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Author Topic: I just received the following letter-  (Read 1133 times)
Beet
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« on: July 25, 2012, 10:09:38 pm »
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Dear Beet,

This latter is to inform you that CareFirst BlueChoice, Inc. will be rebating a portion of your health insurance premiums. This rebate is required by the Affordable Care Act - the health reform law.

The Affordable Care Act requires CareFirst to rebate part of the premiums it received if it doe snot spend at least 80 percent of the premiums CareFirst receives on health care services, such as doctors and hospital bills, and activities to improve health care quality, such as efforts to improve patient safety. No more than 20 percent of the premiums may be spent on administrative costs...

...In your employer's State, Virginia, CareFirst did not meet the 80/20 standard....CareFirst must rebate 2.1% of the total health insurance premiums paid by the employer and employees of your group health plan. We must send this rebate to your employer or group policyholder by August 1, 2012....

If your group health plan is a non-Federal governmental plan, the employer or group policyholder must distribute the rebate in one of two ways:
* Reducing the premium for the upcoming year; or
* Providing a cash rebate to employees or subscribers that were covered by the health insurance on which the rebate is based.

If your group health plan is a church plan, the employer or group policyholder has agreed to distribute the portion of the rebate that is based on the total amount all of the employees contributes to the health insurance premium in one of the ways discussed in the prior paragraph.

If your group health plan is not a governmental plan or church plan, it is likely subject to the Federal Employee Retirement Income Security Income Act of 1974 (ERISA). Under ERISA, the employer of the administrator of the group health plan may have fiduciary responsibilities regarding use of the Medical Loss Ratio rebates...

Sincerely,
Steve Margolis
Senior Vice-President, Small and Medium Group ASU
CareFirst BlueChoice, Inc.

--

My employer is a small business, which likely falls into the last category. Regardless, this appears to benefit my employer and/or me, at the cost of CareFirst.
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Queen Mum Inks.LWC
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« Reply #1 on: July 25, 2012, 11:57:45 pm »
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Lucky you.  I got my hours cut because my boss is scared that the company would have to give all of the part-time employees health insurance if we got too many hours.  It doesn't affect me since I have insurance through my dad, but those who don't have insurance now have less money to buy it with.
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t_host1
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« Reply #2 on: July 27, 2012, 12:32:17 am »
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If, you care to participate… in general terms
What was your portion “payment” prior to 2010 Obama Care? 2009’s premiums.
Co-pays; Doctor‘s and drugs.
Coverage’s – did you choose?
What is your payment for 2012? In general terms, where there any changes in co-pays & coverage’s?
The government says you over paid by 2% for the insurance fiscal year; does it add up?
No details; did you get the benefit of services greater than what you and the employer paid in premiums?
Are you participating in a medical savings account?
CareFirst, is that a state/ federal (Obama Care) subsidized nonprofit group or a privately held/investor based company? The letter looks like a standard letter with rate of overpayment being the only variable.
No, I’m not in the insurance business. Depending on your input, curious how this shakes out; if a pool of money has a net at the end of a cycle and, it must return, well… if the next year cycle has a (-) you’ll pay the difference, no later than August 1, correct?
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« Reply #3 on: July 27, 2012, 12:40:04 am »
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If, you care to participate… in general terms
What was your portion “payment” prior to 2010 Obama Care? 2009’s premiums.
Co-pays; Doctor‘s and drugs.
Coverage’s – did you choose?
What is your payment for 2012? In general terms, where there any changes in co-pays & coverage’s?
The government says you over paid by 2% for the insurance fiscal year; does it add up?
No details; did you get the benefit of services greater than what you and the employer paid in premiums?
Are you participating in a medical savings account?
CareFirst, is that a state/ federal (Obama Care) subsidized nonprofit group or a privately held/investor based company? The letter looks like a standard letter with rate of overpayment being the only variable.
No, I’m not in the insurance business. Depending on your input, curious how this shakes out; if a pool of money has a net at the end of a cycle and, it must return, well… if the next year cycle has a (-) you’ll pay the difference, no later than August 1, correct?


