...differences between individual and group insurance plans. Individual health insurance plans were designed to provide insurance to unemployed or self-employed persons not covered under their employer's plan. In some cases, individual insurance can be difficult to obtain at any price. People with pre-existing, previously diagnosed, or treated health problems seeking new health insurance policies are considered high-risk by insurance companies, and may be unable to find affordable health insurance or any health insurance at all. On the other hand, group insurance plans, which provide coverage for two or more individuals, cannot single out high-risk individuals; nor can they deny them health coverage. All individuals are covered regardless of their existing health problems, and high-risk individuals are factored into the total cost of the group plan. The plan descriptions that follow outline the types of individual and group insurance plans widely available today. A first step is to decide if you will take out an individual or a group health policy. Group insurance is only an option for you, if you are a member of a group that offers a group health policy. Common groups that offer insurance are employers, unions, and trade associations. The most common form of group insurance in the US is insurance offered by an employer. Employers frequently offer insurance because the employer gains tax benefits from offering subsidized care and increases the overall health of the employees. Even...
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...Modern Health Insurance Model Health insurance has changed a lot over the years and will continue to change over time. There are many things to consider when looking at health insurance. Some of the aspects and terminology a person may need to inquire about when dealing with insurance would be group health insurance and individual health insurance. Individual health insurance “is a type of coverage purchased on the private market by a single person for themselves or their families.” (Contributor) It is meant to cover more than one person even though some mistake it for only one person because of the terminology “individual”. People whom normally purchase this type of insurance “don’t have access to group health insurance, can be denied, and will most likely be required to pay higher premiums due to age, gender, or any pre-existing medical conditions.” (Rowell, 2011) “Group health insurance is designed specifically for companies to buy for their employees.” (Contributor) This type of insurance is purchased on the open market just like individual health insurance but only by the employer not the employee. (Contributor) Another meaning for group health insurance is “traditional healthcare coverage subsidized by employers and other organizations (e.g., labor unions, rural and consumer health cooperatives) whereby part or all of the premium costs are paid for and/or discounted group rates are offered to eligible individuals.” (Rowell, 2011) When comparing and contrasting...
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...Structuring Health Care Erroll Reese Instructor: HSA 500 – Health Services Organization January 23, 2010 Table of Contents Introduction ……………………………………………………………………………………. 3 Identify and describe the three main types of health insurance in the U.S ……………..…….... 3 Describe the three methods for categorizing health insurance in the U.S……………………….. 5 Identify the three types of managed care plans and provide the pros and cons of each for the health care provider, insurer, and patient……………………………………...............................5 Describe the impact of managed care on both the Medicare and Medicaid programs.…………. 8 Conclusion ……………………………………………….……………………………………… 8 References …………………………………………….………………………….……………… 9 Introduction Our stable outlook on the U.S. health insurance sector reflects our belief that industry risk is moderating, business conditions--including growth and retention opportunities and access to capital--have improved, and health insurers' financial fundamentals are now relatively strong. Offsetting these favorable factors are concerns about slowing economic growth, growing governmental fiscal pressures (particularly at the state and local levels), and health care reform issues. We believe these factors will affect each business and individuals differently and will likely keep the number of rating actions moderate for 2012. Identify and describe the three main types of health insurance in the U.S Individual health insurance...
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...Popular Articles About Health Insurance NEWS Health insurance December 4, 2007 Health insurance in India is still for the privileged few and is, however, still largely in the form of a plain vanilla cover, mediclaim, introduced a decade-and-half ago. Customisation is used in group health insurance by corporates for their employees. In the case of the individual, customisation has not taken off despite the fact that we now have different products such as hospital cash, critical illnesses and so on. For any product to be customised, the awareness level has to be high. Health Insurance Articles By Date NEWS New health cover norms may save users the heartburns; arbitrary premium hikes will now be a... October 9, 2013 | Preeti Kulkarni , ET Bureau Arbitrary premium hikes by insurance companies at the time of renewal and inordinate delays in claim settlement, among others, could be a thing of the past from this month. The new health insurance norms that came into effect from October would do away with quite a few arbitrary rules that caused heartburn among customers. Sure, we have to wait for a few months to see how the scenario would unfold, but that shouldn't stop us from... [pic] [pic][pic][pic][pic] NEWS Health insurance: Use multiple plans efficiently December 13, 2010 | Khyati Dharamsi It's not uncommon for an individual to be covered by two, or even three, health insurance policies. One reason for this is the rise in the cost of health-care services in the past...
