News and Updates

• Insurance Commissioner Poizner Introduces New Regulations To Stop Unfair Individual Health Insurance Rescissions

  6/4/2009 2:36:00 PM

  We all remember not too long ago it was all over the news.  Big insurance carrier rescinds or cancels The Haileys health insurance policy when they need it most.  The husband was in a disabling car accident and when the medical bills started coming in, the health insurance company decided to cancel their policy.  Their basis was that the husband's health history had been omitted from the original application.  They were not the only ones to go through this.  There were many more families that had a similar situation.

  Today, California Insurance Commissioner Steve Poizner has announced he's doing something about it.  He introduced new regulations that will stop the unfair rescissions.  Please note, these regulations apply to individual health insurance policies only.  It does not apply to group insurance, the insurance provided by an employer to an employee.  The regulations will do the following (direct excerpt):

  • Set clear and rigorous standards that insurers must meet before they issue a health insurance policy. Insurers must do their underwriting job before they issue the policy.
  • Put insurers on notice that they must prove that they have met ALL of the underwriting standards before they can consider rescission.
  • Put an end to lightweight sloppy underwriting if insurers want to keep the right to rescind.
  • Put insurers on notice that they must be 100% sure that an individual knew the answer to a health history question and failed to provide it before considering rescinding that person.
  • Require insurers to make sure that health insurance applications are accurate and complete.
  • Require insurers to ask clear and unambiguous health history questions and avoid confusing applicants.
  • Require agents who assist applicants with their questions to attest to the insurer regarding their assistance, at every stage of the application process.
  • Encourage insurers to use Personal Health Records instead of potentially confusing health history questionnaires to underwrite applicants.
  • Provide fair due process protections for consumers who are being investigated for possible rescission including early notice, opportunity to provide input to the insurers, and the chance to clarify their application. No hidden rescission investigations are allowed under the new rules and this encourages insurers to work with their insureds to resolve questions about the accuracy of their responses.
  • Require insurers to share documentation used during rescission investigations with the insured under investigation.

  This information will be published by The Office of Administrative Law Friday June 5th.

  For further information please follow the link:  http://www.insurance.ca.gov/0400-news/0100-press-releases/0080-2009/release086-09.cfm

• Employee Wellness

  5/27/2009 12:31:00 AM

  The cornerstone of a wellness program is a monitoring process where at-work health screening is done once a year. Blood pressure, cholesterol levels and pulmonary function are checked on the spot, and mental health also is assessed. Then follow-up exams with a physician are required based on the worker's age and gender.

   

  While federal law prohibits discriminating against workers because of health status, it is entirely legal to "incentivize" participation in a health-screening program.  Not only does implementing a Wellnes Program tell your employees that you care about their well-being, but in the long run it can save you money as an employer.  Healthier employees means less hospital visits and prescriptions, these are some of the things that drive your insurance premiums up every year which results in better health insurance rates.

   

  Together with you we can figure out what kind of incentives you will be providing to your employees.  I can show you some creative ways we can implement a cost effective plan and begin seeing results.