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In what might be the most under reported high profile endorsement in the history of health reform, Obama is endorsing the legislation originally proposed by Sens. Ron Wyden and Scott Brown which “would give states” the freedom to opt out of the legislation, though not “entirely,” by 2014.  The “entirely” refers to the fact that guaranteed issue referendum would stay as  and so would outlawing plan recissions.  The reason?

As we get closer to a Supreme Court hearing, this move is construed by most legal experts to be a way of making the bill “Constitutional.”   Almost every single Republican attorney general has filed claims to invalidate the new health care reform law based on being unconstitutional.  So I guess a good question would be, does this opt out provision make it constitutional?  Maybe, is the answer, and already Republicans are playing the fact that Obama realizes that this bill is a so called “job killer” and the fact that the law is being battered by courts and congressional Republicans.

John Boehner’s spokesman described the president’s announcement as an admission of the reform law’s flaws.” And everyone’s favirote spokesman Michael Steel went even further, “The administration has conceded that ObamaCare is unworkable.” Larry Kudlow, on CNBC’s The Kudlow Report (2/28), similarly suggested that the President was “finally admitting he made a mistake.”

Still the Obama administration is trying to get clarification on the court’s ruling striking down ObamaCare.   In a memo to Vinson, the Justice Department wrote, “Clarification is appropriate so that defendants know how to proceed in this litigation and in implementing the Act, and to dispel the confusion of the public and many plaintiff states regarding their rights and obligations going forward.” Meanwhile, Washington Gov. Chris Gregoire (D) “asked Vinson if she could weigh in on the suit, arguing that the state’s attorney general (who is party to the suit) shouldn’t stop the state from getting the benefits of the reform law.”

In other bad news for health reform…

In a Wall Street Journal op-ed, John E. Calfee criticizes the healthcare law,pointing out that every single benefit from health reform has failed in Massachusetts, most importantly costs have continued to rise at pre-reform levels.  And more that it lacks any real means of keeping costs from increasing. To prove his point, Calfee refers to Massachusetts’ health reform which was used as a template for the law, and notes that since Massachusetts’ health reform was implemented in 2006, costs have not decreased, as anticipated. Rather, they have gone up, and emergency room visits have continued to increase as well, despite the fact that almost all residents now have health coverage. Meanwhile, premiums have also risen each year. According to Calfee, all of this bodes ill for national health reform.

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With news of the House Republicans offing the health reform bill, one can only think what wonderful symbolic action might be next for them.  Maybe they should consider symbolically voting away bad dreams for children as who wants that?  Or maybe the should symbolically vote on extending Christmas to be everyday of every year.  Both of these symbolic votes would be equally effective to the vote this morning on repealing health reform.

So who voted to repeal the bill from the democratic ticket?  Writing in the Huffington Post (1/20), Lucia Graves notes that the three Democrats who backed the repeal were Dan Boren (OK), Mike McIntyre (NC), and Mike Ross (AR). The Hill (1/20, Millman) reports in its “Healthwatch” blog, “Democratic support for the repeal measure fell far below the projections of some high-profile Republicans. Earlier this week, Rep. Steve King (R-Iowa) predicted this week that 15 Democrats would vote for repeal.” Meanwhile, “earlier this month, Energy and Commerce Committee Chairman Fred Upton (R-Mich.) predicted the repeal vote would gain some bipartisan backing.”

A Promise Kept

So now that the GOP in the House has met their campaign promise to voters, they will have more time to start working on other important issues like these crazy death panels.  But what does the public feel about health care reform now you may ask?   On NBC Nightly News (1/19, story 3, 2:10, Williams), Chuck Todd discussed the new NBC News/WSJournal poll, which found that “45% oppose repealing” the healthcare law, and “45% favor repealing it. And it is ideological. Democrats are against it, Republicans are for it. It really does split down the middle.”  However what the NBC poll doesn’t show is that many that favor repealing, want to repeal it because it is not “liberal enough,” and does not completely socialize medicine as it is in the rest of the free, bankrupt world.  (To be fair we are bankrupt too).

