48 CFR 228.307-1 - Group insurance plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Group insurance plans. 228..., DEPARTMENT OF DEFENSE GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 228.307-1 Group insurance plans. The Defense Department Group Term Insurance Plan is available for contractor use under cost...

48 CFR 1228.307-1 - Group insurance plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Group insurance plans... GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 1228.307-1 Group insurance plans. (a) Prior... basis on proposed purchases of group insurance plans. Legal advice should be sought where necessary on...

48 CFR 1228.307-1 - Group insurance plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Group insurance plans... GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 1228.307-1 Group insurance plans. (a) Prior... basis on proposed purchases of group insurance plans. Legal advice should be sought where necessary on...

48 CFR 228.307-1 - Group insurance plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Group insurance plans. 228..., DEPARTMENT OF DEFENSE GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 228.307-1 Group insurance plans. The Defense Department Group Term Insurance Plan is available for contractor use under cost...

41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

48 CFR 1028.307-1 - Group insurance plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Group insurance plans. 1028.307-1 Section 1028.307-1 Federal Acquisition Regulations System DEPARTMENT OF THE TREASURY GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 1028.307-1 Group insurance plans. (a) Plans shall be...

48 CFR 1028.307-1 - Group insurance plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Group insurance plans. 1028.307-1 Section 1028.307-1 Federal Acquisition Regulations System DEPARTMENT OF THE TREASURY GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 1028.307-1 Group insurance plans. (a) Plans shall be...

48 CFR 1028.307-1 - Group insurance plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Group insurance plans. 1028.307-1 Section 1028.307-1 Federal Acquisition Regulations System DEPARTMENT OF THE TREASURY GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 1028.307-1 Group insurance plans. (a) Plans shall be...

48 CFR 1028.307-1 - Group insurance plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Group insurance plans. 1028.307-1 Section 1028.307-1 Federal Acquisition Regulations System DEPARTMENT OF THE TREASURY GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 1028.307-1 Group insurance plans. (a) Plans shall be...

State of emergency preparedness for US health insurance plans.

PubMed

Merchant, Raina M; Finne, Kristen; Lardy, Barbara; Veselovskiy, German; Korba, Caey; Margolis, Gregg S; Lurie, Nicole

2015-01-01

Health insurance plans serve a critical role in public health emergencies, yet little has been published about their collective emergency preparedness practices and policies. We evaluated, on a national scale, the state of health insurance plans' emergency preparedness and policies. A survey of health insurance plans. We queried members of America's Health Insurance Plans, the national trade association representing the health insurance industry, about issues related to emergency preparedness issues: infrastructure, adaptability, connectedness, and best practices. Of 137 health insurance plans queried, 63% responded, representing 190.6 million members and 81% of US plan enrollment. All respondents had emergency plans for business continuity, and most (85%) had infrastructure for emergency teams. Some health plans also have established benchmarks for preparedness (eg, response time). Regarding adaptability, 85% had protocols to extend claim filing time and 71% could temporarily suspend prior medical authorization rules. Regarding connectedness, many plans shared their contingency plans with health officials, but often cited challenges in identifying regulatory agency contacts. Some health insurance plans had specific policies for assisting individuals dependent on durable medical equipment or home healthcare. Many plans (60%) expressed interest in sharing best practices. Health insurance plans are prioritizing emergency preparedness. We identified 6 policy modifications that health insurance plans could undertake to potentially improve healthcare system preparedness: establishing metrics and benchmarks for emergency preparedness; identifying disaster-specific policy modifications, enhancing stakeholder connectedness, considering digital strategies to enhance communication, improving support and access for special-needs individuals, and developing regular forums for knowledge exchange about emergency preparedness.

41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

48 CFR 3028.307-1 - Group insurance plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Group insurance plans. 3028.307-1 Section 3028.307-1 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY....307-1 Group insurance plans. Plans shall be submitted to the contracting officer, who must obtain the...

48 CFR 3028.307-1 - Group insurance plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Group insurance plans. 3028.307-1 Section 3028.307-1 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY....307-1 Group insurance plans. Plans shall be submitted to the contracting officer, who must obtain the...

48 CFR 3028.307-1 - Group insurance plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Group insurance plans. 3028.307-1 Section 3028.307-1 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY....307-1 Group insurance plans. Plans shall be submitted to the contracting officer, who must obtain the...

The Status of Group Life Insurance Plans.

ERIC Educational Resources Information Center

Cook, Thomas J.

1981-01-01

Information on provisions of group life insurance plans and the tendency of colleges and universities to provide this coverage is considered. There has been an increase in the percentage of institutions adopting group life insurance plans over the last decade. Absence of coverage is concentrated among smaller two-year and four-year institutions…

[What do company health insurance plans provide?

PubMed

Hamiki, R

2016-12-15

Company health insurance plans are a voluntary employer benefit and an increasingly important part of company pension and benefits systems. They enable employers to invest in the health of their employees. They are also a useful modular complement to both statutory and private health insurance. Company health insurance plans allow employers to attract first-rate staff and to retain them for the long term. Employees, in turn, are provided with a variety of attractive additional benefits, for instance treatment by chief physicians, single or double-room hospital accommodation, additional aids and remedies, and a variety of screenings and medical check ups. It is expected that, in the next few years, company health insurance will become very widespread.

77 FR 47573 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Parts 40 and 46 [REG-136008-11] RIN 1545-BK59 Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes... on issuers of certain health insurance policies and plan sponsors of certain self-insured health...

26 CFR 1.105-11 - Self-insured medical reimbursement plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 2 2014-04-01 2014-04-01 false Self-insured medical reimbursement plan. 1.105... Self-insured medical reimbursement plan. (a) In general. Under section 105(a), amounts received by an employee through a self-insured medical reimbursement plan which are attributable to contributions of the...

26 CFR 1.105-11 - Self-insured medical reimbursement plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Self-insured medical reimbursement plan. 1.105... Self-insured medical reimbursement plan. (a) In general. Under section 105(a), amounts received by an employee through a self-insured medical reimbursement plan which are attributable to contributions of the...

26 CFR 1.105-11 - Self-insured medical reimbursement plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 2 2012-04-01 2012-04-01 false Self-insured medical reimbursement plan. 1.105... Self-insured medical reimbursement plan. (a) In general. Under section 105(a), amounts received by an employee through a self-insured medical reimbursement plan which are attributable to contributions of the...

26 CFR 1.105-11 - Self-insured medical reimbursement plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Self-insured medical reimbursement plan. 1.105... Self-insured medical reimbursement plan. (a) In general. Under section 105(a), amounts received by an employee through a self-insured medical reimbursement plan which are attributable to contributions of the...

26 CFR 1.105-11 - Self-insured medical reimbursement plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 2 2013-04-01 2013-04-01 false Self-insured medical reimbursement plan. 1.105... Self-insured medical reimbursement plan. (a) In general. Under section 105(a), amounts received by an employee through a self-insured medical reimbursement plan which are attributable to contributions of the...

41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Health insurance, life insurance and other benefit plans. 60-250.25 Section 60-250.25 Public Contracts and Property Management... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance...

41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Health insurance, life insurance and other benefit plans. 60-250.25 Section 60-250.25 Public Contracts and Property Management... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance...

41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Health insurance, life insurance and other benefit plans. 60-250.25 Section 60-250.25 Public Contracts and Property Management... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance...

48 CFR 1228.307-1 - Group insurance plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Group insurance plans. 1228.307-1 Section 1228.307-1 Federal Acquisition Regulations System DEPARTMENT OF TRANSPORTATION... basis on proposed purchases of group insurance plans. Legal advice should be sought where necessary on...

45 CFR 149.340 - Rule for insured plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Rule for insured plans. 149.340 Section 149.340 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.340 Rule for insured plans...

45 CFR 149.340 - Rule for insured plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Rule for insured plans. 149.340 Section 149.340 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.340 Rule for insured plans...

Pilot utilization plan for satellite data-based service for agriculture in Poland

NASA Astrophysics Data System (ADS)

Gatkowska, Martyna; Paradowski, Karol; Wróbel, Karolina

2017-10-01

The paper aims at demonstrating the assumptions and achievements of the Pilot Utilization Plan Activities performed within the Project ASAP "Advanced Sustainable Agricultural Production", co-financed by European Space Agency under the ARTES IAP Programme. Within the course of the project, the Pilot Utilization Plan (PilUP) activities are performed in order to develop the remote sensing based models, and further calibrate and validate them in order to achieve the accuracy, which meets the requirements of paying customers. The completion of the first PilUP resulted in development of the following models based of Landsat 8 and Sentinel 2 satellite data: model of homogenous polygons demarcation on the basis of comparison of electromagnetic scanning results and bare soil spectral reflectance, model of problematic areas indication and model for yield potential, delivered on the basis of NDVI map developed 1 month before harvest and the map of yield/collected yield derived from Users participating in PilUP. The second edition of the PilUP is being conducted between March 2017 until the end of 2017. This edition includes farmers and insurance companies. The following activities are planned: development of model for delimitation of loses due to unfavorable wintering of winter crops and validation of the model with in-situ data collected by the insurance companies in-field investigators, further enhancement of the model for homogenous polygons delimitation and primary indication of soil productivity and testing of the applicability and viability of map of problematic areas with the farmers.

Self-Insurance: A Solution for Faculty and Staff Health Promotion? Pilot Study Findings

ERIC Educational Resources Information Center

Giebert, Megan C. H.; Wilson, Kelly L.; Ward, Susan E.

2014-01-01

Faculty and staff health promotion is a cost-saving component of coordinated school health, but little is known about the comprehensiveness of these programs. Self-insured school districts require employees to contribute directly to the district's health insurance pool. The purpose of this pilot study was to identify the prevalence of…

48 CFR 28.307-1 - Group insurance plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... requirement. Under cost-reimbursement contracts, before buying insurance under a group insurance plan, the... other refunds to which the contractor may be entitled in the future shall be taken into account. ...

Are Integrated Plan Providers Associated With Lower Premiums on the Health Insurance Marketplaces?

PubMed

La Forgia, Ambar; Maeda, Jared Lane K; Banthin, Jessica S

2018-04-01

As the health insurance industry becomes more consolidated, hospitals and health systems have started to enter the insurance business. Insurers are also rapidly acquiring providers. Although these "vertically" integrated plan providers are small players in the insurance market, they are becoming more numerous. The health insurance marketplaces (HIMs) offer a unique setting to study integrated plan providers relative to other insurer types because the HIMs were designed to promote competition. In this descriptive study, the authors compared the premiums of the lowest priced silver plans of integrated plan providers with other insurer types on the 2015 and 2016 HIMs. Integrated plan providers were associated with modestly lower premiums relative to most other insurer types. This study provides early insights into premium competition on the HIMs. Examining integrated plan providers as a separate insurer type has important policy implications because they are a growing segment of the marketplaces and their pricing behavior may influence future premium trends.

42 CFR 440.350 - Employer-sponsored insurance health plans.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Employer-sponsored insurance health plans. 440.350 Section 440.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may provide...

42 CFR 440.350 - Employer-sponsored insurance health plans.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Employer-sponsored insurance health plans. 440.350 Section 440.350 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Benchmark-Equivalent Coverage § 440.350 Employer-sponsored insurance health plans. (a) A State may provide...

Evaluating Long-Term Disability Insurance Plans.