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...which individuals seek is insurance for thir families, property, and even life. Here is a list of top 10 insurance companies in the world in 2014 based on their Market Capitalization (measured in USD for 1st quarter 2014). 10. Zurich Insurance: [pic] Zurich is a global Swiss insurance company, headquartered in Zurich, Switzerland. The company is Switzerland’s largest insurer, with three core business segments: General Insurance, Global Life and Farmers Management Services. Through General Insurance, the group provides motor, home and commercial products and services for individuals. Global Life provides wide range of protection and savings propositions to individual and corporate customers. Farmers provide non-claims administrative and management services for the Farmers Exchanges. The company ranks 84 in the Global 2000 list for 2014. Zurich Group employs around 55000 people, with operations in more than 170 countries and territories across the globe. The company has global network of subsidiaries and offices in Europe, North America, and Latin America, Asia Pacific and Middle East and other markets. Zurich’s strategy for 2014-16 is designed to deliver sustainable, profitable growth in a changing and more competitive business environment. Group is focusing more closely on the markets and consumer segments where the group has competitive edge. Revenues (FY13): $72 Billion Net Profit (FY13): $4 Billion Market Cap (Q1-14): $45.4 Billion 9. ING Group [pic]...
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...1: INTRODUCTION AND INDIVIDUAL LIFE INSURANCE 3 CHAPTER 2: REGULATION OF THE INSURANCE INDUSTRY 5 CHAPTER 3: INTRODUCTION TO RISK AND INSURANCE 9 CHAPTER 4: MEETING NEEDS FOR LIFE INSURANCE 15 CHAPTER 5: THE INSURANCE POLICY 19 CHARTER 6: PRICING LIFE INSURANCE. 22 CHAPTER 7: TERM LIFE INSURANCE 26 CHAPTER 8: PERMANENT LIFE INSURANCE AND ENDOWMENT INSURANCE 30 CHAPTER 9: SUPPLEMENTARY BENEFITS 37 CHAPTER 10: LIFE INSURANCE POLICY PROVISIONS 44 CHAPTER 11: LIFE INSURANCE BENEFICIARY POLICIES 50 CHAPTER 12: ADDITIONAL OWNERSHIP RIGHTS 52 CHAPTER 13: PAYING LIFE INSURANCE POLICY PROCEEDS. 59 CHAPTER 14: PRINCIPLES OF GROUP INSURANCE POLICY 63 CHAPTER 15: GROUP LIFE INSURANCE. 68 CHAPTER 16: ANNUITIES AND INDIVIDUAL RETIREMENT SAVINGS PLANS 73 CHAPTER 17: GROUP RETIREMENT AND SAVINGS PLAN. 84 CHAPTER 18: MEDICAL EXPENSE COVERAGE 90 CHAPTER 19: DISABILITY INCOME COVERAGE. 94 CHAPTER 20:TRADITIONAL GROUP HEALTH INSURANCE PLANS 98 CHAPTER 21: TRADITIONAL INDIVIDUAL HEALTH INSURANCE POLICIES 104 CHAPTER 22: MANAGED CARE PLANS 109 CHAPTER 23: REGULATION OF HEALTH INSURANCE 113 CHAPTER 1: INTRODUCTION AND INDIVIDUAL LIFE INSURANCE Insurance companies are organized as either • Stock Insurance companies Company has stock that is bought by shareholders. So company is owned by shareholders. These share holders get dividends. No. of companies: 1604 Income from Premium: 226 billion Dollar amount of Life Insurance in force: 9.8 trillion ...
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...comprehensive health insurance reforms that will roll out over four years and beyond. Use the links below to learn about what’s changing and when: OVERVIEW OF THE HEALTH CARE LAW 2010: A new Patient's Bill of Rights goes into effect, protecting consumers from the worst abuses of the insurance industry. Cost-free preventive services begin for many Americans. See More 2010 Changes. 2011: People with Medicare can get key preventive services for free, and also receive a 50% discount on brand-name drugs in the Medicare “donut hole.” See More 2011 Changes. 2012: Accountable Care Organizations and other programs help doctors and health care providers work together to deliver better care. See More 2012 Changes. 2013: Open enrollment in the Health Insurance Marketplace begins on October 1st. See More 2013 Changes. 2014: All Americans will have access to affordable health insurance options. The Marketplace allows individuals and small businesses to compare health plans on a level playing field. Middle and low-income families will get tax credits that cover a significant portion of the cost of coverage. And the Medicaid program will be expanded to cover more low-income Americans. All together, these reforms mean that millions of people who were previously uninsured will gain coverage, thanks to the Affordable Care Act. See More 2014 Changes. 2010 NEW CONSUMER PROTECTIONS • Putting Information for Consumers Online. The law provides for where consumers can compare health insurance...
