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ObamaCare Fines Increase

Posted By Administration, Tuesday, July 21, 2015


Like when we all played hide and seek as kids and it was time to bag it and go home the cry would go out. Olly olly oxen free. No penalty. Game over. Olly olly oxen free was given to non-participants of the Affordable Care Act in year one. If you didnt obey the law and participate, no problem


Year two was a much different story. Fines for not participating were handed out. In all 6.6 million were issued. Thats 10% more than the Obama administration said would happen and the fine was up to 1% of a persons total income.


That came to a whopping average of $190 says the National Taxpayer Advocate. Its the in-house ombudsman for the IRS. Of the people fined, 300,000 over paid by an average of $110.


No decision yet by the IRS as to whether checks will be issued for the overpayment or if theyll just issue credits.


Source link: Employee Benefit News

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  ObamaCare Fines Increase  The Affordable Care Act  Weekly Industry News 

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The Decision: The People & King V. Burwell

Posted By Administration, Tuesday, July 14, 2015

A couple of weeks ago the U.S. Supreme Court put another nail in the coffin of Republican efforts to end the Affordable Care Act. By a 6 to 3 vote, the court said the subsidies used to purchase health insurance at HealthCare.gov are legal.

With the tax credits now valid in all states using the federal facility, the Kaiser Family Foundation wanted to know what the people thought of the decision.

The answers given are not surprising.

  62% approve of the decision

  32% disapprove of the decision

  Democrats: 82% approve of the decision

  Independents: 61% approve of the decision

  Republicans: 29% approve of the decision

  78% think there will be future ACA battles

  18% think King v. Burwell will be the last major battle

  51% say the debate should continue

  44% are tired of the debate and think the country should focus on other issues

  Repeal the law: 27%

  Expand the law: 25%

  Implement the law as it is: 22%

  Scale back the law: 12%


Source link: Employee Benefit Advisor

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  The Affordable Care Act  The Decision: The People & King V. Burwell  Weekly Industry News 

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Health Insurance Rates Skyrocket: Is ObamaCare Working?

Posted By Administration, Tuesday, July 14, 2015

The proposed 2016 health insurance rates are being tossed around. For those going through the state and federal health insurance exchanges to get their insurance, the hikes will be scary.

Increases could hit 20% to 40% depending on where the consumers lives. Health insurers say those getting health insurance via the Affordable Care Act are sicker than expected and therefore more expensive.

Those expenses are passed onto the consumer as you know.

Blue Cross Blue Shield is the most insistent on big hikes says the New York Times. And federal regulators say theyre on top of it and will not let that happen.

President Obama is telling consumers to contact state regulators and ask them to pressure the insurers to keep rates down. He said if the regulators do their job, my expectations is that theyll come in significantly lower than whats being requested.


Source link: Insurance Business America

Tags:  Health Insurance Rates Skyrocket: Is ObamaCare Wor  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  The Affordable Care Act  Weekly Industry News 

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ObamaCare: The Decision a Done Deal? Not so Fast.

Posted By Administration, Wednesday, July 8, 2015


The U.S. Supremes edict that the state subsidies are legal at the federal level seemed to put a final nail in the efforts of opponents to do away with the Affordable Care Act. 

Not so fast. 

While the decision seems to cement ObamaCare into law, the push to repeal continues. Republicans are shooting for a little known fast-track bill passing process called reconciliation. It could move an Obamacare repeal forward with a simple majority of 51 votes.

Even if that happens and we all know the House will go along President Obama will veto and Republicans cannot muster enough votes to overcome one.

Another problem for the federal government and the Obama administration is 13 more states looking at bagging their exchanges and joining HealthCare.gov. It means more people for the administration that hasnt managed health care that well to manage.

Premiums are rising. In some cases in 2016 theyre proposed to go up as much as 30%. That, too, could hurt. Thats especially true when the premise was sold to the public as reducing health insurance costs. No doubt state insurance regulators will step in where they can and put the kibosh on the increases and slow them down.