So Now Save Us (Symbolically Speaking) from Death Panels & Abortion Funding

“House Republicans will follow their health care law repeal vote with a more targeted attack: legislation to take down provisions that they contend allow for taxpayer funding of abortion.” Politico adds that “anti-abortion legislators will introduce the No Taxpayer Funding for Abortion Act as H.R. 3 on Thursday. The bill intends to prevent federal funding for abortion procedures by codifying the Hyde Amendment, which has long barred federal agencies from paying for abortions.” However, “supporters of abortion rights have long argued that the health reform law does not allow for taxpayer funding of abortion and has the necessary safeguards to prevent public funds from being spent on the procedure.”

Where Do We Go From Here?

Now that the repeal passed through the House it heads to the Senate where it will be debated literally to death, before being upheld by the entirely Democratic Senate.  ” While the “Senate showdown may not begin for several weeks,” it “promises to be substantially messier and more drawn out than the debate just completed in the House.” The Times says, “The result could be a return to bitter, partisan gridlock ahead of a budget confrontation in March, when the health law repeal could become intertwined with a debate over federal spending.”

Remember the Republicans have a great old plan to strangle the health bill to death by withholding funding.  But of course now the GOP’s real work begins. “The next steps — hearings, testimony from administration officials, funding cuts — lack the punch of a straight repeal vote, but Republicans said they will keep at it, hoping the end result is the same: stalling implementation of the $900 billion law.” In addition, “Republicans promise to hold a series of hearings and oversight investigations into the law, attempt to repeal individual provisions and craft an alternative health care plan. Some of the first issues they will tackle are the cost of the law, the mandate on larger employers to provide coverage and the impact of the legislation on the states.”

And What About Malpractice?

Most importantly (and rightfully so) are proposals to revamp the medical malpractice liability system. Changing the liability system is a longtime priority of many physicians and Republicans, who blame it for increasing health care costs. That is the focus of a Thursday hearing in the House Judiciary Committee that Chairman Lamar Smith said will lay the groundwork for replacing the law.” In contrast, “Democrats have resisted changes — such as proposals to cap damages — and sided with trial lawyers and consumer groups who say injured patients deserve to be compensated,” although “President Obama has said the current system does not serve patients or doctors and indicated he would support alternatives.”

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I know that many of my fellow health insurance brokers are just itching for the House vote next week preying for a vote against the health bill by the new Republican House members which of course could lead to a total recission at the Senate, and then finally a crescendo when Obama signs to repeal his own law!  I also know that many Christian evangelists are holding out hope that Jesus may return this year and end the earth except for the agnostics and non believers who of course will have to walk the earth which won’t be a fun place without the Christians.

The question is which of these things have a better chance of happening in 2011.  Well, I am Jewish so I really hope number 2 doesn’t happen, but on the other hand, number one seems like a bad break for my thriving health insurance brokerage which is doing pretty well these days at the top of Google.  But of course the question wasn’t which one would I rather see happen but which one has a better chance, and sadly I am picking number 2 based on the fact that according to many versions of the bible it happened once before.  The same can’t be said for a President repealing his own legislation.

In any event there were a couple of great Florida health insurance articles (the link points to my own great site on the topic not the articles which I am about summarize anyways) about the fact that Florida has done absolutely 0 so far in preparing for 2014 regarding setting up a health exchange.  Many of my fellow brokers are preying that we don’t become like the extinct travel agent or worse like those people that sell their organs on Craigslist (that’s not a great analogy, but I wanted to reference that great money making idea for my fellow brokers looking for alternative ways to generate money).

The two main threats being that MLR will make it impossible to pay commissions and worse that health exchanges will be the only avenue to buy health insurance, and that the exchanges won’t need agents.

Our state (Florida) has a NAHU meeting yesterday and some top insurance reps warned us to take an active role in setting up the health insurance exchanges in order to be like the great state of Utah which in fact already has a health insurance exchange albeit with awful commissions at 7 percent.  Don’t ask me how agents will be involved when someone shops for health insurance in Utah as that seems as ridiculous as WalMart letting me open a mini Walmart in my car where I can sell guns and ammo near an Arizona shopping center.

