Insurance exchanges at heart of new law

BOSTON >> Even a dataset self-described nerd like Peter Kim was almost undone by his hunt for health insurance.
Kim left the corporate world in 2005 to become an independent consultant, losing employer-sponsored insurance for his family of four. But the search for individual health plans proved incredibly complicated, he said. And most were too expensive, to boot.
"It was impossible to compare plans," said Kim, 42, who lives in Cambridge. "I finally gave up trying."
He and his wife use catastrophic coverage, pay out of pocket for routine medical care - until they discover the exchange of health insurance that Massachusetts established in 2006. A linchpin of the state law passed under Mitt Romney as governor, requiring most residents to have health coverage, the exchange is essentially an online marketplace designed to simplify the purchase insurance and thus help people to find a plan they can afford.
If the Supreme Court confirmed President Barack Obama federal law health care in a decision expected this month, proponents say the trade will be a crucial tool for extending insurance. The debate over the law focused on the individual mandate, the provision of lightning rod that requires most Americans to have health insurance by 2014.
But once the court decides if the law is constitutional, the focus could shift to exchanges.
The law requires each state to establish an exchange, but many are reluctant, complaining about everything from spending to perceived federal intrusions. Some, such as Louisiana and Maine, refused. Others are postponing crucial decisions until the court rules and the election in November plays.
So far, only about 15 states and the District of Columbia have established exchanges, with California and Maryland between the furthest in their planning.
Kim's experience in Massachusetts, which, along with Utah is one of only two states with an exchange and running, illustrates how the exchanges are ideally supposed to work. After only one hour of research on the site of the exchange, he said, he found a better deal. He enrolled in Harvard Pilgrim plan for which he pays $ 1086 per month for his family.
The exchange, called the connector of Health, has been operating since Massachusetts passed its own individual mandate in 2006. For all the criticism that has been launched in health state during this year's Republican presidential primary, surprisingly little attention has been paid to this part of the law.
Even if the Supreme Court strikes the federal mandate, many people believe that some form of trade could still be crucial to extend coverage in a number of states.
In Massachusetts, insurers bid to participate in the connector - which include plans offering some level of hospitalization, prescription drugs, maternity care and other services deemed essential by the state - and the connector use its market leverage and guidelines to promote innovation and competition between them.
"He can - and has - helped people to find more affordable options than they otherwise knew existed," said Glen Shor, Executive Director of the connector.
But for the satisfaction of all Kim, connector officials acknowledge that they need more customers like him, full-paying customers who do not qualify for a government grant to offset their premiums. So far the program has attracted only about half of this population in the individual market of the state, officials said connector.
Instead, about 82 percent of the estimated 224,000 people insured through the connector have incomes low enough to qualify for state and federal grants. They pay a modest premium or not.
This is precisely what many opponents fear trade: instead of a free market, they will become something like a program of expanded public welfare.
The connector has fought fiercely to attract another important component of national efforts for health care overhaul - small businesses, who have long complained of being kicked out of health insurance market.
While Massachusetts law requires that many small businesses offer coverage to their employees or pay a penalty, many saw no incentive to purchase insurance through the connector, said Joshua Archambault, Director of Policy health care to the Pioneer Institute, a conservative research organization here. Approximately 1,700 small businesses currently provide a total of 4,320 people across the connector - only a tiny fraction of this market.
"This means that any group that has been promised a reform has not seen," said Archambault.
Shor said that the connector has been taking steps to attract smaller companies, this year by adding more "popular brand" insurance companies with options for small businesses, including Blue Cross Blue Shield of Massachusetts. also added a wellness program that allows discounts of 15 percent off the employer's premium costs if certain conditions are met.
Amy Whitcomb Slemmer, executive director of Health Care for All, an advocacy group in Boston, said she was concerned about the large number of clients in unsubsidized program - 52 percent of them - so choosing Plans called bronze, which have the lowest monthly premiums. These plans tend to have high deductibles (up to $ 4,000 for a family) and maximum out-of-pocket costs, which means that people who become ill often end up paying a lot.
"We are increasingly concerned about high-deductible plans that resemble a short term solution to people," Whitcomb Slemmer said. "We spend so much time helping people understand what their risk take. "
Andrea Cunningham, of Watertown, a plan for the bronze was the most realistic option. She quickly found an insurance for his family of three through the connector after her husband lost his job in February. Sitting at her dining room table with a laptop, Cunningham, 30, entered his age and that of her husband, their zip code and the number of people in their family. Within seconds, his options - plans of tens in total - emerged.
The best part, she said, was how simple it is to compare standardized plans - how each load in co-pays for prescriptions, doctor visits and hospital stays, for example.
"It was very easy to take a look and determine what price range we wanted," she said, "and then dive deep into one or two of them."
She chose a bronze plan for which she and her husband, who is still out of work, pay about $ 900 per month.
The vast majority of people who got insurance through the connector since the downturn began have not had to worry about deductibles because they are eligible for subsidized coverage. In this program, the big challenge was to keep costs down as the numbers have steadily increased.
If the Supreme Court upheld the right of national health, the connector will face significant changes in its customer base. Many customers will be transferred to Medicaid funded under the law of expansion of this program. So attracting more customers for non-subsidized program will be crucial, said Nancy Turnbull, an associate dean at the Harvard School of Public Health, who is on board connector.
"For the exchange to continue to be a major purchaser and the influence on the market," she said, "we will need to be able to add more small employers and people potentially other . "
For the first church in Cambridge, attended by his seven employees in the choice of the Commonwealth this year after facing a rate increase of 10 percent on the previous plan, the switch was worth it.
The church is still paying 3 percent more than last year for its new policy, through Tufts Health Plan, and employees pay more for non-generic drugs only in their old regime. But the Rev. Karen McArthur, Minister Affiliate stewardship, said the church hopes to save 15 percent by joining the program wellness news.
"Even if there were a lot of things we can do to make our internal work policies for what they offered," McArthur said, "there was little energy to do so. We really wanted to participate this, because we truly believe in him. "


