Insider's Insurance Guide

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My auto insurance company has been charging me fees, rate increases (originally I was told it would be a decrease!), and a whole other mess with the DMV. I have not had any tickets, accidents, or claims. No one has been able to satisfactorily explain to me why this is happening. How do I now if I have a case with the insurance commission/and or a small claims lawsuit?
My main problem is not the rate increase. The insurance company received my payment on time. But, they did not POST it until a few days later. sometime in this period of a few days, the DMV audited the insurance companies system and decided this was a lapse I guess. I had to give the DMV 500.00 or lose my registration. This was 6 months ago. It took us 4 months to get the insurance agent to tell us what really happend (they are good at the runaround game). They said that they had sent the paperwork to the DMV and that we should be getting our check in 30 days as the insurance compay was at fault. This month my insurace is 100.00 more and I called the DMV and they recieved the paperwork, but not a follow up call they were supposed to get. Since I called them, I personally was able to give the OK to send the packet to the refund department. My insurance company says that the extra 100.00 is for “reinstatement of coverage”, coverage I never lost in the first place.

My friends home got broken into and car keys were stolen and with that stole the vehicle. The vehicle only had liability insurance. Now both homeowners and auto insurance are telling them that they won’t pay for that loss. Is this correct in any way? The vehicle has a value of $7K. Would obtaining an attorney be helpful?

i recently got over a serious cocaine addiction and have been clean for about a year and a half, and in that time i have been completely changing my life. the only reminder i have is the effect it had on my teeth. i have a cavity on my eye tooth that doesn’t hurt a bit, but goes almost around my tooth by the gum area. i have two other smaller ones on the other eye tooth and right beside it. how much can i get fixed for little out of pocket and $1500 a year dental coverage?

For a driver that is under 25 but older than 21, what is the best auto insurance for a minivan or an suv?

No accident history.
No tickets.
Clean driving record.

Federal

Owing to multiple blizzards in Washington, Congress started its President’s Day recess a full week early and conducted no official business last week. However, there was some legislative drama as Senate Majority Leader Harry Reid pulled the rug out from under Finance Committee Chairman Max Baucus by scrapping the Baucus jobs bill (without warning), which contained many health insurance items, and replacing it with a stripped down, narrow jobs bill. Whether the health items Baucus originally inserted with Republican help will make it back to the table remains fuzzy. Among the health items that have been dropped are: the COBRA eligibility extension (to May 31); the “doc fix” (to October, 2010) of Medicare reimbursement rates; and the favorable statutory direction to CMS to calculate the 2011 Medicare Advantage rates “as if” the doc fix were in place.

States

California health insurance The Office of Patient Advocacy released a report card on the state’s HMOs last week. Aetna received 3 out of 4 stars. The goal of the report card is to allow consumers to compare how well health plans use personal medical records and help address conditions such as asthma, arthritis and diabetes.

COLORADO: Governor Bill Ritter held a press conference to announce what he calls “the next round of reforms that represent common sense.” His legislative package includes bills to preclude insurance companies from charging different rates due to a person’s gender, ensure that women have access to breast cancer screening, assure plain language is used in insurance forms, standardize insurance applications and explanations of benefits, and encourage greater use of online tools to enroll people in public programs. Apart from the Governor’s proposals, a bill that would establish a public option was also introduced.

CONNECTICUT: In a short legislative session of only three months, the Insurance & Real Estate Committee wasted no time in putting forth an agenda that includes many concept drafts for repeat legislation from previous sessions. These include prohibiting health insurance copayments for preventive care, limiting prescription drug copayments, prohibiting Social Security disability payment offsets, and exempting the Municipal Employees Health Insurance Plans from the premium tax on small group premiums. In addition, the committee reintroduced legislation that includes nearly a dozen new health benefit mandates. The Council for Affordable Health Insurance, an independent think-tank, says that health insurance mandates could increase premiums in Connecticut by more than 50 percent overall.

GEORGIA: A bill was proposed last week that would impose significant restrictions on insurers’ ability to rescind health insurance policies. Aetna, through the Georgia Association of Health Plans and AHIP, met with the legislator sponsoring the bill to express concerns with the bill.

INDIANA: The legislative session is at halftime, and the insurance agenda is now limited. Most insurance issue bills are officially dead, including a bill that would have prohibited health plan provisions requiring a contracted provider to accept more than a certain number of patients; coverage for dialysis treatment regardless of whether the facility is contracted or not and without certain benefit restrictions; and a bill that would have allowed out-of-network assignment of benefits. However, Aetna is expecting that a bill requiring insurer and HMO annual reporting of premium cost composition, including administrative costs, may be resurrected. A bill that restricts dental insurers and HMOs from establishing fee schedules for non-covered services passed the Senate, with our amendment to accommodate most of the key concerns expressed by opponents of the bill. As the bill stands, dental insurance plans may impose fee schedules for covered services, regardless of whether the plan actually pays for the services rendered.