The four executives on the panel at Thursday’s forum, which was hosted by Tampa Bay Association of Health Underwriters (TBAHU, we are a member of the Miami chapter in fact) included Jonathan Anderson of Blue Cross Blue Shield of Florida and Sherry Baker of Aetna.  Sherry Baker is currently trying to figure out if she can afford to pay my agency higher commissions based on our outrageously high production than most other brokers.  So if you read this Sherry, for the love of God, please say yes and I in return will get an Aetna tattoo on my genitals.

The four had remarkably similar views on the health-reform law, mostly positive. It has some flaws, they said, but it will bring coverage to many millions of uninsured Americans, most of them healthy enough to improve the risk-pools. In other words: Lots of new business.

Bottom line, said Anderson from Blue Cross, “4.2 million Floridians don’t have insurance, and we have got to find a way to help them find coverage.”

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Well first of all congratulation America on your shiny new car!  As of Monday health insurance commissions will end up in the toilet for us brokers and agents.  Many brokers will be forced to find new work perhaps even illegally, this guess is based on the exploits of some of our peers and the selfish, mean things they do the uninsurable and insurable alike.  As for me, I will be spending much of next year with my head held high and my back slightly crooked from begging on the street much of the day.  (Just kidding folks, I won’t have my head high).

Here are some of the highlights from todays health insurance news that I found to be interesting followed by me making snide comments about the authors and belittling their haircuts.

Rep. Andrews Says Dems Might Support A Health Reform “Fix.”

The Hill (12/30, Pecquet) reports in its “Healthwatch” blog that Rep. Robert Andrews (D-NJ) “said Tuesday Democrats could be open to compromising with Republicans on a ‘fix’ of healthcare reform — but only if congressional budget scorekeepers back off their opinion that the bill cuts the deficit.” Notably, the “comments on Fox News come as Democrats have been accusing Republicans of being hypocritical for pushing repeal even though it would violate their campaign pledge to tackle the deficit.” Andrews said, “If [Republicans] would make the repeal of the law contingent upon the Congressional Budget Office certifying that it wouldn’t increase the deficit to repeal it…maybe that is something we could compromise on,” although “later in the interview, Andrews seemed to back away from any suggestion that Democrats could support outright repeal even if CBO issued an unfavorable score.”

This is some crazy news, but much of it is impossibly hard to decipher.  I am not catching or understanding anything but the first sentence and I do this for a living.  C’mon people write clearly!!!  In any event if the Dems are ready to fix this mess of a bill, then perhaps instead of fighting through repeal we should be negotiating for fixes bilaterally.  Of course this will never happen, but I have many other fantasies as well that I use as a vehicle for making my life less dreary, if you would like a list of my “bright and sunny fixes,” please write to PO Box (just kidding).

Op-Ed Accuses Administration Of Rationing Healthcare.

Attorney David B. Rivkin, Jr. and law professor Elizabeth Price Foley write in a Wall Street Journal (12/30, subscription required) op-ed that the Obama Administration has resurrected “death panels,” although it argued previously that a provision that was cut from the healthcare bill was not akin to these death panels. Rivkin and Foley say that the government is intruding more and more into people’s lives, and that recently, the FDA even voted to remove a breast cancer drug, Avastin (bevacizumab), from the market, thereby denying patients access to it. They argue that taken together, these actions constitute rationing, and pose a threat to Americans that must be challenged.

A quick note on death panels, who cares?  That last sentence is so ridiculous that I refuse to acknowledge it.  Death panels are not as the name would infer, death panels.   I mean really, death panels, is that the name we are using for allowing people to pass quietly on their own terms?

Thats like calling a sheet of paper that give you a paper cut, AIDS Spreaders.  I have a few more of these analogies/punchlines if you would like a list of them please send $5 and a picture of your parents kissing to PO Box (just kidding).