ERIC Educational Resources Information Center

Powell, Jan

1992-01-01

This report analyzes the factors involved in reviewing benefits and services of employer-sponsored group long-term disability plans for higher education institutions. Opening sections describe the evolution of disability insurance and its shape today. Further sections looks at the complex nature of "value" within a plan, relationship…

Health Insurance: Understanding Your Health Plan's Rules

MedlinePlus

... Point of service (POS) plan Preferred provider organization (PPO) Rules for selecting doctors and hospitals Managed care ... If you have a POS plan or a PPO, the insurance company will probably pay for you ...

20 CFR 255.9 - Individual enrolled under supplementary medical insurance plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... supplementary medical insurance premiums will be applied toward payment of such premiums, and the balance of the... medical insurance plan. 255.9 Section 255.9 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS... supplementary medical insurance plan. Where recovery of the overpayment is by setoff as provided for in § 255.6...

20 CFR 255.9 - Individual enrolled under supplementary medical insurance plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... supplementary medical insurance premiums will be applied toward payment of such premiums, and the balance of the... medical insurance plan. 255.9 Section 255.9 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS... supplementary medical insurance plan. Where recovery of the overpayment is by setoff as provided for in § 255.6...

20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2014 CFR

2014-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2011 CFR

2011-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

20 CFR 323.2 - Definition of nongovernmental plan for unemployment or sickness insurance.

Code of Federal Regulations, 2012 CFR

2012-04-01

... unemployment or sickness insurance. 323.2 Section 323.2 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.2 Definition of nongovernmental plan for unemployment or sickness insurance. A...

48 CFR 1352.228-76 - Approval of group insurance plans.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Approval of group....228-76 Approval of group insurance plans. As prescribed in 48 CFR 1328.310-70(i), insert the following clause: Approval of Group Insurance Plans (APR 2010) Under cost-reimbursement contracts, before buying...

48 CFR 1352.228-76 - Approval of group insurance plans.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Approval of group....228-76 Approval of group insurance plans. As prescribed in 48 CFR 1328.310-70(i), insert the following clause: Approval of Group Insurance Plans (APR 2010) Under cost-reimbursement contracts, before buying...

Paying for individual health insurance through tax-sheltered cafeteria plans.

PubMed

Hall, Mark A; Monahan, Amy B

2010-01-01

When employees without group health insurance buy individual coverage, they do so using after-tax income--costing them from 20% to 50% more than others pay for equivalent coverage. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA), several states promoted a potential solution that would allow employees to buy individual insurance through tax-sheltered payroll deduction. This technical but creative approach would allow insurers to combine what is known as "list-billing" with a Section 125 "cafeteria plan." However, these state-level reform attempts have failed to gain significant traction because state small-group reform laws and federal restrictions on medical underwriting cloud the legality of tax-sheltered list-billing. Several authorities have taken the position that insurance paid for through a cafeteria plan must meet the nondiscrimination requirements of the Health Insurance Portability and Accountability Act with respect to eligibility, premiums, and benefits. The recently enacted Patient Protection and Affordable Care Act addresses some of the legal uncertainty in this area, but much remains. For health reform to have its greatest effect, federal regulators must clarify whether individual health insurance can be purchased on a pre-tax basis through a cafeteria plan.

24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Issuance and nature of insured 10-year protection plans. 203.203 Section 203.203 Housing and Urban Development Regulations Relating to... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10...

7 CFR 457.139 - Fresh market tomato (dollar plan) crop insurance provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 6 2011-01-01 2011-01-01 false Fresh market tomato (dollar plan) crop insurance... Fresh market tomato (dollar plan) crop insurance provisions. The fresh market tomato (dollar plan) crop...) Both FCIC and Reinsured Policies Fresh market tomato (dollar plan) crop provisions If a conflict exists...

Extending health insurance coverage to the informal sector: Lessons from a private micro health insurance scheme in Lagos, Nigeria.

PubMed

Peterson, Lauren; Comfort, Alison; Hatt, Laurel; van Bastelaer, Thierry

2018-04-15

As a growing number of low- and middle-income countries commit to achieving universal health coverage, one key challenge is how to extend coverage to informal sector workers. Micro health insurance (MHI) provides a potential model to finance health services for this population. This study presents lessons from a pilot study of a mandatory MHI plan offered by a private insurance company and distributed through a microfinance bank to urban, informal sector workers in Lagos, Nigeria. Study methods included a survey of microfinance clients, key informant interviews, and a review of administrative records. Demographic, health care seeking, and willingness-to-pay data suggested that microfinance clients, particularly women, could benefit from a comprehensive MHI plan that improved access to health care and reduced out-of-pocket spending on health services. However, administrative data revealed declining enrollment, and key informant interviews further suggested low use of the health insurance plan. Key implementation challenges, including changes to mandatory enrollment requirements, insufficient client education and marketing, misaligned incentives, and weak back-office systems, undermined enrollment and use of the plan. Mandatory MHI plans, intended to mitigate adverse selection and facilitate private insurers' entry into new markets, present challenges for covering informal sector workers, including when distributed through agents such as a microfinance bank. Properly aligning the incentives of the insurer and the agent are critical to effectively distribute and service insurance. Further, an urban environment presents unique challenges for distributing MHI, addressing client perceptions of health insurance, and meeting their health care needs. Copyright © 2018 John Wiley & Sons, Ltd.

26 CFR 46.4376-1 - Fee on sponsors of self-insured health plans.

Code of Federal Regulations, 2013 CFR

2013-04-01

... capita amount of the National Health Expenditures most recently released by the Department of Health and... 26 Internal Revenue 16 2013-04-01 2013-04-01 false Fee on sponsors of self-insured health plans... (CONTINUED) MISCELLANEOUS EXCISE TAXES EXCISE TAX ON CERTAIN INSURANCE POLICIES, SELF-INSURED HEALTH PLANS...

HUD PowerSaver Pilot Loan Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zimring, Mark; Hoffman, Ian

2010-12-10

The U.S. Department of Housing and Urban Development (HUD) recently announced the creation of a pilot loan program for home energy improvements. The PowerSaver loan program is a new, energy-focused variant of the Title I Property Improvement Loan Insurance Program (Title I Program) and is planned for introduction in early 2011. The PowerSaver pilot will provide lender insurance for secured and unsecured loans up to $25,000 to single family homeowners. These loans will specifically target residential energy efficiency and renewable energy improvements. HUD estimates the two-year pilot will fund approximately 24,000 loans worth up to $300 million; the program ismore » not capped. The Federal Housing Administration (FHA), HUD's mortgage insurance unit, will provide up to $25 million in grants as incentives to participating lenders. FHA is seeking lenders in communities with existing programs for promoting residential energy upgrades.« less

75 FR 70061 - Dealer Floor Plan Pilot Program Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

... SMALL BUSINESS ADMINISTRATION Dealer Floor Plan Pilot Program Meeting AGENCY: U.S. Small Business... location, date, time, and agenda for a meeting regarding the Dealer Floor Plan Pilot Program established in... Plan Pilot Program meeting will be held on November 16, 2010 from approximately 9 a.m. to 12 p.m...

75 FR 45013 - Pre-Existing Condition Insurance Plan Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... provided (an important protection for a program designed to offer coverage to those with a pre-existing... Part II Department of Health and Human Services 45 CFR Part 152 Pre-Existing Condition Insurance... [OCIIO-9995-IFC] RIN 0991-AB71 Pre-Existing Condition Insurance Plan Program AGENCY: Office of Consumer...

Use and reimbursement costs of smoking cessation medication under the Quebec public drug insurance plan.

PubMed

Tremblay, Michèle; Payette, Yves; Montreuil, Annie

2009-01-01

Since October 2000, the nicotine patch, nicotine gum and bupropion have been reimbursed under Quebec's public drug insurance plan. The objective of this study is to describe use of these medications between October 2000 and December 2004 by smokers covered by the public plan, as well as the costs of reimbursing these medications. Data from the Régie de l'assurance maladie du Québec were used to analyze prescriptions for smoking cessation medication issued to persons insured under the public drug insurance plan. Between October 1, 2000, and December 31, 2004, more than 300,000 Quebeckers covered by the public drug insurance plan were reimbursed for smoking cessation medications. This corresponds to a yearly average of 14% of all smokers insured under the public plan. The proportion of employment assistance recipients who used these medications was higher than the proportion of seniors or "other" insurance plan participants. Nicotine patches were the treatment of choice for most users. A total of $55 million was reimbursed by the public drug insurance plan for the nicotine patch, nicotine gum and bupropion over this four-year period. The reimbursement provisions put in place in Quebec in 2000 were successful in reaching financially disadvantaged smokers, at a cost that was comparable with other effective smoking cessation services.

Pilot study of enhanced tobacco-cessation services coverage for low-income smokers.

PubMed

Doescher, Mark P; Whinston, Melicent A; Goo, Alvin; Cummings, Diane; Huntington, Jane; Saver, Barry G

2002-01-01

This study explored the feasibility of covering nicotine replacement therapy (NRT) and paying for pharmacist-delivered smoking cessation counseling at the time of NRT pick-up for low-income, managed Medicaid and Basic Health Plan (a state insurance program) enrollees. A prospective pilot intervention was used at two community health centers (CHCs) and two community pharmacies. Participants were adult managed-Medicaid or Basic Health Plan enrollees who attended the pilot CHCs and smoked. An innovative insurance benefit that included coverage for NRT and $15 payment to the pharmacist to deliver cessation counseling with each prescription fill. Proportion of eligible patients who used the cessation benefit and patient and pharmacist satisfaction with the intervention. During the 9-month intervention, 32 patients at the pilot clinics were referred for NRT and pharmacist-delivered counseling. This number represented roughly 5% of eligible smokers. Of these, 26 received NRT with concomitant pharmacist-delivered cessation counseling at least once. Recipients reported a high level of satisfaction with this intervention. Pharmacists indicated they would continue providing counseling if reimbursement remained adequate and if counseling lasted no longer than 5-10 min. However, 12 (38%) who were referred were no longer insured by the sponsoring plan by the end of the 9-month pilot period. Pharmacist-delivered cessation counseling may be feasible and merits further study. More importantly, this pilot reveals two key obstacles in our low-income, culturally diverse setting: low participation and rapid turnover of insureds. Future interventions will need to address these barriers.

Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare.

PubMed

Handel, Benjamin R; Kolstad, Jonathan T

2015-08-01

Traditional models of insurance choice are predicated on fully informed and rational consumers protecting themselves from exposure to financial risk. In practice, choosing an insurance plan is a complicated decision often made without full information. In this paper we combine new administrative data on health plan choices and claims with unique survey data on consumer information to identify risk preferences, information frictions, and hassle costs. Our additional friction measures are important predictors of choices and meaningfully impact risk preference estimates. We study the implications of counterfactual insurance allocations to illustrate the importance of distinguishing between these micro-foundations for welfare analysis.

75 FR 70159 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... contracts of insurance. The temporary regulations provide guidance to employers, group health plans, and health insurance issuers providing group health insurance coverage. The IRS is issuing the temporary...

Choosing your health insurance package: a method for measuring the public's preferences for changes in the national health insurance plan.

