CIGNA to acquire ExpressScripts
- Friday, 09 March 2018 07:54
After CVS agreed to acquire insurer Aetna, CIGNA has agreed to purchase express scripts for $67 billion. Express Scripts is the largest pharmacy benefit manager (PBM) in the country. This continues the remake of the nations healthcare system through merger and acquisition:
“Aetna and CVS have said they hope to create “front doors” to healthcare through 9,800 stores run by CVS. That deal could turn many of the chain’s stores into one-stop-shop locations for an array of healthcare needs like blood work and eye or hearing care, in addition to their traditional role of filling prescriptions.
UnitedHealth Group Inc., which runs the nation’s largest insurer, is spending almost $5 billion to buy nearly 300 primary and specialty care clinics and some urgent care and surgery centres. That push will help the company steer patients away from expensive hospital care.
Another insurer, Humana Inc., is making a separate deal to better manage the care of its Medicare Advantage patients.”
Medi-Share expansion in Florida?
- Friday, 09 March 2018 07:49
According to an article in the Orlando Sentinel, legislation is in moving forward in Florida allow this:
“TALLAHASSEE — A bill that could increase enrollment in health-care sharing ministries is headed to Gov. Rick Scott.
The House passed the measure (SB 660) by an 89-27 vote late Wednesday, with opposition coming from Democrats who expressed concerns that the Florida Office of Insurance Regulation doesn’t regulate such sharing arrangements. The Senate voted unanimously to pass the bill earlier in the session.
Health-care sharing ministries have been exempt from Florida’s insurance code since 2008 and limit participation to people who share the same religious beliefs. The bill would broaden current law to include people with the same set of ethical beliefs.
The bill, if signed by Scott, would benefit some large health-care ministries, including Melbourne-based Christian Care Ministries and its cost-sharing program known as Medi-Share.
Last year, Medi-Share, which promotes itself as “God-honoring health care” served 300,000 members nationwide who agreed to attest to a “statement of faith” that, among other things, said the Bible is “God’s written revelation to man and is verbally inspired.”
People who obtain coverage agree to not use illegal drugs, alcohol or tobacco and refrain from having sex outside of marriage or abusing legal drugs.
Members of ministries such as Medi-Share pay monthly membership fees or contributions. According to Med-Share’s website, the share is matched monthly with other people’s medical bills. Members know each month whose “eligible” bills they are helping to pay.
Enrollment in the ministries has grown since passage of Obamacare. That’s because it contains a provision exempting ministries that meet certain requirements from having to comply with the law, which required insurance companies to provide access to birth control.”
Metlife failed to make pension payments
- Wednesday, 21 February 2018 07:32
According to an article in Insurance Business America:
MetLife has come under fire after admitting it failed to make hundreds of millions of dollars worth of pension payments to about 13,500 people over 25 years – averaging at almost $20,000 in missing payouts per head.
The major insurer announced the failure on Tuesday, blaming its practice of presuming customers “would never respond” if staff had made two attempts to reach them without success, according to a Financial Times report. MetLife has now released a statement, saying: “Following a detailed review, management concluded that such administrative practices were not sufficient.”
The blunder occurred at MetLife’s pensions “risk transfer” business, which enables companies to transfer their retirement liabilities to insurers. The company warned in December that it had failed to take adequate steps to track down former employees of its corporate clients.
Shares in the company have dropped 17% in the past two weeks, since MetLife announced it would need to book a charge of more than half a billion dollars to cover the unpaid obligations. On Tuesday, the company said it would need to boost reserves by $510 million on a pre-tax basis.
Steven Kandarian, chief executive and chairman, said the error was “unacceptable and deeply disappointing.” The life and pensions company “can and will do better.”
“We are rigorously addressing the situation and are committed to significantly improving our operational performance to better serve our customers and strengthen shareholders’ confidence,” Kandarian added.”
Idaho Health Plan Says it Will Not Comply with the Affordable Care Act
- Wednesday, 21 February 2018 07:29
Earlier this week, Blue Cross Blue Shield of Idaho announced it would offer options in 2019 that would violate key Affordable Care Act principles.
These options would not offer minimum Essential Benefits and could deny coverage to individuals with preexisting conditions, which violates the 2010 law.
Idaho’s potential challenge to the health care law has national significance. The Trump Administration’s strong opposition to the ACA has raised questions whether it would require Idaho to enforce its requirements.
New U.S. Health and Human Services Secretary Alex Azar told Congress last week that he is waiting for Idaho state regulators to act before getting involved.