Columnist: Palin Right About “Death Panels” In Healthcare Law. Columnist Cal Thomas writes in the Washington (DC) Examiner (12/30), “Sarah Palin deserves an apology,” because “when she said that the new health-care law would lead to ‘death panels’ deciding who gets life-saving treatment and who does not, she was roundly denounced and ridiculed.” But “now we learn, courtesy of one of the ridiculers — the New York Times — that she was right. Under a new policy not included in the law for fear the administration’s real end-of-life game would be exposed, a rule issued by the recess-appointed Dr. Donald M. Berwick, administrator of the Centers for Medicare and Medicaid Services, calls for the government to pay doctors to advise patients on options for ending their lives.”

Well alrighty Sarah, you called one the NY Times a hypocrite successfully!  Yes the NY Times has at least more than 2 writers and one of them is called an editorial writer.  The editorial writer and the hard news writer might actually have different angles of stories.  If you would like to read more about journalism, I would suggest the great book, “Journalism for Ignorant Dummies”, for a free copy of this great book, send $5 and a picture of exploding dynamite next to your car to PO Box, (alright that’s the last one).

Interpretation Of Commerce Clause Will Decide Health Reform Cases.

The Washington Times (12/30, Conery) reports, “Congress has used the Constitution’s Commerce Clause to fight prostitution and domestic violence, to break monopolies and to combat segregation — but its biggest test could come over the Obama administration’s claim that it can compel individuals to buy health insurance.” Recently, “a federal judge…struck down part of the new health care law on the grounds that Congress had stretched the Commerce Clause too far,” but “other federal courts…have upheld the law, and its fate is certain to be decided eventually by the Supreme Court.” The Times notes, “The battle is just the latest in a long line of showdowns over the clause,” and “while some see it as a critical tool to give power to the most important pieces of legislation, others believe Congress has applied it too broadly.”

Very interesting report on the repeal possibility of the Supreme Ct vs. ObamaCare and how the Commerce Clause might affect the decision.  As it is not the Supreme Court’s business to write legislation they are just deciding if the law is “Constitutional,” which in this case it might not be from a strict interpretive viewpoint.  However, the law that makes it unconstitutional was written to apply to other non-related issues.  Its tantamount to using a legal clause that battles obesity and bans donuts to outlaw contraception.  In any case, neither side of this debate should get their hopes up as this case is likely to be decided along party lines with one or two going the wrong way, but to predict this is near impossible even with the info that we have on the judges that sit on the court.

Krauthammer Urges GOP Lawmakers Not To Tamper With Healthcare Law.

The Hill (12/30, Millman) reports in its “Healthwatch” blog, “Charles Krauthammer, a leading conservative voice, said House Republicans should keep their hands off the healthcare reform law to avoid blame for what he thinks will be the law’s inevitable failure.” The Hill adds, “Realizing that a Democratic Senate and president will make their wish to repeal the entire reform law impossible, House Republicans have said they will defund the law over the next two years,” but “Krauthammer, a Washington Post columnist and Fox News contributor who opposes the reform law, said the defunding strategy will result in a ‘clumsily enacted’ law, providing Democrats the opportunity to blame Republicans if it fails.”

This is silly.  Really silly.  Forget about the issue, the logic is wrong.  Its like allowing a rape to happen because you want to avoid liability should the victim die from your efforts.  If you see a perceived wrong and do nothing to fix it then you are just as bad as the wrong you allow.  Maybe Charles like rape, but I don’t.

Editorial: Federal Mandates Force States To Cut Medicaid Program.

The Charleston Daily Mail (12/30) editorializes, “The Medicaid program covers 48 million poor people, half of them children.” Because the “federal government sets the required elements for the program and pays a varying portion of the cost of each state’s program,” the states “must fund the rest,” and many states are facing budget deficits. Several of them, including Massachusetts, North Carolina, Arizona, and Virginia, have made cuts to the Medicaid program, severely impacting coverage for recipients. Meanwhile, “under Obamacare, tens of millions more Americans will get Medicaid coverage.”

Another drawback of health reform (though it is not a reason to not reform it), is that people on social programs now are likely to start getting less care now then before as more people enter these already bankrupt programs.  Medicare will get worse each year from now to the last baby boomer retires.