PubMed

Victoor, Aafke; Hansen, Johan; van den Akker-van Marle, M Elske; van den Berg, Bernard; van den Hout, Wilbert B; de Jong, Judith D

2014-08-01

With rising healthcare expenditure and limited budgets available, countries are having to make choices about the content of health insurance plans. The views of the general population can help determine such priorities. In this article, we investigate whether preferences of the general population regarding the content of health insurance plans could be measured with the help of a stated preference method: the Basket Method (BM). In this method, people use an online tool to include or exclude healthcare interventions from their hypothetical insurance package; this then affects their monthly premium. The study was conducted in the Netherlands. In total, 1007 members of two panels managed by the NIVEL filled out an online questionnaire that included the BM. The suitability of the BM was tested with the help of five criteria, e.g. the BM's ability to distinguish between healthcare interventions. Our results suggest that the BM is suitable for measuring preferences of the general population regarding the content of the health insurance plan, as it performs well on most criteria. Policy makers can use these preferences when deciding the content of the health insurance plan. Its contents will then be more aligned to the population's needs and preferences. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

76 FR 37037 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... interim final regulations published July 23, 2010 with respect to group health plans and health insurance..., group health plans, and health insurance issuers providing group health insurance coverage. The text of...

7 CFR 457.139 - Fresh market tomato (dollar plan) crop insurance provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Fresh market tomato (dollar plan) crop insurance provisions. 457.139 Section 457.139 Agriculture Regulations of the Department of Agriculture (Continued) FEDERAL CROP INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.139...

48 CFR 3028.307-1 - Group insurance plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Group insurance plans. 3028.307-1 Section 3028.307-1 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY... advice of legal counsel. ...

76 FR 44491 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... 37208) entitled, ``Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims..., ``Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and... external review processes for group health plans and health insurance issuers offering coverage in the...

Civilian Health Insurance Options of Military Retirees: Findings from a Pilot Survey

DTIC Science & Technology

2007-01-01

while providing important information, was a pilot study with a small sample size. Understanding the potential impact of an increase in TRICARE...that relies on TRICARE—even if they do not currently use TRICARE—is relevant from an actuarial standpoint. Nonusers who view TRICARE as their...primary source of health insurance coverage will pose an actuarial risk if they become unhealthy in the future. Purpose of This Report This report

75 FR 34571 - Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... Group Health Plans and Health Insurance Coverage Rules Relating to Status as a Grandfathered Health Plan... of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human Services... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

PubMed

Wong, Charlene A; Kulhari, Sajal; McGeoch, Ellen J; Jones, Arthur T; Weiner, Janet; Polsky, Daniel; Baker, Tom

2018-05-29

The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the total cost estimates on public versus private exchanges for a standardized consumer. Nearly all studied consumer decision aids saw increased deployment in the public marketplaces in OEP4 compared to OEP3. Over half of the public exchanges (n = 7 of 13) had total cost estimators (versus 5 of 14 in OEP3) in window-shopping and integrated provider lookups (window-shopping: 7; real-shopping: 8). The most common default plan orders were by premium or total cost estimate. Notable features on private health insurance exchanges were unique data presentation (e.g., infographics) and further personalized shopping (e.g., recommended plan flags). Health plan total cost estimates varied substantially between the public and private exchanges (average difference $1526). The ACA's public health insurance exchanges offered more tools in OEP4 to help consumers select a plan. While private health insurance exchanges presented notable features, the total cost estimates for a standardized consumer varied widely on public

75 FR 37242 - Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable... Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health... guidance to employers, group health plans, and health insurance issuers providing group health insurance...

26 CFR 1.412(i)-1 - Certain insurance contract plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... contract plan satisfying the requirements of paragraph (b) and approved for sale in the State where the... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Certain insurance contract plans. 1.412(i)-1...) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.412(i)-1 Certain...

Intelligent Pilot Aids for Flight Re-Planning in Emergencies

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.; Ockerman, Jennifer

2005-01-01

Effective and safe control of an aircraft may be difficult or nearly impossible for a pilot following an unexpected system failure. Without prior training, the pilot must ascertain on the fly those changes in both manual control technique and procedures that will lead to a safe landing of the aircraft. Sophisticated techniques for determining the required control techniques are now available. Likewise, a body of literature on pilot decision making provides formalisms for examining how pilots approach discrete decisions framed as the selection between options. However, other aspects of behavior, such as the task of route planning and guidance, are not as well studied. Not only is the pilot faced with possible performance changes to the aircraft dynamics, but he or she is also tasked to create a plan of actions that will effectively take the aircraft down to a safe landing. In this plan, the many actions that the pilot can perform are closely intertwined with the trajectory of the aircraft, making it difficult to accurately predict the final outcome. Coupled with the vast number of potential actions to be taken, this problem may seem intractable. This is reflected in the lack of a pre-specified procedure capable of giving pilots the ability to find a resolution for this task. This report summarizes a multi-year effort to examine methods to aid pilots in planning an approach and arrival to an airport following an aircraft systems failure. Ultimately, we hypothesize that automatic assistance to pilots can be provided in real-time in the form of improving pilot control of a damaged aircraft and providing pilots with procedural directives suitable for critical flight conditions; such systems may also benefit pilot training and procedure design. To achieve this result, a systematic, comprehensive research program was followed, building on prior research. This approach included a pencil-and-paper study with airline pilots examining methods of representing a flight route in

A modeling framework for optimal long-term care insurance purchase decisions in retirement planning.

PubMed

Gupta, Aparna; Li, Lepeng

2004-05-01

The level of need and costs of obtaining long-term care (LTC) during retired life require that planning for it is an integral part of retirement planning. In this paper, we divide retirement planning into two phases, pre-retirement and post-retirement. On the basis of four interrelated models for health evolution, wealth evolution, LTC insurance premium and coverage, and LTC cost structure, a framework for optimal LTC insurance purchase decisions in the pre-retirement phase is developed. Optimal decisions are obtained by developing a trade-off between post-retirement LTC costs and LTC insurance premiums and coverage. Two-way branching models are used to model stochastic health events and asset returns. The resulting optimization problem is formulated as a dynamic programming problem. We compare the optimal decision under two insurance purchase scenarios: one assumes that insurance is purchased for good and other assumes it may be purchased, relinquished and re-purchased. Sensitivity analysis is performed for the retirement age.

48 CFR 1028.307-1 - Group insurance plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Group insurance plans. 1028.307-1 Section 1028.307-1 Federal Acquisition Regulations System DEPARTMENT OF THE TREASURY GENERAL... submitted to the CO, who must obtain the advice of legal counsel. ...

The Role of Publicly Funded Family Planning Sites In Health Insurance Enrollment.

PubMed

Yarger, Jennifer; Daniel, Sara; Biggs, M Antonia; Malvin, Jan; Brindis, Claire D

2017-06-01

Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance. Weighted univariate and bivariate analyses were conducted to examine enrollment activities and perceived barriers to facilitating enrollment by site characteristics. Most family planning program sites provided eligibility screening (68%), enrollment education (77%), on-site enrollment assistance (55%) and referrals for off-site enrollment support (91%). The proportion of sites offering each type of assistance was highest among community clinics (83-96%), primary care and multispecialty sites (65-95%), Title X-funded sites (72-98%), sites with contracts to provide primary care services (64-93%) and sites using only electronic health records (66-94%). Commonly identified barriers to providing assistance were lack of staff time (reported by 52% of sites), lack of funding (47%), lack of physical space (34%) and lack of staff knowledge (33%); only 20% of sites received funding to support enrollment activities. Although there were significant variations among them, publicly funded family planning providers in California are actively engaged in health insurance enrollment. Supporting their vital role in enrollment could help in the achievement of universal health insurance coverage. Copyright © 2017 by the Guttmacher Institute.

78 FR 25909 - Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium.... SUMMARY: This document contains proposed regulations relating to the health insurance premium tax credit... who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the...

75 FR 34537 - Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... 45 CFR Part 147 Group Health Plans and Health Insurance Coverage Relating to Status as a... for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan... group health plans and health insurance coverage in the group and individual markets under provisions of...

7 CFR 457.128 - Guaranteed production plan of fresh market tomato crop insurance provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Guaranteed production plan of fresh market tomato crop insurance provisions. 457.128 Section 457.128 Agriculture Regulations of the Department of Agriculture (Continued) FEDERAL CROP INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS...

75 FR 27141 - Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-13

... Group Health Plans and Health Insurance Issuers Providing Dependent Coverage of Children to Age 26 Under... Information and Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage...

75 FR 41787 - Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... Requirement for Group Health Plans and Health Insurance Issuers To Provide Coverage of Preventive Services... Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations with respect to group health plans and health insurance coverage offered in...

Plan choice, health insurance cost and premium sharing.

PubMed

Kosteas, Vasilios D; Renna, Francesco

2014-05-01

We develop a model of premium sharing for firms that offer multiple insurance plans. We assume that firms offer one low quality plan and one high quality plan. Under the assumption of wage rigidities we found that the employee's contribution to each plan is an increasing function of that plan's premium. The effect of the other plan's premium is ambiguous. We test our hypothesis using data from the Employer Health Benefit Survey. Restricting the analysis to firms that offer both HMO and PPO plans, we measure the amount of the premium passed on to employees in response to a change in both premiums. We find evidence of large and positive effects of the increase in the plan's premium on the amount of the premium passed on to employees. The effect of the alternative plan's premium is negative but statistically significant only for the PPO plans. Copyright © 2014 Elsevier B.V. All rights reserved.

75 FR 43109 - Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... Requirements for Group Health Plans and Health Insurance Issuers Relating to Internal Claims and Appeals and... the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human... health insurance coverage offered in connection with a group health plan under the Employee Retirement...

Dissemination of a Web-Based Tool for Supporting Health Insurance Plan Decisions (Show Me Health Plans): Cross-Sectional Observational Study.

PubMed

Zhao, Jingsong; Mir, Nageen; Ackermann, Nicole; Kaphingst, Kimberly A; Politi, Mary C

2018-06-20

The rate of uninsured people has decreased dramatically since the Affordable Care Act was passed. To make an informed decision, consumers need assistance to understand the advantages and disadvantages of health insurance plans. The Show Me Health Plans Web-based decision support tool was developed to improve the quality of health insurance selection. In response to the promising effectiveness of Show Me Health Plans in a randomized controlled trial (RCT) and the growing need for Web-based health insurance decision support, the study team used expert recommendations for dissemination and implementation, engaged external stakeholders, and made the Show Me Health Plans tool available to the public. The purpose of this study was to implement the public dissemination of the Show Me Health Plans tool in the state of Missouri and to evaluate its impact compared to the RCT. This study used a cross-sectional observational design. Dissemination phase users were compared with users in the RCT study across the same outcome measures. Time spent using the Show Me Health Plans tool, knowledge, importance rating of 9 health insurance features, and intended plan choice match with algorithm predictions were examined. During the dissemination phase (November 2016 to January 2017), 10,180 individuals visited the SMHP website, and the 1069 users who stayed on the tool for more than one second were included in our analyses. Dissemination phase users were more likely to live outside St. Louis City or County (P<.001), were less likely to be below the federal poverty level (P<.001), and had a higher income (P=.03). Overall, Show Me Health Plans users from St. Louis City or County spent more time on the Show Me Health Plans tool than those from other Missouri counties (P=.04); this association was not observed in the RCT. Total time spent on the tool was not correlated with knowledge scores, which were associated with lower poverty levels (P=.009). The users from the RCT phase were more

Trends in Health Insurance Coverage of Title X Family Planning Program Clients, 2005-2015.