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No decision yet to introduce unemployment insurance scheme

Kuala Lumpur: The Government has not taken a decision on whether to introduce an unemployment insurance scheme, International Trade and Industry Minister Datuk Seri Mustapa Mohamed said today.
He said a feasibility study in progress on the plan was still in fact-finding and consensus. "The government does not intend to introduce the system until all stakeholders are fully engaged and consulted before the finalization of the study," he told reporters after a ceremony to celebrate the departure retirement and the granting of service scholarships to several staff at the Ministry of International Trade and Industry (MITI) here today.
A joint statement by MITI and the Ministry of Human Resources released today said that a tripartite project committee chaired by the Chief Executive of the Social Security Organisation (SOCSO) and including representatives of the Ministry Human Resources, Malaysian Employers Federation (MEF) and the Malaysian Trades Union Congress (MTUC) has been formed to oversee and guide the study.
The statement was issued by both Mustapa and Human Resources Minister Datuk Seri Dr S. Subramaniam. Mustapa said his ministry has played an important role in the conduct of discussions with small and medium enterprises (SMEs) to obtain their views on the scheme which will be forwarded to the Department of Human Resources.
He said that there had been recommendations for unemployment insurance in the event of layoffs. "We hope to complete the consultation with SMEs and the various stakeholders by MITI in three months time."
Concerns have been raised in the news the last few days on the issue of an unemployment insurance system, particularly SMEs. The concerns were mainly based on higher costs possible for SMEs when an unemployment insurance scheme is implemented.
MITI is expected to channel the reactions of the study committee tripartite project and also gave assurance that the views of SMEs will be considered before making any decision.
The first phase of this study will be made by the International Labour Organization (ILO), engagement sessions and with partners in the tripartite dialogue. To this end, both the MEF and MTUC had organized workshops and meetings in April and May respectively to obtain the views of their members.
A national tripartite workshop was held May 24 to discuss the employers and workers views on the issue. Regional workshops were also held in Kuching and Kota Kinabalu, the statement said.
"We have instructed the committee tripartite project to keep in touch with all parties concerned so that the conclusions of the study take into account the positions and views of dialogue partners and the industry," said the joint statement. - Bernama
Read more: "No decision yet to introduce unemployment insurance system" - Latest - New Straits Times

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3 Inexpensive Healthcare Options For Young People

