverage offered while on MRMIP. These Standard Benefit Plans are the only health coverage required to be offered on a guaranteed issue basis and are separate from other individual health coverage that is available in the marketplace.

Before considering applying for MRMIP, consider other options; including joining your employer sponsored plan (if available) or applying for individual coverage. Many individual and family plans accept many pre-existing conditions, including high blood pressure, elevated cholesterol, and other common medical conditions. In some cases the insurance carrier will charge an "up-charge" or rating.

Always shop for the most competitive and affordable health insurance coverages. Health insurance quoting websites such as QuoteBroker provide you with free instant quotes and comparisons from the largest insurance companies offering coverage in your state.

How to Determine if Your Home is Underinsured

2008-08-08T21:16:00.003-07:00

If you were to lose your home in a fire, would you have enough homeowners insurance coverage to rebuild your home and replace your possessions? You'd also need a place to live while your home is being rebuilt.

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Who Pays More for Car Insurance - Men or Women?

2008-08-08T21:16:00.001-07:00

Who are better drivers - men or women? As with most Battle of the Sexes debates - each gender can make a legitimate case. Women may claim they're safer drivers and less prone to road rage, while men may argue they're more adept at driving at high speeds and avoiding obstacles on the road. The debate can continue ad nauseam. But insurance companies can use statistics to answer the question - who pays more for car insurance - men or women?

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The Gas Price Crisis: 10 Cars That Cost More at the Pump

2008-08-08T21:15:00.001-07:00

Lately the news has been jam-packed with reports about soaring oil and gas prices. We all feel a little extra squeeze at the gas pump these days with the average gas price now up to almost $3.30 a gallon, and experts predicting the price of gas to top $4 per gallon in some states this summer.

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10 Ways Your Car Insurance Can Help You Get Ahead in 2008

2008-08-08T21:13:00.001-07:00

With the arrival of 2008 comes a new time to make resolutions, and hopefully keep them. While some may vow to quit smoking, lose 5 pounds, or start saving more money, this is the perfect time to start reaching your goals. One way to save some extra money that you might not be conscious of is lowering your car insurance rates. While comparing car insurance quotes is the best way to save money, there is still between 20% and 30% of the population that doesn't comparison shop.* Here are InsWeb's Top 10 Ways to Save on car insurance.

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Create Your Own Home Insurance Stimulus Plan in 6 Easy Steps

2008-08-08T21:12:00.001-07:00

Beginning this month, 130 million American households will begin receiving their economic stimulus payments. This is particularly good news for homeowners. In addition to the tax rebates of $600 for individuals and $1,200 for working couples, Americans with more expensive homes will now be able to refinance their homes at cheaper rates. While this economic plan will provide much needed relief for many borrowers, homeowners can experience long-term benefits by creating their own Home Insurance Stimulus Plan.
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Indonesia’s Insurance Threats

2008-08-08T21:09:00.000-07:00

Indonesia is a potential market for insurance, since It has billions of people and relative high growing economics. But why the insurance doesn’t grow as it expected.

I browse to the net, follow the lecturing, done some discussions with my friends, and here are the reasons that I got :

Religion and Belief
Indonesian society has strong belief and religion, they believe if the disaster get on them, it’s because of their failure or disobeying the God, if you get insured means that you don’t believe on God’s protection, and it’s a taboo to talk about disaster (it would be difficult to explain the insurance to them): Education
They felt they have educated enough about insurance, and all they know in generally is : “If I don’t have a trouble, I don’t get the money. My life is almost trouble free, why should I get insured? It’s just wasting my money!”: Financial Perspective
Prior to previous reason, they haven’t realize insurance as an investment, “If you want to invest, why don’t you buy a house, land or jewelry?” Those still a good investment methods, but not liquid enough.: Financial Condition
It’s all about the ability and the stability. We must have the ability to buy the policy and stabilty to pay the premiums consistently. I’m not sure about the number, but I think many Indonesians don’t have either the ability, stability or both. As long as I see, the insurance buyers in Indonesia are from the middle up economic level and forth, in fact there are many Indonesian people living below the poverty line.

