Medical Insurance Billing Nightmare

It is a medical insurance nightmare that began with a physician simply trying to make things easier for a patient.

A simple favor turned into money seizures, bill collections, and a lawsuit that were spinning out of control.

So, it was time to Get Gephardt.

The doctor patient relationship can be very personal.

So personal that I know many kind doctors will go out of their way to provide special help to a patient who is in particular need.

In this case, such a personal favor turned into a medical insurance nightmare for the patient...

With the energy Tiffany Schoenfeld displays to supervise her children around her home, you wouldn't suspect that she has a heart condition.

But she does...

Back in February of 2007, Tiffany wound up here at the University of Utah Medical Center Adult Congenital Heart Clinic, where Tiffany's insurance covered treatment by only one of the doctors. Her insurance did not cover an electrocardiogram heart test.

But, in Tiffany's need, the doctors worked out a deal.

"They all came back in and said, oh, it's your lucky day," Tiffany says.

The doctors arranged that no matter what happened, all of her treatment would be billed through that one doctor who took her insurance.

But then someone filled out insurance forms that sent the bill through the wrong doctor. And that was the beginning of a 2-year medical insurance nightmare.

The first bill from University Healthcare rejected by the insurance company came to $978...And Tiffany sent in her appeals.

"None of it was supposed to be charged," she says.

But after Tiffany appealed to the University of Utah Medical Center, another bill came...with late charges.

So, this time, the nurse went to the billing department to tell them about the mistake.

But that didn't work, as Tiffany found out when the state of Utah seized her money.

That's right. The state of Utah with no trial, or even a hearing, can seize a citizen's tax refund. The Utah Attorney General acts as the collection agent if a state institution, like the University of Utah Medical Center simply says a citizen owes money

The state seizure was $500 dollars. But, by now, the bill had now grown to nearly $1400.

So, this time, the University of Utah Medical Center sent the bill to their collection agency, Express Recovery.

And that brought tiffany to Second District Court in Layton for mediation with Express Recovery's lawyer.

Tiffany was armed with a letter. It is from the nurse who tried to stand up for Tiffany once before. The nurse wrote that she "was personally present" when the doctor said he would be "waiving his fee." Tiffany gave the letter to the lawyer, but that didn't do any good.

The lawyer sent Tiffany back to mediation, and when she tried to explain again Experess Recovery Lawyer Edwin Parry sued Tiffany. Now Tiffany needed a lawyer. It cost her $130 an hour on a bill she never owed.

A court date was set, but Tiffany's lawyer got the trial postponed...and that's when she called me...nearly 2 years later.

I called Chris Nelson, the head of Public Affairs at University of Utah Healthcare. And over night, this medical insurance nightmare was over.

"You know, this went to the highest level of our hospital's administration. And as everyone looked at this, it was kind of an obvious thing. Yeah, this was not handled well...so we need to do what's right for the patient," Nelson says.

And within days, a check came from university hospital for $503. The amount seized so long ago from Tiffany's state tax refund.

And that lawsuit to collect the rest of the money is dropped...Tiffany got lumped into a collection system that sometimes doesn't look closely at individual cases.

“For every one Tiffany,” Nelson says, “unfortunately, there are probably 40 or 50 other cases where folks are trying to maybe not pay their bills. But we need to not be brushing everybody with the same stroke."

And University of Utah Healthcare is paying all of Tiffany's attorney fees.

So, the problem here stemmed from a doctor trying to do a patient in need a favor, but when the doctor did not carefully follow his own paperwork to have it properly billed, the favor wound up as a billing system medical insurance nightmare.

Source:http://www.kutv.com/content/news

Types of health insurance

There are many different types of health insurance programs, most of which can be divided into three basic areas of protection. The first type of protection is called a fee-for-service indemnity plan and generally provides for hospital, surgical and medical needs, including major medical, comprehensive, catastrophic, and dental plans. This insurance is provided by commercial insurance companies, independent organizations, and by Blue Cross and Blue Shield.

Rates depend on which plan you buy, the level of coverage your employer or you choose, and whether you purchase individual or family protection. The second basic type of health insurance protection is the prepaid health care plan. The major providers of prepaid care consist of HMO's or health maintenance organizations, and PPO's or preferred provider organizations.