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...UnitedHealth Group UnitedHealth Group is a 21st Century Company. Their value is consistent in name and heritage. Honesty is the foundation of their organization. The company strives for transparency in reporting and regulatory relationships. They deliver solutions that improve the health and well-being of individuals. UnitedHealth Group strives to communicate their objectives and goals clearly and create ways to measure their progress towards these set goals. Utilizing scientific business methods to drive and sustain improvements and lower costs is what the company uses to meet and exceed the expectations of customers, shareholders and surrounding community. In 1974, Charter Med Incorporated was founded by a group of physicians and healthcare professionals that wanted to expand health coverage options for consumers. In 1977, United Healthcare Corporation was created to reorganize the company and became the parent company of Charter Med Inc. United Healthcare introduced such healthcare innovations as pharmacy/drug formularies, hospital admissions pre-certification processes, physician office software to manage and control costs, mental health/chemical dependency intermediaries (behavioral health) and insurance wrap as one feature on top of traditional HMO products. (http://www.unitedhealthgroup.com/About/History.aspx#!prettyPhoto) UnitedHealth Group's commitment to help people live healthier lives and to innovative thinking is an integral part of the company’s heritage...
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...Why do we need the health insurance industry? Need for health insurance The health insurance industry (XLV) mainly provides a risk management tool for an individual. People cannot predict the extent and timing of their future healthcare expenses. By paying regularly for health insurance, people can get protection against financial losses resulting from high health care expenses. It also enables them to better manage their cash flows as most health insurance plans specify the maximum amount an individual will need to pay in excess of the charge paid for buying the insurance, in a calendar year. Risk pooling According to study by the Congressional Research Service, the top 5% of the total population accounted for about 50% of the health expenses in 2011 and 2012. This uneven distribution of spending forms the basis of risk pooling, where people contribute an amount of money, at least equal to the per capita cost of medical services, expected to be used by the group of insured people. Risk pooling in insurance is essentially a cross-subsidy paid by low-risk members to high-risk members of the insurance plan. The above diagram shows that the performance of healthcare system or the efficiency of health insurance and effectiveness of risk pooling increases as the size of the group increases. However, the benefit of reduced risk resulting from the increasing size of the insured population reduces as the size increases a certain optimal size, S*. As size increases, the probability...
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...It will provide the health insurance planning overview, general information regarding the organization, the existing group health insurance plan which provided by the employer (LHDNM), background of study, the problem statement, research objective, research question, hypothesis, and scope of study, limitation of study, significance of study and definition of terms. Firstly, the title of the research is “The Study on the Factors Influencing The Purchasing Behavior of Personal Health Insurance among The Inland Revenue Board of Malaysia‟s (LHDNM) Staff”. There are general overviews of the personal health insurance planning and the background of the organization. After that the researcher will discuss about the background of study, problem statement, research objective and research questions. Besides, the researcher will state hypothesis of the relationship between three independent variables. Then the researcher will attach the scope of study and limitation of study. The next part is the significant of the study and definition of term. 1 1.1 About health insurance planning Health insurance, like other forms of insurance, is a form of collectivism by means of which people collectively pool their risk, in this case the risk of incurring medical expenses. The collective is usually publicly owned or else is organized on a non-profit basis for the members of the pool, though in some countries health insurance pools may also be managed...
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...ACA changes the non-group insurance markets in the US and each individual should have health insurance which helps significantly to develop the markets of the public insurance and support the private insurance coverages which leads to rise in the revenue from the new taxes and reorganizes the Medicare health insurance plan. According to Gurbers assumption of funding ACA is mainly based on the “Three legged Stool” approach followed to fix the Non employer insurance in the United states and which helps in the increasing the market of the health insurance in the country. The reforms included based on the three legged stool strategy to the non-group insurance market. First to prohibiting exclusions for the pre-existing conditions and charging different prices based on the health status. The second leg of the stool looks in to the individual authority to take the insurance policy. The third leg of the stool deals with the Subsidiary for the low income families to have the insurance plan. ACA finances through following sources for the above are 1) To improve the government Medicare plans for the seniors by reducing befits of the private Medicare Advantage programs which affects the 14% financing share. 2) Decreasing of the Medicare reimbursement through decrease in adjustments provided to the hospitals every year for the Medicare reimbursement due to this 33% of financing share has the impact. 3) Increase in the Medicare tax payroll by 0.9% and to the individual with more than $200...
