Daily Archives: June 16, 2019

Florida Company Sued Over Sales of Skimpy Health Plans

The two policyholders have filed a lawsuit in federal court against Health Insurance Innovations, based in Tampa, Fla., accusing the company of misleading them about the kind of policy they were buying. They say they believed they were purchasing Affordable Care Act plans that include coverage guarantees. But they were sold much less comprehensive coverage that left them vulnerable to tens of thousands of dollars in unpaid medical bills, according to the lawsuit. Their complaints underscore problems with some types of cheaper health insurance alternatives that the Trump administration has expanded. Critics of the government’s decision, including the Association for Community Affiliated Plans and the National Alliance on Mental Illness, are also suing the Trump administration over relaxation of rules for these plans. “This isn’t real insurance,” said Jason Kellogg, one of the lawyers representing the individuals in the Florida case. They are seeking class-action status, estimating that as many as 500,000 people may have bought these policies.

CVS to open 1500 stores focused on healthcare

CVS is changing the look of about 1500 of its stores. By the end of 2021 CVS will transfer those stores into “Health-Hubs” Those stores will devote more than 20 percent of their floor space to healthcare services will like wellness and personalized care. They may even have room for yoga classes! CVS says it’s looking to increase its commitment to healthcare services and depend less on selling retail goods. The company is already reducing floor space for slow-selling items like greeting cards and adding space in some stores for the teeth straightening service, ” Smile Direct Club.”

New York State Rate filings for 2020

Every year carriers are required to request rates, and often the Insurance Department decreases them.  They send a letter out, which tends to confuse people, since the rates are not official.  In any event, here are the rate requests:

Empire Blue Cross and Westchester Medical Center fail to agree

As you know, Empire has been working diligently with Westchester Medical Center Health Network* (“Westchester Medical Center, Mid-Hudson Regional Hospital of Westchester and Bon Secours Charity Health System”) for a new multiyear agreement. Unfortunately, both parties were not able to reach an agreement and Westchester Medical Center Health Network’s contract with Empire terminated on June 1, 2019. As of June 1, 2019, Westchester Medical Center Health Network is no longer an in-network provider with Empire. In addition, some doctors who only admit to Westchester Medical Center Health Network and do not have admitting privileges at another in-network hospital may also be impacted. Except for any transitional care services subject to certain conditions, this means any claims for services received from Westchester Medical Center Health Network on or after June 1, 2019, will be considered out-of-network. Our number one priority is to protect consumers’ access to healthcare that is affordable and meets their specific needs. Empire cares about the value of the healthcare coverage our members and their families receive and Empire will continue to have nationally recognized, high-quality healthcare alternatives for our members. Members can visit http://www.empireblue.com for a full listing of participating facilities. * Westchester Medical Center Health Network includes the following facilities: Westchester Medical Center Mid-Hudson Regional Hospital of Westchester Bon Secours – Good Samaritan Hospital Bon Secours – Mercy Community Hospital Bon Secours – St. Anthony’s Hospital

Emblem and Stonybrook settle

Please be advised that the EmblemHealth Small Group Select Care Network and the Stony Brook hospital system have reached an agreement. As a result, Stony Brook University Hospital and Stony Brook Southamption Hospital will continue to be a part of this network. To search for hospitals in the Select Care Network, you can visit emblemhealth.com/find-a-doctor.

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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