These are groups of doctors, hospitals, and other health care professionals who have joined together to provide members with prepaid medical care. Instead of paying a premium, each member pays a flat monthly or quarterly fee. The last type of coverage available is governmental health insurance, including both Medicare and Medicaid. check
your local governmental offices to see if you qualify. For more information about health insurance, contact a local insurance professional in your area.

Source:http://www.abc15.com/guides

Mass. health plan has national appeal

WASHINGTON - Key players in the debate over how to provide healthcare coverage for the nation's 47 million uninsured say they view Massachusetts' landmark 2006 law as an important model for what Washington could do and how to get it done.
"To those who say these challenges can't be met, I say, 'Look at Massachusetts,' " said Senator Edward M. Kennedy.

Healthcare leader

Massachusetts achieved near-universal coverage by investing heavily in patching the holes in the existing system, where most people get coverage through work - something economist Jonathan Gruber of MIT calls "incremental universalism." This centrist approach rejects both the liberal vision of a Canadian-style Medicare-for-all system and the conservative preference to move to a deregulated market where people buy policies on their own with the help of tax credits.

"The architecture of the Massachusetts plan is very similar to the architecture of what everyone is talking about, which is essentially building on the existing system and not throwing it out," said Drew Altman, president of the Kaiser Family Foundation, a nonpartisan health policy group based in Menlo Park, Cal.

With a new administration and Congress gearing up to push a major initiative to expand insurance access for the first time since the Clinton administration's spectacular failure in 1994, Washington policymakers are eager to avoid making the same political mistakes. Massachusetts leaders made sure that people who liked their coverage could keep it, and they built consensus among a web of healthcare interests to create a new safety net for the uninsured.

"What Massachusetts demonstrates is, it can be done," said Helen Darling, president of the National Business Group on Health, which represents the views of large corporations on health care. "It's really important because people have talked about what we might do for years and years and years. This shows it can work, and for the most part, it can be highly functional."

Senator Edward M. Kennedy, a leader on health care in the Senate who also helped create the state law, cited new figures released yesterday showing that 97.4 percent of Massachusetts residents now have insurance, compared with 90 percent when the law was passed in 2006.

"To those who say these challenges can't be met, I say, 'Look at Massachusetts,' " he said in a statement.

Source:http://www.boston.com/news

Prudential unit to bid for AIG Japan units -sources

A Japanese unit of Prudential Financial Inc plans to bid for two Japanese life insurers put up for sale by American International Group Inc, people familiar with the matter said.
Saved from bankruptcy by a U.S. government bailout that has now ballooned to about $152 billion, AIG is looking to raise cash by shedding assets globally.

AIG's push to sell assets was underscored by comments from chief executive Edward Liddy to the Wall Street Journal. Liddy said in an interview that AIG will try to renegotiate the terms of its rescue package if it can sell off assets to repay the government.

The insurer has said it will sell its three Japanese life insurance businesses -- Alico Japan, AIG Edison Life Insurance Co and AIG Star Life Insurance Co.
Prudential unit Gibraltar Life Insurance Co will bid for AIG Edison and AIG Star, three sources told Reuters. The individuals spoke on condition of anonymity because the bidding process is not public.

The sale could fetch several hundred billion yen, the Nikkei business daily has reported.
Spokespeople for Prudential Financial and AIG in Tokyo declined to comment.
Although its population is shrinking, Japan is still seen as a growth market by some overseas financial firms.

Thanks to a culture of frugality, Japanese household savings are now estimated at a staggering $16 trillion. The desire to tap that pool has brought in big overseas financial firms such as HSBC Holdings Plc and Citigroup Inc.

Insurers have also been drawn by the country's rapidly ageing population. U.S. firm Aflac Inc has made an aggressive push in recent years, blanketing the country with advertisements for insurance products.

With insurance revenue of 407 billion yen ($4.37 billion), AIG Edison ranks No.22 in the Japanese industry. AIG Star ranks No.23 with revenue of 266 billion yen.
AIG has hired JPMorgan Chase & Co and Goldman Sachs to advise it globally on asset sales, while Prudential is using Nomura Securities to help it weigh a bid for the AIG operations, sources said.

