tag:blogger.com,1999:blog-77026998437763680912024-03-13T06:49:22.930-07:00Harver Health Insurance Counter Fraud GroupAnonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.comBlogger29125tag:blogger.com,1999:blog-7702699843776368091.post-90471870972151580662015-05-25T17:49:00.001-07:002015-05-25T17:49:13.914-07:00Harver Health Insurance Group Tokyo Reviews: Tips before buying the right health insurance<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">We all know the popular saying "Health
is Wealth". It is just a simple phrase but its meaning is quite astounding
and profound.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Nowadays, health has become equivalent to the
value of wealth in all societies around the world. A good health must be one of
the most important priorities in our life because without it, no one can
appreciate anything in life. For instance, you can't work and provide the needs
of your family if you are unhealthy.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">So, choosing the right health insurance plan
is actually a tough decision to make. It can provide you and your family the
feeling of comfort and safety. In case someone in your family got sick or has
an accident, you want to give them the best chance of getting well.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Based from the review of <a href="http://hhicfg.com/">Harver Group based in Tokyo</a>, more than eighty
percent of financial crisis comes from health emergencies. For this kind of
emergency, you will not only need money for the treatment but for most
individuals, it will also damage their ability to earn which results to hitting
them with a double impact.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">So health insurance is really a must right
now because you don't want to lose a family member just because you can't
afford to give him the best medical treatment.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Once you have some health issues like
diabetes, the possibilities of having a health insurance goes low and the price
goes high. So it is advisable that you should get a health insurance as soon as
possible because what is the worth of paying a small amount in exchange of
getting a peace of mind.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><a href="http://hhicfg.com/blog/">Harver
Group</a> provided some important tips below that you need to consider before
buying a health insurance:<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Get an individual health insurance<o:p></o:p></span></i></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Even if your company provides you a corporate
group health insurance, you should get an individual health insurance. Because
once you quit or retire from your job, there might be a chance that your
corporate cover will end. The company could also choose to withdraw this benefit
or decide to leave other family members out from the insurance coverage.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">If you can't afford a full individual
Mediclaim, you can get a Super Top Up instead in which it provides additional
protection at an affordable price when hospitalization costs are very high.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Choose as soon as possible<o:p></o:p></span></i></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">It is important that you get a health
insurance before you turn forty or as early as possible. You can have the
benefit of no-claims bonus and combine to the original insurance coverage every
claim-free year, since you are possibly to make no or few claims in earlier
stages of life.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Buy a health insurance that is renewable for
lifetime<o:p></o:p></span></i></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Your objective is to get a health insurance
which provides lifetime renewability. Once you get older and have illnesses,
protection is possible if only your policy offers lifetime renewability.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Don't buy a health insurance with claim
loading<o:p></o:p></span></i></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">In case you get a serious illness that needs
a long-term cure then with claim loading, your premiums keeps on growing and
shortly can become unaffordable.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Buy from a reputable and trustworthy broker<o:p></o:p></span></i></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">It is necessary to purchase from a reliable
and reputed broker that has a wide selection of insurance plans and can
recommend you for the most ideal plan and works in your best interest, and
doesn't prefer one company over another.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Don't buy direct and online. You can choose a
plan or review services online but only buy the health insurance through an
entity which has the means to assist you with claims.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Do not lie or hide information<o:p></o:p></span></i></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Just in case you have an illness, see to it
that you state it in your application form. You can have the broker to help you
get a plan that will cover the illness even after a waiting period. Most of the
plans nowadays also covered pre-existing conditions after 3 to 5 years based
upon the plan.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Choose a health insurance that offers a short
waiting period<o:p></o:p></span></i></b></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">All health insurance have a waiting period
for pre-existing conditions. It is usually recommended to choose for a company
that provides minimum waiting period. Don't forget to determine the waiting
period of the health insurance that has been advised to you. Varying from company
to company, waiting period usually extends from 2 to 5 years. Don't include
companies that offer you insurance coverage with lifetime exclusions from your
choices.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<b><i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Choose a policy with no or minimal sub-limits<o:p></o:p></span></i></b></div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Sub-limits clause is used by some insurance
companies to reduce their claims cost and is restricted to some common
diseases. The list of diseases under sub-limits and restriction in treatment
costs varies from company-to-company.<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Room rent, diagnostics and doctor's fee are
the most commonly introduced sub-limits. You need to understand the sub-limits
clause to avoid paying from your own sources and, thereby, defeating the very
purpose of buying health insurance.</span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Cambria, serif; font-size: 12pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: Cambria, serif; font-size: 12pt; line-height: 115%;">You must read all your insurance policy
documents all over again before having the final decision of buying a health
insurance. Ask your insurance advisor or the insurance company as many
questions as possible to clarify all your concerns. It will solve any
misunderstandings or uncertainties that might exist.</span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-75706380043865045622015-05-17T18:29:00.002-07:002015-05-17T18:30:19.696-07:00Home Health Aide Sentenced to 3 Years in Prison After Medicaid Fraud Scheme<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="color: #00b050;"><a href="http://hhicfg.com/"><span style="color: #00b050;">Harver Health Insurance Group Tokyo News</span></a></span></b>
– A home health aide has been sentenced to three years in prison for Medicaid
fraud. He admitted submitting hundreds of phony claims to Medicaid for services
he never performed.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
The suspect is Anatoli
Rountsev, a 53 year old living in Totowa, New Jersey. He is one of the six
employees from the Confident Care Corporation caught in the scam.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
Confident Care Corporation of
Hackensack provides care and services to individuals in their homes. The firm
is an ideal alternative to an institutionalized living for seniors and disabled
because they know that most people prefer to be taken care of at home. They
care for those who demand short-term and long-term assistance. Furthermore, people of different ages and
socioeconomic status can use their services.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
They also have ten satellite
offices all over New Jersey, as well as offices in Florida.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
The amount that the
investigators say Medicaid paid for the phony claims was $12,598. Acting Attorney
General John J. Hoffman states that the suspect should pay the said amount in
restitution under the sentence imposed.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
The 53-year-old Rountsev
admitted in December that he'd charged Medicaid 463 times from January 2008 to
June 2009 for patients he never saw because he was working another unrelated
job during that time.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
Edward A. Jerejian, a judge on
the Vicinage 2 Superior Court in New Jersey said that Rountsev must return the
money in addition to serving time.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
The professionals who
coordinated the investigation are Deputy Attorney General Jordan D. Mamorsky,
Detective Kylie Mattis and Analyst B'leia Williams.</div>
<br />
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="color: #00b050;"><a href="http://hhicfg.com/blog/"><span style="color: #00b050;">Harver Group Health Insurance</span></a></span></b>
suggests that the public must report a suspected fraud by calling the local
authorities, and always be aware of fraudsters and their strategies. You can
also read old posts from our website to learn more about fraud and the damages
it may cause to you.<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-47865456613432038522015-04-29T02:15:00.001-07:002015-04-29T02:15:23.892-07:00Tips to consider on getting a health plan<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Choosing
health benefits is one of the most significant decisions you make every year, <a href="http://hhicfg.com/">Harver Health Insurance Counter Fraud Group</a>
provided below some basic points you need to consider in choosing the plan that
is best for you and your family.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">1. Understand the meaning of terms<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Basically,
you need to comprehend the meaning of various health benefits-related terms
such as deductible, co-insurance, premium, in-network and health savings
account. You can check different glossaries online related to healthcare.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">2. Give consideration to other people<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">If
other people are going to be covered under your <a href="http://hhicfg.com/blog/">benefits plan</a>, don’t just think of yourself.
As you are reassessing your benefits for the upcoming year, take this tip into
consideration.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">3. Create a list<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Make a
summary of your recent and expected future health care needs. This list may
include any planned surgeries, health care procedures or prescription
medications for the upcoming year.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">4. Ask your doctor<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">In
addition to your list, ask your doctor or one of the doctor’s associate’s
questions about your consultations, tests medications and other health care
services you might need over the coming year.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">5. Decide which is the best benefit plan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">You
should identify on which benefit plan have worked best for you in the past
because it may still work for you. But you need to reconsider your health
benefit needs if you had a major change in life like getting married, having a
baby or retiring. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">6. Read the fine print<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Think
of the problems you had with your previous benefits plans. The open enrollment
period is a good time to try to learn more about coverage you wish you had in
the past. Also, be sure to read well the ‘fine print’ – number of clauses
within a health insurance policy. It consists of important definitions and
explanations. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">7. Review your plan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Review
thoroughly the open enrollment material supplied by your employer, or
information from your insurer about plans for the next year. Especially, make
an effort to make note of how the benefits plans are going to change from this
year to next, and whether your selected doctors and hospitals are in the plan’s
network.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">8. Understand the deadline<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">You
must know the deadline for making your decision. Make specific note regarding
the timeline for enrollment and give yourself enough time to decide on your benefits
before the deadline. Start ahead of time because you do not wish to be rushing
answers with the deadline approaching.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">9. Ask questions<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">You
must understand what you’re buying. You can pose a question to your employer or
your broker, marketplace or insurance company if you don’t understand the
details of the plan offered if you’re buying coverage yourself. Many employers
also provide open enrollment meetings as well as other resources that will help
you better understand your choices.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">10. Keep in mind the cost of your plan<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Tahoma, sans-serif; font-size: 12pt;">While
there are probably several factors in your health benefits decision, cost is
practically one of the primary factors. Be sure you understand all the costs
associated with your plan, and not simply the plan premium.</span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-5901258062779305982015-02-17T15:46:00.000-08:002015-02-17T15:46:03.012-08:00Harver Health Insurance Counter Fraud Group: Cyberattack Targets Health Insurer Records<div style="text-align: justify;">
<b>One of the US' largest health insurers, Anthem, has announced last week that millions of their employee and client records have been illegally accessed through a sophisticated cyberattack.</b></div>
<br />
<div style="text-align: justify;">
While Anthem is still cooperating with ongoing investigations regarding the attack, the initial information given was that around 80 million customer and employee records in a database were compromised. The data apparently include addresses, birthdates, names, employment and income information.</div>
<br />
<div style="text-align: justify;">
However, they claim that credit card data were not included in the breach and stated that medical records and doctor information were likely not compromised. </div>
<br />
<div style="text-align: justify;">
This could be one of the largest breaches in client data to date and the largest in the healthcare sector, noted <a href="http://hhicfg.com/">Harver Health Insurance Counter Fraud Group</a>, as Anthem owns a number of brands like Anthem Blue Shield, Anthem Blue Cross, Empire Blue Cross and Blue Cross of Georgia.</div>
<br />
<div style="text-align: justify;">
According to the health insurer, they learned of the breach by the end of January and have notified the FBI promptly. Cybersecurity firm Mandiant was also called in to secure Anthem's computer systems.</div>
<br />
<div style="text-align: justify;">
Anthem Chief Executive Joseph Swedish, whose personal data was involved as well, apologized through a letter and emphasized that they are working continuously to ensure their clients' and staff's data.</div>
<br />
<div style="text-align: justify;">
<a href="http://hhicfg.com/blog/">Security breach threats</a> are particularly concerning in the financial and healthcare sectors that usually collect sensitive information about clients. Even without credit card information, combinations of names, birthdates and Social Security numbers would be more than enough to gain a lot of money in the black market. In fact, the FBI has already ranked cybercrime as a top law enforcement activity.</div>
<br />
<div style="text-align: justify;">
Technology experts from Harver Health Insurance Counter Fraud Group and other law enforcement officials are saying that getting hacked is inevitable and it's only a matter of when. They admitted that it is a challenge to keep up with the cyber criminals especially since most of them are based abroad.</div>
<br />
<div style="text-align: justify;">
Anthem promised that it will give free credit monitoring and identity repair services for affected clients.</div>
<br />Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-78814801397403259932015-02-02T16:45:00.004-08:002015-02-02T16:46:18.096-08:00Harver Health Insurance Group Tokyo News: Fidelis Care Offers Tips for Selecting Coverage<div style="text-align: center;">
<img src="http://i.imgur.com/YpdDhTs.jpg" height="266" style="-webkit-user-select: none;" width="400" /></div>
<br />
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">As NY State of Health Extends
Enrollment Deadline, Fidelis Care Offers Tips for Selecting Coverage<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">By a News Reporter-Staff News Editor at Managed Care Weekly Digest
-- If you need health insurance coverage on January 1, 2015 and have yet to
enroll through NY State of Health: The Official Health Plan Marketplace, time
is running out. This Saturday, December 20, is the deadline to enroll for
coverage that takes effect when the new year begins (see also Medical,
Healthcare).<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Choosing coverage is an important decision, but it doesn't have to
be overwhelming. Fidelis Care Chief Marketing Officer Pamela Hassen offers the
following <b><a href="http://insurancenewsnet.com/oarticle/2014/12/23/as-ny-state-of-health-extends-enrollment-deadline-fidelis-care-offers-tips-for--a-581170.html"><span style="text-decoration: none; text-underline: none;">tips to help you pick the
coverage</span></a></b> that's right for you.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Compare the coverage options:<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The NY State of Health products are organized by metal level
(platinum, gold, silver, and bronze), all offering the same coverage but with
different monthly premiums and cost sharing. Hassen recommends taking a look at
your health care needs to determine which metal level will be the most
economical, balancing the premium with your expected out-of-pocket costs. While
there are child-only products, you likely have the option of enrolling your
child in quality, affordable coverage through the State-sponsored Child Health
Plus program.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Determine the cost of coverage:<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">"Everyone wants to know how much their coverage will cost,
but it's not always as simple as looking at the premium rate that's listed.
