Insurance rating agency A.M. Best said it is maintaining its stable market segment outlook on the U.S. health insurance industry, despite the impact of the COVID-19 virus outbreak. It cited:
- A trend of strong earnings;
- Strengthened risk-adjusted capitalization;
- Lower-than-estimated utilization and medical cost trends; and
- The cancellation or postponement of visits for routine care and elective procedures.
U.S. life insurers continued in 2019 to increase their holdings of commercial mortgage loans, an asset class that industry participants say faces unique challenges during the coronavirus pandemic, S&P Global reports. The long-term nature of commercial mortgages makes them a good asset match for the long-duration liabilities life insurers carry. However, commercial mortgage loans could be under stress as the pandemic-sparked economic slowdown continues.
More than 50 Texas health policy and industry groups are urging Gov. Greg Abbott to expand the state’s Medicaid program to cover more than 1 million people as a way to slow the spread of the coronavirus and the illness it causes, COVID-19.
Millions of people have lost jobs — and often the health coverage that came with those jobs. More still have had their work hours reduced or have received drastic pay cuts, so monthly premiums that may have been manageable before are now out of reach.
A great deal of uncertainty surrounds how the COVID-19 epidemic will evolve, including how many people will become infected and how many will become severely ill and require hospitalization. The Kaiser Family Foundation provides a range of cost estimates for the Trump administration’s proposal to reimburse hospitals for COVID-19 treatments for uninsured patients, based on results from recent studies and models.
UnitedHealthcare (UHC) this week became the latest major insurer to waive members’ cost sharing for COVID-19 treatments. The health insurer said it would waive the associated costs for members in its fully insured commercial, Medicare Advantage, and Medicaid plans.
UHC added that it’s working with interested self-funded employer plans to offer the same waivers.
Anthem announced similar steps, saying it would cover the cost-sharing for COVID-19 treatment through May 31 for its Medicare, Medicaid, individual market and fully insured employer plans. The insurer also said it was “strongly encouraging” its self-funded employers to adopt the waivers.
Anthem has also taken other steps similar to its peers in the industry, such as waiving the cost-sharing for testing and tele-health, and easing prescription limits.
Aetna, Cigna and Humana all previously announced they would waive members’ cost-sharing for COVID-19 treatment. These insurers also waived copayments and other cost-sharing for testing and telehealth visits.
Regional health plans are taking similar steps. Florida Blue announced Tuesday it would waive cost-sharing for treatment, as did Harvard Pilgrim Health Plan.
There are a lot of unknowns right now about what Trumpcare, the replacement for Obamacare aka the Affordable Care Act, may bring.
So the news that South Carolina-based Hibbits Insurance has filed an application to trademark the name Trumpcare is drawing a lot of curiosity.
As the South Carolina Post and Courier reports, Hibbits filed the application with the United States Patent and Trademark Office on January 19, 2017 – one day before the inauguration of President Donald Trump.
The Post and Courier says the filing date was coincidence, but the decision to trademark intentional.
It quotes Jack Hibbits, vice president at Hibbits Insurance, saying:
“It would be a strategic opportunity for us to trademark what could become an equally popular term under this new administration. We would like to be using it from a marketing standpoint on our materials as well.”
Hibbits Insurance is a family-owned insurance brokerage specializing in all lines of insurance, including health.
IP Watchdog adds that in the trademark application Hibbits is seeking to protect the standard character mark Trumpcare for commercial use in offering insurance lead collection and matching services, as well as health insurance underwriting.
While Fourth of July is a time of celebration for Americans, man’s best friend may be at increased risk for injury and illness over the holiday.
Veterinary Pet Insurance Co shares the most common Fourth of July related pet injuries based on its database of more than 525,000 insured pets.
Pets are at risk for a number of firework-related injuries. Common injuries include: burns; strangulation from getting a collar caught on a fence or jumping a fence due to the loud noise of fireworks; and laceration from breaking through a glass window or fence. Average costs for treatment run upward from $355.
Other common holiday-related injuries/illness include heat stroke, drowning after falling in a pool and poisoning from eating chocolate or table scraps and ingesting alcohol.
VPI suggests pet owners plan ahead with the following tips to keep our furry friends safe during the holiday weekend:
- Set up a safe zone for your pet and never leave your pet unattended or tied up in the back yard.