PubMed

Decker, Emily J; Ahrens, Katherine A; Fowler, Christina I; Carter, Marion; Gavin, Loretta; Moskosky, Susan

2018-05-01

The federal Title X Family Planning Program supports the delivery of family planning services and related preventive care to 4 million individuals annually in the United States. The implementation of the 2010 Affordable Care Act's (ACA's) Medicaid expansion and provisions expanding access to health insurance, which took effect in January 2014, resulted in higher rates of health insurance coverage in the U.S. population; the ACA's impact on individuals served by the Title X program has not yet been evaluated. Using administrative data we examined changes in health insurance coverage among Title X clinic patients during 2005-2015. We found that the percentage of clients without health insurance decreased from 60% in 2005 to 48% in 2015, with the greatest annual decrease occurring between 2013 and 2014 (63% to 54%). Meanwhile, between 2005 and 2015, the percentage of clients with Medicaid or other public health insurance increased from 20% to 35% and the percentage of clients with private health insurance increased from 8% to 15%. Although clients attending Title X clinics remained uninsured at substantially higher rates compared with the national average, the increase in clients with health insurance coverage aligns with the implementation of ACA-related provisions to expand access to affordable health insurance.

Designing insurance to promote use of childhood obesity prevention services.

PubMed

Rask, Kimberly J; Gazmararian, Julie A; Kohler, Susan S; Hawley, Jonathan N; Bogard, Jenny; Brown, Victoria A

2013-01-01

Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

Why not private health insurance? 1. Insurance made easy

PubMed Central

Deber, R; Gildiner, A; Baranek, P

1999-01-01

How realistic are proposals to expand the financing of Canadian health care through private insurance, either in a parallel stream or an expanded supplementary tier? Any successful business requires that revenues exceed expenditures. Under a voluntary health insurance plan those at highest risk would be the most likely to seek coverage; insurers working within a competitive market would have to limit their financial risk through such mechanisms as "risk selection" to avoid clients likely to incur high costs and/or imposing caps on the costs covered. It is unlikely that parallel private plans will have a market if a comprehensive public insurance system continues to exist and function well. Although supplementary plans are more congruous with insurance principles, they would raise costs for purchasers and would probably not provide full open-ended coverage to all potential clients. Insurance principles suggest that voluntary insurance plans that shift costs to the private sector would damage the publicly funded system and would be unable to cover costs for all services required. PMID:10497613

Statistical analysis plan of the head position in acute ischemic stroke trial pilot (HEADPOST pilot).

PubMed

Olavarría, Verónica V; Arima, Hisatomi; Anderson, Craig S; Brunser, Alejandro; Muñoz-Venturelli, Paula; Billot, Laurent; Lavados, Pablo M

2017-02-01

Background The HEADPOST Pilot is a proof-of-concept, open, prospective, multicenter, international, cluster randomized, phase IIb controlled trial, with masked outcome assessment. The trial will test if lying flat head position initiated in patients within 12 h of onset of acute ischemic stroke involving the anterior circulation increases cerebral blood flow in the middle cerebral arteries, as measured by transcranial Doppler. The study will also assess the safety and feasibility of patients lying flat for ≥24 h. The trial was conducted in centers in three countries, with ability to perform early transcranial Doppler. A feature of this trial was that patients were randomized to a certain position according to the month of admission to hospital. Objective To outline in detail the predetermined statistical analysis plan for HEADPOST Pilot study. Methods All data collected by participating researchers will be reviewed and formally assessed. Information pertaining to the baseline characteristics of patients, their process of care, and the delivery of treatments will be classified, and for each item, appropriate descriptive statistical analyses are planned with comparisons made between randomized groups. For the outcomes, statistical comparisons to be made between groups are planned and described. Results This statistical analysis plan was developed for the analysis of the results of the HEADPOST Pilot study to be transparent, available, verifiable, and predetermined before data lock. Conclusions We have developed a statistical analysis plan for the HEADPOST Pilot study which is to be followed to avoid analysis bias arising from prior knowledge of the study findings. Trial registration The study is registered under HEADPOST-Pilot, ClinicalTrials.gov Identifier NCT01706094.

Show Me My Health Plans: Using a Decision Aid to Improve Decisions in the Federal Health Insurance Marketplace

PubMed Central

Politi, Mary C.; Kuzemchak, Marie D.; Liu, Jingxia; Barker, Abigail R.; Peters, Ellen; Ubel, Peter A.; Kaphingst, Kimberly A.; McBride, Timothy; Kreuter, Matthew W.; Shacham, Enbal; Philpott, Sydney E.

2017-01-01

Introduction Since the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. Methods We designed and evaluated a decision aid, Show Me My Health Plans (SMHP), that provides education, preference assessment, and an annual out-of-pocket cost calculator with plan recommendations produced by a tailored, risk-adjusted algorithm incorporating age, gender, and health status. We evaluated whether SMHP compared to HealthCare.gov improved health insurance decision quality and the match between plan choice, needs, and preferences among 328 Missourians enrolling in the marketplace. Results Participants who used SMHP had higher health insurance knowledge (LS-Mean = 78 vs. 62; P < 0.001), decision self-efficacy (LS-Mean = 83 vs. 75; P < 0.002), confidence in their choice (LS-Mean = 3.5 vs. 2.9; P < 0.001), and improved health insurance literacy (odds ratio = 2.52, P <0.001) compared to participants using HealthCare.gov. Those using SMHP were 10.3 times more likely to select a silver- or gold-tier plan (P < 0.0001). Discussion SMHP can improve health insurance decision quality and the odds that consumers select an insurance plan with coverage likely needed to meet their health needs. This study represents a unique context through which to apply principles of decision support to improve health insurance choices. PMID:28804780

77 FR 72721 - Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... Research Trust Fund AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY... sponsors of certain self-insured health plans to fund the Patient- Centered Outcomes Research Trust Fund...-Centered Outcomes Research Institute (the ``Institute''). Through research, the Institute will assist...

Do individuals respond to cost-sharing subsidies in their selections of marketplace health insurance plans?

PubMed

DeLeire, Thomas; Chappel, Andre; Finegold, Kenneth; Gee, Emily

2017-12-01

The Affordable Care Act (ACA) provides assistance to low-income consumers through both premium subsidies and cost-sharing reductions (CSRs). Low-income consumers' lack of health insurance literacy or information regarding CSRs may lead them to not take-up CSR benefits for which they are eligible. We use administrative data from 2014 to 2016 on roughly 22 million health insurance plan choices of low-income individuals enrolled in ACA Marketplace coverage to assess whether they behave in a manner consistent with being aware of the availability of CSRs. We take advantage of discontinuous changes in the schedule of CSR benefits to show that consumers are highly sensitive to the value of CSRs when selecting insurance plans and that a very low percentage select dominated plans. These findings suggest that CSR subsidies are salient to consumers and that the program is well designed to account for any lack of health insurance literacy among the low-income population it serves. Copyright © 2017 Elsevier B.V. All rights reserved.

How a new 'public plan' could affect hospitals' finances and private insurance premiums.

PubMed

Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory

2009-01-01

Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.

ADS pilot program Plan

NASA Technical Reports Server (NTRS)

Clauson, J.; Heuser, J.

1981-01-01

The Applications Data Service (ADS) is a system based on an electronic data communications network which will permit scientists to share the data stored in data bases at universities and at government and private installations. It is designed to allow users to readily locate and access high quality, timely data from multiple sources. The ADS Pilot program objectives and the current plans for accomplishing those objectives are described.

Vermont lakes and ponds: a pilot recreation planning process

Treesearch

Daniel T. Malone; John J. Lindsay

1992-01-01

This report analyzes a pilot planning study conducted on two Vermont ponds by University of Vermont outdoor recreation planning students. It discusses the planning process used for these ponds and offers ways in which a statewide lake and pond planning process could be implemented.

29 CFR 2550.401c-1 - Definition of “plan assets”-insurance company general accounts.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 9 2012-07-01 2012-07-01 false Definition of âplan assetsâ-insurance company general... assets”—insurance company general accounts. (a) In general. (1) This section describes, in the case where... policies are supported by assets of an insurance company's general account), which assets held by the...

29 CFR 2550.401c-1 - Definition of “plan assets”-insurance company general accounts.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 9 2014-07-01 2014-07-01 false Definition of âplan assetsâ-insurance company general... assets”—insurance company general accounts. (a) In general. (1) This section describes, in the case where... policies are supported by assets of an insurance company's general account), which assets held by the...

29 CFR 2550.401c-1 - Definition of “plan assets”-insurance company general accounts.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 9 2011-07-01 2011-07-01 false Definition of âplan assetsâ-insurance company general... assets”—insurance company general accounts. (a) In general. (1) This section describes, in the case where... policies are supported by assets of an insurance company's general account), which assets held by the...

29 CFR 2550.401c-1 - Definition of “plan assets”-insurance company general accounts.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false Definition of âplan assetsâ-insurance company general... assets”—insurance company general accounts. (a) In general. (1) This section describes, in the case where... policies are supported by assets of an insurance company's general account), which assets held by the...

The Significant Impact of Different Insurance Enrollment Criteria on the HEDIS Chlamydia Screening Measure for Young Women Enrolled in Medicaid and Commercial Insurance Plans.

PubMed

Patel, Chirag G; Tao, Guoyu

2015-10-01

The impact of length of enrollment in a health plan on eligibility of women under the Healthcare Effectiveness Data and Information Set (HEDIS) chlamydia screening measure is not fully understood. We assessed the representativeness of the measure among the proportion of women aged 15 to 24 years with a gap in coverage for Medicaid and commercial health insurance. Truven Health Marketscan Medicaid and commercial health insurance data from 2006 to 2012 were used to make comparisons between proportions of women with a gap in coverage to those enrolled in insurance plans for different numbers of months. Approximately 48% of Medicaid-insured women and 31% of commercially insured women had an at least 2-month gap that disqualified them from eligibility for inclusion in the HEDIS chlamydia screening measure. Extending eligibility to women with at least 6 months of coverage, regardless of gap, would increase the proportion of insured women included in the HEDIS measure to 76% (from 52%) for Medicaid and 83% (from 69%) for commercial insurance, without much effect on chlamydia testing rate. This would make the measure more representative of all insured women. The large proportion of young women who had a 2-month or greater gap in coverage in Medicaid had a significant impact on the overall representativeness of the current HEDIS chlamydia screening measure.

Connected vehicle pilot deployment program phase 1, deployment outreach plan -- New York City.

DOT National Transportation Integrated Search

2016-07-19

This document is a high level plan that describes the Outreach Plan for the New York City Connected Vehicle Pilot Deployment. The plan defines the communications strategy for the CV Pilot Deployment; identifies roles and responsibilities of persons t...

Still-Born Autonomy Insurance Plan in Quebec: An Example of a Public Long-Term Care Insurance System in Canada.

PubMed

Hébert, Réjean

2016-01-01

Funding long-term care (LTC) is a challenge under the existing Beveridgean universal healthcare system. The Autonomy Insurance (AI) plan developed in Quebec was an attempt to introduce public LTC insurance into our healthcare system. The AI benefit was based on an assessment of the needs of older people and those with disabilities using a disability scale (SMAF) and case-mix classification system (Iso-SMAF Profiles). Under the plan, the benefit would be used to fund public institutions or purchase services from private organizations. Case managers were responsible for assessments and helping users and their families plan services and decide how to use the AI benefit. Funding AI was based on general tax revenues without capitalized funding, under a separate protected budget program. Projections were made for the additional budget needed to support AI, which would have mitigated the forecast increase in LTC spending due to population aging. All the legal, administrative, funding, training and contractual issues were dealt with, for implementation of the plan in April 2015. Unfortunately, the project was still-born for political reasons, but it demonstrates the feasibility of this essential innovation for Canada.