Many individuals and families qualify for subsidies or tax credits that can
lower their premiums and cost sharing," Hassen explained.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">It's easy to get an estimate of your costs in about 60 seconds,
using the Fidelis Affordable Care Advisor. Found on the homepage of Fidelis
Care's website, fideliscare.org, the Affordable Care Advisor only needs basic
information to calculate an estimated monthly premium, including federal
subsidies and tax credits. It will also let you know if you may qualify for
Medicaid.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Check the providers and the formulary:<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">If you prefer to see specific doctors or regularly take certain
prescription drugs, be sure to do your homework. Hassen advises you check the
health plan's provider network to see if your specific doctor is included.
Also, drug formularies vary from health plan to health plan. It's important to
consider how much you will pay for specific prescription drugs.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Keep an eye on the calendar:<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">While you must enroll by December 20 in order for your coverage to
be effective on January 1, 2015, NY State of Health open enrollment runs
through February 15, 2015. After that time, it is difficult to select or change
health insurance coverage. Most New York State residents are required to have
health insurance coverage in 2015 or face a tax penalty.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">To make the enrollment process as easy as possible, Hassen
recommends turning to an expert for assistance.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">"Our trained representatives will meet you at our office, a
community location, or even at your home. They are experts and can make sure
you enroll correctly and sign up for federal assistance if you are
eligible," she said.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<br />
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">To prevent and detect fraud within the health care and the
insurance industry, <b><a href="http://hhicfg.com/"><span style="text-decoration: none; text-underline: none;">Harver Health Insurance Counter Fraud Group</span></a></b> will help you.
The <b><a href="http://hhicfg.com/blog"><span style="text-decoration: none; text-underline: none;">Harver Health Insurance
Counter Fraud Group</span></a></b> has official connections with health fraud
investigation agencies.</span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-38384689505871614502015-01-29T17:14:00.000-08:002015-01-29T17:16:23.241-08:00Harver Health Insurance Group Tokyo News: Tax returns this year require health insurance information, government offers tips<div class="MsoNoSpacing">
Because 2015 is the first year Californians will have to
provide information about their <a href="http://insurancenewsnet.com/oarticle/2015/01/19/tax-returns-this-year-require-health-insurance-information-government-offers-ti-a-585747.html">health
insurance</a> on their tax returns, the U.S. Department of Health and Human
Services released a fact sheet detailing what they'll need to know, officials
announced.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
In the coming weeks, the administration will continue to
provide added resources to help consumers prepare for tax filing season,
including online tools to help individuals connect with <a href="http://hhicfg.com/">local tax preparation services</a> and determine if
they are <a href="http://hhicfg.com/blog/">eligible for an exemption</a>,
officials said.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
More than three quarters of tax filers will just need to
check a box on their tax return indicating they had health coverage for all of
2014, but there will be added steps for those who bought coverage through the
Health Insurance Marketplaces, or decided not to enroll in coverage. Those who
had basic health insurance in 2014 meeting the Minimum Essential Coverage
requirement for the Affordable Care Act won't receive any new forms in the mail
and won't have to fill out new forms when they file their 2014 income tax
returns.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
What consumers need to know:<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
When you file your tax return, you'll need to check a box
indicating you and your family had health insurance for all of 2014. Types of
coverage that meets the Affordable Care Act's standards include: Most job-based
plans, including retiree plans and COBRA coverage; Medicare Part A or Part C;
Medicaid; the Children's Health Insurance Program (CHIP); most individual
health plans you bought outside the Marketplace, including
"grandfathered" plans.; If you're under 26, coverage under a parent's
plan.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Filing electronically is the easiest way to file a
complete and accurate tax return. Last year, some 85 percent of taxpayers
e-filed. Electronic Filing options include free Volunteer Assistance, IRS Free
File and professional assistance. Helpful resources available include the IRS
Resource Guide: Health Care Law: What's New for Individuals & Families.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Last year millions of people purchased coverage through
the Health Insurance Marketplace, and most benefited from a tax credit to lower
their monthly premium. Those enrolled in such a plan must provide some basic
information about their health insurance when they file their taxes. All
Marketplace consumers will receive a new statement called a Form 1095-A that includes all the information they need
about their coverage to file their return. Form 1095-A will come by mail by
early February. In most states, you can also download a copy of your statement
through your Marketplace account starting in late January or early February.
You must wait for your Form 1095-A to arrive before filing your taxes. If it
hasn't come by early February, you should contact the Marketplace Call Center
at 1-800-318-2596. TTY users should call 1-855-889-4325.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
When you get your Form 1095-A, check the information on
it like the number of people in your household for accuracy. If you find an
error, call the Marketplace Call Center at 1-800-318-2596 to find out how to
get a corrected form.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Keep your Form 1095-A with your other important tax
information, like your W-2.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
If a tax credit lowered your monthly health insurance
premiums for 2014, you will use your Form 1095-A to input some basic
information when you file your taxes. When you signed up for health insurance,
you had to estimate your 2014 income, which determined the size of your tax
credit. Now, you must compare your estimated income with your actual income
which could impact the final amount of your tax credit, as can a change in your
income or household size during the year. You may see a smaller refund or owe
money back if you underestimated your income. You may also get a bigger refund
if you overestimated you income.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
If you owe money back, there are several repayment options
available.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
If you did not receive a tax credit to lower your monthly
premiums in the Marketplace, you can visit HealthCare.gov/taxes/tools/ to get
information you'll need to enter into your tax forms to see if you might
qualify.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
If your Marketplace coverage started partway through 2014
and you were uninsured earlier in the year, or if you were uninsured for only a
short period of time during the year, you may be eligible for an exemption from
the requirement to have health coverage. You can claim the exemption on your
tax return when you file. The process is fast and easy, requiring only that you
select the exemption that applies to you and enter the corresponding code.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Available helpful resources:<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
HHS Fact Sheet: 3 Tips About Marketplace Coverage &
Your Taxes.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Use a tool to get information you may need to determine
your 2014 premium tax credit.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Learn more about your taxes if you had a 2014 plan
through the Health Insurance Marketplace.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
IRS Resource Guide: Health Care Law: What's New for
Individuals & Families.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Learn more about Payment Plans, Installment Agreements
and Offers in Compromise.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
While those who can afford health coverage but chose not
to buy it may have to pay a fee, individuals who could not afford coverage or
met other conditions can receive an exemption. If you qualify, receiving an
exemption is simple and easy, and means you won't have to pay a fee. You can
claim most exemptions on your tax return, but some exemptions are only
available through the Marketplace.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
There are a variety of exemptions available, including
if:<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
The cost of coverage was too high. This applies to you if
the lowest priced plan available to you would have cost more than 8 percent of
your income. Visit HealthCare.gov/taxes/tools for information you may need to
claim the 2014 unaffordable coverage exemption.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
You were uninsured for only a short period of time.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
You experienced a hardship, such as if you had medical
expenses that resulted in substantial debt, if a close family member passed
away, or if you experienced domestic violence, among other hardships. You will
need to apply to the Health Insurance Marketplace to qualify for this
exemption.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
When you file your taxes, you will enter information
about the months you had coverage and any exemptions you qualify for on your
tax forms. If you could have afforded coverage in 2014 but chose not to buy it
and you don't qualify for an exemption you will have to pay a fee with your
federal tax return. The fee is based on your income and on how many months you
didn't have coverage.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
If you didn't have health coverage for all of 2014,
you'll pay the higher of $95 per adult and $47.50 per child, without coverage,
limited to a family maximum of $285, or 1 percent of your income, subject to
certain caps.<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-73462321861095367352015-01-26T21:32:00.003-08:002015-01-26T21:32:23.800-08:00Harver Health Insurance Counter Fraud Group: Health insurance options for ACA shoppers<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Maine
citizens looking to purchase health insurance on healthcare.gov now have more
choices for their 2015 plans. We did a quick roundup of the 3 main players in
the local health insurance field in Maine.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;"><a href="http://hhicfg.com/">Anthem Blue Cross and Blue Shield</a>. A veteran in
the health insurance industry, Anthem has been around even before the launch of
the Affordable Care Act website 3 years ago. In fact, it has registered over
18,000 Maine citizens as individual clients (i.e. customers who bought their
own coverage instead of getting it through work benefits). Their enrolment
rates is almost twice as high as their closest rival which is not surprising since
they are getting corporate backing from WellPoint, one of the national health
insurers with a big market share. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Almost
20% of the enrollees on the ACA site for 2014 plans were through Anthem. So this year, they seem
to be prepared for a big comeback with their premium rates reduced by 1%.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;"><a href="http://hhicfg.com/blog/">Harvard Pilgrim Health Care</a>. A newcomer in
the industry, the non-profit Harvard Pilgrim came to the market with 4 plans
for 2015. Though relatively new, it's already familiar with health reforms from
its partnership with the now-defunct Dirigo Health (Maine's effort to increase
the number of citizens with health insurance).<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Harver
Health Insurance Counter Fraud Group noted that with 3 health insurers from
which to choose from, Maine citizens are benefiting greatly in a growing
competitive market, which is incidentally also a goal of the Obamacare.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Maine
Community Health Options. This health insurer from Lewiston has around 80%
share of Maine buyers in healthcare.gov's website in the primary enrolment
period. This startup was created after the ACA (Obamacare) which provides loans
for those who want to create health insurance cooperatives. A number of
"co-ops" have already registered enrolment rates that are below their
targets but Maine Community Health Options seems to be operating as a great
example especially in providing reasonable prices.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Tahoma, sans-serif; font-size: 12pt;"><br /></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Tahoma, sans-serif; font-size: 12pt;">This
year, the premium rate for their most-availed plan decreased by around 0.5%.
Their other premium rates were increased albeit on the less popular plans.</span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-24435324101057461512015-01-23T17:07:00.002-08:002015-01-23T17:07:18.104-08:00Harver Health Insurance Group Tokyo News: A Chief of Surgery Offers Insider Tips to Finding the Right Surgeon<div style="text-align: center;">
<img src="http://i.imgur.com/8GI6Yfr.jpg" style="-webkit-user-select: none;" /></div>
<div style="text-align: center;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">On Sunday
morning, my neighbor Carolyn knocked on my front door holding a basket of carbs
and said, "I need to have my gallbladder out. I've never had an operation
and have no idea how to find a surgeon to do my surgery. I don't want to die. I
brought you some scones."<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Carolyn
brings up a valid point -- if you've been blessed with reasonably good health,
you probably don't have a surgeon's number on speed dial. Therefore, the bigger
question is, in the unfortunate event that you need one, how do you find the
best surgeon for your medical condition?<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Even routine operations have risks<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Straightforward
surgeries like gallbladder removal or hernia repair can result in occasional
complications so it pays to choose your surgeon with care. But other than
asking the doctor who recommended the surgery and running down the list of
surgeons on your insurance plan, how do you narrow down the list?<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">I decided to
go directly to the source and consulted with board-certified general surgeon
Dr. Amit Kharod, chief of the Department of Surgery at CentraState Medical
Center in Freehold, New Jersey for his recommendations.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">"You
are looking for a highly-skilled service provider with whom you are entrusting
your life," Dr. Kharod says. "Take the time to perform proper due
diligence so you will be comfortable with the caliber and quality of the
surgeon you choose."<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The doctor
went on to <b><a href="http://www.huffingtonpost.com/stephanie-duncan-caceres/chief-of-surgery-offers-i_b_6470800.html"><span style="text-decoration: none; text-underline: none;">outline tips for finding the
right surgeon</span></a></b> to meet your specific needs:<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">• Ask hundreds of people in five seconds<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">With a click
of the "send" key, you can electronically reach out to friends,
colleagues, neighbors and their friends for feedback and recommendations. The
message you send can be as personal or indirect as you wish -- but social
networking should uncover some solid leads.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">• Nurses are in the know<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Medical
office and hospital-based nurses get feedback from patients and colleagues
about different surgeons day in and day out. If there aren't any nurses in your
social network, call your hospital of choice and ask the nursing director who she
would chose if a loved one needed your type of operation.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">• Confirm these key credentials<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ascertain
that the surgeon is board-certified or board-eligible in his or her specialty
by visiting the American Board of Medical Specialties and the Federation of
State Medical Boards to make sure he or she is licensed in your state.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">• Can the surgeon perform your operation
laparoscopically?<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Some, but
not all, surgeons have undergone advanced training to perform many different
procedures laparoscopically using state-of-the-art tools and technology, such
as robotics. This can mean significantly less pain and faster recovery for you.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">• How often and how many times has the doctor
performed your surgery?<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">You want to
see that the surgeon is actively performing this operation with consistently
successful outcomes. This can be especially important for procedures which are
new or uncommon. Over time, many surgeons tend to perform the certain surgeries
with regularity and have dealt with complications before.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">• Interview your top candidates<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Ideally,
meet with your potential surgeon/s in person or at least have a phone
conversation. See how quickly you can get on his surgical calendar, also. Use
this time to pose your key questions and concerns. Remember, you are purchasing
an expensive service from the surgeon, not making a new friend.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<b><span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">After you've chosen a surgeon<o:p></o:p></span></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Carolyn took
Dr. Kharod's advice and discovered a great surgeon who had operated on her
husband's colleague and was on staff at her preferred hospital. I reminded her
to call the doctor's medical insurance administrator and re-confirm that the
doctor, the anesthesiologist and the hospital accepts Carolyn's insurance.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Patients who
feel confident in their choice of surgeon should feel more at ease before the
operation, which is important. Studies conducted on pre-operative patients show
that those with higher stress levels at the time of surgery can take as much as
25 percent longer to recover.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Dr. Kharod
also advises people not to hesitate to ask doctors for references. "A good
surgeon maintains a roster of satisfied patients who are willing to speak about
their experiences under his care. Believe me, if I needed surgery, I would be
doing the same thing."<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
</div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Cambria","serif"; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">To prevent
and detect fraud within the health care and the insurance industry, <b><a href="http://hhicfg.com/"><span style="text-decoration: none; text-underline: none;">Harver Health Insurance
Counter Fraud Group</span></a></b> will help you. The <b><a href="http://hhicfg.com/blog/"><span style="text-decoration: none; text-underline: none;">Harver Health Insurance Counter Fraud Group</span></a></b>
has official connections with health fraud investigation agencies.<o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-6174178287792957882014-11-24T17:04:00.002-08:002014-11-24T17:04:24.183-08:00Harver Health Insurance Counter Fraud Group: Zetia Lowers Risk of Heart Attack, Stroke<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: Georgia, serif; font-size: 12pt;">After almost 10 years, the results of a
long-awaited clinical study has proven that cholesterol drug Zetia of Merck
& Co is capable of reducing heart attack risk when it is used together with
statin.</span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The study was conducted worldwide on 18,000
heart patients using Zetia, an
ezetimibe, plus simvastation as compared to treatments with only simvastatin.