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The Obama administration released Tuesday new proposed rules that Health insurance companies seeking a rate increase of 10 percent or more in 2011 must publicly explain why the increase is needed.  Under this new proposal, the highlighted premium rate increases would be subject to review by the states or in some cases the federal government to make a decision if they are fair or not. Soon to come, each individual state will get their percentage rates adjusted by the Department of Health and Human Services. Due to differing medical costs per state, the limits will most likely not be uniform.

The proposal states it will only concern the insurance policies dealing with individuals and the smaller type businesses, but the larger employers will not be affected by the new health care law.  Statistics show that for the past three years, the majority of increases have been in the individual market and have been exceeding 10 percent each year, which exceeds some of the national measures of cost inflation according to the proposal.  While consumers may see any big increase as biased, the proposal says it is not possible to know whether an increase is unreasonable until its underlying assumptions are analyzed.  More final rules most likely will be issued in about six months, after a public comment period.  These would affect rate increases filed or effective after July 1, 2011.
The industry lobby, America’s Health Insurance Plans says rising premiums are caused by a variety of factors, including rapidly increasing medical costs. The regulation considers some of those costs, the group says, but doesn’t adequately factor in new benefit mandates and the recession, which is causing younger and healthier people to drop coverage, leaving fewer premium dollars to cover a pool of relatively older or sicker policyholders.
“For example, data from the state of Oregon show that prices of many medical services have increased at an average annual rate exceeding 10 percent,” says AHIP CEO Karen Ignagni. “California data show that
prices for a hospital stay increased by more than 150 percent between 2000 and 2009—an average annual growth rate of 11 percent. Trends likes these are being seen across the country.”
Some consumer advocates say the proposed regulation doesn’t go far enough. The proposal, for example, gives states discretion on revealing some of the detailed data provided by insurers, but states could reveal simpler summaries of the data.  The health care law requires review and justification for increases deemed unreasonable, but does not give the federal government authority to reject rate increases. Federal officials hope public disclosure will discourage unnecessarily large rate increases, encourage state regulators to take a closer look and help individuals and businesses make wise choices. State officials can also bar insurers with a pattern of
unreasonable increases from selling their products in new marketplaces, called exchanges, which are set to open in 2014.

State regulation of premiums varies widely. Some states review proposed rate changes and can deny increases before they go into effect; others allow insurers to put new rates into effect and examine them only if questions are raised.

HHS says it will look at several factors in determining whether rates are unreasonable, including whether an insurer meets a requirement that it spend at least 80 percent of its revenue on medical costs and whether it produces substantial evidence for the increase.

Insurers would have to post on their websites proposed increases above the thresholds and if the rates ultimately are deemed unreasonable they’d have to post that fact as well, in addition to explaining reasons for the increases. Insurers would need to publicly detail what they are spending on medical care, expected future claims costs and administrative spending, including executive compensation.
States would do their own rate reviews unless HHS determines they don’t have an effective system. Among other things, states must show they collect data sufficient to determine whether a rate increase is unreasonable and review that data effectively, the proposal says.

Forty-five states and the District of Columbia have already accepted about $1 million each in grants to help them bolster their ability to review rate increases. HHS officials said a substantial majority of states already have effective rate review.

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With health care reform ready to sick its ugly teeth into our health care system, I have been at a loss in order to continue upgrading this site based on helping people shop and understand health insurance.  Because of the coming changes as of 9/23 and then even more changes coming on 10/1 and then even more unpredictable craziness to follow over the next three years, I am terrified of having to update this entire site with each change as I will end up spending my entire life rewriting the same articles again and again.

So what am I to do?  All I can think to recommend to people is that they call us at 888-803-5917 to get live assistance or email us with their unique situations.

I totally support this reform and lets not forget how bad health care was getting before it, but on the other hand I don’t remember it being this absurd.  I can’t even shop plans right now with an effective date of 2 weeks away as no companies have approved plans!  Yes that’s right I can’t sell health plans if they have an effective date of more than 2 weeks from now.   And prices?  They are even more unobtainable for most Americans.  With local government going bankrupt in the face of poor central banking planning, there are even less subsidies available for those Americans that can’t afford coverage.