Planning for chronic disease medications in disaster: perspectives from patients, physicians, pharmacists, and insurers.

PubMed

Carameli, Kelley A; Eisenman, David P; Blevins, Joy; d'Angona, Brian; Glik, Deborah C

2013-06-01

Recent US disasters highlight the current imbalance between the high proportion of chronically ill Americans who depend on prescription medications and their lack of medication reserves for disaster preparedness. We examined barriers that Los Angeles County residents with chronic illness experience within the prescription drug procurement system to achieve recommended medication reserves. A mixed methods design included evaluation of insurance pharmacy benefits, focus group interviews with patients, and key informant interviews with physicians, pharmacists, and insurers. Most prescriptions are dispensed as 30-day units through retail pharmacies with refills available after 75% of use, leaving a monthly medication reserve of 7 days. For patients to acquire 14- to 30-day disaster medication reserves, health professionals interviewed supported 60- to 100-day dispensing units. Barriers included restrictive insurance benefits, patients' resistance to mail order, and higher copay-ments. Physicians, pharmacists, and insurers also varied widely in their preparedness planning and collective mutual-aid plans, and most believed pharmacists had the primary responsibility for patients' medication continuity during a disaster. To strengthen prescription drug continuity in disasters, recommendations include the following: (1) creating flexible drug-dispensing policies to help patients build reserves, (2) training professionals to inform patients about disaster planning, and (3) building collaborative partnerships among system stakeholders.

How are state insurance marketplaces shaping health plan design?

PubMed

Rosenbaum, Sara; Lopez, Nancy; Mehta, Devi; Dorley, Mark; Burke, Taylor; Widge, Alicia

2013-12-01

Part of states' roles in administering the new health insurance marketplaces is to certify the health plans available for purchase. This analysis focuses on how state-based and state partnership marketplaces are using their flexibility in setting certification standards to shape plan design in the individual market. It focuses on three aspects of certification: provider networks; inclusion of essential community providers; and benefit substitution, which allows plans to offer benefits that differ from a state's benchmark plan. A review of documents collected from 18 states and the District of Columbia finds that 13 states go beyond the minimum federal requirements with respect to provider network standards, four states specify additional standards for including essential community providers, and five states and Washington, D.C., bar benefit substitution. These interstate variations in plan design reflect the challenges policymakers face in balancing health care affordability, benefit coverage, and access to care through the marketplace plans.

78 FR 32126 - VA Dental Insurance Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN99 VA Dental Insurance Program AGENCY... its regulations to establish rules and procedures for the VA Dental Insurance Program (VADIP), a pilot program that offers premium-based dental insurance to enrolled veterans and certain survivors and...

75 FR 70114 - Amendment to the Interim Final Rules for Group Health Plans and Health Insurance Coverage...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

...This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.

Birth plans and health insurance enrolment of pregnant women: a cross-sectional survey at two secondary health facilities in Lagos, Nigeria.

PubMed

Okusanya, Babasola O; Roberts, Alero A; Akinsola, Oluwatosin J; Oye-Adeniran, Boniface A

2016-01-01

We evaluated birth plans and health insurance enrolment of pregnant women at secondary health care level as a strategy for post-2015 goals. This was a cross-sectional study at two secondary health facilities in Lagos state, Nigeria. A pre-tested questionnaire was used to collect data that were analysed and results presented with frequencies. An overall estimate with 95% confidence interval was used at significant p values of less than 0.05. Five hundred and twenty-four women, with a mean age of 3 0 ± 4.1 years, participated. Most women chose hospital delivery (84%) and had plan for transportation (86.3%) during labour. Few women were well prepared for birth (9.7%) and had health insurance (10.1%). Compared with women without insurance, more health-insured women had plans for transport in labour (p = 0.1383) and identified a place of birth (p = 0.2294), but did not have as much plan for someone to accompany them in the case of an emergency (p = 0.3855) and donate blood (p = 0.5065). Few health insured women saved money for delivery (p = 0.7439). Health insured women did not have better birth plans and expanding pregnant women's access to health insurance may be an insufficient strategy to achieve post MDG 2015 goals.

Mental health and substance abuse insurance parity for federal employees: how did health plans respond?

PubMed

Barry, Colleen L; Ridgely, M Susan

2008-01-01

A fundamental concern with competitive health insurance markets is that they will not supply efficient levels of coverage for treatment of costly, chronic, and predictable illnesses, such as mental illness. Since the inception of employer-based health insurance, coverage for mental health services has been offered on a more limited basis than coverage for general medical services. While mental health advocates view insurance limits as evidence of discrimination, adverse selection and moral hazard can also explain these differences in coverage. The intent of parity regulation is to equalize private insurance coverage for mental and physical illness (an equity concern) and to eliminate wasteful forms of competition due to adverse selection (an efficiency concern). In 2001, a presidential directive requiring comprehensive parity was implemented in the Federal Employees Health Benefits (FEHB) Program. In this study, we examine how health plans responded to the parity directive. Results show that in comparison with a set of unaffected health plans, federal employee plans were significantly more likely to augment managed care through contracts with managed behavioral health "carve-out" firms after parity. This finding helps to explain the absence of an effect of the FEHB Program directive on total spending, and is relevant to the policy debate in Congress over federal parity.

Health Insurance Basics

MedlinePlus

... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?

PubMed

Trish, Erin E; Herring, Bradley J

2015-07-01

The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration. Copyright © 2015 Elsevier B.V. All rights reserved.

Implementing small group health insurance reform: the HEALTHpact plan of Rhode Island.

PubMed

Miller, Edward Alan; Trivedi, Amal N; Kuo, Sylvia; Mor, Vincent

2011-12-01

This study analyzes administrative impediments to enrollment in HEALTHpact, a high-deductible plan with premiums capped at 10% of the average Rhode Island wage. HEALTHpact includes an opportunity for enrollees to reduce their deductibles from $5,000 ($10,000 for a family) to $750 ($1,500 for a family) if they engage in prespecified wellness behaviors. A stakeholder panel was convened to develop guidelines for insurers, which, in turn, were required to develop products satisfying those guidelines. Implementation was examined using stakeholder interviews and archival documents. Results indicate that since no funds were allocated for education and monitoring, there was little opportunity to promote "bottom up" demand or to oversee insurers. They also indicate that both insurers and brokers adopted strategies that inhibited take-up. Providing the resources necessary for effective government oversight and outreach will be critical to small group market reform nationally. So too will be promoting broker and insurer buy-in.

Agriculture Insurance: Adaptation to Vulnerability of Climate Change in Bali, Indonesia

NASA Astrophysics Data System (ADS)

Ambarawati, I. G. A. A.; Hongo, C.; Mirah Adi, A. A. A.; Tamura, E.

2014-12-01

Bali province of Indonesia is worldwide known for its tourist destination and it contributes more than 60 per cent to the regional domestic product. Meanwhile, agricultural sector including rice production still plays an important role in the Bali economy because of its 30 per cent contribution. Rice production in Bali is not just susceptible to loss caused by flood, drought and pest and disease attack but also from the climate change. The impact of climate change on food production in Indonesia is expected to decline in 2050, ranging from 38 per cent to more than ten-folds of the current production (Syaukat, 2011). Accordingly, adaptation to climate changes is required to minimize the risk along with the plans and strategies for food security and sustainable development. The government of Indonesia (GoI) has launched several pilot projects including agriculture insurance program to minimize the risk in production failure particularly rice farming, unfortunately Bali was excluded from the projects. Implementation of agriculture insurance in Indonesia has the legal basis now after the announcement of the Farmer Protection and Empowerment Act (Law No. 19/2013). Agriculture insurance is seen better in mitigating farmer's risk than that of the other program in rice production. The GoI plans to implement the insurance scheme in the beginning of 2015. This scheme is something "new" to farmers in Bali and Indonesia. Considering the importance of crop insurance to agriculture, this study attempts to explore the potential of such insurance to reveal a clear picture of opportunities and challenges in agriculture insurance implementation in Bali. The study empirically presents awareness and perception of farmers towards the insurance and adaptation to vulnerability of climate change. The study concludes with various suggestions for increasing the awareness of farmers for ensuring better penetration of agriculture insurance in Bali. Key words: agriculture insurance, farmer

Insurance Coverage and Clinical Trials

Cancer.gov

Most health insurance plans are required to cover routine patient care costs in clinical trials under certain conditions. Learn about the conditions that insurance plans take into account and how to work with your insurance company.

NYC CV Pilot Deployment : Safety Management Plan : New York City.

DOT National Transportation Integrated Search

2016-04-22

This safety management plan identifies preliminary safety hazards associated with the New York City Connected Vehicle Pilot Deployment project. Each of the hazards is rated, and a plan for managing the risks through detailed design and deployment is ...

Consumer Cost-Sharing in Marketplace vs. Employer Health Insurance Plans, 2015.

PubMed

Gabel, Jon; Whitmore, Heidi; Green, Matthew; Stromberg, Sam; Oran, Rebecca

2015-12-01

Using data from 49 states and Washington, D.C., we analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. We examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance. We found cost-sharing under marketplace plans remained essentially unchanged from 2014 to 2015. Stable premiums during that period do not reflect greater costs borne by enrollees. Further, 56 percent of enrollees in marketplace plans attained cost-sharing reductions in 2015. However, for people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average, while cost-sharing under gold plans is similar employer-based plans on average. Marketplace plans are far more likely than employer-based plans to require enrollees to meet deductibles before they receive coverage for prescription drugs.

78 FR 62441 - VA Dental Insurance Program-Federalism

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AO85 VA Dental Insurance Program... Veterans Affairs (VA) is taking direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and...

78 FR 63143 - VA Dental Insurance Program-Federalism

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AO86 VA Dental Insurance Program... Affairs (VA) proposes to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents...

Diabetes in employer-sponsored health insurance.

PubMed

Peele, Pamela B; Lave, Judith R; Songer, Thomas J

2002-11-01

To examine medical and mental health care expenditures for large numbers of individuals with diabetes enrolled in employment-sponsored insurance plans. Health insurance billing data for approximately 1.3 million individuals enrolled in health insurance plans sponsored by 862 large self-insured employers nationwide were used to examine employer expenditures and consumer out-of-pocket payments for 20,937 people identified with diabetes. These expenditures were compared with expenditures for individuals with other chronic illnesses. Main outcome measures were covered charges, insurance plan reimbursements, and estimated consumer out-of-pocket payments for both medical and mental health services. A total of 1.7% of enrollees were identified as having diabetes and approximately 11% of those used at least one mental health service during 1996. Health care expenditures were three times higher for those with diabetes compared with all health care consumers in these insurance plans, but when compared with individuals with other chronic illnesses such as heart disease, HIV/AIDS, cancer, and asthma, those with diabetes were not more expensive for employers' insurance plans. Diabetes accounts for 6.5% of total health plan expenditures. Diabetes is not more expensive for either consumers or their employer-sponsored insurance plans than other chronic illnesses.