What language is this?
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bgwah
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« Reply #4 on: July 27, 2012, 12:45:09 am »
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Lucky you.  I got my hours cut because my boss is scared that the company would have to give all of the part-time employees health insurance if we got too many hours.  It doesn't affect me since I have insurance through my dad, but those who don't have insurance now have less money to buy it with.

And how are you still on your dad's plan?
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t_host1
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« Reply #5 on: July 27, 2012, 12:52:58 am »
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If, you care to participate… in general terms
What was your portion “payment” prior to 2010 Obama Care? 2009’s premiums.
Co-pays; Doctor‘s and drugs.
Coverage’s – did you choose?
What is your payment for 2012? In general terms, where there any changes in co-pays & coverage’s?
The government says you over paid by 2% for the insurance fiscal year; does it add up?
No details; did you get the benefit of services greater than what you and the employer paid in premiums?
Are you participating in a medical savings account?
CareFirst, is that a state/ federal (Obama Care) subsidized nonprofit group or a privately held/investor based company? The letter looks like a standard letter with rate of overpayment being the only variable.
No, I’m not in the insurance business. Depending on your input, curious how this shakes out; if a pool of money has a net at the end of a cycle and, it must return, well… if the next year cycle has a (-) you’ll pay the difference, no later than August 1, correct?


What language is this?
The same one that ObamaCare is written in... Why?
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« Reply #6 on: July 27, 2012, 12:58:51 am »
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If, you care to participate… in general terms
What was your portion “payment” prior to 2010 Obama Care? 2009’s premiums.
Co-pays; Doctor‘s and drugs.
Coverage’s – did you choose?
What is your payment for 2012? In general terms, where there any changes in co-pays & coverage’s?
The government says you over paid by 2% for the insurance fiscal year; does it add up?
No details; did you get the benefit of services greater than what you and the employer paid in premiums?
Are you participating in a medical savings account?
CareFirst, is that a state/ federal (Obama Care) subsidized nonprofit group or a privately held/investor based company? The letter looks like a standard letter with rate of overpayment being the only variable.
No, I’m not in the insurance business. Depending on your input, curious how this shakes out; if a pool of money has a net at the end of a cycle and, it must return, well… if the next year cycle has a (-) you’ll pay the difference, no later than August 1, correct?


What language is this?
The same one that ObamaCare is written in... Why?

I didn't realise that "ObamaCare" is written in kindergarden gibberish.
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t_host1
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« Reply #7 on: July 27, 2012, 01:09:43 am »
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If, you care to participate… in general terms
What was your portion “payment” prior to 2010 Obama Care? 2009’s premiums.
Co-pays; Doctor‘s and drugs.
Coverage’s – did you choose?
What is your payment for 2012? In general terms, where there any changes in co-pays & coverage’s?
The government says you over paid by 2% for the insurance fiscal year; does it add up?
No details; did you get the benefit of services greater than what you and the employer paid in premiums?
Are you participating in a medical savings account?
CareFirst, is that a state/ federal (Obama Care) subsidized nonprofit group or a privately held/investor based company? The letter looks like a standard letter with rate of overpayment being the only variable.
No, I’m not in the insurance business. Depending on your input, curious how this shakes out; if a pool of money has a net at the end of a cycle and, it must return, well… if the next year cycle has a (-) you’ll pay the difference, no later than August 1, correct?


What language is this?
The same one that ObamaCare is written in... Why?

I didn't realise that "ObamaCare" is written in kindergarden gibberish.
Oh’… best you try not to comprehend this then, if, that is all you’re familiar with.
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greenforest32
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« Reply #8 on: July 27, 2012, 02:22:03 am »
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Regardless, this appears to benefit my employer and/or me, at the cost of CareFirst.

CareFirst is originally benefiting at the expense of you and your employer. This is basically a regulation cutting down their profit margin.

I don't understand why when we decide to offer a service, we insist it be controlled by a private provider who has an inherent conflict of interest to overcharge. I look over every one of my monthly utility bills (particularly the cell-phone and internet) provided by for-profit companies after I've gotten these obscure charges for services I never used.