LDL cholesterols levels, which is singled out as a critical cause in the
development of a cardiovascular problem, decreased by 54 on average.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">A 6% reduction in all cardio events, though a
modest benefit in high-risk patients, is significant enough. This is the first
time that it was proven that the addition of a cholesterol fighter non-statin
to the already effective statin will reduce the risk of serious cardiovascular
disease. <o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The resuting data proves that Zetia -- which is
already widely used for 12 years for its LDL-reduction capability -- offers a
significant protection to several patients. It also supports the hypothesis
that a lower LDL cholesterol is beneficial.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Zetia works by preventing dietary cholesterol
from being absorbed in the gut, which is different from statins that prevent
cholesterol production in the liver. Its presumed lack of effect on the
arteries was seen as a challenge to the initial hypothesis that a lower LDL
will reduce heart risk. <o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Dr. Christopher Cannon of Brigham and Women's
Hospital in Boston is the lead author of the study presented in Chicago last
week. He said, "One of our goals was to test if even lower LDL even
better, and the answer is yes. We have a zillion trials showing statins reduce
events... our conclusions are that, yes, a non-statin lowering of LDL with
ezetimibe reduced cardiovascular events."<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Six years ago, a relatively smaller study was
conducted which resulted in the findings that the medicine failed to prevent
the accumulation of fatty deposits (plaque) in the arteries. Several experts
assumed that this failure to at least slow the plaque accumulation might also
mean that it will fail to prevent strokes and heart attacks.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">According to the Dr. Cannon, this latest study
dubbed "Improve-It" attempts to address that concern, hence asserting
the significance of LDL reduction. Furthermore, it showed a benefit for getting
really LDL cholesterol levels from patients who had had a heart attack recently
and were prescribed with only simvastatin.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Patients have suffered unstable angina or heart
attack prior to the trials and all their LDL cholesterol levels were lowered to
the target of 70 by using simvastatin. Meanwhile, those who used Zetia got 20%
lowered LDL.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">In the clinical tests, around 32% of the
patients who were treated with a statin and ezetimibe had a stroke or a heart
attack after 7 years of follow-up against the 34% when only statin was used.
Although the primary benefit came in lowering the chance of strokes and heart
attacks, it did not result in survival.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Cannon said, "In absolute terms, there are
two heart attacks or strokes prevented for every 100 patients treated. An
important factor is this is really a long term safety."<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">It also proved relatively safe -- there was no
highly alarming side effects, that is. Out of the thousands of people in the
trials, many of them had LDL levels that are not more than 40 and that did not
seem to affect them adversely.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">However, experts from <a href="http://hhicfg.com/">Harver Health Insurance Counter Fraud Group</a> are
concerned that with no other studies backing up such results about heart
attacks, patients might be deprived of proven medication, in the form of
statins. But the results are certainly highly significant to those patients who
cannot take statins.<o:p></o:p></span></div>
<br />Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-30136635566256109392014-10-20T16:48:00.002-07:002014-10-20T16:48:36.705-07:00Harver Health Insurance Counter Fraud Group: General Insurance Tips<div class="MsoNormal">
Developed countries such as Japan, USA and Canada have high
percentages of people who get insurance coverage for various purposes. It is
said that the degree of awareness a populace with regard to the value and
benefits of insurance coverage determines the level of economic progress. Or,
perhaps, it is the other way around. Economic health could be spurred by people
investing in their future security.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Insurance is a form of forced savings which allows people to
leverage their future in the event that the unexpected or the unforeseen
occurs. A lot of people would not have enjoyed their retirement years without
having some form of retirement insurance.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><a href="https://www.facebook.com/hashtag/harverhealthinsurancecounterfraudgroup?source=feed_text&story_id=1002307823129625">Here
are some valuable tips about insurance for business-owners which will help them
appreciate what insurance can do for them and what they can do with having one:</a><o:p></o:p></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
1. Make it a practice to consider the merits of three or
more insurance companies through brokers or free-lance agents. Find out as much
as you can about the companies’ corporate culture. Are they earnestly
interested in your losses in case you reach that point? Or are they merely
eager to get you to sign a policy?<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
2. For many small business-owners, self-insurance is common.
However, it can be counter-productive as the potential for acquiring coverage
for the whole business is sacrificed in favor of the individual. With so much
capital available today, it is more prudent to get coverage for one’s business.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
3. Annual assessment of one’s property is essential as the
needs of your company and the liabilities grow. Waiting for several years to
have a re-assessment might compromise your firm’s ability to recover in case of
loss.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
4. Oftentimes, the insurer has the option to recompense your
loss in three ways: paying the amount lost, repairing the insured asset or
replacing the same. Nevertheless, let the insurer know which option you would
prefer as it could be to their advantage to grant your wish in order to keep
you as their client.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
5. When arbitration regarding the valuation of any loss does
occur, make sure you are properly represented by an arbitration judge. If a
compromise is not achieved, a lawsuit will ensue and a longer battle will await
you. Unfortunately, there is no insurance against a lawsuit.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Just like investing in stocks, insurance can be a complex
and demanding endeavour. But in the end, understanding what you are getting
into will help you come out a satisfied winner rather than a sour loser.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><a href="http://hhicfg.com/blog/harver-health-insurance-counter-fraud-group-general-insurance-tips/">About
Us</a><o:p></o:p></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b><a href="http://hhicfg.tumblr.com/post/100539581814/harver-health-insurance-counter-fraud-group-general">The
Harver Health Insurance Counter Fraud Group</a></b> coordinates closely with
its local partners, such as the NHS Counter Fraud Service MOU, NHS Counter
Fraud Northern Ireland MOU, NHS Counter Fraud Scotland MOU, City of London
Police, National Fraud Authority, Insurance Fraud Bureau, and the Insurance
Fraud Investigators Group to assist the process of intelligence and conduct
common investigations into fraud.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Health care fraud respects no boundaries. The Harver Health
Insurance Counter Fraud Group has official connections with health fraud
investigation agencies. If your company is interested in becoming a member of
the Harver Health Insurance Counter Fraud Group, kindly get in touch through
this site.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-33890440188799142962014-08-30T02:08:00.003-07:002014-08-30T02:08:39.874-07:00Harver Health Insurance Counter Fraud Group Fundamental Principles<div class="MsoNoSpacing" style="text-align: justify;">
The issue on <b><span style="color: #00b050;"><a href="http://hhicfg.com/"><span style="color: #00b050;">health insurance</span></a></span></b>
recently hugged the headlines not just in the US but also in some countries
which recognized the need to address the health services that their populace
need and expect from their employers and the government.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
Previously, health insurance
was practically non-existent. Pension funds and provident funds were already in
the consciousness of people as well as in the administration of institutions,
whether private or public, for many decades. And yet, health is as important as
one’s future retirement fund and present financial needs and is, in fact,
closely related to both essential requirements for a healthy and productive
working population. Hence, the rush to enact laws requiring all workers to
acquire health insurance of some form has become a crucial issue.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
For us to understand what
health insurance is all about and its<b> <span style="color: #00b050;"><a href="http://hhicfg.com/blog/harver-health-insurance-counter-fraud-group-fundamental-principles/"><span style="color: #00b050;">foundational</span> <span style="color: #00b050;">principles</span></a></span></b>,
consider some pointers to guide you decide whether having health insurance is
really essential or not:<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
1. <b>Ideally, health insurance is not state-sponsored medicine</b><o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
We hear activists declare that
health insurance is a form of taxation or revenue- generating scheme of the
state. Well, if some corrupt officials were to be given the hand that would be
true as news of government funds being carted away by top-level officials flood
the news daily today.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
However, as conceived and its
ideal form, health insurance is a “plan whereby money is collected usually from
the employer, the employee and the state and set aside as a fund out of which
those who render services (health practitioners) to the insured population (the
employees, that is) are paid.” It is not “state medicine” which is a technical
phrase define by the American Medical Association as “a form of medical
treatment provided, conducted, controlled or subsidized by the federal or any
State (provincial) Government or municipality” and has certain exceptions.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
2. <b>The end beneficiary of health insurance is the insured<o:p></o:p></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
Again, this is the ideal case.
At any time an employee or member of the fund requires medical attention, the
fund is obligated to answer the immediate need without the insured having to
pay anything above the premium already being collected. Of course, we hear of
cases where hospitals or doctors turn away patients who could not put up a
deposit or, perhaps, certain technical requirements such as a missing ID or
other reasons; but these are exceptional cases. In general, the fund is meant
to serve the beneficiary for the state sees the fund as a means to promote
health.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
3. <b>The other beneficiary of the health insurance is the medical
practitioner.</b><o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
The health insurance may
appear as if it puts the health service providers as the masters and not as the
public servants that they are. We all have those people in every place – those
who look at their work not as a way of alleviating suffering but aggravating it
among those who sustain their livelihood. Yet, it is through the health
insurance fund that health practice is enlivened and made more accessible to
more people with the proper implementation of the program.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
4. <b>No monetary benefits</b>.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
The only benefit the insured
gets from the fund is medical service, not cash benefits. In some cases, the
insured may receive free medicine, diagnosis or medical surgery for free,
depending on the coverage and the type of services that a particular state
provides for it populace. However, in general, only medical service is given to
the insured and not cash as it is often done in other insurance policies.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
5. <b>Preventive and curative medicine are given equal attention in health
insurance.<o:p></o:p></b></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
This is one of the ideal
principles in the program; but it is one that is easily forgotten or abused by
practitioners and even by politicians who manage or control how the funds
coming from the State should be used.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
We know that medical practice
has become a big moneymaking venture, especially among those who support the
industry with pharmaceutical drugs, equipment and assorted medical supplies.
The end-user in terms of medical care has to be knowledgeable enough to know
what he or she needs for any particular health issue in order not to be taken
advantage of by unlawful medical-service providers.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
With these basic facts about
health insurance, you can determine what you can expect to derive from having a
health insurance. Ultimately, sustaining an active and healthy life will not
depend on having the protection of a health insurance but having a healthful
and wholesome lifestyle. Doctors and the medicine they use to cure people,
ultimately, do not heal us. The body has the built-in immune system to do that.
Medicines and other therapies and methods only enhance the immune system’s
ability to bring back the body to its optimum condition.<o:p></o:p></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<br />
<div class="MsoNoSpacing" style="text-align: justify;">
Hence, a health insurance is
more a temporary fall-back position than a real solution to having a reasonably
healthful and fulfilling life. Leading a consciously active and healthful way
of life is much better than depending on a supposedly a fail-safe crutch while
living a carelessly unhealthful lifestyle.<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-80362843926171533412014-07-28T17:22:00.000-07:002014-07-28T17:22:44.526-07:00Harver Health Insurance Counter Fraud Group Tokyo on Financial Planner Tips<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">“People
have homeowners insurance to protect against fires and floods,” notes
independent financial planner Stephen Ng, founder and president of Stephen Ng <a href="http://www.yourhoustonnews.com/ranch/living/financial-planner-shares-tips-for-protecting-your-retirement-savings/article_74cba600-11e0-11e4-bc51-001a4bcf887a.html">Financial
Group</a>, (www.stephenngfg.com). “They buy insurance to replace their car if
it gets wrecked and they buy health insurance to protect themselves from
medical costs.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">“But
for many people, their biggest material asset is their retirement portfolio.