A deadline for the bidding has been set for Dec. 9, the sources said. It was not immediately clear whether Gibraltar was the sole bidder or other potential buyers were involved. ($1=93.14 Yen) (Additional reporting by Nathan Layne, Yumiko Nishitani and Dave Dolan; Editing by Michael Watson)

Source:http://www.guardian.co.uk/business/

Investors Buy $17.25 Billion in Banks' Bonds

A fresh asset class is quickly carving a new niche for itself on Wall Street.

In just two days, Goldman Sachs Group Inc., Morgan Stanley and J.P. Morgan Chase & Co. sold a cumulative $17.25 billion of government-guaranteed bank bonds as part of the Federal Deposit Insurance Corp.'s Temporary Liquidity Guarantee Program.

The program has opened the financing door for banks that were otherwise shut out from repaying or refinancing debt as a result of the credit crisis. The government guarantee allows banks and firms that have been approved to participate, such as General Electric Co., to take advantage of cheap financing.


Barclays Capital fixed-income analyst Rajiv Setia estimates financial institutions may use the program to issue $250 billion to $350 billion of debt by June 30 of next year, when the issuing period expires.

Approximately $215 billion of U.S. bank debt is set to mature during the first two quarters of 2009, according to Dealogic.

Mitch Stapley, chief fixed-income officer for Fifth Third Bank who has bought some of the new bonds, classifies them as better-yielding Treasury bonds.

"With yields on Treasury bonds that can make a goat just about choke, these are a no-brainer alternative," Mr. Stapley said.

On Tuesday, three-year Treasurys yielded 1.37%. In comparison, Goldman Sachs's new three-year guaranteed bonds were priced with a yield of 3.367%, Morgan Stanley's sold with a yield of 3.262% and J.P. Morgan's notes yielded 3.147%.

Reduced credit risk coupled with additional yield has helped the new bonds blaze their way into portfolios.

Mr. Stapley and others expect the market for these bonds will continue to flourish and anticipate a surge of supply next week.

"The universe for this product is growing day by day as more and more accounts sign on and/or get approval to participate in the program," according to Paul Spivack, head of U.S. debt syndicate at Morgan Stanley.

Citigroup Inc. and Bank of America Corp. have said they are preparing to sell FDIC-backed deals as early as next week, and others are sure to follow.

Global interest in the new bonds also has been sparked, as the FDIC will insure debt that is denominated in a foreign currency. J.P. Morgan is planning to sell a two-part, euro- and sterling-denominated bond issue under the FDIC program, a person familiar with the situation told Dow Jones Newswires on Wednesday.

Goldman Sachs was the first firm to offer the new bonds. It sold a $5 billion three-year issue at a risk premium of two percentage points over Treasurys on Monday. That issue snapped after it was freed to trade, fetching a risk premium of 1.84 percentage points in the secondary market.

Morgan Stanley sold a total of $5.75 billion of bonds in four parts Wednesday.

According to syndicate participants who worked on the deal, 347 investors placed orders for the debt, with 70% of the debt sold going to U.S. buyers, 20% landing in European hands and only 10% going to Asia.

The Morgan Stanley deal was the first issued under the government program to include a floating-rate note, an instrument recently absent from the corporate-bond primary market.

The Morgan Stanley fixed-rate notes also traded well in the secondary market.

And J.P. Morgan sold a combined $6.5 billion of securities Wednesday. The bulk of the issue consisted of J.P. Morgan's $5 billion three-year fixed-rate note, which was sold at a risk premium of 1.775 percentage points over Treasurys.

Source: http://online.wsj.com/article/SB122782428906462449.html

AIG Mulling Overseas Life Unit Sale to China Fund, Nikkei Says

American International Group Inc. is in talks to sell a stake in an overseas life insurance unit to a group led by a Chinese sovereign wealth fund, the Nikkei newspaper said, citing unidentified people familiar with the matter.

AIG is negotiating to sell a minority stake in its American Life Insurance Co. unit, which operates in more than 55 countries including Japan, the newspaper said. The group including the China Investment Corp. and China-based insurers and have until yearend to come to an agreement with AIG, the Nikkei said.