A study by Kaiser Family Foundation shows were looking at increases of 4% on average. This years average hit 2%. So its a 2% increase over this years increase. 

Kaisers Larry Levitt said a huge challenge for the administration is doubling the number of people signing up. Currently, 10.2 million are on the ObamaCare rolls. A good mix of healthy people is needed to offset the payouts of those that arent so healthy.

To get there the administration needs another 10 million. The biggest challenge ahead is increasing enrollment. Getting more people signed up is central to the law's primary aim. Increasing enrollment is also key to keeping premiums under control.

And the legal challenges are not done. A suit was filed by the House Republicans claiming the president is overreaching his authority. Hes accused of spending money on cost-sharing reductions that are not appropriated. Obama has given insurers money to reduce the deductibles of the insured to help low income people. Those funds were not appropriated.


Source link: The Hill

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  ObamaCare: The Decision a Done Deal? Not so Fast.  The Affordable Care Act  Weekly Industry News 

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Special Report: ObamaCare Here to Stay

Posted By Administration, Tuesday, June 30, 2015


You all heard the decision. The Affordable Care Act it appears is here to stay. Last week the U.S. Supreme Court said the subsidies received by 6.4 million people in 34 states to purchase health insurance via the federal governments exchange HealthCare.gov is legal. 

It also ruled gay marriage is legal and ought to be honored by the states. That, too, has insurance implications.

PIA National Executive Vice President and CEO Mike Becker said, This decision means the health insurance marketplace will continue to operate as it is currently constituted. It will be business as usual. As always, PIA will remain in the forefront of advocacy on behalf of PIA members, who remain fully committed to providing their clients with professional advice and choices regarding their health insurance needs.

Your association continues to support the battle to remove agent commissions from the medical loss ratios. 

In the decision, Chief Justice John Roberts sided with the courts liberal justices and conservative Justice Anthony Kennedy in saying that was the intent of Congress when it passed the legislation.

In the majority opinion Roberts wrote: The combination of no tax credits and an ineffective coverage requirement could well push a State's individual insurance market into a death spiral. It is implausible that Congress meant the Act to operate in this manner.

Roberts continued: The argument that the phrase 'established by the State' would be superfluous if Congress meant to extend tax credits to both State and Federal Exchanges is unpersuasive.

Referring to the broad interpretation of the law and the many changes the Obama administration has made in the Affordable Care Act, Justice Antonin Scalia ripped it for what he says are somersaults of statutory interpretation. We should start calling this law SCOTUScare, he said.

Roberts countered with, Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter. 

President Obama who didnt have a backup plan if the court ruled otherwise was thrilled about the decision. He called it a victory for hard working Americans. The law has helped hold the price of health care to its slowest growth in 50 years. If your family gets insurance through your job so youre not using the Affordable Care Act youre still paying about $1,800 less per year on average than you would be if we hadnt done anything. By one leading measure, what business owners pay out in wages and salaries is now finally growing faster than what they spend on health insurance. That hasnt happened in 17 years and thats good for workers and its good for the economy.

Acknowledging the law needs some fixes, the president urged Republicans to move on and to stop trying to repeal the law. Today, after more than 50 votes in Congress to repeal or weaken this law, after a presidential election based in part on preserving or repealing this law, after multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay. This was a good day for America. Lets get back to work.

The plea fell on deaf ears. Unable to win the battle to repeal in the courts, Republicans led by Senate Majority Leader Mitch McConnell are working on a budgetary fix to defund the law. Under this procedure, the Republicans can pass a repeal package by a simple majority vote.

House Speaker John Boehner continues to call ObamaCare fundamentally flawed and broken. Republicans will continue to listen to American families and work to protect them from the consequences of ObamaCare. And we will continue our efforts to repeal the law and replace it with patient-centered solutions that meet the needs of seniors, small business owners and middle-class families.