When I look at a new client’s portfolio and ask, ‘Where’s your insurance?’ they
look at me like I’m crazy!”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Insure
your <a href="http://hhicfg.com/">retirement fund</a> by taking steps to
safeguard at least a portion of it, Ng says. As you get closer to retiring, the
amount you safeguard will be what you need to rely on for your retirement
income.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">“Your
retirement income should be derived from guaranteed sources, such as Social
Security benefits and your pension plan,” says Ng, a licensed 3(21) fiduciary
advisor, certified to advise companies about their 401(k) and other retirement
plans. “It’s the amount you need to pay the bills and do the other things you
hope to do in retirement, so your retirement income needs to be a <a href="http://hhicfg.com/blog/">guaranteed source of income</a>.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">“Then
you look for your ‘play checks.’ That’s the money you don’t absolutely have to
have, so you can still try to grow it, and take risks with it, in the market.”<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Ng
offers these tips for insuring your retirement plan:<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">• Invest a portion of your portfolio in
annuities.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">Annuities
are long-term investment options through insurance companies that guarantee you
payments over a certain rate of time, which could be the rest of your life or
the life of your spouse or other survivor. Note: The guarantee is subject to
the financial strength and claims-paying ability of the issuing insurance
company.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">• If you leave your job, quickly roll your
employer-sponsored 401(k) into an IRA.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">While
401(k)s are a great tool for saving, particularly if your employer is providing
matching funds, if you were to die, the taxes your survivors would pay on your
401(k) would be much higher than on an IRA. That’s because they would have to
inherit the money in a lump sum – that could easily take 35 percent right off
the top. The lump-sum rule does not apply to IRAs. While your spouse would have
the option to inherit your 401(k) as an IRA, your children would not. So, take
advantage of your employer-sponsored 401(k), but if you leave the company,
convert to an IRA or ROTH IRA. You can also begin transferring your 401(k)
funds to an IRA at age 59½.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">• Consider converting your IRA to a ROTH
IRA.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">For
protection from future income tax rate increases, you should consider slowly
converting your tax-deferred IRA funds into a ROTH IRA. Yes, you’ll have to pay
the taxes now on the money you transfer, but that will guarantee that
withdrawals in your retirement are not taxed – even as the money grows. If you
plan to leave at least part of your IRA to your children, they’ll benefit from
a fund that continues to grow tax-free.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt;">About Stephen Ng<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Tahoma, sans-serif; font-size: 12pt;"><br /></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Tahoma, sans-serif; font-size: 12pt;">Stephen
Ng is the founder and president of Stephen Ng Financial Group™
(www.stephenngfg.com). Since 1992, he has helped pre-retirees and retirees
preserve and increase their wealth by, in part, helping them avoid common
mistakes. He regularly holds financial management, retirement investing and
insurance planning seminars at businesses, churches and non-profit
organizations. Ng is a Chartered Life Underwriter, Chartered Financial
Consultant and a Certified Estate Planner. He is also an Investment Advisor
Representative with SagePoint Financial, Inc., member FINRA/SIPC. He brings a
national and international perspective to his financial advice, with
professional and educational roots in Australia and Asia, and certifications in
19 states.</span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-39846547253012863872014-07-25T18:14:00.002-07:002014-07-25T18:21:49.165-07:00Harver Health Insurance Counter Fraud Group Tokyo: Where is the Health Care Poverty Gap?<div class="WordSection1">
<div class="MsoNoSpacing">
The Affordable Care Act is already <a href="http://www.nerdwallet.com/blog/finance/advisorvoices/health-care-poverty-gap/">cutting
health care costs</a>, especially at hospitals that in the past provided
charity care for uninsured, low-income patients. The reduction in charity care
in states that have expanded their Medicaid programs with federal funds means
the costs for this care are no longer being shifted to insured and self-paying
patients, which makes health insurance more profitable for hospitals and
insurers without increasing consumer costs.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<div class="MsoNoSpacing">
But this drop in costs is happening only in the states in
about half of the nation that have expanded their Medicaid programs. The other
states — mostly in the South and the Plains — have been involved in political
struggles that have blocked expansion of health insurance for their poor
residents.<o:p></o:p></div>
<div class="MsoNoSpacing">
<o:p></o:p></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-ZKXOc9wH0uE/U9MAtISse1I/AAAAAAAAAHw/e0xUpoY36yo/s1600/harver.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-ZKXOc9wH0uE/U9MAtISse1I/AAAAAAAAAHw/e0xUpoY36yo/s1600/harver.JPG" /></a></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Expanding state-run Medicaid assistance programs has been
called critical for the success of the new federal health care law. In states
that haven’t expanded Medicaid, it is currently available to those who have
incomes at or below the federal poverty line, which in 2014 is $11,670 for a
single person and $27,910 for a family of four. In the states that have
expanded their Medicaid programs, the eligibility level is 138%, or $16,104 for
an unmarried person and $37,375 for a family of four.<o:p></o:p></div>
</div>
</div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
The <a href="http://hhicfg.com/">federal health law</a>
was written with this expansion in mind, and it offers most people with incomes
ranging from 138% to 400% of the federal poverty level the opportunity to be
eligible for federal subsidies as they purchase health care policies through
the new health insurance exchanges.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
These subsidies were to be paid for by decreases in
Medicare reimbursements to hospitals and doctors. The U.S. Supreme Court
decided that the federal government could not force states to expand their
Medicaid programs, but the cuts in Medicare reimbursements did not change.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Unfortunately, the cutoff point for a subsidy was set at
138%, leaving those between 100% and 138% with no options in the states that
didn’t expand their <a href="http://hhicfg.com/blog/">Medicaid programs</a>.
The resistance to Medicaid expansion is creating a poverty gap.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
“It’s a crime,” Lisa Dubay, a senior fellow at the
nonpartisan Urban Institute, said of the poverty gap. “These are the most
vulnerable people in our society. They have no other access to health care. We
have no way to take care of them and that just seems wrong.”<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Aside from the ethical dilemma of not providing health
care to low income people who don’t have the ability to purchase subsidized
insurance, there is a significant financial cost for the states that aren’t
expanding. This cost is being passed on to providers and insurers alike, and
they are beginning to exert pressure on state governments to agree to the federally
funded expansions.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
In the states that haven’t expanded Medicaid, at least
4,805,380 people are in the poverty gap. These people won’t receive federal
subsidies to help them purchase insurance, and they will continue to require
costly charity care that is shifted to those with insurance and self-payers.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
The Americans who fall into the poverty gap in their
state also won’t be able to get preventive care they need and this in turn
could shorten their lives. In addition, the number of bankruptcies will continue
to grow, as nearly 2 out of 3 filings are caused by medical bills. No one can
predict the outcomes of these efforts, but one thing is certain: The ones who
are suffering the most are those being left behind in the health care poverty
gap.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Here’s a closer look at four states — Maine, North
Carolina, Utah and Virginia — that haven’t expanded their Medicaid programs
with federal funds. These states have adopted widely differing approaches to
the question of Medicaid expansion.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<b>Maine<o:p></o:p></b></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
In Maine, Gov. Paul LePage, a Republican, who has vetoed
legislative attempts to expand Medicaid in his state, cites the future costs
once the federal subsidies for expansion end. The Democratic majority in the
legislature plans to continue to introduce and pass legislation aimed at
expanding Medicaid for the 24,390 people who are in the poverty gap.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Jeffrey Austin, vice president of government affairs and
communication at the Maine Hospital Association, said the state’s 39
community-governed hospitals need Medicaid expansion to make up for scheduled
cuts in Medicare payments.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
“The logic behind the tradeoff is sound,” he said in
testimony. “Hospitals will receive less reimbursement under one program
(Medicare) in order to expand another program (Medicaid). When the Supreme
Court ruled that Medicaid expansion was optional, it did not rule that the
associated cuts were optional as well. So hospitals across the country faced
the prospect of significant pain (Medicare cuts) without the bargained for gain
(Medicaid expansion). That is why you have seen significant hospital advocacy
in favor of expansion in Maine and across the country. So it matters to us that
people understand 100% federal financing of expansion in large measure equates
to hospital-financing of expansion. Hospitals can not afford $30, $50 and $100
million annual cuts in Medicare without the benefit of Medicaid expansion.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<b>North Carolina<o:p></o:p></b></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
In North Carolina, GOP state legislators have refused to
expand Medicaid for the 318,710 people in the poverty gap, and are considering
cuts to the state’s Medicaid program. Two weeks ago, 100 members of the North
Carolina Hospital Association joined together to tell states legislators how
difficult these cuts would make their job of delivering health care to current
Medicaid participants. They told lawmakers that government programs pay for 2
out of every 3 patients hospitalized statewide and generally at rates that are
below the cost of care.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
“They mean truly people getting care, people not, people
getting jobs, and for some hospitals, they may mean survival,” said Democratic
Rep. Rick Glazier.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
In recent years, after control of both houses shifted to
Republican hands, the conservative agenda that trimmed rights and cut back on
social services set off widespread citizen protests called “Moral Mondays.” To
date, over 1,000 people have been arrested statewide for acts of civil
disobedience.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<b>Utah<o:p></o:p></b></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
In Utah, Republican Gov. Gary Hebert is trying to work
with the federal government to create a program to use federal funds slated for
Medicaid expansion in his state to help the 57,850 who would be in the poverty
gap purchase private insurance plans. The governor’s plan would use federal
Medicaid funds to purchase health care insurance for all residents earning less
than 138% of the federal poverty level.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Unlike other Medicaid expansions, this proposal would
allow Utah to drop the eligibility to 100% of the federal poverty level in
three years, when federal officials expect the states to pick up 10% of the
cost of the expanded Medicaid programs.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
Opponents of the proposal are worried that employers will
cut back on insuring low-earning employees and that at the end of the
three-year pilot project, there will be more uninsured residents if the state
returns to the 100% level. Utah House Speaker Becky Lockhart said she would
rather use $35 million in state funds for limited coverage. “Attaching
ourselves as a state to Obamacare is extremely concerning to me,” she said.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<b>Virginia<o:p></o:p></b></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
In Virginia, a court battle is brewing between Democratic
Gov. Terry McAuliffe and the GOP-led state legislature over 190,840 people in
the poverty gap. Citing a moral imperative, McAuliffe tried to use his existing
executive powers to create a procedural path to provide Medicaid to Virginia’s
400,000 potentially eligible adults.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
“Secretary Hazel will have a plan on my desk by no later
than September 1st detailing how we can move Virginia health care forward even
in the face of the demagoguery, lies, fear and cowardice that have gripped this
debate for too long,” McAuliffe said about Bill Hazel, the state’s Secretary of
Health and Human Services. Virginia’s House GOP leaders warned the governor
that they will block him.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
“We are prepared to challenge this blatant executive
overreach through all available avenues, including the court system, ” said a
joint statement recently by Republican House Speaker William Howell.<o:p></o:p></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
McAuliffe just vetoed seven items, including an amendment
passed by Republicans that stated Medicaid can’t be expanded unless the General
Assembly explicitly appropriates money for it.<o:p></o:p></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-57315462282194368162014-07-23T17:41:00.002-07:002014-07-23T17:42:52.472-07:00Harver Health Insurance Counter Fraud Group Tokyo, The Obamacare Transition: Tips for Buying Health Insurance<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Now
that the <a href="http://www.theepochtimes.com/n3/blog/the-obamacare-transition-tips-for-buying-health-insurance/">Obamacare
transition</a> has come into effect, it is important to understand some of the
differences that are now at work. Understanding some of the changes can make it
easier to get the greatest benefit from new policy changes that might affect you
most. This can also help you to avoid potential negatives. For example, missing
the important March 31 deadline can result in a fine of $95 or 1% of your total
income (whichever number is greater).<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">“For
those that do not qualify for Medicaid, you will be required to pay your
monthly premium fee to your selected insurance company in order to receive
coverage,” said Jim Holm of EnhanceInsurance.com . “In some cases, customers
will need to pay for their deductibles along with a set copay fee for doctor visits
or a portion of the cost for the <a href="http://hhicfg.com/">medical service</a>.”
This latter scenario is referred to as co-insurance, and customers will
generally need to complete these payments before the insurance company can
actually cover your medical costs. For most information on this, you can visit
the federal government’s website at HealthCare.gov , a federal government
website, and learn more about your options for <a href="http://hhicfg.com/blog/">each
insurance plan</a>. To find this information, located the section entitled “See
plans before I apply.”<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Plan
Choices<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Many
industry experts recommend that you narrow down your potential choices to five
comparable plans, and then go to the insurer’s official website in order to
educate yourself about the various benefits available in each program. It is
important to look for the types of things that might not be covered — for
example, acupuncture or hearing aids. This can help you to avoid plans that are
probably not best-suited for your expected needs. It is also a good idea to pay
attention to the company’s cited coverage examples. These will help explain
exactly what the patient will be expected to pay and which costs will be
covered by your plan. Note the ways that co-pays, co-insurance and deductibles
are explained, as these elements help form the basis for what your plan has to
offer.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Choosing
your Doctors<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Making
the proper doctor selection is another important factor to consider. In some
cases, your doctor or hospital has not contract ties to the network of your
health plan. This can mean you will be responsible for paying out much more.