Of course the charges are reversed when I call to ask about them but I doubt even 25% of people charged these illegitimate fees even notice them to the point they are reversed. And that's ignoring the billions in dividends that are extracted from ratepayers. How are these things a net gain for the service?

It's a pretty moderate position to say that you shouldn't inject private profit into a utility or public service, especially when it comes at the expense of the users and yet you're considered some kind of radical communist to insist that utilities or basic health insurance be run by the government so the service is provided at the lowest possible cost.
« Last Edit: July 27, 2012, 03:04:35 am by greenforest32 »Logged
Vosem
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« Reply #9 on: July 27, 2012, 06:51:05 am »
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Regardless, this appears to benefit my employer and/or me, at the cost of CareFirst.
It's a pretty moderate position to say that you shouldn't inject private profit into a utility or public service, especially when it comes at the expense of the users and yet you're considered some kind of radical communist to insist that utilities or basic health insurance be run by the government so the service is provided at the lowest possible cost.

The thing is that when you have competition (multiple private companies running alongside each other) you have a lot more efficiency and a much better service. When the government does it, everyone gets poor service. When private companies do it, some people get good service (those who pay more), some people get poor service (those who pay less), and some people get none (those who can't pay). I prefer the latter system.

Also, t_host just won this thread. I never thought I would type that, but he totally did and it was awesome. 
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oakvale
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« Reply #10 on: July 27, 2012, 07:12:50 am »
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Regardless, this appears to benefit my employer and/or me, at the cost of CareFirst.
It's a pretty moderate position to say that you shouldn't inject private profit into a utility or public service, especially when it comes at the expense of the users and yet you're considered some kind of radical communist to insist that utilities or basic health insurance be run by the government so the service is provided at the lowest possible cost.

The thing is that when you have competition (multiple private companies running alongside each other) you have a lot more efficiency and a much better service. When the government does it, everyone gets poor service. When private companies do it, some people get good service (those who pay more), some people get poor service (those who pay less), and some people get none (those who can't pay). I prefer the latter system.

It's really fascinating that - even if we accept your dogmatic excuse for a premise - you genuinely have no problem with a society where the wealthy are entitled to a higher standard of healthcare (and longer lives!) solely because they're rewarded by the current economic system.

Can you honestly say that you have no qualms with a system that means "some people get none"? I find that hard to believe, even considering the source. Huh
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Do the Democratic hacks on this forum even understand dialectical materialism?
Vosem
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« Reply #11 on: July 27, 2012, 07:33:06 am »
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Regardless, this appears to benefit my employer and/or me, at the cost of CareFirst.
It's a pretty moderate position to say that you shouldn't inject private profit into a utility or public service, especially when it comes at the expense of the users and yet you're considered some kind of radical communist to insist that utilities or basic health insurance be run by the government so the service is provided at the lowest possible cost.

The thing is that when you have competition (multiple private companies running alongside each other) you have a lot more efficiency and a much better service. When the government does it, everyone gets poor service. When private companies do it, some people get good service (those who pay more), some people get poor service (those who pay less), and some people get none (those who can't pay). I prefer the latter system.

It's really fascinating that - even if we accept your dogmatic excuse for a premise - you genuinely have no problem with a society where the wealthy are entitled to a higher standard of healthcare (and longer lives!) solely because they're rewarded by the current economic system.

Can you honestly say that you have no qualms with a system that means "some people get none"? I find that hard to believe, even considering the source. Huh

Yes. Healthcare is a service; nobody is entitled to it. Even if we disregard that, ultimately under a government-funded care system care will be of a poorer quality than it will be under a free-market system for those that can afford it, and I don't think we should not allow people to buy the better healthcare they can afford. And, yes, not only can I honestly say I have no qualms about such a system, I'm pretty confident the majority of Americans agree with me based on opinion polling.