MassMutual Creates New Workplace Environments To Match IT Transformation Effort

2008-08-06T21:14:00.001-07:00

Greetings from Massachusetts, where I’ve just completed a series of face-to-face interviews with several technology and business executives at MassMutual for an upcoming Carrier Confidential feature.

The Springfield, Mass.-based carrier is in the midst of an ambitious and far reaching technology transformation effort and while the nuts and bolts of that initiative (including SOA and ECM implementations) dominated many of the conversations, MassMutual’s technology leadership made sure that the topic of workplace culture was discussed as well.

In part to facilitate the kind of collaboration and cross-department outreach that is needed to support these large technology and process transformation, MassMutual has taken time to reassess its work environment. And in two specific programs, says Rich Pedersen, MassMutual’s corporate vice president and division head for US insurance group systems, the company has completely changed it workplace layout to address those needs.

“We’ve changed completely the lay out of the room [in these cases]. There are big open spaces and big overstuffed chairs,” Pederson says. “It’s a much more conducive place for creative work and for doing that out-of-the-box type thinking.”

Also as part of that effort, IT and business workers were co-located in the same space to facilitate alignment between the two groups. Overall, the goal is for open spaces and non-hierarchical seating. “You can see from one end of the room to the other. It’s that open, expansive kind of feeling and it’s just a different way than [how] a traditional insurance company might have approached it even five years ago,” Pedersen says.

As someone who has worked in both stuffy, uninviting workspaces and in more open, collaborative areas (the I&T offices share much in common with MassMutual’s new spaces, although I wouldn’t mind a more “overstuffed” desk chair.) I believe that these efforts are more important than most realize.

If you treat someone like a cubicle monkey, don’t be surprised when they act like one. And, on the other hand, when you place your intellectual capital in a collaborative environment, don’t be surprised if you start to see better partnerships formed and more innovative ideas.

“It’s a move away from that expected conservatism towards a more collegial environment,” explains MassMutual deputy CIO Bob Casale. “People seem to respond well to that.”

Nothing Suceeds Like........

2008-08-06T21:05:00.000-07:00

When it comes to legacy systems replacement the definition of success varies from company to company. And the criteria for success and how those criteria are measured varies from pretty low to …………………….not very high.

Let’s consider four key criteria that might be appropriate to measure the degree of success of a core legacy system replacement:

· the new system was implemented into production where it meets the functional, technical and quality requirements as defined

· the replaced legacy assets were decommissioned and no longer run

· the project was completed roughly within time and cost parameters

· the estimated business benefits which were used to justify the cost of the project were substantially realized.

Clearly these criteria are cumulative with the first being the most basic measure. Indeed it tends to be this basic measure, and only this basic measure, which most carriers invoke when declaring success, or ……..putting the project on hold. And even by this basic measure it is generally agreed that at least half of all such projects fail, as in they don’t result in an implemented system, or result in only a partially implemented system. This low level of success criteria and its corresponding high level of failure is yet another indication of how hard it is to succeed at transformational change. In fact it is not uncommon for carriers to try two or three or more times to replace a core legacy system before finally succeeding. Consider the following time line which is real but has de-personalised to protect the honest folks who put it together:

· 1998 – Carrier’s “Replacement Project” convenes with its number one recommendation endorsed by CEO – Replace the current Claim System!!

· 1998 – IT commences a huge project to build its own claim system – X is the lead BA; Y is the sole SME

· 1999 – The project fails miserably; the CIO is fired. X and Y get to keep their jobs

· 2000 – After Y2K, an RFP team (led by Y) chooses a Software vendor to replace all systems

· 2001 – The project commences to implement the vendor’s Commercial Lines System

· 2002 – The project commences to build with the vendor a new claim system

· 2003 – Both efforts (led by Y) fail miserably

· 2003 – And yet another RFP commences to find another Claim system (led by X)

· 2004 – The RFP team concludes there’s nothing out there and Carrier should build its own system!!