- Leave out extra water bowls to ensure your pet stays hydrated and be aware of foods that could be toxic to your dog.
- Be mindful of your dog around a pool and if they are allowed to swim, make sure they’re a comfortable swimmer and know how to get out of the pool.
The American Kennel Club makes the point that it’s safer to keep your pets at home during Fourth of July celebrations instead of bringing them to your neighbor’s party. Keeping your pet in a safe room where he/she is comfortable can reduce stress from the noise of fireworks.
Have a safe and happy Fourth of July!
June is Pride month and our annual round-up of the latest insurance news around the LGBT (lesbian, gay, bisexual and transgender) community takes on added significance with today’s U.S. Supreme Court decision on same-sex marriage.
The Supreme Court decision in Obergefell v Hodges means that the U.S. Constitution guarantees a right to same-sex marriage in all 50 states. This has a number of implications for health, life, and auto insurance.
For example, health and life benefits that currently exist in states that recognize same-sex marriage will—once the law goes into effect—extend to all states.
Some of these benefits include: coverage of a same-sex spouse and children under health insurance plans; equal tax treatment of health insurance premiums for married gay couples; and recognition of a spouse for survivor benefits, including social security and life insurance.
For auto insurance offerings, too, this means that LGBT customers who are married will be entitled to the married rate, regardless of where they live.
Esurance, one of the first car insurers to extend the married rate to LGBT customers, points to what equality means for auto insurance in a just-issued press release here.
For LGBT couples who are married or are planning to get married, Esurance offers the following advice:
In addition to saving money with the married rate, married couples in states newly recognizing same-sex marriage can be identified as a spouse on their partner’s insurance policy. This will allow them to receive additional benefits on that policy such as coverage while driving a rental or borrowed car.
Until the ruling goes into effect in individual states, Esurance will continue to extend its married rate to either married gay couples, domestic partners or those in civil unions–even in states that have yet to recognize same-sex marriage. Something it has done since 2011.”
I.I.I. chief actuary Jim Lynch brings us some surprising numbers on America’s addiction to opioids:
Americans are grossly misinformed about the dangers of opioid drugs, according to a recent survey by the National Safety Council (NSC).
Opioids are commonly prescribed painkillers like Vicodin, OxyContin and Percocet. The drugs are meant to mimic the nervous system actions of heroin and morphine and all too often lead to similar levels of addiction and suffering. More than 170,000 Americans have died from opioid overdoses this century, nearly triple the number of U.S. military deaths in Vietnam (see my earlier post).
I wrote about the epidemic in Contingencies magazine, focusing on the toll the drugs have taken in the workers compensation system.
Too few Americans are aware of this risk, according to the survey of 1,014 adults, reported in the March 24 edition of Workers’ Compensation Report. Just one in five considered opioids to be a serious safety threat. Only 12 percent said addiction was a concern; two-thirds were unconcerned about any side effects from the drugs.
Education is part of the problem. Only 29 percent of respondents said they had taken or been prescribed an opioid in the past three years, though the number jumped to 42 percent once they were provided with a list of common opioids.
Nearly 60 percent of users had at least one addiction risk factor. Common risk factors include alcoholism, depression, use of psychiatric medication or being the victim of physical, mental or sexual abuse.
Users held opioids in high esteem. For example, 78 percent said they were the fastest method of pain relief, 74 percent said they were stronger pain relievers than alternative prescriptions, and 71 percent said they were the best way to relieve pain.
They underestimate the risk. Though 16,235 people died from prescription drug overdoses in 2013, just 19 percent of survey respondents said they had major concerns about the risk of injury or death from the drugs.
That’s less concern than they had about injury or death from severe weather or a natural disaster, from which 586 people died in 2013, and about the same level of concern as riding in a commercial airliner in the U.S., an activity that in 2013 killed eight, roughly 0.5 percent as many as opioids.
Details on the NSC survey can be found here.
Here’s a simple chart that compares the number of people killed in the opioid epidemic from 2000 to 2013 with the number of soldiers killed in the Vietnam theater, writes I.I.I. chief actuary Jim Lynch.
Opioids are legally prescribed drugs designed to safely mimic the painkilling effects of heroin and morphine. They have not proved as safe as had been hoped.