Unmanned Aerial Systems: Air Force and Army Should Improve Strategic Human Capital Planning for Pilot Workforces

DTIC Science & Technology

2017-01-01

UNMANNED AERIAL SYSTEMS Air Force and Army Should Improve Strategic Human Capital Planning for Pilot Workforces...Should Improve Strategic Human Capital Planning for Pilot Workforces What GAO Found The Air Force and the Army have not fully applied four of the five...key principles for effective strategic human capital planning for managing pilots of unmanned aerial systems (UAS) that are important for resolving

Connected Vehicle Pilot Deployment Program Phase 2, Data Management Plan

DOT National Transportation Integrated Search

2017-10-17

This document represents a data management plan that delineates all of the data types and data treatment throughout the New York City Connected Vehicle Pilot Deployment (NYC CVPD). This plan includes an identification of the New York City connected v...

[Spending on private health insurance plans of Brazilian families: a descriptive study with data from the Family Budget Surveys 2002-2003 and 2008-2009].

PubMed

Garcia, Leila Posenato; Ocké-Reis, Carlos Octávio; de Magalhães, Luís Carlos Garcia; Sant'Anna, Ana Claudia; de Freitas, Lúcia Rolim Santana

2015-05-01

Spending on health insurance represents an important share of private expenditure on health in Brazil. The study aimed to describe the evolution of spending on private health insurance plans of Brazilian families, according to their income. Data from the Family Budget Surveys (POF) 2002-2003 and 2008-2009 were used. To compare the spending figures among the surveys, the Consumer Price Index (IPCA) was applied. The proportion of families with private health insurance expenses remained stable in both surveys (2002-2003 and 2008-2009), around 24%. However, the household spending on health insurance plans increased. Among those families who spent money oh health insurance plans, the average spending increased from R$154.35 to R$183.97. The average spending on health insurance plans was greater with increasing household income, as well as portions of the family income and total expenditure committed to these expenses. Spending on health insurance is concentrated among higher-income families, for which it was the main component of total health expenditure.

State insurance exchanges face challenges in offering standardized choices alongside innovative value-based insurance.

PubMed

Corlette, Sabrina; Downs, David; Monahan, Christine H; Yondorf, Barbara

2013-02-01

Value-based insurance is a relatively new approach to health insurance in which financial barriers, such as copayments, are lowered for clinical services that are considered high value, while consumer cost sharing may be increased for services considered to be of uncertain value. Such plans are complex and do not easily fit into the simplified, consumer-friendly comparison tools that many state health insurance exchanges are formulating for use in 2014. Nevertheless some states and plans are attempting to strike the right balance between a streamlined health exchange shopping experience and innovative, albeit complex, benefit design that promotes value. For example, agencies administering exchanges in Vermont and Oregon are contemplating offering value-based insurance plans as an option in addition to a set of standardized plans. In the postreform environment, policy makers must find ways to present complex value-based insurance plans in a way that consumers and employers can more readily understand.

77 FR 33498 - Joint Industry Plans; Order Approving, on a Pilot Basis, the National Market System Plan To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-06

... pilot program, which was implemented through a series of rule filings by the Exchanges and FINRA. This... as a one-year pilot program in two Phases. Phase I of the Plan would be implemented immediately...

Health insurance: how does your plan compare? Plus, a look to new reforms.

PubMed

2012-11-01

A good insurance plan can steer you to the care that helps and away from wasting your time and money on unnecessary tests and treatments. For the third year running, we are presenting health plan rankings from the National Committee for Quality Assurance (NCQA), a nonprofit health care accreditation and quality measurement group, of a record 984 plans on their quality of care, customer satisfaction, and commitment to improvement and disclosure of information. This year, the NCQA ranked 474 private plans (which consumers obtain through a job or purchase on their own), 395 Medicare Advantage plans, and 115 Medicaid HMOs.

Connected Vehicle Pilot Deployment Program Phase 1, Outreach Plan – Tampa (THEA).

DOT National Transportation Integrated Search

2016-07-06

This document presents the Outreach Plan for the Tampa Hillsborough Expressway Authority (THEA) Connected Vehicle (CV) Pilot Deployment. The goal of the pilot deployment is to advance and enable safe, interoperable, networked wireless communications ...

Value-Based Insurance Design Benefit Offsets Reductions In Medication Adherence Associated With Switch To Deductible Plan.

PubMed

Reed, Mary E; Warton, E Margaret; Kim, Eileen; Solomon, Matthew D; Karter, Andrew J

2017-03-01

Enrollment in high-deductible health plans is increasing out-of-pocket spending. But innovative plans that pair deductibles with value-based insurance designs can help preserve low-cost access to high-value treatments for patients by aligning coverage with clinical value. Among adults in high-deductible health plans who were prescribed medications for chronic conditions, we examined what impact a value-based pharmacy benefit that offered free chronic disease medications had on medication adherence. Overall, we found that the value-based plan offset reductions in medication adherence associated with switching to a deductible plan. The value-based plan appeared particularly beneficial for patients who started with low levels of medication adherence. Patients with additional clinical complexity or vulnerable populations living in neighborhoods with lower socioeconomic status, however, did not show adherence improvements and might not be taking advantage of value-based insurance design provisions. Additional efforts may be needed to educate patients about their nuanced benefit plans to help overcome initial confusion about these complex plans. Project HOPE—The People-to-People Health Foundation, Inc.

Optional deductibles in social health insurance systems: findings from Germany.

PubMed

Pütz, Claudia; Hagist, Christian

2006-12-01

A fundamental aspect of the German health insurance system is the principle of solidarity. At the same time, it is possible for certain socio-economic groups to opt out of the otherwise compulsory system. To determine whether rates incorporating deductibles are compatible with the principles of solidarity and have the ability to heighten the appeal of statutory health insurance (SHI) funds compared with private health insurance companies, Germany's third largest SHI fund, Techniker Krankenkasse, implemented a pilot scheme involving the use of deductibles. Preliminary scientific evaluations of the pilot scheme indicate three main results for these deductibles: Firstly, they are compatible with the principles of solidarity in the statutory health insurance system; secondly, they provide an effective means of preventing defection to private health insurance companies and thirdly, they reduced the volume of insurance claims (moral hazard).

Structure of the physical therapy benefit in a typical Blue Cross Blue Shield preferred provider organization plan available in the individual insurance market in 2011.

PubMed

Sandstrom, Robert W; Lehman, Jedd; Hahn, Lee; Ballard, Andrew

2013-10-01

The Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer-sponsored plans. The purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011. A cross-sectional survey design was used. The physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit. Physical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered. The results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied. Physical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.

Health insurance coverage and use of family planning services among current and former foster youth: implications of the health care reform law.

PubMed

Dworsky, Amy; Ahrens, Kym; Courtney, Mark

2013-04-01

This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population.

The cost of unintended pregnancies for employer-sponsored health insurance plans.

PubMed

Dieguez, Gabriela; Pyenson, Bruce S; Law, Amy W; Lynen, Richard; Trussell, James

2015-04-01

Pregnancy is associated with a significant cost for employers providing health insurance benefits to their employees. The latest study on the topic was published in 2002, estimating the unintended pregnancy rate for women covered by employer-sponsored insurance benefits to be approximately 29%. The primary objective of this study was to update the cost of unintended pregnancy to employer-sponsored health insurance plans with current data. The secondary objective was to develop a regression model to identify the factors and associated magnitude that contribute to unintended pregnancies in the employee benefits population. We developed stepwise multinomial logistic regression models using data from a national survey on maternal attitudes about pregnancy before and shortly after giving birth. The survey was conducted by the Centers for Disease Control and Prevention through mail and via telephone interviews between 2009 and 2011 of women who had had a live birth. The regression models were then applied to a large commercial health claims database from the Truven Health MarketScan to retrospectively assign the probability of pregnancy intention to each delivery. Based on the MarketScan database, we estimate that among employer-sponsored health insurance plans, 28.8% of pregnancies are unintended, which is consistent with national findings of 29% in a survey by the Centers for Disease Control and Prevention. These unintended pregnancies account for 27.4% of the annual delivery costs to employers in the United States, or approximately 1% of the typical employer's health benefits spending for 1 year. Using these findings, we present a regression model that employers could apply to their claims data to identify the risk for unintended pregnancies in their health insurance population. The availability of coverage for contraception without employee cost-sharing, as was required by the Affordable Care Act in 2012, combined with the ability to identify women who are at high

The Cost of Unintended Pregnancies for Employer-Sponsored Health Insurance Plans

PubMed Central

Dieguez, Gabriela; Pyenson, Bruce S.; Law, Amy W.; Lynen, Richard; Trussell, James

2015-01-01

Background Pregnancy is associated with a significant cost for employers providing health insurance benefits to their employees. The latest study on the topic was published in 2002, estimating the unintended pregnancy rate for women covered by employer-sponsored insurance benefits to be approximately 29%. Objectives The primary objective of this study was to update the cost of unintended pregnancy to employer-sponsored health insurance plans with current data. The secondary objective was to develop a regression model to identify the factors and associated magnitude that contribute to unintended pregnancies in the employee benefits population. Methods We developed stepwise multinomial logistic regression models using data from a national survey on maternal attitudes about pregnancy before and shortly after giving birth. The survey was conducted by the Centers for Disease Control and Prevention through mail and via telephone interviews between 2009 and 2011 of women who had had a live birth. The regression models were then applied to a large commercial health claims database from the Truven Health MarketScan to retrospectively assign the probability of pregnancy intention to each delivery. Results Based on the MarketScan database, we estimate that among employer-sponsored health insurance plans, 28.8% of pregnancies are unintended, which is consistent with national findings of 29% in a survey by the Centers for Disease Control and Prevention. These unintended pregnancies account for 27.4% of the annual delivery costs to employers in the United States, or approximately 1% of the typical employer's health benefits spending for 1 year. Using these findings, we present a regression model that employers could apply to their claims data to identify the risk for unintended pregnancies in their health insurance population. Conclusion The availability of coverage for contraception without employee cost-sharing, as was required by the Affordable Care Act in 2012, combined with

How Do Health Insurer Market Concentration and Bargaining Power with Hospitals Affect Health Insurance Premiums?

PubMed Central

Trish, Erin E.; Herring, Bradley J.

2017-01-01

The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006–2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans’ transactions with employers and the other concentration measure representing insurers’ bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration. PMID:25910690

7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Insured 10-Year Home Warranty Plan Requirements L...-Year Home Warranty Plan Requirements I. Purpose In recent years, numerous third-party home warranty... and/or major structural defects in their homes. This exhibit establishes the criteria and procedures...

7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Insured 10-Year Home Warranty Plan Requirements L...-Year Home Warranty Plan Requirements I. Purpose In recent years, numerous third-party home warranty... and/or major structural defects in their homes. This exhibit establishes the criteria and procedures...

The Financial Impact of Advanced Kidney Disease on Canada Pension Plan and Private Disability Insurance Costs.

PubMed

Manns, Braden; McKenzie, Susan Q; Au, Flora; Gignac, Pamela M; Geller, Lawrence Ian

2017-01-01

Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown. The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs. This study used an analytical model combining Canadian data from various sources. This study included all patients with advanced CKD in Canada, including those with estimated glomerular filtration rate (eGFR) <30 mL/min/m 2 and those on dialysis. We combined disability estimates from a provincial kidney care program with the prevalence of advanced CKD and estimated disability payments from the Canada Pension Plan and private insurance plans to estimate overall disability benefit payments for Canadians with advanced CKD. We estimate that Canadians with advanced kidney failure are receiving disability benefit payments of at least Can$217 million annually. These estimates are sensitive to the proportion of individuals with advanced kidney disease who are unable to work, and plausible variation in this estimate could mean patients with advanced kidney disease are receiving up to Can$260 million per year. Feasible strategies to reduce the proportion of individuals with advanced kidney disease, either through prevention, delay or reduction in severity, or increasing the rate of transplantation, could result in reductions in the cost of Canada Pension Plan and private disability insurance payments by Can$13.8 million per year within 5 years. This study does not estimate how CKD prevention or increasing the rate of kidney

Addressing health care market reform through an insurance exchange: essential policy components, the public plan option, and other issues to consider.