Find the right health insurance at the right price is not easy. It can be difficult for anyone at any age to find the best plan. If you are a young adult just out of college, job search, or your employer does not offer health benefits, it can be a stressful time in your life.
If you are a young person in these situations, you have options for medical coverage. Uninsured young adults account for 30% of all uninsured Americans, but they have the highest rate of injury related visits to emergency rooms, according to the Center for Disease Control. Instead of going without health coverage altogether, check out these alternatives below.
The Health Insurance Act by the Affordable CareIn 2010, President Obama enacted the Affordable Care and parts of law directly affecting young people. For example, if you are under 26 and can not obtain insurance from your current employer, you may be eligible for coverage through a parent. The New York Times, in some cases, even if you are married and your parents do you claim on their taxes as a dependent, you may still be able to get insurance through them. There are restrictions for registration under the insurance plan of a parent based on other insurance options available to you, so the search for affordable Care Act to see if you qualify . Keep in mind the Affordable Care Act adds additional functionality to the beginning of each year until 2015. So if you are looking for affordable health care right now, or in the coming years, you may want to consider this option. You can find more information Healthcare.gov.
Low-cost private plans existAlthough it may not seem like there are private insurance plans out there that are not cost hundreds of dollars each month. A young adult who does not have many physical problems can find insurance for less than $ 100 per month. Of course, there is a disadvantage when it comes to the premium. A quick glance at eHealthInsurance.com a plan 30 years of insurance male brings multiple plans for under $ 100. Deductibles range from $ 5,000 to $ 10,000, and some plans will cover visits to the doctor's office. Other plans may receive a share or not help with the cost of everything.
Many of these plans are month to month and do not charge cancellation fees. If you find a job in the future that offers health insurance, you can place your discount ideas without penalty. While franchises can be raised with less expensive coverage, consider the fact that 46% of young adults who have no insurance have some type of medical debt.
The forgotten option, Health Co-OpsIf you can think a little outside the box, another way to get inexpensive health care is to join a health cooperative, op. Think of it as a membership organization where you pay for being a member, and one of its advantages is cheaper medical coverage. There are different types of cooperatives there and they all do not work exactly alike. Some cooperatives, as health partners, have their own doctors, clinics and hospitals. They are able to keep costs low by offering both medical insurance and medical care.
Other unions do not offer insurance and real instead of covering the costs of most medical expenses. With these co-ops you pay a monthly fee to be part of the co-op, then the co-op will either reimburse you for medical or work directly with the provider of health on your bills. Many cooperatives do not work the same way as traditional insurance, so be sure to do plenty of research on co-op you are considering.
The Bottom LineIf you're young and in the market for health coverage, consider all your options before you decide to waive any coverage at all. You better have a plan in place, although it covers only extreme situations.


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Managing People - someone is responsible

In any number of important projects or allocation, the manager of the business unit may not be very specific about who is responsible for what. Certainly, the tasks are distributed sub-teams are formed and given the schedules. This is not enough. The manager should makes it absolutely clear and unambiguous as to exactly Who will be responsible for the results.

Is not it enough for the assignment or take a "team leader" responsible for managing the target? No. Not really.

There is a big psychological difference between "you're in charge of this task" and "you are in charge and totally responsible for seeing that the objectives are met. You have my full support and confidence." There is a big difference. director leaves no doubt who is in charge means being accountable for outcomes. No excuses will be room for something or someone put on the road.

There are several simple techniques that improve both effective delegation of tasks and authority to do the job.

1. First, make sure that there is no doubt about accountability. The manager communicates "this is what to do, this is how it has to be fulfilled and is when you must complete. You are in charge of the Under-and this responsibility is of full accountability, 100% to get the assignment completed as directed. Any questions? "

2. Establishes the need for an immediate response if an obstacle threatens to derail the project. "During the execution of the assignment and management of sub-group, if the question could have a negative effect on the execution of this task, you will need to reach me immediately. If you can not pass the problem I want to know about it in real time. "

3. Establish checkpoints for status reports. "Every week on Friday morning at 8:00 AM, I would like an update of 15 minutes of progress in the sub-team in the execution of the task. Include the current status, nest measures and possible problems. Be ready with solutions. "

Taking these basic but important to be clear to all concerned that this work is important, specifically in charge and where the responsibility is to do the job well done. "(Name) is responsible for directing the computer to run the task, has full authority to implement the project plan for the sub-team and be responsible for the results." This is how senior managers to focus on the parameters and drive accountability for results. anything less leaves loopholes in the implementation of project plans.
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