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...profound problem with health care spending. Rising health care costs are stifling economic growth, consuming increasing portions of the nation’s gross domestic product, and putting added burdens on businesses, the public sector, individuals, and families. GROSS DOMESTIC PRODUCT Health care accounts for about one-sixth of the entire economy — more than any other industry. Spending on health care totals about $2.5 trillion, 17.5% of our gross domestic product a measure of the value of all goods and services produced in the United States. That's up from 13.8% of Gross Domestic Product in 2000 and 5.2% in 1960, when health spending totaled just $27.5 billion — barely 1% of today’s level, according to the Kaiser Family Foundation, a nonpartisan health policy group. (http://usatoday30.usatoday.com/news/health/2009-06-19-health-economy) A variety of factors that has contributed to the growth in health care spending relative to the GDP. These factors include the following: • rapid development and dissemination of medical technology that expanded the treatment of disease • rising expectations about the value of health care services • government financing of health services • the nature of third-party reimbursement • the growth in the proportion of elderly • the lack of competitive forces in the health care system to increase efficiency and productivity in delivery of services , and • the misdistribution of physicians and other providers of health services HEALTH CARE LEGISLATION ...
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...Health insurance is a contract between a people or group that says the health insurance company will pay a portion of the medical expenses when the individual accesses the healthcare system for the illness, injuries or routine care. The amount the insurance company pays depends on the coverage and varies greatly between companies and policies. A few of the top managed care organizations are Aetna, Humana and United Health Group. These insurance companies offer health insurance, dental, vision, pharmaceutical, Medicare, Medicaid and some even offer disability, life insurance, and pet insurance. All of these companies offer similar plans and services but vary greatly in price. Price per plan can vary depending on the health of the individual on the plan and how many people are on the plan. Employers typically purchase Group Insurance because they can receive a more discounted rate than individual rate insurance plans. Monthly insurance costs are hard to determine. With just a basic quote for a healthy individual between 21 and 30 there is still a huge variation. Aetna is not available in my area, but they are contracted with CoventryOne. CoventryOne has basic plans that vary anywhere from $42.82 a month to $338.87. Humana doesn’t have such a vast price difference and varies between $219.70 -$258.53 per month. United Health Group ranges from $250.65 -$452.34. These prices are all for very similar plans, which makes it hard to choose which one to go with. There are very subtle...
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...State Insurance Exchanges as Catalysts to America’s Health Revolution HSC-536 W-Credit Saud Al Busmait (C060-797-64) 4/30/2012 The Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act signed into law on March 23rd 2010 are both essential portions of American legislation, as well as wildly misunderstood in their entirety. Personally, and from recent academic experience, I meant that to sound exactly as the previous sentence expressed. Prior to actually introducing the main topic of this paper, being the ACA’s health insurance exchanges, and beginning to write, I honestly found myself experiencing writers block. This was so strange as there is an endless amount of very straightforward information available on the topic. I realized that the problem was rather interesting. I felt the need to first express my opinions of the ACA on a simpler note, purely writing what I really felt and believed about it as the thoughts flowed. I now realize why that was so. I believe that it was my newfound understanding and strong, honest support for the act that I had to sell, to at least a sufficient degree, to whomever may read this college student’s paper. This “sufficient degree” of mine is a fair understanding of the long-term, national importance that the ACA’s provisions may serve, ultimately through the efficiency of health insurance exchanges. The national importance being served is exponentially expanding medical care to the U.S...
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...Health Insurance Guide Health Insurance Guide * What is health insurance? * How does health insurance work? * What are the different kinds of health insurance? * Individual mediclaim policy * Floater Policy * Critical illness policy * Overseas mediclaim policy * Student medical insurance * Tax saver * So, what kind of coverage can I get? * Accidental death benefit * Permanent and total disability cover * E opinion rider * Children's education allowance * How much does health insurance cost? * The no of people to be covered * Amount of coverage needed * Age of the oldest family member who is proposed to be covered * Can I get tax benefits with health insurance? * Are there any alternatives to health insurance? * Critical illness benefit * Hospital cash benefit * Things to watch out for What is Health Insurance ? Health Insurance also known as Mediclaim in India provides you the cover against the medical care costs arising from disease or accidental injuries. Health insurance is a crucial financial product that every individual must have irrespective of their age. It allows you to focus on getting the best treatment without bothering about the financial costs of the same. Depending on the terms of the health insurance policy it covers all or part of the medical costs of treating the disease or injury including doctor's...
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