From a European point-of-view the American healthcare debate is downright bizarre, because in Europe free healthcare is regarded as an innate right more sacred than even your right to own guns, but in America the majority of people don't want it.
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« Reply #12 on: July 27, 2012, 09:01:24 am »
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I've just accepted Vosem's bizarre dogmatic reactionary views, but I just hope that he doesn't identify as one of those 'compassionate conservatives' or whatever.
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« Reply #13 on: July 27, 2012, 09:55:12 am »
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Regardless, this appears to benefit my employer and/or me, at the cost of CareFirst.
It's a pretty moderate position to say that you shouldn't inject private profit into a utility or public service, especially when it comes at the expense of the users and yet you're considered some kind of radical communist to insist that utilities or basic health insurance be run by the government so the service is provided at the lowest possible cost.

The thing is that when you have competition (multiple private companies running alongside each other) you have a lot more efficiency and a much better service. When the government does it, everyone gets poor service. When private companies do it, some people get good service (those who pay more), some people get poor service (those who pay less), and some people get none (those who can't pay). I prefer the latter system.

It's really fascinating that - even if we accept your dogmatic excuse for a premise - you genuinely have no problem with a society where the wealthy are entitled to a higher standard of healthcare (and longer lives!) solely because they're rewarded by the current economic system.

Can you honestly say that you have no qualms with a system that means "some people get none"? I find that hard to believe, even considering the source. Huh

Yes. Healthcare is a service; nobody is entitled to it. Even if we disregard that, ultimately under a government-funded care system care will be of a poorer quality than it will be under a free-market system for those that can afford it, and I don't think we should not allow people to buy the better healthcare they can afford. And, yes, not only can I honestly say I have no qualms about such a system, I'm pretty confident the majority of Americans agree with me based on opinion polling.

From a European point-of-view the American healthcare debate is downright bizarre, because in Europe free healthcare is regarded as an innate right more sacred than even your right to own guns, but in America the majority of people don't want it.
Don't just pull stuff out of your ass, kid.  At least wait to get off your parents' plan before making a statement like that.
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anvi
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« Reply #14 on: July 27, 2012, 10:19:04 am »
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Yes. Healthcare is a service; nobody is entitled to it. Even if we disregard that, ultimately under a government-funded care system care will be of a poorer quality than it will be under a free-market system for those that can afford it, and I don't think we should not allow people to buy the better healthcare they can afford.  

Merely saying that something is a service doesn't by itself imply anything about how that service is best delivered.  One could easily say that the military is a service too; that by itself implies nothing about how to finance and organize its provision.  

Regarding the second point you make, I actually agree that private competition in health insurance improves the quality of its delivery and that people who can pay for more coverage should get more.  I think, however, that when such private companies are for-profit ones, that's where the skewing of incentives comes in, because it leads to things like recision and purging.  Recision and purging do allow insurance companies to survive, but I think it's much harder to argue that they create efficiency in the delivery of the product.  Insurance enables people to pool their risk, some some who are covered will use the coverage they buy and some won't, but recision and purging bar some people from the even the chance to pool their risk.  In this case, insurance companies survive not through the optimal delivery of the product to the greatest number of buyers, but by barring some people from even buying the product.  That, while certainly not the only reason, is one major reason why only 57% of the American public are covered by private insurance plans (27% are covered by government plans and 16% are uncovered).  That kind of figure strikes me as a major efficiency fail.  With numbers like that, I think a government has to step in and either provide coverage for uncovered people directly or subsidize those who can't afford coverage so companies can cover the costs of the larger risk pools.  The alternative would be to have very, very large numbers of people in society walking around with no health insurance coverage, and, for a large host of reasons, many of them economic and not just moral, that would be quite bad.    
« Last Edit: July 27, 2012, 10:21:00 am by anvi »Logged

Vosem
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« Reply #15 on: July 27, 2012, 10:20:23 am »
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I've just accepted Vosem's bizarre dogmatic reactionary views, but I just hope that he doesn't identify as one of those 'compassionate conservatives' or whatever.