Chief Executive Officer Edward Liddy is trying to sell almost all of AIG's businesses excluding property-causality insurance to repay a U.S. loan that saved the firm from bankruptcy. The company said Oct. 3 that it would look for buyers or investors in two overseas life insurance companies -- one operating in Japan, parts of Europe, Latin America and the Middle East, and the other operating in China, Korea and India.

AIG wants to keep majority control in the American Life Insurance unit, the newspaper said, and a 49 percent stake may cost 500 billion yen ($5.2 billion) to 1 trillion yen. An agreement may lead to other deals with the sovereign wealth fund, the Nikkei said.

Nicholas Ashooh, a spokesman for New York-based AIG, didn't immediately return a call seeking comment. An e-mail to the China Investment Corp. wasn't immediately returned.

Source:http://www.bloomberg.com/apps/news?pid

Children's insurance program may need wait list

SACRAMENTO—The state's budget woes could leave thousands of California children on a waiting list for health care.

State officials who oversee the Healthy Families Program are scrambling to find ways around a $17.2 million budget shortage.

The program provides low-cost health, dental and vision coverage to uninsured children of working families.

Currently, 883,589 children rely on the low-cost health insurance state program, and about 27,125 new applicants enroll each month.

The Managed Risk Medical Insurance Board warns a long waiting list could amass quickly, with an estimated 160,000 children waitlisted in the first six months.

The board is slated to meet in Sacramento on Wednesday. If approved, the stoppage could be implemented as soon as Dec. 18.

Source: http://www.mercurynews.com/news/ci_10977114

If you lose your job, keep your health insurance

The latest unemployment numbers are awful.

U.S. job losses accelerated in the last two months, pushing the nation's unemployment rate to a 14-year high in October.

As workers lose their jobs, a crucial benefit they must keep is their health insurance. Don't go without this.

It may be tough to pay the premium while you search for a new job, but you'll really be in a world of hurt if a major illness or accident wipes out what funds you have.

"If you think losing your job is a possibility in the next year, start reviewing your employer health care plans now," said Sam Gibbs, a senior vice president and consumer expert with eHealth Insurance.com, a health insurance information Web site.

"During open enrollment [when you select benefits for the coming year], you may be able to choose a plan that would cost less if you were later required to pay all of the premium through COBRA," he said. "Always make sure that the plan you choose will cover the health care benefits you need for the coming year."

It's important to understand what COBRA is because it plays a major role in your health insurance if you're laid off.

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1986. The federal law requires employers that lay off workers to offer them a chance to continue with the employer's health insurance policy for 18 months after leaving their job.

However, you will have to pay the monthly premium – and it's expensive because you're paying both the employee and employer contributions.

The average monthly COBRA premium is $400 for an individual and $1,078 for a family, according to eHealthInsurance.com.

It may be tempting to go without health insurance and save the expense, but that would be a mistake. Instead, take the COBRA coverage and shop around for less expensive coverage that still meets your needs.

"If you are considering switching your health insurance plans, never switch from an employer-based plan or COBRA continuation coverage until you are approved for another plan," Mr. Gibbs said. "It is important to have no interruption in your health insurance coverage."

If you're healthy, you may qualify for an individual and family health policy.

If your health isn't so good, you may still qualify for an individual or family plan – but you may have to pay a higher premium. Talk to at least two insurance agents to find out whether you qualify for an individual and family plan.

You might also consider raising your deductible to save on the premium.

"If you're healthy and don't need to see your doctor a lot, go with a higher deductible unless you are anticipating expensive procedures like a surgery or child birth, or other medical expenses within the year," Mr. Gibbs said.

If you've already been laid off, see if you can get on your spouse's health insurance plan.

If not, and you're healthy, find an individual and family plan that has the same benefits and the same doctors that you like.

An uncertain employment situation calls for cutting out unnecessary expenditures, but health insurance isn't one of them.

Source:

S&P changes US health insurance outlook to negative

NEW YORK, Nov 3 (Reuters) - Standard & Poor's on Monday said it expects the number of downgrades of companies in the U.S. health insurance sector to pick up, reflecting weaker operating results and a worsening economy.

S&P changed its outlook on the sector to negative, from stable, indicating companies in the sector are more likely to be downgraded over the next one to two years.

"Aggressive pricing, unforeseen medical trend development, and slowing top-line growth that have driven performance shortfalls beyond our downside expectations," S&P said in a statement.