PubMed

Fronstin, Paul; Ross, Murray N

2009-06-01

HEALTH INSURANCE EXCHANGE: This Issue Brief examines issues related to managed competition and the use of a health insurance exchange for the purpose of addressing cost, quality, and access to health care services. It discusses issues that must be addressed when designing an exchange in order to reform the health insurance market and also examines state efforts at health reform that use an exchange. RISK VS. PRICE COMPETITION: The basic component of managed competition is the creation an organized marketplace that brings together health insurers and consumers (either as individuals or through their employers). The sponsor of the exchange would set "rules of engagement" for participating insurers and offer consumers a menu of choices among different plans. Ultimately, the goal of a health insurance exchange is to shift the market from competition based on risk to competition based on price and quality. ADVERSE SELECTION AND AFFORDABILITY: Among the issues that need to be addressed if an exchange that uses managed competition has a realistic chance of reducing costs, improving quality, and expanding coverage: Everyone needs to be in the risk pool, with individuals required to purchase insurance or face significant financial consequences; effective risk adjustment is essential to eliminate risk selection as an insurance business model--forcing competition on costs and quality; the insurance benefit must be specific and clear--without standards governing cost sharing, covered services, and network coverage there is no way to assess whether a requirement to purchase or issue coverage has been met; and subsidies would be necessary for low-income individuals to purchase insurance. THE PUBLIC PLAN OPTION: The public plan option is shaping up to be one of the most contentious issues in the health reform debate. Proponents also believe of a public plan is necessary to drive private insurers toward true competition. Opponents view it as a step toward government-run health

Smart Choice Health Insurance©: A New, Interdisciplinary Program to Enhance Health Insurance Literacy.

PubMed

Brown, Virginia; Russell, Mia; Ginter, Amanda; Braun, Bonnie; Little, Lynn; Pippidis, Maria; McCoy, Teresa

2016-03-01

Smart Choice Health Insurance© is a consumer education program based on the definition and emerging measurement of health insurance literacy and a review of literature and appropriate theoretical frameworks. An interdisciplinary team of financial and health educators was formed to develop and pilot the program, with the goal of reducing confusion and increasing confidence in the consumer's ability to make a smart health insurance decision. Educators in seven states, certified to teach the program, conducted workshops for 994 consumers. Results show statistically significant evidence of increased health insurance literacy, confidence, and capacity to make a smart choice health insurance choice. Discussion centers on the impact the program had on specific groups, next steps to reach a larger audience, and implications for educators, consumers, and policymakers nationwide. © 2015 Society for Public Health Education.

Health Insurance Coverage and Use of Family Planning Services among Current and Former Foster Youth: Implications of the Health Care Reform Law

PubMed Central

Dworsky, Amy; Ahrens, Kym; Courtney, Mark

2013-01-01

This research uses data from a longitudinal study to examine how two provisions in the Patient Protection and Affordable Care Act could affect health insurance coverage among young women who have aged out of foster care. It also explores how allowing young people to remain in foster care until age twenty-one affects their health insurance coverage, use of family planning services, and information about birth control. We find that young women are more likely to have health insurance if they remain in foster care until their twenty-first birthday and that having health insurance is associated with an increase in the likelihood of receiving family planning services. Our results also suggest that many young women who would otherwise lack health insurance after aging out of foster care will be eligible for Medicaid under the health care reform law. Because having health insurance is associated with use of family planning services, this increase in Medicaid eligibility may result in fewer unintended pregnancies among this high-risk population. PMID:23262773

Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit. Final regulations.

PubMed

2015-12-18

This document contains final regulations on the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, and the Department of Defense and Full-Year Continuing Appropriations Act, 2011. These final regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges, sometimes called Marketplaces) and claim the health insurance premium tax credit, and Exchanges that make qualified health plans available to individuals and employers.

Aviation and insurance

NASA Technical Reports Server (NTRS)

Mayo, R H

1922-01-01

This article considers some of the causes which hinder the development of aircraft insurance. Different risks are discussed as well as the causes of aircraft accidents. Pilot error, poor airdromes, weather conditions, poorly adapted airplanes, and engine failures are all examined and some conclusions are made.

Connected vehicle pilot deployment program phase 1, safety management plan – Tampa (THEA).

DOT National Transportation Integrated Search

2016-04-01

This document presents the Safety Management Plan for the THEA Connected Vehicle (CV) Pilot Deployment. The THEA CV Pilot Deployment goal is to advance and enable safe, interoperable, networked wireless communications among vehicles, the infrastructu...

Insurance against climate change and flood risk: Insurability and decision processes of insurers

NASA Astrophysics Data System (ADS)

Hung, Hung-Chih; Hung, Jia-Yi

2016-04-01

1. Background Major portions of the Asia-Pacific region is facing escalating exposure and vulnerability to climate change and flood-related extremes. This highlights an arduous challenge for public agencies to improve existing risk management strategies. Conventionally, governmental funding was majorly responsible and accountable for disaster loss compensation in the developing countries in Asia, such as Taiwan. This is often criticized as an ineffective and inefficient measure of dealing with flood risk. Flood insurance is one option within the toolkit of risk-sharing arrangement and adaptation strategy to flood risk. However, there are numerous potential barriers for insurance companies to cover flood damage, which would cause the flood risk is regarded as uninsurable. This study thus aims to examine attitudes within the insurers about the viability of flood insurance, the decision-making processes of pricing flood insurance and their determinants, as well as to examine potential solutions to encourage flood insurance. 2. Methods and data Using expected-utility theory, an insurance agent-based decision-making model was developed to examine the insurers' attitudes towards the insurability of flood risk, and to scrutinize the factors that influence their decisions on flood insurance premium-setting. This model particularly focuses on how insurers price insurance when they face either uncertainty or ambiguity about the probability and loss of a particular flood event occurring. This study considers the factors that are expected to affect insures' decisions on underwriting and pricing insurance are their risk perception, attitudes towards flood insurance, governmental measures (e.g., land-use planning, building codes, risk communication), expected probabilities and losses of devastating flooding events, as well as insurance companies' attributes. To elicit insurers' utilities about premium-setting for insurance coverage, the 'certainty equivalent,' 'probability

Growth and variability in health plan premiums in the individual insurance market before the Affordable Care Act.

PubMed

Gruber, Jonathan

2014-06-01

Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law. Using rates of increase in the individual insurance market collected from state regulators, this issue brief documents trends in premium growth in the pre-ACA period. From 2008 to 2010, premiums grew by 10 percent or more per year. This growth was also highly variable across states, and even more variable across insurance plans within states. The study suggests that evaluating trends in premiums requires looking across a broad array of states and plans, and that policymakers must examine how present and future changes in premium rates compare with the more than 10 percent per year premium increases in the years preceding health reform.

The Financial Impact of Advanced Kidney Disease on Canada Pension Plan and Private Disability Insurance Costs

PubMed Central

Manns, Braden; McKenzie, Susan Q.; Au, Flora; Gignac, Pamela M.; Geller, Lawrence Ian

2017-01-01

Background: Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown. Objective: The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs. Design: This study used an analytical model combining Canadian data from various sources. Setting and Patients: This study included all patients with advanced CKD in Canada, including those with estimated glomerular filtration rate (eGFR) <30 mL/min/m2 and those on dialysis. Measurements: We combined disability estimates from a provincial kidney care program with the prevalence of advanced CKD and estimated disability payments from the Canada Pension Plan and private insurance plans to estimate overall disability benefit payments for Canadians with advanced CKD. Results: We estimate that Canadians with advanced kidney failure are receiving disability benefit payments of at least Can$217 million annually. These estimates are sensitive to the proportion of individuals with advanced kidney disease who are unable to work, and plausible variation in this estimate could mean patients with advanced kidney disease are receiving up to Can$260 million per year. Feasible strategies to reduce the proportion of individuals with advanced kidney disease, either through prevention, delay or reduction in severity, or increasing the rate of transplantation, could result in reductions in the cost of Canada Pension Plan and private disability insurance payments by Can$13.8 million per year within 5 years. Limitations

Tobacco Surcharges on 2015 Health Insurance Plans Sold in Federally Facilitated Marketplaces: Variations by Age and Geography and Implications for Health Equity.

PubMed

Liber, Alex C; Drope, Jeffrey M; Graetz, Ilana; Waters, Teresa M; Kaplan, Cameron M

2015-11-01

In 2014, few health insurance plans sold in the Affordable Care Act's Federally Facilitated Marketplaces had age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plans implementing tobacco surcharges that increase with age. This underscores concerns that older tobacco users will find postsubsidy health insurance premiums difficult to afford. Future monitoring of enrollment will determine whether tobacco surcharges cause adverse selection by dissuading tobacco users, particularly older users, from buying health insurance.

Farmers Insures Success

ERIC Educational Resources Information Center

Freifeld, Lorri

2012-01-01

Farmers Insurance claims the No. 2 spot on the Training Top 125 with a forward-thinking training strategy linked to its primary mission: FarmersFuture 2020. It's not surprising an insurance company would have an insurance policy for the future. But Farmers takes that strategy one step further, setting its sights on 2020 with a far-reaching plan to…

Reducing Unintended Pregnancies Through Web-Based Reproductive Life Planning and Contraceptive Action Planning among Privately Insured Women: Study Protocol for the MyNewOptions Randomized, Controlled Trial.

PubMed

Chuang, Cynthia H; Velott, Diana L; Weisman, Carol S; Sciamanna, Christopher N; Legro, Richard S; Chinchilli, Vernon M; Moos, Merry-K; Francis, Erica B; Confer, Lindsay N; Lehman, Erik B; Armitage, Christopher J

2015-01-01

The Affordable Care Act mandates that most women of reproductive age with private health insurance have full contraceptive coverage with no out-of-pocket costs, creating an actionable time for women to evaluate their contraceptive choices without cost considerations. The MyNewOptions study is a three-arm, randomized, controlled trial testing web-based interventions aimed at assisting privately insured women with making contraceptive choices that are consistent with their reproductive goals. Privately insured women between the ages of 18 and 40 not intending pregnancy were randomly assigned to one of three groups: 1) a reproductive life planning (RLP) intervention, 2) a reproductive life planning enriched with contraceptive action planning (RLP+) intervention, or 3) an information only control group. Both the RLP and RLP+ guide women to identify their individualized reproductive goals and contraceptive method requirements. The RLP+ additionally includes a contraceptive action planning component, which uses if-then scenarios that allow the user to problem solve situations that make it difficult to be adherent to their contraceptive method. All three groups have access to a reproductive options library containing information about their contraceptive coverage and the attributes of alternative contraceptive methods. Women completed a baseline survey with follow-up surveys every 6 months for 2 years concurrent with intervention boosters. Study outcomes include contraceptive use and adherence. ClinicalTrials.gov identifier: NCT02100124. Results from the MyNewOptions study will demonstrate whether web-based reproductive life planning, with or without contraceptive action planning, helps insured women make patient-centered contraceptive choices compared with an information-only control condition. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

26 CFR 1.72-16 - Life insurance contracts purchased under qualified employee plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

... includible in the gross income of the employee under this paragraph shall be considered as premiums or other... in Gross Income § 1.72-16 Life insurance contracts purchased under qualified employee plans. (a) Applicability of section. This section provides rules for the tax treatment of premiums paid under qualified...