Because of this, it is a good idea to go to your favorite doctors and then to
see which health plans they are able to accept. Your health insurance plan will
also have a list of drugs and medicines that they will cover. In cases where
your prescription is not on this list, you can expect your bills to be higher.
So, it is also important to make certain that your insurer offers access to the
medications you need.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Potential
Tax Credits<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">The
new healthcare system offers ways of reducing your total medical costs. But
this can be done in ways that extend beyond simple cost reductions. Additional
gains can be made from the Federal tax credits that can make premiums more
affordable. These tax breaks apply to households with annual incomes that fall
between 100% and 400% of the federal poverty line. In Dollar terms, this
equates to roughly $11,500 to $46,000 for individuals, and $24,000 to $95,000
for a family of four. The government’s HealthCare.gov website also includes
some informative statistics in this area. If your annualized household income
falls below 250% of the federal poverty level (which comes out to just below
$60,000 for a family of four), you could qualify for reduced out-of-pocket
expenses when buying a silver plan.<o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-14018735593707305802014-06-21T19:12:00.001-07:002014-06-21T19:12:34.443-07:00Harver Health Insurance Counter Fraud Group: Health Insurers may have Fleeced Taxpayers<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;"><a href="http://www.skyvalleychronicle.com/BREAKING-NEWS/REPORT-SAYS-PROBE-INDICATES-HEALTH-INSURERS-MAY-HAVE-FLEECED-TAXPAYERS-OUT-OF-70-BILLION-1766176">Report
Says Probe Indicates Health Insurers may have Fleeced Taxpayers out of $70
Billion</a><o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">(NATIONAL) -- A year-long investigation by the
Center for Public Integrity has revealed that <a href="http://hhicfg.com/">health
insurers</a> may have fleeced taxpayers out of $70 billion in just five years.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The report is posted on the Center's website by
reporter Wendall Potter who says taxpayers should not assume their elected
lawmakers in Washington will be outraged or even launching a federal probe
about this.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Potter: <o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<i><span style="font-family: "Georgia","serif"; font-size: 12.0pt;">"You
would think members of Congress in both parties would be so outraged they’d be
launching their own investigation and railing against the “<a href="http://hhicfg.com/blog/">fraud and abuse</a>” they decry on the campaign
trail.<o:p></o:p></span></i></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<i><span style="font-family: "Georgia","serif"; font-size: 12.0pt;">But I’m
not holding out much hope. That’s because I know just how powerful and
influential the health insurance industry is and how its lobbyists almost
always get what they want out of Congress and the White House, regardless of
who is sitting in the Oval Office."<o:p></o:p></span></i></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The Center’s investigation called the
"Medicare Advantage Money Grab" found here discovered that:<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">- Federal officials made nearly $70 billion in
“improper” payments to Medicare Advantage plans from 2008 to 2013, mostly
over-billings, by manipulating or misusing a Medicare payment tool called a
“risk score.”<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">- From 2007 through 2011, Medicare Advantage
risk scores rose more than twice as fast as the average for people in standard
Medicare in more than 500 counties nationwide.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">- Federal health officials have long kept key
financial records of Medicare Advantage plans in a “black box,” inaccessible to
the public and press.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">- Medicare Advantage health plans collect
billions of dollars from controversial “house calls” that industry officials
say help improve care but which critics argue inflate costs needlessly.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Reporter Potter says the findings didn't come as
a shock to him because during his two decades in the industry, at both Humana
and Cigna, "I came to understand just how much of a cash cow the Medicare
Advantage program has become to insurers participating in the program. Wall
Street financial analysts devote considerable attention to determining how much
insurers’ Medicare Advantage business contributes to their bottom lines and how
much of the money they take in from the government is actually paid out in
medical claims. The less they spend on medical care, the better, from Wall
Street’s perspective." <o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<br />
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Potter adds this is a huge business and one that
is growing rapidly and because the business is so profitable, insurers spend
millions of dollars on lobbying, advertising, PR and “grassroots” political
activities to keep the money flowing unimpeded.<o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-9733244191567990592014-06-20T18:10:00.003-07:002014-06-20T18:10:32.281-07:00Harver Health Insurance Counter Fraud Group: Have You Contributed to a Health Scam?<div class="separator" style="clear: both; text-align: center;">
<a href="http://cdn.theatlantic.com/static/newsroom/img/mt/2014/06/Screen_Shot_2014_06_13_at_5.45.46_PM/lead.png?n7dg3b" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://cdn.theatlantic.com/static/newsroom/img/mt/2014/06/Screen_Shot_2014_06_13_at_5.45.46_PM/lead.png?n7dg3b" height="220" width="400" /></a></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;"><br /></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;"><br /></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">If it works, the GoBe will be life-changing. But
it’s a big if.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The GoBe is a bracelet that looks like a small
microplane has been affixed to a black watchband—the top of the microplane is a
display, and its underside is a sensor. Through its “patented flow technology,”
the GoBe promises to measure the wearer’s heart rate, calories burned, sleep,
and stress levels. That’s all conceivable, given what the FitBit and other body
trackers already measure. But the GoBe also promises something a little more
sensational: Automatically tracking the calories of everything the wearer eats,
through his or her skin.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">“We live in an age where people struggle with
their diets and need simple ways to take control of their health,” Artem
Shipitsyn, the CEO of GoBe’s parent company, HealBe, says in a video on the
device’s Indiegogo campaign page. He says the technology would help “people
like me live a healthy life with less effort.”<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The automatic calorie-tracking, which GoBe
claims to do by reading glucose levels in cells, would revolutionize
dieting—even the best calorie-counting apps today rely on manual food logging. <o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">“Tell it nothing. Know everything,” the soothing
video narrator’s voice says over b-roll of people skiing and clicking on their
smartphones.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The premise was so lofty, in fact, that it
didn’t take long for tech reporters, led by PandoDaily’s James Robinson, to
attack.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Let’s say GoBe does measure glucose levels
without piercing the skin, as it claims to do. That would be a godsend to
diabetics, who, as it stands, must regularly prick their fingers to test blood
sugar. The less-invasive technology is probably coming soon, Michelle
MacDonald, a clinical dietician at the National Jewish Health hospital in
Denver, told PandoDaily, “but when it does it will be the size of a shoebox ...
It will come from a big lab, will be <a href="http://hhicfg.com/">huge news</a>
and make a lot of money.”<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">But on top of that, blood glucose is only a
rough measure of total energy intake. Eat a tablespoon of olive oil, and you’ve
consumed 119 calories, but your blood sugar would barely rise. A very thin
slice of white bread, meanwhile, would send blood sugar soaring and only yields
40 calories.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">From its launch in March, the GoBe campaign
steadily raked in Indiegogo donations—it’s now at 1,081 percent of its original
$100,000 goal. Robinson stayed on the warpath, citing more and more experts who
denounced the GoBe technology and publishing several <a href="http://hhicfg.com/blog/">more articles</a> about what he considers to be
a complete scam.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">HealBe began commenting negatively on Robinson’s
articles, then deleting the comments. GoBe backers started demanding refunds.
Delivery of the finished device was pushed back to August.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<br />
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">“I’ve been seeing some disturbing articles
regarding this project,” one commenter wrote on the HealBe Indiegogo campaign
page. “Various articles stating that the things that the GoBe promises cannot
be done ... Can anyone offer a rebuttal? Worried about all of the delays and
negative statements. Thanks!” <a href="http://www.theatlantic.com/health/archive/2014/06/can-you-spot-the-fake-health-gadget/372788/">See
more…</a><o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-74519857690006304772014-06-19T18:01:00.000-07:002014-06-19T18:01:18.278-07:00Harver Health Insurance Counter Fraud Group: Advance directives clarify choices<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.gannett-cdn.com/-mm-/37cf45547413c81798ffa632fff05c85cec6273e/c=23-0-2767-2058&r=x404&c=534x401/local/-/media/GreatFalls/2014/06/16/-advancedirectives2.jpg20140607.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://www.gannett-cdn.com/-mm-/37cf45547413c81798ffa632fff05c85cec6273e/c=23-0-2767-2058&r=x404&c=534x401/local/-/media/GreatFalls/2014/06/16/-advancedirectives2.jpg20140607.jpg" height="300" width="400" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;"><a href="http://www.greatfallstribune.com/story/life/health-and-fitness/2014/06/16/advance-directives-clarify-choices-guide-family/10652171/">Advance
directives clarify choices, guide family</a> <o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Pulmonologist Dr. Rick Blevins often sees
patients and families grappling with a decision he says should have been made
long before.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Blevins treats many patients in the intensive
care unit who won't survive. If they do not have advance directives, their
families are left to make hard decisions that they may not have answers to.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">"It's a subject that comes up and (in the
ICU) is the worst possible time for conversations to be initiated,"
Blevins said.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Many times, the ICU patient is unable to make
decisions for himself, so it falls on the family, Blevins said.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The role of the family in that situation is to
make the decision the patient would make, Blevins explained. But families don't
always know or don't agree.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Advance directives, such as living wills,
provide instruction to families and especially health care providers on how the
patient wants to be treated in the event of incapacity. Besides the living
will, other common forms people complete are powers of attorney for health care
that gives another person the authority to make health care decisions in the
event of incapacity of the patient, and a form called Five Wishes, which
provides not only instructions on medical care but also emotional care.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Blevins said it can be difficult not only for
families to have discussions about advance directives, but these conversations
may not be happening in the doctor's office either.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Doctors are encouraged to talk to their patients
about their health care wishes, but time constraints might prevent that, he
said.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Many advance directives are legal documents, so
lawyers can help people draw them up. But many are also available on the
Internet, and Benefis has a link to the Five Wishes form on its <a href="http://hhicfg.com/">website</a>.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The POLST form, which stands for Provider Orders
for Life-Sustaining Treatment, is available for patients who have a serious
illness and provides instructions on how they want to be treated in an
emergency situation. It can be filled out by a provider only in consult with
the patient.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Sue Rose, the State <a href="http://hhicfg.com/blog/">Health Insurance</a> Assistance Program, or
SHIP, coordinator for Area VIII Agency on Aging in Cascade County, said she can
assist seniors who want to fill out advance directives.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">All the services provided are free.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Rose explained that SHIP can provide assistance
with Medicare and other health insurance, possible Medicare fraud and long-term
care assistance, including advance directives.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">While Rose can't offer legal advice, she is able
to explain to seniors the purpose of the forms and help them fill the forms
out. Work on advance directives is done one-on-one, but Rose gives group
presentations periodically.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">"We have so many resources to get people
connected," said Rose.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Rose said most of the people who come to her for
help are aware of what the advance directives do and what they want.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">"You also get cold calls where people say,
'I don't know anything. What do I do?'" Rose said.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Eleven agencies on aging exist across the state,
and among them all areas of the state are covered. Area VIII covers Cascade
County only. All 11 of the agencies have SHIP programs, Rose said.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">All these services are free, including notary
services, she said.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Blevins encourages people to talk to their
doctors and families about advance directives. He also advises people not to
wait. Young people need advance directives too, he said, and it is important to
make wishes explicitly known.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">"People's definitions are different,"
he said.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Montana has an End-of-Life Registry online that
is available through the Department of Justice. The secure database acts as a
depository for advance directives. More information is available at <a href="https://doj.mt.gov/consumer/end-of-life-registry/">https://doj.mt.gov/consumer/end-of-life-registry/</a>.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Blevins also recommends speaking with a lawyer
about advance directives, and once they are completed, keeping copies with your
lawyer, family, doctor and local hospital.<o:p></o:p></span></div>
<br />Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-12745499898810467282014-06-17T17:53:00.000-07:002014-06-17T17:53:36.312-07:00Harver Health Insurance Counter Fraud Group: Lawmakers Join All-Out Push to Combat Medicare Fraud<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">WASHINGTON, DC - As law enforcement <a href="http://insurancenewsnet.com/oarticle/2014/06/16/lawmakers-join-all-out-push-to-combat-medicare-fraud-a-518362.html#.U6GtwfldUh4">announced
a nationwide sting against Medicare fraudsters today</a>, a bipartisan
group of lawmakers in Washington was putting the finishing touches on
legislation aimed at making a significant dent in the problem.<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Federal law enforcement officials in Miami today
announced the details of a multi-agency strike force operation that resulted in
the arrest of 90 people nationwide for defrauding Medicare out of
some $260 million.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">U.S. Senate Special Committee on Aging Chairman
Bill Nelson (D-FL) and Ranking Member Susan Collins (R-ME), who have spent
a great deal of time examining the problem of <a href="http://hhicfg.com/">Medicare fraud</a>
and ways to curtail it, commended the actions announced today by federal
officials while also saying that the crackdown illustrates the need to do more
to stop Medicare fraud.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Nelson and Collins, along with Sens. Tom
Carper (D-DE) and Chuck Grassley(R-IA), have authored legislation to
strengthen the government's hand in stopping Medicare fraud. The
lawmakers plan to formally file the legislation on Thursday.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">"This is exactly why we're doing the
legislation," said U.S. Sen. Bill Nelson (D-FL) who chairs the Senate
Special Committee on Aging. "We've got to get the problem under
control."<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Senator Collins added, "For decades, the
GAO has identified Medicare as being at high risk for improper
payments. This is unacceptable. The loss of these funds not only compromises
the financial integrity of the Medicare program, but it also
undermines our ability to provide needed health care services to the more than
54 million older and disabled American workers who depend on this vial program.