"Overall, we believe the sector is feeling the strain of a slumping U.S. economy and more intense competitive pressure, which we expect to persist meaningfully into 2009," the rating agency added.

Shares of health insurance companies were hurt last week after Aetna Inc (AET.N: Quote, Profile, Research, Stock Buzz) said third quarter net income dropped to $277.3 million from $496.7 million a year earlier, and Cigna Corp (CI.N: Quote, Profile, Research, Stock Buzz) said net income dropped to $171 million from $365 million for the same period.

"In the past few months, health-insurer-related rating activity has quickly taken a negative turn as pressure on earnings and cash-flow levels raised concerns about goodwill valuation (for some companies) and quality of capital in general," S&P added.

In spite of the negative outlook, S&P said it expects downgrades to be limited to only a subset of companies with negative outlooks, the negative sector outlook also indicates that upgrades will also be less common. (Reporting by Karen Brettell; Editing by James Dalgleish)

Source: http://www.reuters.com/article/marketsNews/idUSN0332254520081103

Many uninsured kids have parents with insurance

WASHINGTON (Reuters) - More than 2 million children in the United States who have no health insurance of any kind have at least one parent who gets employer-provided medical coverage, researchers said on Tuesday.

These parents typically get insurance through work that covers them but cannot afford the extra thousands of dollars that may be needed for a plan that also covers their children, the researchers wrote in the Journal of the American Medical Association.

"I think there's been a myth that all uninsured children have uninsured parents, and so if we cover the parents we can cover the kids," Dr. Jennifer DeVoe of Oregon Health & Science University, who led the study, said in an interview.

"In most cases the parents have insurance through work at reduced rate or no cost, but adding their family is unaffordable," DeVoe added.

The Census Bureau said in August 8.1 million, or 11 percent, of children under 18 had no health insurance in 2007.

The researchers calculated that about 28 percent of these uninsured children -- or about 2.3 million -- had at least one parent with health insurance. Most are from low- or middle-income families, DeVoe said.

The high cost of health care and medical insurance and the large numbers of Americans who remain uninsured have been key issues in the U.S. presidential campaign this year.

The study found that children of single parents and children in Hispanic families were more likely than others to lack health insurance even if a parent is covered. It was also more likely in the South and West.

The study was based on data from 2002 to 2005 released by the Agency for Health Care Research and Quality, part of the U.S. Department of Health and Human Services.

Dr. Carolyn Clancy, who heads the agency, said some of these uninsured children likely qualify for public coverage, but their parents may not be aware of their eligibility.

DeVoe said a short-term approach to address the problem would be to expand the State Children's Health Insurance Program that provides public coverage for certain children in low- and moderate-income families.

President George W. Bush twice has vetoed bills that would have expanded the program.

The Census Bureau said 15.3 percent of Americans overall had no health insurance in 2007, meaning 45.7 million were uninsured in a country of about 300 million people.

Source:http://uk.reuters.com/article/healthNews

Insurance firm won't cover deaths

A medical malpractice insurance company claims it does not have to pay any damages that may be awarded to the families of deceased former patients of a Murray doctor charged in their deaths.
In court documents filed Tuesday, the Utah Medical Insurance Association argues its insurance policy issued to Dr. Warren R. Stack does not cover the deaths of patients Brandon Scott or Thaison Roark.
Stack, 61, is accused of illegally prescribing painkillers to as many as 80 people a day, leading to the deaths of at least five. He was indicted last year on 18 criminal counts, including conspiracy, dispensing drugs outside the bounds of medical practice resulting in death, unlawful distribution of a controlled substance and health care fraud.
One of Stack's employees has pleaded guilty to conspiracy in the case and agreed to testify against Stack in federal court, the association stated.
Stack's insurance policy excludes coverage for acts that violate the law, the association wrote. That means it does not cover the deaths of Scott or Roark, whose families have sued Stack.
Scott was 34 when he died in 2005. Roark died in 2006 at age 20. Court documents state that drugs prescribed by Stack also led to the deaths of Tyler Lugo, 24; Kaydie Winters, 25; and Michael W. Barker, 50.


