IRDA asks PSUs not to force elders to switch to new health plans

MUMBAI:
Insurance regulator Insurance Regulatory and Development Authority (IRDA) has
asked state-owned coverage companies not to coerce senior citizens to switch over to
a new wellness insurance program with less benefits at the clip of renewal of
policies. The regulator have reiterated that insurance companies cannot rise rates on
mediclaim policies by more than than 50-75% of the former year’s premium,
following an harmful claims experience. With ailments pouring in
from senior citizens, the regulator have put up a particular cell to look into their
complaints. The regulator have appointed Roentgen Srinivasan as military officer on particular duty,
in complaint of the cell based at IRDA’s Hyderabad office. Senior citizens
who have got jobs with their mediclaim renewal can reach this special
cell. The thought was mooted by the IRDA panel on wellness insurance
issues faced by senior citizens. Senior citizens’ association have been
clamouring for a particular cell, given that wellness coverage business relationships for over 15%
of non-life premium. The IRDA panel had also recommended a wellness coverage pool
under the auspices of IRDA to take over high hazards cases, including the 1s whose
renewal insurance premium is hiked by over 40%. A similar pool bes for
motor third-party liability insurance. IRDA is yet to take a position on the pool
for rejected wellness coverage covers. Incidentally, the regulator had set a
similar cap on rates for third-party liability coverage a couple of old age ago,
even after it was decided to increase rates by over 100%. In a
circular to public sector coverage companies, the regulator said that PSUs have
already revised the insurance premium rates in regard of mediclaim policies in April
2007. “The authorization received respective ailments from senior citizens that
renewal insurance premiums charged to them were exorbitant. The authority,
therefore, advised all the public sector full general coverage companies that: The
loading of insurance insurance premiums if justified for renewals of mediclaim policies issued to
senior citizens shall not transcend 50-75% of the premiums charged prior to the
revision.” IRDA have also said, “Senior citizens shall not
be compelled by the coverage companies to transmigrate to other wellness insurance
products, if it is to the disadvantage of senior citizens. The above
instructions are applicable to renewal lawsuits only. The authorization has
now created a separate cell to go to to the grudges of senior citizens in
respect of non-renewals Oregon extortionate additions in coverage premium of mediclaim policies
of public sector full general insurance companies,” the circular
said.

Anthem rolls out bare-bones health plan

By Daniel Lee

Anthem Blue Cross and Blue Shield on Wednesday unveiled a bare-bones health coverage program designed for employers struggling to offer benefits to their workers because of the rise cost of premiums.

The new plan, called Blue Entree Hospital Surgical PPO, supplies "catastrophic" insurance for most hospitalizations and surgeries, as well as limited insurance for physician visits and other services, according to Anthem, a subordinate of Capital Of Hoosier State health-insurance giant WellPoint.

Anthem said the plan's insurance premiums are up to 70 percentage cheaper than those for a full-range preferred supplier organisation plan.

"It's another option for employers who otherwise might be forced to cut back or get rid of wellness insurance altogether because of budgetary constraints," said Henry Martin Robert W. Hillman, president of Anthem Blue Cross and Blue Shield in Indiana, in a statement.

Anthem is rolling out the program in Indiana, Ohio, Kentucky, Show Me State and Wisconsin. The program previously was available lone on the individual wellness insurance market, not for employee-sponsored plans.

The new program reflects broader tendencies in the wellness coverage marketplace.

More employers are finding it financially hard to offer their workers health-care coverage. Premiums for household insurance in 2007 averaged $12,106 a year, with workers on norm paying about $3,281 of that out of their paychecks, according to the Kaiser Family Foundation, a non-profit-making health-care research group.

In response, more than than health- insurance programs are shifting more health-care costs to workers.

Under the Blue Entree Hospital Surgical PPO, workers may salvage on those insurance premiums but human face plentifulness of other costs as they seek care.

Deductibles -- or out-of-pocket costs before any coverage starts -- scope from $1,000 to $5,000 for a single individual and $3,000 to $15,000 for a family.

After the deductible is met, a patient would be responsible for a $20 co-pay, asset 50 percentage of the sum complaint for an outpatient physician visit, according to Anthem. An emergency-room visit necessitates a $150 co-pay asset 20 percentage of the sum charge.

Full insurance would kick in after the patient attains an out-of-pocket maximum, which begins at $5,000 for a single individual and $10,000 for a family.

The program also includes generic prescriptions for a $10 in-store co-pay.

The Blue Entree Hospital Surgical PPO makes not supply insurance for visits to urgent-care halfways or for lasting medical equipment such as as wheelchairs that commonly are covered in more than than comprehensive plans.

Some medical experts worry that some patients covered by wellness programs with high out-of-pocket demands could detain seeking needed medical treatment.

"The challenge for a merchandise like this is the hazard that people will detain their care," said Dr. Deanna Willis, helper professor of household medical specialty at Hoosier State University School of Medicine.

Willis points to research collected by the wellness advocacy group, The Commonwealth Fund, that reported that 31 percentage of enrollees in high-deductible programs were more likely to detain or avoid attention because of costs, compared with 17 percentage of those enrolled in comprehensive plans.