Yes somehow, a bad situation has become worse.  Its not a question of politics or opinion, its a life and death situation and sadly there is no answers for people that can’t obtain health insurance right now nor is there a shining light on the horizon.  But like I said our brokers at East Coast Health Insurance know health insurance and health reform and can help you find the program or plan from the insurance companies or the government itself, so give us a whirl you have nothing to lose.

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Your children will now be able to stay on your health insurance policy until they finally reach Medicare, good news for them bad news for you and your insurance company.

In a recent email from Aetna, Aetna has come forward with a new change for those people that have Aetna or plan on getting it, whether individual or group.  Good news!  Your children who still live with you can also stay on your insurance until they finally marry the neighbor’s kids and get off of your back! We know many families are worried about their dependents losing medical coverage when they graduate from high school or college or otherwise age out of coverage. Health care reform will address this issue nationwide later this year, when new regulations will go into effect. In keeping with the spirit of health care reform, Aetna will work with our customers to extend coverage to their medical plans’ current dependents ahead of schedule. This means current dependents under the age of 26 would not have to leave their plans when they would otherwise age out or are no longer full-time students (including those who would have lost eligibility effective May 31, 2010). Note: that this would not include reinstatement of dependents who previously aged out of their plan. It also does not affect dental, vision, standalone pharmacy or other benefits..

For individual medical plans Aetna will continue coverage effective June 1, 2010 for dependents under age 26 currently covered on a parent’s medical plan. Aetna will not change the plan’s premium until renewal. Regardless of whether a plan makes this change ahead of schedule, health care reform is bringing changes to all plans soon. On the next renewal date on or after September 23, 2010, all medical plans must cover all dependents up to age 26 (and older for plans in states that mandate coverage above age 26). This may include dependents who are not currently enrolled in the plan, in accordance with regulations. We will be able to tell you more when the federal government issues regulations telling insurers and employers how this must be administered. We are pleased to offer our plan members the ability to keep their dependents insured. This is one step toward the goal of health care coverage for all Americans. If you have questions about how this will affect individual members who are interested in making this change ahead of the health care reform law, please contact your Aetna representative as soon as possible.

Individual Health Insurance Quotes

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Just when you thought you were happy or comfortable with your Blue Cross Blue Shield of Florida health insurance plan, here comes the bad news.  There is a large increase coming for everyone regardless of when you signed up.  Here is a list of the effected populations:

Rate Increase Products

• Individual U65 BlueChoice®,
• BlueSelect®
• Florida Farm Bureau
• BlueOptions® Products
• Large Group
• Small Group
• Individual Under 65
• Medicare
• Group Medicare

If you are a Blue Cross of Florida policy holder, now is  a good time to fill out the quote form above and start shopping health insurance plans!

Here is the agency email received by agents to give us a heads up of the coming news so we can break it to you our trustful clients.

The purpose of this bulletin is to provide you with information on the upcoming rate increase for all Individual Under 65 BlueChoice®, BlueSelect®, Florida Farm Bureau and most BlueOptions® products. (This excludes BlueOptions Temporary
Plans 562-563, all Hospital-Surgical products and GoBlue.) This year’s implementation continues to include the alternate offer process and the transition to the restructured rate environment for impacted members. Carefully review the following
information.

And here are some relative estimations,

Rate Increase Percentage, Effective Date & Implementation: The Office of Insurance Regulation (OIR) approved an 11.2% rate increase for BlueChoice (Underwritten & Guaranteed Issue), BlueOptions (Underwritten and Guaranteed Issue),
BlueSelect and Florida Farm Bureau products. The new rates are effective June 1, 2010 and will be implemented based on the subscriber’s first paid-to date that falls on or after June 1. Approximately 197,000 contracts representing 319,000
members will be impacted by this rate action. The last rate increase experienced by these members occurred June 1, 2009.

How you will find out

Customer Mailings: The first round of rate increase notification packages will be mailed April 13-16, 2010. These notification packages will be mailed using a staggered approach with daily mailings scheduled to continue through the third
quarter of 2010.