Source:http://www.sltrib.com/news/ci_10674569

In Sickness and in Health (Insurance)

Re “Health Benefits Inspire a Rush to the Altar, or to Divorce Court” (front page, Aug. 13): The grotesque reality of my life has been constant constraint by the need for health insurance. With a congenital heart condition and a degenerative eye condition, I married my wife while in graduate school because I was no longer eligible for my parents’ group plan, and at the time few graduate programs offered grouphealth.

My career choices were dictated by the knowledge that I needed group health: the tenuous life of an academic in a tough job market seemed too risky, so I switched to law school. I avoided private-sector legal jobs upon discovering that many firms do not provide group insurance but expect individual lawyers to find individualhealth plans, so I ended up working for the state.

Fortunately, things have worked out for me so far. It was not desperate need, such as you described, but a sense of obligation and responsibility that drove me to make major life decisions based onhealth insurance needs (I do not have family who could foot the bill for open-heart surgery). But only in America are people with pre-existing medical conditions forced to plan every aspect of their lives around the need for grouphealth insurance. I have often toyed with the thought of emigrating to Canada or Britain simply to escape the constant, gnawing, lifelong fear of what might happen should my grouphealth for any reason ever lapse.

news source : http://www.nytimes.com/

Is Low-Cost Health Insurance Worth It?

Infomercial king Billy Mays, known for screaming about the wonders of cleaning solutions Kaboom!, OxiClean, and other household products, is now starring in a commercial for what he calls "the most important product I've ever endorsed:" health insurance. The bearded salesman started pitching iCan Benefit Group's "health insurance that you can actually afford" in May 2008, pointing to the need for its health plans given that 47 million Americans are uninsured. In the commercial, Mays says iCan's plans include guaranteed acceptance, starting as low as $160 per month for individuals and $260 for families, and can allow you to lower your monthly premium, increase coverage, or both. Concludes Mays: "You can't afford not to make this call."

His pitch shows how difficult it has become for many hard-pressed Americans to afford basic necessities, such as health care, as the cost of food, gasoline, and many adjustable-rate mortgage payments climb, while wages barely budge and employers cut jobs. To protect your assets, it's important that yourinsurance policies give you enough coverage in case something horrible happens to you or a loved one. Mays is understandably "passionate about health care." We all need health insurance, yet many Americans can't afford it, while the cost of the plans and of medical care keeps rising. Mays is pitching iCan's Mini Medical, a type of limited healthinsurance for those who can't afford major medical insurance or have been turned down because of preexisting health conditions.

Low Premiums Mean High Risk

These limited plans are not for everyone, and they could end up costing more if you need expensive care. "The problem is they're advertising these unbelievably low premium healthinsurance plans," says Mark Kenison, a financial adviser who specializes in insurance at Turning Point Benefits Group in Charlotte, N.C. "All you're doing its transferring risk to yourself so your monthly premiums are lower."

Consumers might focus on the low monthly price and not examine the cost and coverage of each health service, Kenison says. Beware of policies that don't set a maximum amount that you'd be responsible for paying for a health service, he advises. For example, iCan's mini-medical plan will probably not provide enough coverage if you get badly injured or need surgery. Looking at an example of the company's lowest-cost offering, iCan's mini-medical plan costs an individual $160 per month in North Carolina—plus an additional, $100 one-time enrollment fee—and covers a maximum of just $1,000 for surgery per year, with anesthesia limited to $250 per surgery. If you're hospitalized, the plan would cover only $200 for the first day and $100 each additional day, with a maximum of $1,100 for up to 10 days. On average, hospital care is estimated to cost $1,931 a person per year, according to the latest figures (2004) from the U.S. government's Centers for Medicare & Medicaid Services.

The low maximum benefits—and the prospect of huge additional out-of-pocket expenditures—bothers some financial pros. "It just feels wrong," says Kenison, adding that most people would be better off getting a major medical plan that limits their risk to a certain dollar amount. If you end up with a large medical bill, members of iCan's health plans have a health advocate to negotiate pricing and hospital charges, says Harold Shatz, managing member of iCan Benefit Group in Boca Raton, Fla. A $40,000 to $50,000 medical bill can be reduced to $10,000 to $12,000 through network pricing and use of a health advocate to examine the bills and find errors, he says.

news source : http://www.businessweek.com/

Insurance plan launched

MANAMA: Life Insurance Corporation (International) yesterday celebrated 20 years of operating out of Bahrain with the launch of a unit linked insurance plan called Fortune Builder. The product, which offers three separate funds, will offer investors the opportunity to take advantage of opportunities in the capital markets of India or across global equities.