Our legislation emphasizes a strategy to prevent fraud from happening in the
first place."<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">"Medicare provides lifesaving care to
some of our nation's most vulnerable citizens," said Sen. Carper.
"Unfortunately, too many unscrupulous individuals take advantage of this
vital program and end up costing taxpayers millions and shortchanging
beneficiaries. It is critical that we do all that we can to curb fraud while
protecting beneficiaries and ensuring effective care. This legislation is an
important step in combating Medicare fraud and preserving this
essential program for the future generations. I commend Sens. Nelson and
Collins for their leadership in this effort."<o:p></o:p></span></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">"Our bill will build on the Physician
Payments Sunshine Act that I co-authored," Grassley said. "It
requires HHS to use available data, including data from the Sunshine Act, to
verify doctors' reported information about ownership interests in organizations
that bill Medicare. This will help flush out any doctors who commit fraud
from their own facilities."<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">Specifically, the legislation will require Medicare to
verify that those wishing to enroll in the program have not owned a company
that previously defrauded the government. Currently, Medicare relies
on self-reported information. As a consequence, a provider who previously had
an ownership interest in an organization that defrauded Medicare could
potentially get back into the program by using a different name and failing to
disclose their interest in the previous organization.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The bill will also allow private insurers to
share information about potentially fraudulent providers with Medicare,
and requires new medical coding systems to be tested before they're deployed to
ensure Medicare's fraud prevention systems work properly.
Additionally, the Medicare Payment Advisory Commission will be
allowed to make recommendations regarding fraud prevention and Medicare will
be required to develop a strategy to reliably estimate just how many taxpayer
dollars are lost each year to fraud.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">According to a recent estimate, fraud in the
country's Medicare system takes some $60 billion to $90
billion annually out of the system and puts it into the pockets of crooks.<o:p></o:p></span></div>
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<br /></div>
<br />
<div class="MsoNoSpacing" style="text-align: justify;">
<span style="font-family: "Georgia","serif"; font-size: 12.0pt;">The lawmakers' legislation already has the
support of the National Health Care Anti-Fraud Association, the Coalition
Against Insurance Fraud, the National Insurance Crime Bureau, America's <a href="http://hhicfg.com/blog/">Health Insurance </a>Plans, Humana and
theBlue Cross Blue Shield Association. <a href="http://insurancenewsnet.com/oarticle/2014/06/16/lawmakers-join-all-out-push-to-combat-medicare-fraud-a-518362.html#.U6GrOPldUh4">Continue
reading…</a><o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-36465146541261584022014-05-16T19:24:00.001-07:002014-05-16T19:24:17.213-07:00The Harver Group: Son watched father die, writes book on health care system<img src="https://pbs.twimg.com/media/Bnzaq4QIIAAKdGu.jpg" style="-webkit-user-select: none;" /><br />
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">David Goldhill’s father died from
an infection he contracted in a well-regarded New York hospital.<o:p></o:p></span></b></div>
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<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">That began a
quest to<b> <a href="http://members.jacksonville.com/opinion/editorials/2014-05-13/story/son-watched-father-die-writes-book-health-care-system"><span style="text-decoration: none; text-underline: none;">investigate America’s health
care system</span></a></b>. In his book “Catastrophic Care: How American Health
Care Killed My Father and How We can Fix It,” Goldhill reports that nearly
100,000 Americans die every year from hospital-borne infections.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">That’s more
than double the number of Americans killed in car crashes and five times the
number of those murdered.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">How did
American hospitals miss the quality control revolution that affected the rest
of the American economy?<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Goldhill
contends that our current system drives “excess treatment, cost inflation and
medical errors.” And he says the Affordable Care Act only worsens the perverse
incentives and would raise the cost of care.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">He worries
that the exchanges will reduce competition among insurers, the subsidies will
make consumers less price-conscious and mandates will cause healthy people to
drop insurance.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The result
may be less coverage at higher costs than the authors of the Affordable Care
Act intended. He describes the health care system as “the Beast” that tolerates
excess and careless medicine.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">“Bad health
care is crowding out needed care,” he writes.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">His solution
is to combine the liberal desire for universal health care with a conservative
desire for market-oriented approaches.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">He calls for
a national <b><a href="http://hhicfg.com/blog/"><span style="text-decoration: none; text-underline: none;">insurance safety</span></a></b> net that covers health crises that are
“major, rare and unpredictable.”<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">“Insuring
everyone isn’t the same as insuring everything,” he writes.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">That means
using insurance as it was meant to be used, for rare catastrophic events.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">What the
health care system does disastrously is provide quality care at affordable
prices. In 2009, Medicare had $54 billion in proper payments.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Goldhill’s plan
involves health savings accounts, health loans and catastrophic insurance.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">- Increase
money we put into health care and save the difference.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">- Reduce the
use of unnecessary health care to some people so others may build savings.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">- Cut
spending in ways that don’t hurt quality and transfer that into savings.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Money
currently put into the health system would accumulate in a tax-free account.
That money would be used to pay premiums for cradle-to-grave health insurance.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
<div class="MsoNoSpacing">
<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">If you run
out of money, you can borrow against your future contributions. While it
doesn’t sound practical in today’s political system, the ideas are based on an
interesting set of principles. His plan is basically along the same lines as
Singapore’s national system.<o:p></o:p></span></div>
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<br /></div>
<br />
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">“We’re stuck
in a vicious cycle in health care. The more we try to protect ourselves from
the realities of care, the more complex and unconnected from us the system
becomes,” he wrote. It’s far too complicated for the average person.<o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-69449157673289495722014-05-15T18:03:00.000-07:002014-05-15T18:06:21.856-07:00The Harver Group - Most state health insurers seek rate boost: Proposals compared<div class="separator" style="clear: both; text-align: center;">
</div>
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<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-ISsFhXyEdi0/U3VkYSARYHI/AAAAAAAAAG8/fxKa4YgkKdE/s1600/111.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-ISsFhXyEdi0/U3VkYSARYHI/AAAAAAAAAG8/fxKa4YgkKdE/s1600/111.PNG" height="303" width="400" /></a></div>
<i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><br /></span></i>
<i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Proposed rate changes for 2015
individual health plans are all over the map, but most companies are keeping up
with tradition by requesting increases in premiums</span></i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">If approved,
rate increases for 2015 individual health plans proposed by 12 insurance
companies may affect most policyholders, whether they bought their plans
through Washington Healthplanfinder’s online marketplace or in the outside
market.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Washington
is one of the first states to see proposed rate changes for 2015 individual
health-insurance plans.<o:p></o:p></span></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"><a href="http://seattletimes.com/html/localnews/2023593959_insurancenewratesxml.html"><span style="text-decoration: none; text-underline: none;">The proposed rate changes</span></a></span></b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> range from a decrease of 6.8
percent — from Molina Healthcare of Washington — to an increase of 26 percent
from Time Insurance, a national company with relatively few Washington
policyholders.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Most
rate-change requests, particularly from larger insurers, were in the middle
ground, with most asking for increases from about 2 to about 11 percent.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">To anyone
who has had individual insurance, premium increases are not surprising: Records
show that, on average, insurers have proposed rate increases for individual
plans from about 9 percent to more than 18 percent every year from 2007 to
2013. After review by the Office of the Insurance Commissioner, the average
rate increases imposed were lower — in most cases, only slightly lower. But in
one year, rate-increase requests were cut by more than 3.5 percentage points.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">With the
exception of relatively few grandfathered plans, all individual plans were new
in 2014 to comply with provisions of the Affordable Care Act (ACA), which set
certain standards for coverage and barred insurers from excluding people with
pre-existing conditions.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Some
insurers offer plans only inside the Healthplanfinder exchange; some offer
plans only in the outside market. Five are proposing plans both inside and
outside the exchange. Any rate- change proposals for those insurers would
affect both inside and outside plans.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The rates do
not become final until they pass review.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Spokeswoman
Stephanie Marquis said it likely would be a tough review this year because
insurers have only a few months’ worth of actual claims data, so they must use
other data sources to justify rate increases.<o:p></o:p></span></div>
<div class="MsoNoSpacing">
<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">There didn’t
appear to be differences between proposed rates for plans sold only inside the
Healthplanfinder exchange market and those sold only outside.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">BridgeSpan
Health, whose exchange plans picked up a relatively small portion of the market
this year, asked for a 1.7 percent increase; its affiliate, Regence BlueShield,
which offers only outside-the-exchange plans, asked for 5.1 percent.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Coordinated
Care Corp., with exchange-only plans, asked for 11.2 percent, as did Group
Health Cooperative, which has plans both inside and outside the exchange. Group
Health Options, with plans offered only outside the exchange, asked for
14.2 percent.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Premera Blue
Cross, offered both inside and outside the exchange, and Community Health Plan of
Washington, with only exchange plans, asked for 8.1 and 8.4 percent,
respectively.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">In the small
group market, insurers on average proposed smaller rate increases, with at
least four insurers asking to decrease rates. That may be because insurers
expect to pick up younger members now insured by association plans that have
been discontinued because they did not meet the requirements of the ACA,
Marquis said.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Four new
companies have submitted proposals for individual plans to be sold inside
Washington’s Healthplanfinder exchange. Because the plans are new, there are no
rate changes proposed. Those companies are Columbia United Providers, Health
Alliance Northwest Health Plan, UnitedHealthcare of Washington, and Moda Health
Plan. Moda currently has individual plans in the outside market but plans to
replace all existing plans.<o:p></o:p></span></div>
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<i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">For more related topic, visit</span></i><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;"> <b><a href="http://hhicfg.com/blog/"><span style="text-decoration: none; text-underline: none;">Harver Health Insurance Counter Fraud Group</span></a></b><o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-39155335029807551432014-05-14T18:37:00.004-07:002014-05-14T18:37:42.968-07:00The Harver Group: How Will 2015 Health Insurance Premiums Compare to 2014?<div style="text-align: center;">
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The
Affordable Care Act’s (ACA) 2014 open enrollment period for the individual
health insurance market has only just ended, and actuaries for health insurers
already are developing premium rates for the 2015 plan year. Much of the
uncertainty regarding the health spending by plan enrollees that existed when
insurers submitted their 2014 rates remains for 2015. Although insurers have information on
enrollee demographics, only limited information will be available on enrollee
health status and health spending when premium submissions are due this spring.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Key drivers
of <b><a href="http://healthaffairs.org/blog/2014/05/13/how-will-2015-health-insurance-premiums-compare-to-2014/"><span style="text-decoration: none; text-underline: none;">2015 premium changes</span></a></b>
include how the composition of the risk pools in 2014 compares to what was
expected, the reduction of funds available through the temporary reinsurance
program, and the underlying growth in health costs. How enrollment differs from
projected will vary by insurer and by state, with larger premium increases
possible in states that adopted the transition policy allowing
non-ACA-compliant plans to be renewed.<o:p></o:p></span></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The composition of the risk pool
and how it compares to what was projected<o:p></o:p></span></b></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">When
calculating 2014 premiums, insurers had to make assumptions regarding which
individuals would purchase coverage and what their medical spending would be.
There was much uncertainty regarding these assumptions because insurers had
only limited experience data on individuals who would be newly insured.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Insurers
face a similar uncertainty for 2015. Although they have information regarding
the age and gender of their 2014 enrollees, they have only limited information
on enrollee health status, due to the reporting lag between when <b><a href="http://hhicfg.com/blog/"><span style="text-decoration: none; text-underline: none;">health care services</span></a></b>
are provided and when claims are processed. Practitioners are observing that
while some insurers are seeing 2014 enrollee demographics fairly similar to
what they projected, others are seeing an older-than-expected enrollee
population. Any available medical claims data will need to be adjusted to
reflect any expectations that individuals enrolling later during the open
enrollment period are healthier.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The
composition of the risk pool and the impact on premiums will vary by state.
Many states opted for the transitional policy that allowed non-ACA-compliant
plans to be renewed. In these states, the risk profile of 2014 ACA-compliant
plans might be worse than insurers projected if lower-cost individuals retained
their prior coverage and higher-cost people moved to new coverage. The
transitional policy was instituted after 2014 premiums were finalized, meaning
insurers weren’t able to incorporate this policy into their premiums. For most
states, the transitional policy for 2015 is known in advance and can be
incorporated into assumptions regarding the composition of the 2015 risk pool.
The impact on premiums could be greatest in states that had large,
heavily-underwritten individual markets in place prior to 2014.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Differences
by state in enrollment outreach efforts or technical problems with the
marketplaces could also have affected the composition of the 2014 risk pool.
