Of the endlessly debated provisions in the Patient Protection and Affordable Care Act (PPACA), the requirements for Medical Loss Ratios (MLRs) stand out for insurance companies because the requirements are designed to dictate how those companies pay their bills.
Until now, it’s been mostly unclear how those requirements will affect consumers. But a new study from the U.S. Government Accountability Office released last week sheds some light. And experts are weighing in.
First, some background: For every dollar taken in by insurance companies for health plans, those companies will now be required this year under the PPACA to spend either 80 or 85 cents – depending on the size of the plan; smaller group plans are held to the lower number – on costs related to healthcare.
In the past, insurance companies have traditionally spent less than that on healthcare costs and as much as 30 or 40 percent on administrative costs. The ratio of healthcare costs to administrative costs is called – you guessed it – the Medical Loss Ratio.
Luckily she had invested in gadget insurance, so her camera (along with her laptop, cellphone and other electronics) was covered for theft with a $50 deductible. Speed says she is glad for the peace of mind that comes with paying Worth Ave Group Insurance a couple of hundred dollars a year to cover all of her electronics.
When Ronna Wisbrod, a real estate broker and personal organizer, returned to the Chicago area last year, she needed to figure out new health insurance. Now 57, she knew she had to have insurance, but as she set up her own business, Organization by Ronna, she also wanted to keep costs down.
“I’m at a rebuilding stage and in the process of rebuilding my budget, [which] is very tight,” Wisbrod says.
No one’s immune. Virgin Atlantic mogul Richard Branson’s compound on Necker Island in the British Virgin Islands was destroyed by fire this week after being struck by a Hurricane Irene-connected lightning bolt.
Is my head in the clouds? As darkly volatile as this moment in personal investing may seem, it’s actually a golden age for portfolio insurance. Retirement worries as we know it can come to an end — if you know how to hedge properly. There are plenty of retail tools available to that end.
If you’re self-employed and work out of your home, it’s probably occurred to you that you ought to have long-term disability insurance. If you’ve mentioned this to your insurance agent, they’ve probably told you it’s a good idea and not a problem.
But, chances are when you looked into it, it has, indeed, been a problem.
Policies seem expensive and unlikely to replace the income you actually need — if you can get coverage at all.
A mid-career engineer, Michael Eckman, 37, bounced back from a year of unemployment by recently landing a new job about 15 miles northwest of Philadelphia. It happened quickly. He sent the initial application on a Wednesday, heard back that Thursday, interviewed Friday and received an offer a week later.
Once employed, his benefit choices emerged quickly, too.
For health insurance, he had two options: He could access a traditional preferred provider organization, which would organize every aspect of his healthcare.
Marissa Dennis had a relatively uneventful labor and recovery when her son was born at a New York City hospital in 2008. So she and her husband were taken aback when they received a bill for more than $800 for the handful of routine check-ins they received from the on-call pediatrician.
“It was 10 times what the entire rest of the bill came to,” she said. It turned out that while the hospital took the family’s insurance, the pediatrician didn’t. Dennis and her husband managed to pay the unexpected bill, she said, “but it really ticked us off.”
The following is a guest post by Jennifer Merritt. The opinions expressed are her own.
When 49-year-old Femi Obikunle began shopping for life insurance three months ago, the price seemed right. For under $900 per year, the generally healthy father of four was told he could likely get a $500,000 term policy. Then came the physical and blood tests. The new rate he was quoted: more than $4,000 per year.
According to a Wall Street Journal report, some of them will scour state mortality lists to make sure they aren’t paying out any lifetime benefits (such as from annuities) to people who have died. But they won’t bother to check those lists for life insurance policyholders whose beneficiaries may have some money coming to them.
“That’s not their job,” said fee-only insurance consultant Peter Katt. “It’s in their business interest to avoid paying death claims.”