Life Insurance Corporation (International) chief executive officer Roy Chowdhury said the new product was flexible, catered to all life requirements and offered a wealth generation tool that simultaneously provided life insurance protection. The product is being marketed across the GCC and the company has forged a strategic alliance with Doha Bank to market the product.

LIC has more than 80,000 customers in the region and investment income of $450 million. It is part of LIC of India which has issued more than 220m policies and has a financial base of $175 billion and is the biggest life office in India.

news source : http://www.gulf-daily-news.com/

Max India hikes stake in insurance JV

The amended JV agreement gave Max India the right to increase its shareholding in Max New York Life by up to 24% of the issued and paid up capital Max India has restructured its joint venture (JV) arrangements with New York Life International LLC by executing an amended agreement on July 15. The JV, Max New York LifeInsurance Co. accounts for about 80% of Max India's consolidated revenue.

Max India has amended the existing JV agreement dated November 3, 1999, in respect of Max New York life insurance. The original JV agreement has been replaced and substituted by the amended JV pact. The amended JV agreement gave Max India the right to increase its shareholding in Max New York Life by up to 24% of the issued and paid up capital. It has raised its stake in Max New York Life from 50% to 74%. New York Life International had the option of increasing its shareholding in the JV to 50% at par value. However, under the fresh JV agreement, Max India has repaid the Rs1.74bn deposit paid by New York Life International and increased its stake to 74%.

The US partner will now have to buy the additional 24% shareholding at 90% of fair market value. New York Life International will get a 10% discount for being a promoter-shareholder. This option will be valid till 2016. The company has posted a net profit of Rs136.1mn for the quarter ended June as against Rs38.1mn in the same quarter a year earlier. Net sales for the reporting quarter are Rs915.2mn versus Rs482.6mn in the year-ago period. At 12:46 pm, Max India was trading at Rs168.60, up Rs13.5 or 8.7% over the previous close. Earlier, the stock touched an intra-day high of Rs172 and a low of Rs160. It is down nearly 6% in the last one month.

news source : http://www.indiainfoline.com/

State audit cites errors in health insurance plan

Accounting errors related to the billing of medical claims for the now disbanded Columbiana County Schools Health Care Benefits Consortium resulted in already settled findings for recovery in an audit released Thursday.

The audit report issued by Auditor of State Mary Taylor showed that the Salem City school district reimbursed the Columbiana County Educational Service Center for $14,925 on April 8 this year and the Southern Local school district reimbursed the United Local school district for $11,576 on March 6 this year, both related to erroneous charges or credits by the health insurance consortium. The consortium provided health insurance coverage to several area school districts.

According to the audit, a credit of $14,925 was issued to Salem's medical claims account to correct a misclassified prescription drug claim posted to medical claims on March 31, 2004. The credit should have been posted to the medical claims account for the ESC because that's where the original invoice was posted, the report said. Salem city schools Treasurer Jill Rowe said she received an e-mail from the fiscal administrator for the consortium, East Palestine schools treasurer Rick Ellis, regarding the accounting error and the need to reimburse the ESC. It was her understanding that "it was just an accounting error," she said when contacted Thursday.

The other finding for recovery stemmed from apparent posting errors made on Aug. 5, 2005 when invoices for medical claims were charged to the wrong school districts. The audit noted an invoice for $41,294 for medical claims for Southern Local schools was mistakenly charged to United Local schools and an invoice for $29,717 for United Local medical claims was mistakenly charged to Southern Local schools. The report said the Southern Local schools owed the difference of $11,576 to the United school district. Emily Frazee, deputy press secretary for the state Auditor's Office, also said the findings from the audit covering July 1, 2005 through June 30, 2007 will be forwarded to the county prosecutor's office and the Ohio Attorney General. She acknowledged that the issues looked like accounting errors and everybody had made good on the findings.

news source : http://www.salemnews.net/

Health insurance premiums in Southwest predicted to rise 7.3 percent in 2009

Health Insurance premiums throughout the Southwest, including Texas, are expected to increase by 7.3 percent in 2009, according to preliminary information released by Hewitt Associates Inc. Still, this is the lowest rate increase in the region in four years. Health maintenance organization (HMO) premiums for the Southwest region increased 13.7 percent on average last year.