Insurers will incorporate that experience into their 2015 premium assumptions
to the extent they expect such trends to continue.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Importantly,
if actual experience regarding the risk profile of 2014 enrollees differs from
assumptions and losses occur in 2014, insurers cannot recoup past losses
through higher future premiums. Instead, assumptions for 2015 will be reset
incorporating available 2014 experience.<o:p></o:p></span></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Reduction of reinsurance program
funds<o:p></o:p></span></b></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The ACA
transitional reinsurance program compensates plans in the individual market
when they have enrollees with especially high claims. Reinsurance payments reduce
net claims, allowing insurers to offer premiums lower than they otherwise would
be.<o:p></o:p></span></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">For the 2014
plan year, $10 billion will be used to reimburse plans for a portion of the
spending for high-cost individuals. These payments generally have reduced projected
2014 net claims by about 10 to 14 percent. For the 2015 plan year, the amount
collected for the reinsurance program will decline to $6 billion, and will
likely reduce net claims by about 6 to 8 percent. This lower reduction in
claims translates to about a 4 to 7 percent increase in projected claims for
2015 relative to 2014, due solely to the reduction in the reinsurance program
and not factoring in any other factors such as medical trend. This increase
could be offset to the extent that insurers expect a healthier risk pool
profile in 2015, arising for instance from lower-cost individuals delaying
enrollment until 2015 rather than enrolling in 2014.<o:p></o:p></span></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Underlying growth in health care
costs<o:p></o:p></span></b></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">The increase
in costs of medical services, referred to as medical trend, reflects not only
the increase in per-unit costs of services, but also increases in health care
utilization and intensity. In recent years, health spending growth has been low
relative to historical levels. Premiums for 2015 will reflect assumptions
regarding the extent to which the recent slowdown will persist.<o:p></o:p></span></div>
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<b><span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Other drivers of 2015 premium
changes<o:p></o:p></span></b></div>
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<span style="font-family: "Cambria","serif"; font-size: 12.0pt; mso-ascii-theme-font: major-latin; mso-hansi-theme-font: major-latin;">Other
factors potentially contributing to rate changes include any modifications to provider
networks; provider reimbursement structures; benefit packages; risk margins;
administrative costs; or geographic region definitions. The increase in the
health insurance fee imposed by the ACA could put upward pressure on premiums
if it is not offset by a commensurate increase in enrollment. Insurers will
also incorporate market considerations when determining 2015 premiums.<o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-68028496023158393872014-05-13T19:06:00.004-07:002014-05-13T19:06:54.635-07:00The Harver Group - Your Health Insurance Counter Fraud Services Tokyo<b><a href="http://www.nytimes.com/2014/05/13/business/more-insured-but-the-choices-are-narrowing.html">More Insured, but the Choices Are Narrowing</a></b>
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<img src="http://media-cache-ec0.pinimg.com/736x/fc/80/39/fc803957f55192b48e5800a6f13bb4ee.jpg" />
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In the midst of all the turmoil in health care these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.
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These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans. While the sizes of the networks vary considerably, many plans now exclude at least some large hospitals or doctors’ groups. Smaller networks are also becoming more common in health care coverage offered by employers and in private Medicare Advantage plans.
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<br />
Insurers, ranging from national behemoths like WellPoint, UnitedHealth and Aetna to much smaller local carriers, are fully embracing the idea, saying narrower networks are essential to controlling costs and managing care. Major players contend they can avoid the uproar that crippled a similar push in the 1990s.
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<br />
The Times would like to hear from Americans who have signed up for health care under the Affordable Care Act.
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“We have to break people away from the choice habit that everyone has,” said Marcus Merz, the chief executive of PreferredOne, an insurer in Golden Valley, Minn., that is owned by two health systems and a physician group. “We’re all trying to break away from this fixation on open access and broad networks.”
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<br />
But while there is evidence that consumers are willing to sacrifice some choice in favor of lower prices, many critics, including political opponents of the new health care law, remain wary about narrowing networks. A concern is that insurers will limit access to <b><a href="http://hhicfg.com/blog/">specialists</a></b> or certain hospitals. “Too often, Obamacare cancels the policy you wanted to keep and tells you what policy to buy,” Senator Lamar Alexander, a Tennessee Republican, said in a speech in April.
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<br />
Dr. Monica Wehby, a pediatric neurosurgeon, is using the potential reaction to narrower networks as momentum for her campaign for Senate in Oregon. A Republican promising to repeal the Affordable Care Act, her slogan is “Keep your doctor. Change your senator.”
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Other complaints involve confusion over which providers are participating in which plans.
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“The thing you’re buying is access to the provider network,” said Lynn Quincy, a policy expert at Consumers Union. “Right now it feels like you’re forced to guess.”
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In response, state and federal regulators say they are more closely monitoring the plans being offered in the coming year to be sure they are clear and that consumers have sufficient access to hospitals and doctors. In some cases, they are already insisting on changes.
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Nonetheless, for people who are directly picking plans in the open markets, insurers say price is turning out to be critical. People “are weighing affordability and breadth of network,” said Karen Ignagni, the chief executive of America’s Health Insurance Plans, an industry trade group. “What we’re finding is individuals are experiencing a preference for affordability,” she said.
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Minnesota would seem to be a case in point.
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On the state exchange, PreferredOne offered an inexpensive plan with a network of 13 hospitals, but those low premiums helped the insurer grab 60 percent of the individual insurance market.
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While many insurers are including only those hospitals and doctors willing to charge lower prices, experts say the makeup of the networks is likely to evolve over time, focusing less directly on price and more on the ability of providers to deliver coordinated and high-quality care.
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<br />
Although a similar attempt to restrict choice failed in the early ‘90s, after opposition to H.M.O.s and managed care, insurers insist these efforts will not run into the same resistance because they are now working more closely with providers, and customers are more concerned about costs. “It’s a new era,” said Dr. Sam Ho, the chief medical officer for United Healthcare.
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<br />
Others agree. “You’re going to see this as a dominant strategy,” said Jeff Hoffman, who works closely with hospitals for Kurt Salmon, a consulting firm.
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-34229376942011662462014-05-11T17:41:00.001-07:002014-05-11T17:57:36.148-07:00The Harver Group - Your Health Insurance Counter Fraud Services Tokyo<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<b><span style="font-family: "Tahoma","sans-serif";"><a href="http://hhicfg.com/blog/the-harver-group-your-health-insurance-counter-fraud-services-tokyo/"><span style="text-decoration: none; text-underline: none;">7 tips to make retirement
savings last</span></a></span></b></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">Even if you were smart (or lucky)
enough to have a comfortable retirement nest egg, you may still worry that it
may not last you through what may be 30 years of retirement. As many retirees
and pre-retirees saw in 2008, one unexpected financial disaster can devastate your
life <a href="http://hhicfg.com/"><span style="text-decoration: none; text-underline: none;">savings</span></a>.<b><o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">And many others have discovered that
even the best-laid plans for retirement can be ripped apart by an unanticipated
medical crisis.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">Not to worry. We talked to financial
planning firms, big and small, across the United States, and asked for their
best tips to help retirees protect, preserve and grow their retirement savings.<o:p></o:p></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://3.bp.blogspot.com/-5LWopDjJUns/U3AYGo67ocI/AAAAAAAAAGk/JxR5D8Qz3uw/s1600/Savings+are+just+part+of+the+retirement+picture..jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><br /></a></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: Tahoma, sans-serif;">There are the easy ones, like once
you turn 50 you can take advantage of the catch-up contributions to your 401(k)
($5,500) and IRA ($1,000). You can delay taking Social Security until you're 70
because each year you wait, your benefit will increase by 8%. Or you can
increase your savings rate.</span><br />
<span style="font-family: Tahoma, sans-serif;"><br /></span>
<a href="http://3.bp.blogspot.com/-5LWopDjJUns/U3AYGo67ocI/AAAAAAAAAGk/JxR5D8Qz3uw/s1600/Savings+are+just+part+of+the+retirement+picture..jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em; text-align: center;"><img border="0" src="http://3.bp.blogspot.com/-5LWopDjJUns/U3AYGo67ocI/AAAAAAAAAGk/JxR5D8Qz3uw/s1600/Savings+are+just+part+of+the+retirement+picture..jpg" height="240" width="320" /></a></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">"I see people putting away 1% or
3% of their salary," says John Sweeney, executive vice president of
retirement and investing strategies at Fidelity Investments. "People have
to realize that is probably not enough to maintain their lifestyle in
retirement. We're talking about 10% to 15% of your current income."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">Besides increasing your savings, here
are a few other tips:<o:p></o:p></span><br />
<span style="font-family: "Tahoma","sans-serif";"><br /></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<b><span style="font-family: "Tahoma","sans-serif";">1.
Have an emergency or "rainy day" fund outside of your retirement
account. Some retirement planners say retirees should have six months to a year
of living expenses outside of your retirement accounts.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">"Rainy funds are absolutely
important," says Srinivas Reddy, senior vice president and head of
full-service investments at Prudential Retirement. "You need to have a
rainy-day fund that covers 90 to 180 days of living expenses, not only so you
have a safety net, but so you don't draw from longer-term investment savings
for retirement."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">Jeremy Kisner, president of Surevest
Wealth Management in Phoenix, says his company recommends four to five years of
living expenses insulated from the stock market — and they put the money in a
laddered bond portfolio. That account is where your annual living expenses are
drawn from.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">"As you spend your money for
this year, you have to replenish it (from the growth accounts)," he says.
"In a typical year you are harvesting gains and dividends from growth
side, and replenishing your safe money in the income segment."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">That offers his clients five years of
"reliable" income. They did not have to worry about withdrawing funds
after the crash in 2008. And by the time they had to transfer money from those
retirement accounts, the market had recovered, he says.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">But that rainy day money should not
be in cash, says Nicholas Yrizarry, president and CEO of Nicholas Yrizarry
Wealth Management Group in Laguna Beach, Calif. "Money in cash is a
negative investment. There is no return after taxes and inflation. Be careful
not to put too much money in cash."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<b><span style="font-family: "Tahoma","sans-serif";">2.
Plan for health care, even if you are relatively healthy. "You have to
plan for catastrophic illness," says Curt Knotick, CEO of Accurate
Solutions Group in Butler, Pa. "You have to plan for some kind of critical
illness, whether it's long-term care or mid-term disability." There's a
good chance that two out of five retirees will need some level of long-term
care, and that can destroy your nest egg, Knotick says.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">Sweeney says health issues are
difficult to predict. "You never know what problems may develop later, how
severe it might be or how long it might last," he says. "We include
it in the budgeting. Couples will probably need $225,000 for medical expenses
over the span of their lifetimes. "And they usually don't anticipate
changes in expenses because they are expenses they don't have today,"
Sweeney says.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">If a health savings account is
offered, people should take it. "It's triple tax-free," he says. It
goes in before tax, grows tax-free, and it's tax-free upon withdrawal. The key
condition is you have to have enough income while working to not draw that down."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<b><span style="font-family: "Tahoma","sans-serif";">3.
Consider downsizing. Not only will a home sale add to your savings, but you may
also reduce your living expenses.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">"A lot of people need to start
thinking about using the equity in their homes," Kisner says. Think about
downsizing and think about it well in advance. There are people who live in
Southern California. They can't afford to retire in Southern California.
Relocating and downsizing is an important topic."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<b><span style="font-family: "Tahoma","sans-serif";">4.
Consider taxes in everything you do. Curt Whipple, chief managing partner at C.
Curtis Financial Group in Plymouth, Mich., and author of Retiree Lifeline! How
to Get Government Out of Your Pocket, says most couples want to live on the
interest from their investments, but that's not always the most tax-efficient
way to draw income.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">"I had a couple come in,"
he says. "They were making $45,000 a year. Of that, $25,000 represented
Social Security and $20,000 was interest income off their investments.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">"The problem with interest
income is it's all taxable," he says. "As a result, they ended up
being taxed on 85% of their Social Security. I called the company they had
their investments with and rearranged how the money was invested. Their taxes
went to zero. Now they are getting the whole $45,000 with no taxes.They stopped
paying taxes on Social Security. That's a major key to make sure your money
lasts longer in the most tax-efficient manner possible."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<b><span style="font-family: "Tahoma","sans-serif";">5.
Don't wait until 70½ to begin withdrawals from your retirement account. Whipple
says many people wait, even though they are eligible to make withdrawals
starting at 59½, but avoid doing so to avoid the taxes. But that only makes the
problems worse.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">His recommendation: At 60 years old,
start withdrawals, pay the taxes and put it in a Roth IRA account. The result:
The money growth is in the tax-free Roth. And when the retiree reaches 70,
there is far less in required minimum distributions.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<b><span style="font-family: "Tahoma","sans-serif";">6.
Consider life insurance. Knotick says life insurance may help protect a nest
egg in some situations.<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">"For some individuals it may not
be an appropriate tool, because they may not have the funds necessary," he
says. "But what we've found is if someone has marginal assets or needs to
use a lot of assets in retirement, one way to free up in their mind is to
incorporate life insurance into their lives, so when the first spouse passes,
the surviving spouse receives a tax-free benefit."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">His example: "If a couple has
$600,000 and intends to draw $2,000 a month, they may instead draw down $2,500
or $2,600 and pay insurance premiums. The surviving spouse is left with a
$100,000 to $150,000 lump sum that could be reinvested tax efficiently to
provide that surviving spouse with any lost income."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">"Life insurance is unique to
each individual situation," he says. "There may be insurability
issues. But when appropriate and when possible, it is a great planning tool to
provide for the surviving spouses and frees up the assets."<o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<b><span style="font-family: "Tahoma","sans-serif";">7.