The drugs killed more than 170,000 over 14 years, about three times as many as this country lost in Vietnam. The Centers for Disease Control and Prevention (CDC) provides the data for opioids, and Vietnam statistics come from the Congressional Research Service (CRS) and National Archives.
I compare the epidemic to warfare because I became aware of the issue at a 2014 Workers Compensation Research Institute (WCRI) conference, when a Boston poll noted (if memory serves) that for every Massachusetts fatality in Iraq or Afghanistan, there were eight opioid victims. It’s also valuable, I think, to compare the War on Drugs with the more traditional battlefront.
Sometimes opioids like OxyContin, Vicodin and Percocet are referred to with the general term narcotics, as I did in an article for Contingencies magazine that traced the epidemic’s impact on workers compensation insurance:
Chances are good that if you’ve made a workers comp claim, you’ve had opioids in [your] medicine cabinet. Narcotics made up 25 percent of workers comp drug costs, according to the National Council on Compensation Insurance (NCCI), and more than 45 percent of narcotics costs pay for drugs containing oxycodone.”
There is some relatively good news. Opioid deaths appear to have peaked in 2010 at 16,917, the CDC reported last month. In 2013 the toll was 16,235.
By contrast, 16,899 died in Vietnam in 1968, the most violent year of the war. So the opioid epidemic has leveled off to deliver tragedy as frequently as the worst year of the Vietnam War.
On another front the news is not good. Opioid addicts often turn to heroin when their prescriptions run out, and the number of heroin-related deaths rose 39 percent last year, to 8,257, the CDC reports. That’s in addition to the opioid toll.
Together, opioids and heroin killed 215,031 between 2000 and 2013, about 80 percent more than the approximately 120,000 U.S. military deaths since World War II.
I.I.I. chief actuary Jim Lynch reports from the Workers Compensation Research Institute (WCRI) annual conference:
An important cost-control mechanism of the Affordable Care Act could end up annually shifting hundreds of millions of claim dollars into the workers compensation system, preliminary research by the Workers Compensation Research Institute (WCRI) indicates.
The mechanism is the Accountable Care Organization (ACO), and WCRI researchers used the ACO’s similarity to Health Maintenance Organizations (HMOs) to estimate the nature of the cost shift as well as give a general idea of its magnitude.
An ACO is a network of doctors and hospitals that share the financial and medical responsibility for a group of patients. The ACO receives a set amount per patient for a year, regardless of the services each patient receives, a structure known as a capitated plan. HMOs are another type of capitated plan. The difference: an ACO can be paid more if it saves money while providing high quality care.
This difference gives some health experts hope that ACOs can rein in healthcare costs better than HMOs do. They believe healthcare will respond to the profit incentive ACOs offer.
The Affordable Care Act encourages ACOs and other capitated plans.
WCRI’s research indicates that capitated plans tend to push sprains, strains and other soft tissue injuries into the workers compensation system, WCRI Executive Director Richard Victor told about 300 attendees at the organization’s annual conference in Boston on March 5.
Often it is hard to tell exactly what caused a strain like a sore back, Victor said. It may have come while at work or at home. Usually the classification is the doctor’s decision.
In an ACO or any other sort of capitated plan, the doctor has a choice: call the injury work-related and bill the workers compensation insurer or decline to do so and collect no additional fee. The financial incentive is obvious.
The WCRI study looked at a nationwide sample of more than 700,000 claims from 2008 to 2010, about 17 percent of which came from HMOs. It classified states into two buckets, depending on how prevalent HMOs were.
In states with a relatively large HMO presence, HMO doctors put 26 percent of soft tissue injuries into workers comp. That was 30 percent more often than doctors in traditional fee for service arrangements.
For injuries like a broken arm, where it was easy to know what caused the injury, HMO and fee-for-service doctors put about the same percentage of claims into workers comp.
States with fewer HMOs didn’t exhibit the same shifting, the study indicated.
It is harder to estimate the financial impact, because it’s hard to say how popular ACOs will become. To develop an estimate, Victor hypothesized that ACOs could increase the percentage of workers in capitated plans by 25 percentage points. Such an increase would allow capitation plans to regain the 15 percentage points of market share they have lost since 2000 and then some.
Under that scenario, cost shifting in Illinois would push $90 million of claims into workers comp. In Pennsylvania, the shift would cost workers comp insurers $55 million.