Combined with House actions, a bill to repeal could end up on the presidents desk and he most certainly will veto the measure. McConnell and other Republicans hope this will get the president to do some ObamaCare negotiation. 

Others think the Republicans are taking an unrealistic approach. The American Benefits Council suggests ObamaCare repairs and some solutions rather than repeal. In a news release the council said Congress needs to: 

   Expand health reimbursement arrangements

   End the Cadillac tax

   Modify the employer shared responsibility requirement

   Simplify employer reporting requirements

   Repeal automatic enrollment requirements

   Improve Health Savings Accounts

Several PIA Western Alliance state insurance regulators responded to the ruling.

California Insurance Commissioner Dave Jones said, This is another victory for families across the country whose health insurance coverage was made possible by the Affordable Care Act. Nearly 8.7 million people nationwide, including more than 1.2 million Californians, are finding health insurance more affordable because they are eligible for the premium tax credit.

Washington Insurance Commissioner Mike Kriedler agreed. He said the court has delivered a powerful message in support of the Affordable Care Act. Now its time to get back to the day-to-day work of delivering on the laws promises.

The Affordable Care Act is here to stay, but it still needs some work. Theres much more that we can and must do to improve upon it, including finding ways to lower the cost of health care and increase transparency for consumers. I hope that with this decision behind us, we can find new ways to work together and keep building on the reforms weve created and that millions of Americans now enjoy. We all need to work together in Congress and here, locally.

Montana Insurance Commissioner Monica Lindeen who also currently heads the National Association of Insurance Commissioners (NAIC) said 41,000 Montanans will benefit from the Supreme Court decision. Uncertainty in insurance is not a good thing, and todays decision allows my office, consumers and the health insurance industry a level of certainty about our market in Montana. Now our companies can devote themselves to paying claims and covering Montanans without keeping a nervous eye on the Supreme Court.

Insurance groups also reacted. Dan Durham of Americas Health Insurance Plans (AHIP) said, With the certainty provided by the Supreme Courts decision, now is the time to focus on what matters most to consumers ensuring access to affordable coverage and high-quality health care. Health plans will continue to lead in advancing this goal.

Anne Filipic who heads Enroll America added, Right now, our priority is to make sure consumers know what this ruling means: that nothing has changed about their financial help. And this is a critical opportunity to inform those who have not yet enrolled that financial help is available, and here to stay. Opponents have repeatedly attempted to derail this law, but in spite of that opposition, it is working and millions of Americans are benefiting. 

Aons J.D. Piro said,  This is really more of a status quo decision. Employers werent doing anything differently during this whole litigation they had to implement the employer mandate, they had to look at whether they were offering coverage to the right number of employees, they had to do their testing for affordability and for minimum value. All those things were going on, and employers arent going to do anything differently after this [decision]. But it really does remove the last major judicial hurdle to full implementation of the Affordable Care Act.

Adam Bruckman who is the CEO of Digital Insurance added, This decision does not change the way millions of Americans receive and pay for health coverage, yet the world of employee benefits remains in constant flux. For example, many employers still face potentially daunting challenges, including required government reporting and the impact of the upcoming Cadillac Tax. Employers should use this opportunity to consult with their benefits advisers about how to protect their businesses and employees to strategically position their benefits for the future.

The bottom-line for this industry is how does the Supreme Court decision impact insurers. Standard & Poors took care of that answer in a news release following the decision.

Todays ruling is a positive for the US health insurance industry, especially for insurers that have invested heavily to compete on the insurance exchanges. This will help resolve an uncertainty that has been a pain point not just for insurers, but for the ACA as a whole, Standard & Poors said.

S&P said ObamaCare is here to stay that is a certainty and this decision simply keeps the market at status quo. Its possible that had the court ruled in favor of the plaintiffs, some states would have been motivated to attempt to establish their own state-run health insurance exchanges. Alternatively, policy advocates in the states without state-run exchanges may have urged the legislatures in those states to backfill the withdrawal of federal subsidies. The courts ruling frees these states from having to consider undertaking these administratively complex and costly policy initiatives.