KANSAS: An amended version of S.B. 389 related to dental services passed the Senate Financial Institutions and Insurance Committee on February 11. The amended bill prohibits any contract between a health insurer that offers a health benefit plan and a dentist from containing a provision that requires the dentist to accept a fee schedule for services unless the service is a covered service. Committee amendments added to the definition of a “health benefit plan” the following: any subscription agreement issued by a non-profit dental service corporation; any policy of health insurance purchased by an individual; the state children’s health insurance plan; and the state medical assistance program under Medicaid. We will continue to update you as this bill progresses and hope to make favorable changes as the bill moves through the House.

MASSACHUSETTS: Governor Deval Patrick filed a 40-page bill that proposes giving the insurance commissioner the power to hold public hearings on rate adjustments and essentially cap health care price increases. Rate increases for individuals would be held to the rate of medical inflation; those sold to employers with 50 or fewer workers could not exceed one and a half times the level of medical inflation. The legislation would also impose a two-year moratorium on any new health benefit mandates. Legislative leaders praised the intent of the governor’s plan but declined to promise support. Strong opposition is expected from medical provider groups. The Governor simultaneously announced emergency regulations to take immediate effect that will require health insurers to submit proposed small business rate increases for review by the state 30 days before they take effect. Several other proposed provisions include a requirement that insurers offer at least one coverage plan with a limited network of health care providers costing at least 10 percent less than health plans with access to more physicians. The Massachusetts Association of Health plans is lobbying in support of a bill introduced by Senate Insurance Chair Richard Moore that would create a cheaper health insurance product for small employers by capping payments to providers at just 10 percent above Medicare rates. The Massachusetts Medical Society is against that proposal.

MISSOURI: An autism coverage mandate bill was amended and “perfected” by the Senate and then sent to the Government Accountability and Fiscal Oversight Committee from which it must emerge before returning to the floor of the Senate. In addition to two mandate-related amendments, a third amendment to the bill allowing for limited cross border sales of health insurance also passed. In its current form, the bill contains a mandated offering of the coverage in the individual market. Coverage is limited to treatment ordered by a licensed physician or psychologist whose treatment plan the carrier is entitled to review every six months. Coverage for applied behavior analysis (ABA) is limited to $52,000 annually (down from the $72,000 as introduced) for persons under age 21. Meanwhile in the House, a bill containing significant language relating to the credentialing of autism service providers also passed. The bill also contains a mandate to offer coverage in the individual market and to groups of fewer than 25. Groups of 25 to 50 would be entitled to an exemption from the mandate if they could demonstrate an increase in premiums tied to the mandate. The bill limits annual coverage of ABA ($36,000 for children ages 3-9; $20,000 for children ages 9-21). Aetna will continue to monitor the status of these mandates, but it appears fairly clear at this point that something will pass on the issue of autism.

NEW JERSEY: Last week Governor Chris Christie declared a fiscal state of emergency calling a special session of the legislature to lay out his plan for dealing with state’s current $2.2 billion budget shortfall. His plan calls for significant cuts or eliminations across 375 state programs and withholding $500 million of state education aid. Of note on the program side is a $12.6 million reduction in Charity Care funding to hospitals, which pays for care to uninsured residents. In legislative action, the Assembly Financial Institutions and Insurance Committee held a three-hour public hearing on out-of-network reimbursement. Much of the hearing focused on the markedly higher billing practices of ambulatory surgery centers and one non-par hospital. Aetna presented testimony regarding its experience with the non-par hospital, citing their disparate year-over-year increase in charges compared to other similarly situated hospitals. Chairman Schaer indicated the committee will work over the next several months to craft a solution.

NEW YORK: With Democratic Senator Hiram Monserrate officially expelled from the Senate, the Democratic majority (31-30) now faces an uphill battle getting the 32 votes needed to pass legislation. However, both the Senate and the Assembly moved forward with a public hearing on the Executive Budget proposal for health, including the section mandating the prior approval of rate adjustments. The Health Plan Association testified on behalf of the industry. If enacted, Governor Paterson’s proposal for an 85 percent medical loss ratio and a prior approval hearing process for all rate adjustments would essentially amount to government control of health insurance, undermining the private health insurance market in New York. Price controls would weaken health plan solvency, hurt providers and virtually eliminate innovation and efficiency. At the same time, the proposal ignores the underlying cause of the increasing cost of health insurance — the increase in the actual costs of health care services.

OKLAHOMA: The second session of the 52nd Oklahoma Legislature convened in Oklahoma City on February 1. Legislators quickly turned to the state’s $1.3 billion budget deficit described by Governor Brad Henry (D) in his eighth and final state of the state address and FY 2011 executive budget. During his address, the Governor focused on his plans for resolving the $1.3 billion budget deficit through precise budget cuts. His only reference to health insurance was to encourage the expansion of Insure Oklahoma, a program developed by the state in partnership with small employers to provide affordable health coverage. The legislature is scheduled to adjourn on May 28 but only after addressing a range of legislation including several bills of interest to Aetna.

