Megapolis Insurance

According to the US Government Accountability Office (GAO), more than 60 percent of American employers are expected to offer a consumer-directed health plan (CDHP) in 2011 in an effort to curb costs. With a CDHP plan, an enrollee is responsible for more of the decision making process in obtaining healthcare, making knowledge of the costs involved a critical component.

Prescription Drugs Offer the Greatest Opportunity for Cost Savings

A consumer-directed health plan combines a high-deductible health plan with a tax-advantaged account – a health reimbursement arrangement or HRA – that enrollees can use to pay for healthcare expenses. The GAO estimates that CDHP enrollees spend $2,000 less than those with traditional health insurance plans. Large companies that currently offer CDHP’s include Microsoft, Kraft, GE and General Motors.

Read: Consumer-Directed Health Plans Encourage Preventive Care

In an HRA, the enrollee must pay a premium to access covered services, which are also subject to a deductible. Some services, such as preventive care services, may be exempted from the deductible. HRA Read more…

Last week, Health & Human Services Secretary Kathleen Sebelius issued a letter to the National Association of Insurance Commissioners expressing concerns about the approach some carriers have considered for child-only health insurance coverage. In particular, while endorsing the idea of open enrollment periods, she rejected the idea of denying sick children outside the open enrollment period, but accepting healthy kids year-round.

While Congress is in recess until the upcoming elections, we continue to closely monitor activity in Washington, contributing comments on a variety of issues directly as well as through trade organizations. Regulators continue to issue guidance and seek industry input.

Carved-Out Plans

Some employers may have structured their benefit offerings so that one type of plan is available for one group of employees, but another plan for other groups. For example, management may be offered only a PPO, while hourly workers can only take HMO coverage.

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Due to a stipulation in the new health reform law, the world’s largest restaurant chain may be unable to provide its limited-benefits plan to nearly 30,000 hourly workers. McDonald’s has asked for a waiver from the Department of Health and Human Services to allow its “mini-med” plan which provides coverage with lower administrative costs.

Many retail employers offer “mini-med” plans for their hourly workers as an affordable health care option. McDonald’s plan by provider BCS Insurance Group has been offered to employees for more than 10 years and provides outpatient, inpatient, preventive care, and prescription drug coverage.

The new health law requires large employers to offer adequate health insurance coverage for full-time workers and to spend at least 85% of premiums on medical benefits rather than administrative costs. Because McDonald’s faces high employee turnover and relatively low claims payouts, their program spends more than most on administrative costs.

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If you are planning to study in the United States for a semester, for a year, or even longer, you should make certain you educate yourself on the U.S. healthcare system before departing. The privatized nature of the system means you will need to purchase international student health insurance in order to avoid the high costs of medical treatment.

Without a health insurance plan, you will find that obtaining medical care in the U.S. is quite expensive. Simple doctor’s visits can cost hundreds of dollars, while more complex procedures can cost thousands. As a student, you likely have little if any disposable income, so you cannot afford any unnecessary expenses.

International student medical insurance plans absorb those costs, leaving you to pay only a very small amount. So you can get the high quality healthcare you need without having a large bill accompanying it. You will also find that these types of plans are much less restrictive than similar plans offered by universities themselves, meaning you will have more freedom in selecting a doctor or hospital you are comfortable with. Read more…