Source links: Three links from The Hill link 1, link 2, link 3, Insurance Business America, Insurance Networking News, Insurance Journal, PropertyCasualty360.com, Employee Benefit News

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance News  ObamaCare  Special Report: ObamaCare Here to Stay  The Affordable Care Act  Weekly Industry News 

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ObamaCare: No Clear Plan

Posted By Administration, Tuesday, June 23, 2015

In the next week or two the U.S. Supreme Court is basically going to decide the fate of the Patient Protection and Affordable Care Act, aka the Affordable Care Act, aka ObamaCare.

The fate of the health insurance of millions of Americans rest on the courts decision on whether the subsidies being given to those forced to the federal governments HealthCare.gov for their insurance is constitutional.

Opponents of ObamaCare say those subsidies are not. States with exchanges are okay because as they read the law only the states can offer the subsidies. To break it down even more, 6.4 million could lose subsidies in 34 states.


That leads to the point of this article. What happens if the court says the opponents are correct and only states can offer the subsidies and just a few of them have insurance exchanges where the subsidies are available? A Republican Congress is not going to fix the laws flaw. The states are not offering answers.

In fact, no one is offering answers. Many like Kaiser Family Foundations Larry Levitt say it will cause a significant number of people to drop their insurance and those opting to stay in will see rates triple or even quadruple. Chaos would ensue quite quickly.

Some are urging the court if it decides the subsidies are illegal to grant some sort of a stay until Congress finds a solution both parties and the president can agree upon.

House Republicans like Wisconsin Republican Rep. Paul Ryans idea of sending block grants to the states to cover the subsidies for two years. It gives the next president and the next Congress time to figure out what to do. The states by the way would get to decide how the money to cover people is spent. 

In the Senate another Wisconsin Republican Sen. Ron Johnson wants to extend premium subsidies until 2017 when the next Congress and president can deal with the issue.

President Obama will not like either option. The White House has clearly stated those alternatives undermine the law and will cause rates to skyrocket and leave people without health insurance. Obama says South Texas College law professor Josh Blackman will go all out to make Republicans and the court look bad in the case of a negative decision.

The presidents going to trot out people on dialysis, people getting cancer treatment, hes going to pull out the full-court press on this, he said.


Source links: The Hill & insurancejournal.com

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  ObamaCare: No Clear Plan  The Affordable Care Act  Weekly Industry News  What Agents & Brokers Really Think about ObamaCare 

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House Votes to Repeal ObamaCare Medical Device Tax

Posted By Administration, Tuesday, June 23, 2015

The final vote was 280 to 140. In all 46 Democrats agreed with the Republicans who voted yes. The place is the U.S. House of Representatives and the issue is the ObamaCare tax on medical devices.

The tax is 2.3% and it affects 7,000 manufacturers who build things like ventilators or X-ray machines. Critics say the tax holds back innovation. Or so thinks Minnesota Republican Rep. Eric Paulson who introduced the bill. Only in Washington would you impose a tax on life-saving medical technology and think you will actually reduce healthcare costs.

Actually this is the second time the House has voted to repeal. It also got an up vote in 2012.

What it doesnt do is replace the $25 billion in lost revenue that helps subsidize the Affordable Care Act. Thats why President Obama if it manages to pass the Senate will likely veto. However, the repeal has some powerful allies in the Senate including Massachusetts Sen. Elizabeth Warren and a Senate Majority Leader in Mitch McConnell wholl bring it up for a vote.


Source link: The Hill

Tags:  Healthcare  HealthCare.gov  House Votes to Repeal ObamaCare Medical Device Tax  Insurance Content  Insurance Industry  Insurance News  ObamaCare  The Affordable Care Act  Weekly Industry News 

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ObamaCare: Not Working for Those Needing it

Posted By Administration, Tuesday, June 9, 2015


This storys focus is California. Its one state. Can what is happening in California be applied to other states? While we cant say definitely, the odds are long that it is being repeated elsewhere.