· 2004 – The project to build a system begins; a screen-scrape of the old system for claims occurs in the meantime

· 2004 – Both projects (led by X) fail miserably

· 2005 – Carrier contracts with a new vendor and begins (in July) the first of three phases to replace the claims system

· 2006 – Phase 1 goes in on schedule

· 2007 – Phase 2 goes in on schedule

· 2008 – Phase 3 goes in on schedule

· 2008 – Ten years after Replacement II, carrier replaces a core operating system!!

The striking thing to me is that this story is not unique, it is common. Many carriers fail multiple times before they succeed at transformational change. The interesting thing in this instance is that having got it right, the carrier got it really right. The phases of the implementation went in on schedule, and by implication pretty much on budget as well. Now the legacy claims system has been “completely replaced”, allowing for legacy retirement. I don’t know the extent to which the stated benefits are being realized in this specific instance but as the song (almost) goes: “three out four ain’t bad”.

So are there any lessons that can be generalized from this particular story? Yes indeed.

They at least include the following:

· most carriers have no rational case for getting involved in trying to build core insurance applications. The apps are too complex and the carrier will almost certainly fail

· if you do not select a vendor partner carefully and thoroughly a “package” implementation is also likely to fail

· if you are involved in a build failure or “package” failure learn from it like the folks in the timeline did

· just because there wasn’t a good third party solution the last time you looked, doesn’t mean there isn’t now

And finally, this is a story with a happy ending. And happy endings are not guaranteed.

As we have said before, transformational change is a risky business.

New Diabetes Technology: Should Insurance Companies Pay?

2008-07-10T05:28:00.000-07:00

Recently, Kerri has chronicled her struggles to get insurance approval of a continuous glucose monitor. She is hardly alone in her battle with healthcare providers to get coverage; many people struggle with this very issue. In fact, late last year, cgmscentral.com went live on the web as the only site dedicated to helping people secure reimbursement for their continuous glucose monitoring systems.

Manny at TuDiabetes sent out a request yesterday asking if we would post his video on this subject. At first, I was resistant to the idea, not so much because I disagree with him, but more because I think the insurance companies have been demonized, I think unfairly.
To some extent, I think the technology does deliver improved management for certain people, but in my opinion, the frustration over coverage (or lack thereof) should not really be directed at the insurance companies, but to the manufacturers, who frankly, have done next to nothing to get their product covered. In fact, they have largely left the task of justifying coverage to the Juvenile Diabetes Research Foundation to conduct the studies, rather than doing it themselves.

I have found myself playing the role of devil's advocate, asking people to look at the situation from a business perspective. The insured patients are, 99% of the time, NOT the insurance company's customer, rather it's the employers who buy the policies, and they are under enormous pressure to keep costs under control or they risk losing their customers to rivals. It's no secret that the insurance companies have a fiduciary responsibility to make a profit for their shareholders (which, by the way, are what many of you're 401K's and/or pensions are invested in, incidentally), and frankly, they make money, but not on a ROI basis at a comparable level to the drug and medical device companies. The insurance companies are essentially forced to make their decisions from this business perspective. It's true that they would for the most part, rather us have complications, but its NOT because they haven't fully analyzed the economics.

Insurance is all about managing odds, and the simple fact is that by denying this coverage, the odds are in their favor, because chances are extremely high that you will not even be covered by them when complications actually do strike. First, many people are likely to have several insurance carriers over the years due to job changes, or simply because employers negotiate deals with new companies (see my post here for more on that). The simple fact is that in most cases, those costs will be soaked up and paid for by Medicare, so our tax dollars end up absorbing that cost, but few if any insurance companies will be saving much of anything by actually paying the cost of this costly technology. In other words, they have everything to lose by paying it and stand to gain little if anything by covering it.