Your Choices

Remember, these letters were addressed to us, so these instructions are to agents not to policy holders.

Alternate Product Offer Including Rate Quote

In conjunction with this rate increase we are continuing the Alternate Offer program. This process has been very successful and has enabled us to retain over 95% of customers who contact us. With Alternate Offer, we suggest a
specific lower cost alternate insurance plan to the subscriber and we include the monthly premium that will apply to that subscriber’s coverage if they choose to transfer to the alternate product. This immediately displays to them the
monthly premium savings available.

Monthly Premium Criteria (Underwritten Customers Only)

If the monthly premium for the alternate product is equal to or less than the subscriber’s monthly rate today (pre-rate increase), then the customer will receive a specific Alternate Offer (presuming other criteria are satisfied).

If the monthly premium for the alternate product is more than the subscriber’s monthly rate today (pre-rate increase), the customer will not receive a specific alternate offer. Their letter will contain general verbiage around other lower
cost products that are available and will encourage them to contact us.

The Alternate Offer process was designed and built to support all Individual Under 65 products. There is a variety of different scenarios requiring different letters. All letters have been assigned unique letter codes that appear at the
bottom of each letter.

Depending on which rate increase letter you get, the alternative products are listed below.

A

. BlueChoice with optional maternity if the Alternate Offer is BlueChoice. The suggestion will be to increase their deductible in BlueChoice.
. BlueChoice without optional maternity when the Alternate Offer is BlueOptions.
. Most BlueOptions & BlueSelect Plans (with or without optional maternity).
. Most BlueOptions HSA-compatible plans.
. Florida Farm Bureau (FFB).

D

BlueChoice with optional maternity when the Alternate Offer would be BlueOptions. This letter does not include a specific Alternate Offer because the structure of the optional
maternity benefit available with BlueOptions is entirely different than what is available with BlueChoice. Further, there are two different BlueOptions optional maternity benefits
available with different and separate deductible amounts. Customers are encouraged to contact us for more information.

H

Guaranteed Issue (Choice & Options). There are no alternate products for this population.

The above categories represent the majority of subscribers involved in this rate action.

B

Criteria for alternate offer not met (i.e., the rate for the alternate offer product is higher than their pre-rate increase premium, they changed products within the last 180 days, they were a new sale within the last 180 days, etc.)

C

Current product is a non-HSA plan and the Alternate Offer would be an HSA-compatible plan.

F

. The current product is a non-HSA compatible plan with optional maternity and the alternate offer would be an HSA-compatible plan. This letter does not include a specific Alternate Offer. While enrollees are eligible to transfer into an HSA-compatible plan, optional maternity is not available with the HSA-compatible plans.
. BlueOptions Plans 81 and 98 (with or without optional maternity).
. Highest deductible HSA-compatible Plans with BlueRx Discounts Program

G

BlueOptions MyBasic Plans 82 & 582.

Sample letters are attached for your reference. Where an Alternate Offer is made, the applicable Benefit Authorization
Form and a Business Reply Envelope will be included in the package.

Restructured Rates

Impacted BlueChoice and BlueOptions customers will continue to be transitioned into the restructured rate environment. This transition plan was negotiated with and approved by the OIR. As a reminder, rate restructuring is a required routine
industry practice that insures continued financial integrity and regulatory compliance of our rates. It is revenue neutral to BCBSF. To ensure our rates remain correct, appropriate and consistent, we analyzed the rate relationships between
different benefit plans, different deductibles, different geographic areas, etc., along with structural factors for age, gender, county, etc. This detailed review resulted in the development of restructured rates that brought the entire state into
alignment so that everyone pays a fair and equitable premium for the coverage they maintain. Virtually every rate at every age in every county changed. On Oct. 1, 2006, restructured rates were implemented for all new sales into Individual
BlueOptions and BlueChoice products that occurred on or after that date. All new IU65 products introduced since that date have been developed at the Restructured Rate level.