The statistics come from the Henry J. Kaiser Family Foundation. It says nine of 10 enrollees in Californias ObamaCare exchange Covered California are getting a subsidy to help them pay for their health insurance. Whats disturbing is 44% of them say they are having trouble affording their monthly premium.

For those getting insurance elsewhere like from employers just 25% report theyre struggling making the monthly payment.

Kaiser policy analyst Melissa Majerol offers this thought, It is clear that assistance is looking like it is not enough. And with that she throws out another thought. California has a higher cost of living than most other states so thats a possible reason.

Covered Californias James Scullary agrees. He calls it a hard reality that food, housing and transportation eat up more of the average Californians pay. It is no surprise that adding health insurance puts a strain on families. We know we need to change the underlying [cause] of health care being expensive.

Maybe thats the reason. Maybe not.

Theres more. The Kaiser survey also says many of the now newly insured cant get doctors appointments. It found many of those 13% with Covered California and 8% with Medi-Cal said providers refused to see them because of the type of coverage.

For those with other types of coverage the figure is 3%.


Source link: Employee Benefit News

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  ObamaCare: Not Working for Those Needing it  The Affordable Care Act  Weekly Industry News 

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ObamaCare, the Republicans & the Supreme Court

Posted By Administration, Tuesday, June 9, 2015

Later this month the U.S. Supreme Court is going to announce its decision on whether the Affordable Care Act subsidies are being legally applied. The law as written says the states can award the subsidies but it makes no mention of the federal government.

The Supreme Court a few years ago said the individual mandate was legal but also ruled the federal government cannot penalize states by withdrawing Medicaid funds for not setting up an insurance exchange.

A high percentage of the 34 states participating in HealthCare.gov the federal exchange did so because of that ruling. The law, say Republicans and those challenging the law in King v. Burwell, does not allow the federal government to apply those subsidies.

If the court rules thats the case, then those getting subsidies to purchase health insurance via the federal government will no longer be eligible for them.

Wisconsin Republican Sen. Ron Johnson is proposing a plan to extend those subsidies through August of 2017 if the court rules theyre not constitutional. His bill has 31 Republican co-sponsors. It will likely pass the Senate. No one is sure whatll happen in the House.

Meanwhile, House Republicans have introduced a bill called the Republican Study Committees American Health Care Reform Act. It repeals ObamaCare totally and creates an above the line tax deduction that applies to both income and payroll taxes of $7,500 for individuals and $20,500 for a family.


Source links: Employee Benefit News and The Hill

Tags:  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  ObamaCare  The Affordable Care Act  the Republicans & the Supreme Court  Weekly Industry News 

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A New Debate Ignites: ObamaCare & Insurer Profits

Posted By Administration, Tuesday, June 2, 2015

The rule is the medical loss ratio (MLR). It is part of the Affordable Care Act and says health insurers have to spend 85% of premium dollar income on health care and not on profit or administrative expenses.

Now the Obama administration has taken that concept and applied it to health insurance companies managing Medicaid health insurance plans. Insurers are up in arms over the decision and are offering up the same arguments they presented when the MLRs were adopted for ObamaCare.

Dan Durham who is the interim CEO of Americas Health Insurance Plans said, An arbitrary cap on health plans administrative costs could undermine many of the critical services beyond medical care that make a difference in improving health outcomes for beneficiaries, such as transportation to and from appointments, social services, and more.

By the way, PIA opposed the MLR when the administration put it into effect and contends they have cost independent insurance agents millions in commissions.


Source link: The Hill

Tags:  A New Debate Ignites: ObamaCare & Insurer Profits  Healthcare  HealthCare.gov  Insurance Content  Insurance Industry  Insurance News  The Affordable Care Act  Weekly Industry News 

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