SOUTH DAKOTA: A dental fee schedule bill (S.B. 108) unanimously passed the Senate Commerce Committee and is expected to be taken up by the full Senate early this week. The bill prohibits any contract between a health insurer that offers a health benefit plan and a dentist from containing a provision that requires the dentist to accept a fee schedule for services unless the service is a covered service. Aetna will continue to follow the bill’s progress as it progresses.

TENNESSEE: Several bills have been proposed that would make changes to the state’s external review law. Aetna and other industry representatives will be meeting with the Tennessee Department of Commerce and Insurance regarding its proposed changes to the external review law. The bill proposed by the TDCI most closely mirrors the model legislation proposed by the National Association of Insurance Commissioners.

UTAH: The Speaker of the House has introduced a health reform bill addressing health information technology, individual and small group market reforms and transparency. The overarching theme of the reforms is micromanagement of rates and rating factors, and a broadening of the Insurance Commissioner’s authority. The transparency provisions apply plan designs and benefit descriptions submitted by carriers, and would require providers to make available, upon request, a price list for services on both an inpatient and outpatient basis.

Group health insurance can be incredibly complex, and it can seem overwhelming when you are trying to choose the right coverage option. That’s why a group medical insurance guide is such an important part of any health insurance package. Employers who offer group health insurance should request a guide from their insurance company so that they can distribute it to all of their eligible employees.

The sheer number of options available through most health insurance plans requires some time and study for most individuals. You have to assess your personal medical history and potential needs, as well as those of any dependents you may want to add to your insurance plan. Once you have a good idea what you will need, the group medical insurance guide can steer you through the options toward the plan that fits your budget as well as your coverage requirements.

In general, the choices are between an HMO and a PPO plan. HMO insurance is the least expensive for the patient, with lower premiums and relatively low deductibles. HMO patients do have to sacrifice freedom of choice to gain those discounts, though. An HMO plan will have a group of participating doctors, and the patient is required to use one of those doctors in order to receive insurance coverage.

A PPO health plan gives the patient a little more flexibility, but at a price. If you don’t mind paying a little extra, you have the option of using doctors within a larger network. A PPO will also allow you to use doctors who don’t belong to the network, though you will have to pay for the treatment up front and expect reimbursement from the insurance company later.

Whatever coverage you need, your group medical insurance guide will give you a great start toward finding the best health insurance plan.

I’m a 58 year old single man needing some work done on my teeth, and I was wondering, which would deliver more bang (drilling) for my buck, a dental plan or dental insurance? Thanks a head of time for your responses!

A number of online companies will give you disability insurance quotes, but without having a little background knowledge, you may end up comparing apples to oranges. To avoid some of the confusion that comes with comparing prices and policies, it is extremely helpful to know what types of benefits are included in the policies you have been offered. With this information you will be able to truly compare disability insurance quotes in order to get the best value for your money.

What are the terms included in the various disability insurance quotes? In order to compare quotes, you need to ensure that the coverage for the policies is similar. For example, most policies are not going to cover a disability that was preexisting. Likewise, worker’s compensation policies are unlikely to cover disabilities that did not occur on the job.

It is also worthwhile to determine how your policies work together. If you are in an auto accident, it is possible that your car insurance will pay for lost wages. In this case, it might be unnecessary to make a second claim on another insurance policy. In other cases, you may not be allowed to make both claims, so it is important to check into this possibility in advance.

You will also want to consider how the policy pays off if you should ever need to make a claim. Some disability insurance will pay a percentage of your income, while others will simply pay a flat monthly fee. In the majority of cases, the disabilities are temporary, and you will eventually be going back to work and returning to your full salary. If the disability is longer than that, your policy may stop paying after a predetermined amount of time. Make sure you take this into consideration, as well, when you compare the different disability insurance quotes.

Disability insurance policies can be very fickle, so it is especially important to consider what happens in case of partial disability. In many cases, disability insurance quotes are only for policies that cover you in case of total disability. This means that someone who is only partially disabled will not be able to collect despite their illness or injury.

Total disability means that the insured is completely unable to work. If you are able to hold a job, even though it may pay way less than your previous one, your insurance policy may not have to pay off. For this reason, many people, especially those with higher-paying occupations, choose to purchase own occupation policies. These are also referred to as own-occ.

For example, say that a doctor becomes injured and can no longer perform surgery. He or she will likely lose a large salary. If it is determined that the doctor can still take a job in an office for a fraction of the previous salary, the policy may not have to pay. For this reason, many doctors would be best served by comparing disability insurance quotes for policies that pay out if they can not return to their own occupations.

Different countries have different rules about coverage in case of a disabling injury or illness. In some places, the government steps in to make a contribution to the care of someone who has become either partially or completely disabled. The worker’s compensation mentioned above may also come into play for those injured on the job. Auto insurance, homeowner’s insurance, and life insurance policies may all have their own disability riders, so take these into consideration when comparing other disability insurance quotes.

Confused about renters insurance? This video gives you a renters insurance guide that will help you understand it.