Members enrolled prior to 10/01/06 are in the non-restructured rate environment. These are the customers who will be impacted by the transition and they will receive the following additional reminder message printed on the reverse of their
rate adjustment notification letter.

NOTICE OF RATE RESTRUCTURE

To ensure you’re receiving health insurance rates that are appropriate, accurate, and fair, our BlueChoice and BlueOptions Individual Under 65 products have undergone a rate restructure. This is a standard industry practice. It ensures your
premiums best reflect the appropriate rates for your age, gender, and county where you live. Rate restructuring is different from rate changes, which are typically rate increases due to rising medical costs, trends, and age. The Office of Insurance
Regulation has approved this rate restructure. The restructured rates will continue to be implemented gradually over the next several years.

Inquiry Support

Product specific toll-free numbers are provided in the rate notification letters. These lines will be staffed by Intermedia, an external vendor that has supported rate increase activities for the Individual Under 65 products for several years and is very familiar with our products, retention practices and all aspects of this initiative.

Rates
Rates will be available on accessBlue by close of business on Wednesday, April 14, 2010.

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In one of the more reasoned viewpoints on health care, Ron Paul seems to have the antidote for our health insurance woes.  Though many consider Congressman Paul to be a fringe element, the truth is that he is being embraced by millions that are simply tired of our two party system which of course is what our forefathers warned about.

He is also a doctor.   This is the transcription of a speech he gave right after health reform was passed.  See if you can find any point that you can debate.  I couldn’t.

Following months of heated public debate and aggressive closed-door negotiations, Congress finally cast a historic vote on healthcare late Sunday evening. It was truly a sad weekend on the House floor as we witnessed further dismantling of the Constitution, disregard of the will of the people, explosive expansion of the reach of government, unprecedented corporate favoritism, and the impending end of quality healthcare as we know it.

Those in favor of this bill touted their good intentions of ensuring quality healthcare for all Americans, as if those of us against the bill are against good medical care. They cite fanciful statistics of deficit reduction, while simultaneously planning to expand the already struggling medical welfare programs we currently have. They somehow think that healthcare in this country will be improved by swelling our welfare rolls and cutting reimbursement payments to doctors who are already losing money. It is estimated that thousands of doctors will be economically forced out of the profession should this government fuzzy math actually try to become healthcare reality. No one has thought to ask what good mandatory health insurance will be if people can’t find a doctor.

Legislative hopes and dreams don’t always stand up well against economic realities.

Frustratingly, this legislation does not deal at all with the real reasons access to healthcare is a struggle for so many – the astronomical costs. If tort reform was seriously discussed, if the massive regulatory burden on healthcare was reduced and reformed, if the free market was allowed to function and apply downward pressure on healthcare costs as it does with everything else, perhaps people wouldn’t be so beholden to insurance companies in the first place. If costs were lowered, more people could simply pay for what they need out of pocket, as they were able to do before government got so involved. Instead, in the name of going after greedy insurance companies, the federal government is going to make people even more beholden to them by mandating that everyone buy their product! Hefty fines are due from anyone found to have committed the heinous crime of not being a customer of a health insurance company. We will need to hire some 16,500 new IRS agents to police compliance with all these new mandates and administer various fines. So in government terms, this is also a jobs bill. Never mind that this program is also likely to cost the private sector some 5 million jobs.

Of course, the most troubling aspect of this bill is that it is so blatantly unconstitutional and contrary to the ideals of liberty. Nowhere in the constitution is there anything approaching authority for the Federal government to do any of this. The founders would have been horrified at the idea of government forcing citizens to become consumers of a particular product from certain government approved companies. 38 states are said to already be preparing legal and constitutional challenges to this legislation, and if the courts stand by their oaths, they will win. Protecting the right to life, liberty and pursuit of happiness, should be the court’s responsibility. Citizens have a responsibility over their own life, but they also have the liberty to choose how they will live and protect their lives. Healthcare choices are a part of liberty, another part that is being stripped away. Government interference in healthcare has already infringed on choices available to people, but rather than getting out of the way, it is entrenching itself, and its corporatist cronies, even more deeply.

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