I don't think I'm bizarre, dogmatic, reactionary, or a compassionate conservative.
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t_host1
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« Reply #16 on: July 27, 2012, 10:31:14 am »
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All aside for a short moment, the billing –Affordable Care Act (ObamaCare) – by comparison.
 Ones’ 2009 coverage cost vs. 2012? Pooling dollars where all administration costs are subtracted first, is a scheme, not insurance by the original definition. The “rebate”; if government subsidies are involved in any way, call it what it is, the incumbent “vote for me” payment plan. Any estimates on 2013 rebates? Or, will assessments above the premium price be the norm in non election years?

Hey, give Vosem a break; his opinion has merit, it is my understanding that those who pay the bills have the same reaction.
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Governor Varavour
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« Reply #17 on: July 27, 2012, 04:30:49 pm »
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If, you care to participate… in general terms
What was your portion “payment” prior to 2010 Obama Care? 2009’s premiums.
Co-pays; Doctor‘s and drugs.
Coverage’s – did you choose?
What is your payment for 2012? In general terms, where there any changes in co-pays & coverage’s?
The government says you over paid by 2% for the insurance fiscal year; does it add up?
No details; did you get the benefit of services greater than what you and the employer paid in premiums?
Are you participating in a medical savings account?
CareFirst, is that a state/ federal (Obama Care) subsidized nonprofit group or a privately held/investor based company? The letter looks like a standard letter with rate of overpayment being the only variable.
No, I’m not in the insurance business. Depending on your input, curious how this shakes out; if a pool of money has a net at the end of a cycle and, it must return, well… if the next year cycle has a (-) you’ll pay the difference, no later than August 1, correct?


What language is this?

It's bizarrely punctuated, but perfectly comprehensible, actually.
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opebo
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« Reply #18 on: July 27, 2012, 04:47:25 pm »
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The thing is that when you have competition (multiple private companies running alongside each other) you have a lot more efficiency and a much better service. When the government does it, everyone gets poor service. When private companies do it, some people get good service (those who pay more), some people get poor service (those who pay less), and some people get none (those who can't pay). I prefer the latter system.

No, when private companies provide a service, 1st - only people with money can access the service, thus cutting out most citizens in the first place, 2nd - they have an incentive to cheat and deny the service whenever possible, and generally deceive even those customers who can afford the service, 3rd - and finally, the have an incentive to provide the service as cheaply as possible, so that the service will be of terrible quality.

By contrast with a State-provided service, everyone gets access, and the service is tremendously better.   Think of when you go to the DMV - a lot of propagandists say it is bad, but I've only ever had the nicest, friendliest, and most efficient services there.
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t_host1
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« Reply #19 on: July 28, 2012, 03:15:11 pm »
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No, when private companies provide a service, 1st - only people with money can access the service, thus cutting out most citizens in the first place, 2nd - they have an incentive to cheat and deny the service whenever possible, and generally deceive even those customers who can afford the service, 3rd - and finally, the have an incentive to provide the service as cheaply as possible, so that the service will be of terrible quality.

By contrast with a State-provided service, everyone gets access, and the service is tremendously better.   Think of when you go to the DMV - a lot of propagandists say it is bad, but I've only ever had the nicest, friendliest, and most efficient services there.
Perfect! With a slight adjustment.
Change the “No” to Yes, The description/prescription of private sector health as greed, must, flourish at will. Killing their clients at high prices will not play out.

2nd paragraph description of public health (governing public safety) is the competitor to the private.
It’s not insurance, rather, it’s health care. With exception for supplies and structural support, Public monies do not cross over to the private sector health care as a whole, only in rare extreme conditions.

Where do the public monies come from?
Not from the private sector health care.

Where then, do the public sector health care monies come from? There has been some discussion on this with the realization being for one or two people, that, people & print (monetized to the in kind trade) are the source. Commerce must be void of any direct or indirect (employer’s) healthcare tax, fee and levees.  

Hail!! opeumbo Maximus, the American health care system has now been resolved, let’s PARTY!!
« Last Edit: July 28, 2012, 04:33:30 pm by t_host1 »Logged

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