Consider an annuity. An immediate annuity will turn part of your savings into a
lifetime stream of income for you and your spouse. For some people, having a
regular monthly payment means peace of mind. And annuities have another
benefit: "You've sheltered yourself from longevity risk," Yrizarry
says. "People are living longer. I suggest people insure that risk."<o:p></o:p></span></b></div>
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</div>
<div class="MsoNormal" style="margin: 12pt 0in 0.0001pt; text-align: justify;">
<span style="font-family: "Tahoma","sans-serif";">You have to protect against longevity,"
says Sweeney. "For couples, there is a 25% chance that one of the two will
live into their 90s. People underestimate how long they will live in
retirement. You must have an income stream that anticipates that."<o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-7528690206801217662014-05-10T22:32:00.000-07:002014-05-10T22:44:03.199-07:00Matrix Absence Management introduces ADA Advantage™<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;">
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: Tahoma, sans-serif;">Service platform
integrates with full-service Absence management offering</span></div>
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<span style="font-family: "Tahoma","sans-serif";"><a href="http://hhicfg.com/"><span style="text-decoration: none; text-underline: none;">The Harver Group</span></a> — Matrix Absence Management, Inc., (Matrix),
a market leading integrator of insurance and absence management services, has
introduced ADA Advantage™, a service platform to help employers administer
American with Disability Act (ADA) programs.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Tahoma","sans-serif";">The Americans with
Disabilities Act (ADA) was signed into law on July 26, 1990 by President George
H.W. Bush. Modeled after the Civil Rights Act of 1964, ADA is an “equal
opportunity” law for people with disabilities. The ADA Amendments Act (ADAAA),
which went into effect in 2009, expanded upon the definitions and applicability
of ADA in the workforce.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif";">ADA requires employers
to consider accommodations for employees with disabilities so that their jobs
can be maintained, with or without reasonable accommodations. These
accommodations often involve extensions of employee leave that is otherwise
governed by federal (FMLA) or state leave laws. Your Health Insurance Counter
Fraud Services Tokyo<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Tahoma","sans-serif";">“In our market space,
as an extension of our clients’ HR and benefits organizations dedicated to
managing employee absence and productivity, we most often see an intersection
with ADA at the time Federal and or State leave entitlements and/or disability
benefit periods end,” according to Kenneth Cope, president of Matrix. “In that
regard, we have developed an offering to help our clients address the
escalating demands of ADA in synch with other, often conflicting, employee
entitlements.”<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif";">Headquartered in
Phoenix, AZ, Matrix has service locations nationwide, including claims hubs in
San Jose, Phoenix, AZ, Hawthorne, NY and Portland, OR. Matrix clients employ
nearly 2 million employees nationwide with total payrolls exceeding $60
billion.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif";">Together, Matrix and
sister company Reliance Standard Life Insurance Company market a range of
integrated employee benefits called Absence Solutions®.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Tahoma","sans-serif";">Focusing on medical
investigation and support, Matrix will provide ADA support services for all
employee leaves, empowering the employer to make the best determinations based
on available information. This service delivery model leverages a secure
software platform accessed jointly by both Matrix and client administrators for
streamlined data collection, communication, tracking and reporting. Tasks
required for effective administration and to drive compliance will be
documented in the system allowing for full audit capabilities.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif";">ADA allowances for
requests other than extended absence – such as the need for a modified
workstation, ergonomic keyboard or change in work shift – are a large part of
managing compliance with the law. The new Matrix product is inclusive of both
leave and “non-leave” requests.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif";">Highlights of the
top-tier service model include management of all activities including obtaining
medical information; conducting interactive employee assessments; obtaining
referrals such as ergonomic evaluations; tracking and managing employee
accommodations; and providing follow up and reporting. The service delivery
model leverages a secure software platform accessed jointly by both Matrix and
client administrators for streamlined data collection, communication and
reporting.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-family: "Tahoma","sans-serif";">The Matrix offering
was successfully piloted beginning in the 4th quarter of 2013 and is now
available as an add-on service for all leave customers. For more information,
see your local Reliance Standard sales representative or account manager, or
visit www.reliancestandard.com.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif";">Reliance
Standard Life Insurance Company</span></b><span style="font-family: "Tahoma","sans-serif";">
(Reliance Standard) is a leading insurance carrier specializing in innovative
and flexible employee benefits solutions including disability income and group
term life insurance, a suite of voluntary (employee paid) coverage options and
fully integrated absence management. Reliance Standard markets these solutions
nationwide through independent brokers and agents to employers of all sizes.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<b><span style="font-family: "Tahoma","sans-serif";"><a href="http://hhicfg.com/blog/matrix-absence-management-introduces-ada-advantage/"><span style="text-decoration: none; text-underline: none;">Both Matrix and Reliance
Standard are members of the Tokio Marine Group</span></a>.</span></b><span style="font-family: "Tahoma","sans-serif";"> Tokio Marine Holdings, Inc., the
ultimate holding company of the Tokio Marine Group, is incorporated in Japan
and is listed on both the Tokyo and Osaka Stock Exchanges. The Tokio Marine
Group operates in the property and casualty insurance, reinsurance and life
insurance sectors globally. The Group’s main operating subsidiary, Tokio Marine
& Nichido Fire (TMNF), was founded in 1879 and is the oldest and leading
property and casualty insurer in Japan.<o:p></o:p></span></div>
<br />
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<br /></div>
</div>
Anonymoushttp://www.blogger.com/profile/02901953195252189249noreply@blogger.com0tag:blogger.com,1999:blog-7702699843776368091.post-19740256943943442272014-05-06T19:02:00.000-07:002014-05-06T20:52:59.662-07:00Foreign travel advice - Japan<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Safety and security</span></b></div>
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<br /></div>
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<b><span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Crime<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Crime levels are low. It is generally safe to walk about
at night and to travel on public transport, but you should maintain the same
level of vigilance as you would at home and take sensible precautions.<o:p></o:p></span></div>
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<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://3.bp.blogspot.com/-tYhgkv8lQR0/U2mSApJ2xOI/AAAAAAAAAFk/oG4QXV43_wk/s1600/Crime.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://3.bp.blogspot.com/-tYhgkv8lQR0/U2mSApJ2xOI/AAAAAAAAAFk/oG4QXV43_wk/s1600/Crime.jpg" height="213" width="320" /></a></div>
<span style="font-family: Tahoma, sans-serif; font-size: 10pt; line-height: 115%;">Reports of inappropriate touching or ‘chikan’ of female
passengers on commuter trains are fairly common. The police advise that you
shout at the perpetrator to attract attention and ask a fellow passenger to
call the train staff.</span><br />
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: Tahoma, sans-serif; font-size: 10pt; line-height: 115%;"><br /></span>
<span style="font-family: Tahoma, sans-serif; font-size: 10pt; line-height: 115%;">The Roppongi entertainment district of Tokyo is
considered a higher risk area for crime. British nationals have been arrested
following disputes with bar staff and doormen. There have also been reports of
drink spiking with drugs like Rohypnol. Victims have described loss of
consciousness for several hours, during which time large amounts have been
fraudulently billed to their credit card.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">If your passport is lost or stolen, you should report
this at a police station and get a police report.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Emergency services<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">In cases of emergency, dial 110 for the police and 119
for the fire or ambulance services.
Calls are free of charge from any phone, including pay phones.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;"><br /></span></div>
<div class="separator" style="clear: both; text-align: left;">
<a href="http://2.bp.blogspot.com/-yiGJV-XaC70/U2mSPSUbQvI/AAAAAAAAAFs/Qy1-DukcQkc/s1600/Emergency+services.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-yiGJV-XaC70/U2mSPSUbQvI/AAAAAAAAAFs/Qy1-DukcQkc/s1600/Emergency+services.jpg" height="199" width="320" /></a></div>
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<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;"><br /></span></div>
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<br /></div>
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<b><span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Fukushima<o:p></o:p></span></b></div>
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<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Based on guidance from UK Government scientists, the FCO
advise against all travel to the exclusion zones around the Fukushima Dai-ichi
Nuclear Power Plant identified by the Japanese authorities. These exclusion
zones are kept under review. Even areas where evacuation orders are ready to be
lifted (marked green on the map) are still subject to some restrictions - for
instance visitors are not allowed to stay overnight.<o:p></o:p></span></div>
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<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-QpswM_OyOG4/U2mShal0VNI/AAAAAAAAAF0/LLlbb5HwssQ/s1600/Fukushima.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://2.bp.blogspot.com/-QpswM_OyOG4/U2mShal0VNI/AAAAAAAAAF0/LLlbb5HwssQ/s1600/Fukushima.jpg" height="211" width="320" /></a></div>
<span style="font-family: Tahoma, sans-serif; font-size: 10pt; line-height: 115%;">The exclusion zone around the Fukushima Daiichi Nuclear
Power Plant has been designated a restricted area. Anyone entering this area
illegally is liable to a fine of up to 100,000 yen (£589) or detention.</span><br />
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<br /></div>
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<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">The Japanese authorities are carrying out comprehensive
checks to monitor radiation in the area surrounding Fukushima and to monitor
possible contamination of water, and food and produce. They impose strict
controls where necessary. There continue to be reports about leaks of
contaminated water. These reports are being monitored by UK government
scientists. Any significant change in the current situation will be reported on
this page.<o:p></o:p></span></div>
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<br /></div>
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<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Although the situation at Fukushima will remain of concern
for some time, the risks are gradually declining.<o:p></o:p></span></div>
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<br /></div>
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<b><span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Road travel<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">To drive in Japan, you must hold an International
Driving Permit (IDP), a current UK licence and insurance. An IDP is only valid
for use in Japan for one year regardless of its date of expiry. Check the Tokyo
Metropolitan Police Department website for further details. You must carry your
driving license with you at all times. Penalties for driving in Japan without
the correct documents are severe.<o:p></o:p></span></div>
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<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;"><br /></span></div>
<div class="separator" style="clear: both; text-align: left;">
<a href="http://2.bp.blogspot.com/-Alwhle7p8UM/U2mSt9HpD3I/AAAAAAAAAF8/mesgoNX4bJw/s1600/Road+travel.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-Alwhle7p8UM/U2mSt9HpD3I/AAAAAAAAAF8/mesgoNX4bJw/s1600/Road+travel.jpg" height="183" width="320" /></a></div>
<div class="separator" style="clear: both; text-align: left;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">If you intend to stay in Japan for longer than one year,
you should apply for a Japanese driving licence. For more information and
details of offices where you can apply for a Japanese licence, visit the
Japanese Automobile Federation website. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">There are two types
of driving insurance available in Japan:<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Compulsory insurance (jibaisekihoken) and voluntary
insurance (nin’i no jidoshahoken). The compulsory insurance on its own may be
insufficient in cases of personal liability.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Roads are well maintained. Driving is on the left, as in
the UK. Road rules are mostly the same as in the UK, but drivers should pay
particular attention to: pedestrians crossing roads at green lights, especially
at junctions; cyclists travelling on the pavements or on the wrong side of the
road and without lights at night; and taxi drivers stopping suddenly.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">There are severe penalties to deter drink driving,
including allowing someone else to drink and drive (for example if you are a
passenger in a vehicle being driven by a drunk driver). Offences can attract a
heavy fine or imprisonment. <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">In 2012 there were 5,237 road deaths in Japan (source
Dft). This equates to 4.1 road deaths per 100,000 of population and compares to
the UK average of 3.0 road deaths per 100,000 of population in 2012.<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Political situation<o:p></o:p></span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Japan is a stable democracy. Civil disturbances and
violent demonstrations are rare. Occasionally, demonstrations of a
pro-nationalist kind can involve hostility to foreign countries. Keep yourself
informed of developments and if you become aware of any protests, leave the
area immediately.<o:p></o:p></span></div>
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<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;"><br /></span></div>
<div class="separator" style="clear: both; text-align: left;">
<a href="http://2.bp.blogspot.com/-5O4PMFBnlRU/U2mTEhBLQxI/AAAAAAAAAGE/g5pjJ_kj1oo/s1600/Political+situation.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-5O4PMFBnlRU/U2mTEhBLQxI/AAAAAAAAAGE/g5pjJ_kj1oo/s1600/Political+situation.jpg" height="201" width="320" /></a></div>
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<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;"><br /></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<b><span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Mobile phone
networks</span></b></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Only 3G and 4G capable UK handsets will work in Japan.
GSM-only UK phones don’t work, as there’s no GSM network. If you plan to make
lots of calls or use mobile data in Japan, SIM cards are available to hire
online or in-store. WiFi zones are also increasingly available in coffee shops,
hotels and other public spaces.<o:p></o:p></span><br />
<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;"><br /></span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in;">
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<span style="font-family: "Tahoma","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-bidi-font-size: 10.5pt;">Foreign Travel Advice by <a href="http://hhicfg.com/"><span style="text-decoration: none; text-underline: none;">The Harver Group</span></a> -
Your Health Insurance Counter Fraud Services Tokyo<o:p></o:p></span></div>
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