Nationwide, HMO rates are expected to increase 11.8 percent -- lower than last year's initial rate increases of 13.2 percent but still on track to outpace inflation.

Officials with Hewitt expect employers in the Southwest will be able to reduce overall rate increases next year by two or three percentage points through aggressive negotiations, changes in plan offerings and designs and an increased focus on employee health and productivity.

As the economy continues to weaken, Hewitt expects to see more companies move away from traditional employer strategies, such as cost shifting toward more aggressive and innovative steps to mitigate health care costs. Among these trends is an increasing focus on improving employee health and moving to self-insured plans.

news source : http://www.bizjournals.com/

Our view: Coverage for all

Good for Florida labor and civic groups that began a campaign Tuesday in Tallahassee to put universal health care on the radar screen in the presidential and congressional races. With 3.8 million Floridians having no health coverage, the nation's third-highest rate of uninsured, it's a crisis that's rightly a top issue with Sunshine State voters -- and should be for candidates too.

That includes state lawmakers who have the responsibility to scrutinize Florida's newly created low-cost no-frills health insurance program, touted by Gov. Charlie Crist as a way to open the door to affordable medical care. The program is supposed to cost about $150 a month and be available for anyone has been without insurance for at least six months.

Last week the governor started soliciting bids from insurers interested in offering the bargain-rate plans, but details remain uncertain. Depending on what deals the state cuts -- such as caps set on care, what's not covered, and how high deductibles and co-pays can go -- the cheap policies could be little more than window dressing. Insurers shouldn't be allowed to rip the guts out of coverage with extremely limited benefits that deny seriously ill patients the treatment they need. And, at best, the no-frills plans should serve merely as a step toward universal, comprehensive coverage for all hardworking families -- similar to that Florida lawmakers get at taxpayers' expense.

news source : http://www.floridatoday.com/

Corzine Signs Health Insurance Bill

Gov. Jon Corzine today signed a bill (S-1557) that makes more parents eligible for the state program that provides free and subsidized health insurance to low-income families. It expands the eligibility for NJ FamilyCare to parents in households that earn up to double the poverty level, which is approximately $42,000. "This is a very important, pragmatic doable step on a way to universal access," Gov. Jon S. Corzine recently told NJBIZ.

While the program's eligibly for children remains at 350 percent of poverty level, the bill for the first time mandates that parents enroll their children. The bill also establishes new private healthinsurance market reforms designed to lower the premiums for small businesses and individual policy holders.

About 90,000 parents would be eligible for NJ FamilyCare under the new legislation. The bill's chief sponsor, Sen. Joseph Vitale (D-Middlesex), said he expects about a quarter of them to sign up the first year. The bill increases state spending by $8.3 million—which generates matching federal dollars, to expand the FamilyCare program. It also calls for spending another $1 million for advertising the new eligibility requirements.

There are 1.3 million uninsured people in New Jersey, primarily because the skyrocketing cost of health insurance is difficult to afford, Vitale said. Of the $1.3 million uninsured, he estimates that 400,000 parents and children would be eligible for the new family care program, 300,000 are undocumented; and 600,000 simply can’t afford it and don’t qualify for subsidies.

news source : http://www.njbiz.com/

Negotiations between National Health Insurance Fund and Bulgarian Medical Association fail

Sofia. Representatives of the National Health Insurance Fund (NHIF) left the negotiations with the Bulgarian Medical Association (BMA). The meeting was set in order the new National Framework Agreement (NFA) to be negotiated and adopted. NHIF representatives withdrew from the table of negotiations with the motive that the BMA did not send legitimate representatives. Head of the NHIF board Emil Raynov demanded documentation proving that BMA reps were legally appointed and sent to the meeting. BMA agreed to send a copy of the decision of appointment later in the day. NHIF remained strong on its position and insisted negotiations to be interrupted until legal matters of the legitimacy of the representatives are cleared.

news source : http://www.focus-fen.net/