In my opinion, the real crooks here aren't the insurance companies, but the manufacturers of this costly technology -- no one is trying to deny them the chance to earn a profit, but they don't need to rape, pillage and plunder us and our healthcare providers in the process! Let me also add that the only way to really effectively address this is to abandon the for-profit insurance system we now have ... something I'd LOVE to see happen, but I doubt we'll ever see that because of industry lobbyists in Washington! The odds are that we still also won't have any form of universal coverage by the end of 2009, regardless of who wins the White House, because we're now so far into debt for the Iraq war that whoever is in the White House or in Congress will really have their hands tied as to what they can realistically hope to accomplish given the budget situation. Who should we be thanking for that?

Others have justifiably argue that the U.S. tax code also should share some of the blame, and they have valid points. The U.S. government does not allow this medical expense to be tax deductible until it has reached 11% of your gross income. Think about what that means -- taxing my medical supplies that you might be forced to pay cash for is not sound policy under any circumstances, yet its done and no one is complaining to their Congressional reps about it while they have no problems blaming their insurance companies. Let's also remember that consumers pay anywhere from 35%-40% more than the list price of the sensors, so true cost of the sensors may be even more when considered at the after-tax cost.

To be sure, the insurance companies are hardly guilt-free; but I would argue they are being blamed unnecessarily for tax policies and poor healthcare policies that are really decided in Washington and in State Houses across the country.

Accounting and Financial Systems: Technological Enhancements Offer Promise — and Questions

2008-07-10T05:24:00.000-07:00

Insurers' accounting and financial systems -- including billing, annual reporting, portfolio management and investment management platforms -- are becoming increasingly integrated with other enterprise systems, boosting the automation of many financial processes. In addition, more-powerful reporting capabilities are putting vital information in the hands of decision makers. What are some of the technological enhancements to these systems that can improve the way carriers track, manage and report on their investments and financial performance? And what impact will new regulatory trends, such as principles-based reserving, and the possibility of an optional federal charter (OFC) have on the ways insurers address financial reporting and accounting requirements?

Insurance Technology Blog Started

2008-07-10T05:23:00.000-07:00

I see that CastleBay Consulting Corp., a consulting services firm to the P&C insurance market, has launched and will facilitate a new "P&C technology" blog to offer the industry "an open forum for opinion, conversation and experience-sharing". The P&C technology blog is intended to: "Coalesce and share perspectives from a broad group of technology minds in insurance for the benefit of the entire industry."

I'm sure that the blog will offer some very interesting perspectives, some of relevance to EDM-related issues, such as rules, analytics, and decision strategies, as well as many other issues outside our standard EDM realm. Users can access the blog at http://insurancetechnology.typepad.com.

We welcome the Insurance Technology Blog to the Blogosphere! And if the blogger-in-chief George Grieve would like to post here, we certainly encourage him to make contributions!

Fiserv Refocuses

2008-07-10T05:22:00.000-07:00

The insurance technology vendor world keeps making news, most recently with the announcement arguments that Oracle's and EDS' recent moves would heat up vendor consolidation, it does reinforce the notion that investors have confidence that insurance companies will continue to spend liberally on technology. that Fiserv will sell a majority share in its insurance businesses. While the news came too early to validate

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A Different Kind of Boot Camp

2008-07-10T05:17:00.001-07:00

I've recently started work on an upcoming I&T feature story on recruiting and retaining IT talent. I'm just now developing a focus but, already, I can tell that there will be no shortage of sources for the story. Just after taking a quick glance at the "workforce" folder in my e-mail inbox, I see that Aflac, Northwestern Mutual and Medical Mutual of Ohio's Antares Management Solutions (Antares, a wholly owned MMOH subsidiary, acts as an outsourcer to other insurers and also handles much of the carrier's internal IT work), among others have earned Best Places to Work in IT honors from Computerworld.

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