Three years in - changing plan features in the U.S. health insurance marketplace.

PubMed

McKillop, Caitlin N; Waters, Teresa M; Kaplan, Cameron M; Kaplan, Erin K; Thompson, Michael P; Graetz, Ilana

2018-06-15

A central objective of recent U.S. healthcare policy reform, most notably the Affordable Care Act's (ACA) Health Insurance Marketplace, has been to increase access to stable, affordable health insurance. However, changing market dynamics (rising premiums, changes in issuer participation and plan availability) raise significant concerns about the marketplaces' ability to provide a stable source of healthcare for Americans that rely on them. By looking at the effect of instability on changes in the consumer choice set, we can analyze potential incentives to switch plans among price-sensitive enrollees, which can then be used to inform policy going forward. Data on health plan features for non-tobacco users in 2512 counties in 34 states participating in federally-facilitated exchanges from 2014 to 2016 was obtained from the Centers for Medicaid & Medicare Services. We examined how changes in individual plan features, including premiums, deductibles, issuers, and plan types, impact consumers who had purchased the lowest-cost silver or bronze plan in their county the previous year. We calculated the cost of staying in the same plan versus switching to another plan the following year, and analyzed how costs vary across geographic regions. In most counties in 2015 and 2016 (53.7 and 68.2%, respectively), the lowest-cost silver plan from the previous year was still available, but was no longer the cheapest plan. In these counties, consumers who switched to the new lowest-cost plan would pay less in monthly premiums on average, by $51.48 and $55.01, respectively, compared to staying in the same plan. Despite potential premium savings from switching, however, the majority would still pay higher average premiums compared to the previous year, and most would face higher deductibles and an increased probability of having to change provider networks. While the ACA has shown promise in expanding healthcare access, continued changes in the availability and affordability of health

Private Health Insurance Exchanges

PubMed Central

Buttorff, Christine; Nowak, Sarah; Syme, James; Eibner, Christine

2017-01-01

Abstract Private health insurance exchanges offer employer health insurance, combining online shopping, increased plan choice, benefit administration, and cost-containment strategies. This article examines how private exchanges function, how they may affect employers and employees, and the possible implications for the Affordable Care Act's (ACA's) Small Business Health Options Program (SHOP) Marketplaces. The authors found that private exchanges could encourage employees to select less-generous plans. This could expose employees to higher out-of-pocket costs, but premium contributions would drop substantially, so net spending would decrease. On the other hand, employee spending may increase if, in moving to private exchanges, employers decrease their health insurance contributions. Most employers can avoid the ACA's “Cadillac tax” by reducing the generosity of the plans they offer, regardless of whether they move to a private exchange. There is not yet enough evidence to determine whether the private exchanges will become prominent in the insurance market and how they will affect employers and their employees. PMID:28845340

Family Planning for Inner-City Adolescent Males: Pilot Study.

ERIC Educational Resources Information Center

Reis, Janet; And Others

1987-01-01

Describes a pilot family planning program in an inner-city pediatric practice. Male adolescents were more likely to accept contraceptives if the provider first raised the topic of birth control to them. Identified a desire for anonymity/confidentiality and embarrassment or discomfort as the key reasons for not seeking contraceptives. Emphasizes…

Advance care treatment plan (ACT-Plan) for African American family caregivers: a pilot study.

PubMed

Bonner, Gloria J; Wang, Edward; Wilkie, Diana J; Ferrans, Carol E; Dancy, Barbara; Watkins, Yashika

2014-01-01

Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. Cardiopulmonary resuscitation, mechanical ventilation, and tube feeding were end-of-life treatments discussed in the ACT-Plan. In a four-week pre/posttest two-group design at urban adult day care centers, 68 caregivers were assigned to the ACT-Plan or attention-control health promotion conditions. Findings strongly suggest that the ACT-Plan intervention is feasible and appropriate for African American caregivers. Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.

The Pilot Land Data System: Report of the Program Planning Workshops

NASA Technical Reports Server (NTRS)

1984-01-01

An advisory report to be used by NASA in developing a program plan for a Pilot Land Data System (PLDS) was developed. The purpose of the PLDS is to improve the ability of NASA and NASA sponsored researchers to conduct land-related research. The goal of the planning workshops was to provide and coordinate planning and concept development between the land related science and computer science disciplines, to discuss the architecture of the PLDs, requirements for information science technology, and system evaluation. The findings and recommendations of the Working Group are presented. The pilot program establishes a limited scale distributed information system to explore scientific, technical, and management approaches to satisfying the needs of the land science community. The PLDS paves the way for a land data system to improve data access, processing, transfer, and analysis, which land sciences information synthesis occurs on a scale not previously permitted because of limits to data assembly and access.

Patient Protection and Affordable Care Act; establishment of the multi-state plan program for the Affordable Insurance Exchanges.

PubMed

2013-03-11

The U.S. Office of Personnel Management (OPM) is issuing a final regulation establishing the Multi-State Plan Program (MSPP) pursuant to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Through contracts with OPM, health insurance issuers will offer at least two multi-State plans (MSPs) on each of the Affordable Insurance Exchanges (Exchanges). One of the issuers must be non-profit. Under the law, an MSPP issuer may phase in the States in which it offers coverage over 4 years, but it must offer MSPs on Exchanges in all States and the District of Columbia by the fourth year in which the MSPP issuer participates in the MSPP. This rule aims to balance adhering to the statutory goals of MSPP while aligning its standards to those applying to qualified health plans to promote a level playing field across health plans.

ARCHITECTURAL FLOOR PLAN OF PROCESS AND ACCESS AREAS HOT PILOT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ARCHITECTURAL FLOOR PLAN OF PROCESS AND ACCESS AREAS HOT PILOT PLANT (CPP-640). INL DRAWING NUMBER 200-0640-00-279-111679. ALTERNATE ID NUMBER 8952-CPP-640-A-2. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

ARCHITECTURAL ROOF PLAN AND WESTSOUTHEAST ELEVATIONS OF HOT PILOT PLANT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ARCHITECTURAL ROOF PLAN AND WEST-SOUTHEAST ELEVATIONS OF HOT PILOT PLANT (CPP-640). INL DRAWING NUMBER 200-0640-00-279-111680. ALTERNATE ID NUMBER 8952-CPP-640-A-3. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

Competition between health maintenance organizations and nonintegrated health insurance companies in health insurance markets.

PubMed

Baranes, Edmond; Bardey, David

2015-12-01

This article examines a model of competition between two types of health insurer: Health Maintenance Organizations (HMOs) and nonintegrated insurers. HMOs vertically integrate health care providers and pay them at a competitive price, while nonintegrated health insurers work as indemnity plans and pay the health care providers freely chosen by policyholders at a wholesale price. Such difference is referred to as an input price effect which, at first glance, favors HMOs. Moreover, we assume that policyholders place a positive value on the provider diversity supplied by their health insurance plan and that this value increases with the probability of disease. Due to the restricted choice of health care providers in HMOs a risk segmentation occurs: policyholders who choose nonintegrated health insurers are characterized by higher risk, which also tends to favor HMOs. Our equilibrium analysis reveals that the equilibrium allocation only depends on the number of HMOs in the case of exclusivity contracts between HMOs and providers. Surprisingly, our model shows that the interplay between risk segmentation and input price effects may generate ambiguous results. More precisely, we reveal that vertical integration in health insurance markets may decrease health insurers' premiums.

Estimating a Change from TRICARE to Commercial Insurance Plans.

PubMed

Murray, Carla T; Schmit, Matthew

2018-03-14

We estimate the effect on health care spending of an option to change TRICARE. Under the option, which is based on a proposal made by the Military Compensation and Retirement Modernization Commission (MCRMC), most beneficiaries could choose from a range of commercial health networks instead of the current TRICARE plans. Military treatment facilities would become network providers under the commercial plans. We used data from the Department of Defense (DoD) to estimate the cost of providing the current health care benefit to working-age retirees and their dependents and survivors, and active duty family members. We then adjusted those data to estimate what the private insurance premiums would be for those groups. Greater details about the methodology can be found in earlier work by the Congressional Budget Office. Because payments by TRICARE to physicians and hospitals are tied to payments made by Medicare, we used the information from studies that compare Medicare payment rates to rates paid to doctors and hospitals by private insurance to estimate what it would cost private insurers to provide approximately the same level of care, with adjustments to account for the higher out-of-pocket costs that beneficiaries would pay under the option. We also made adjustments to account for the possibility that many beneficiaries would decrease their use of the MTFs in favor of private providers, which could increase the overall costs of DoD. We then estimated that increasing the cost sharing to a level found in popular civilian plans would lower overall demand for services by about 10% for military retiree households and about 18% for active duty family members. We estimated that DoD would pay subsidies to retain about half of the excess capacity created by beneficiaries switching their care from MTFs to the private sector. Evaluated at the midpoint of the ranges, the net effect on DoD's budget would be approximately $0, we estimate, but costs could fall in a likely range

78 FR 38483 - Area Risk Protection Insurance Regulations and Area Risk Protection Insurance Crop Provisions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

...The Federal Crop Insurance Corporation (FCIC) finalizes the Area Risk Protection Insurance (ARPI) Basic Provisions, ARPI Barley Crop Insurance Provisions, ARPI Corn Crop Insurance Provisions, ARPI Cotton Crop Insurance Provisions, ARPI Forage Crop Insurance Provisions, ARPI Grain Sorghum Crop Insurance Provisions, ARPI Peanut Crop Insurance Provisions, ARPI Soybean Crop Insurance Provisions, and ARPI Wheat Crop Insurance Provisions to provide area yield protection and area revenue protection. These provisions will replace the Group Risk Plan (GRP) provisions in 7 CFR part 407, which includes the: GRP Basic Provisions, GRP Barley Crop Provisions, GRP Corn Crop Provisions, GRP Cotton Crop Provisions, GRP Forage Crop Provisions, GRP Peanut Crop Provisions, GRP Sorghum Crop Provisions, GRP Soybean Crop Provisions, and GRP Wheat Crop Provisions. The ARPI provisions will also replace the Group Risk Income Protection (GRIP) Basic Provisions, the GRIP Crop Provisions, and the GRIP-Harvest Revenue Option (GRIP-HRO). The GRP and GRIP plans of insurance will no longer be available. The intended effect of this action is to offer producers a choice of Area Revenue Protection, Area Revenue Protection with the Harvest Price Exclusion, or Area Yield Protection, all within one Basic Provision and the applicable Crop Provisions. This will reduce the amount of information producers must read to determine the best risk management tool for their operation and will improve the provisions to better meet the needs of insureds. The changes will apply for the 2014 and succeeding crop years.

Insurance-related Practices at Title X-funded Family Planning Centers under the Affordable Care Act: Survey and Interview Findings.

PubMed

Zolna, Mia R; Kavanaugh, Megan L; Hasstedt, Kinsey

Given the recent reforms in the United States health care system, including the passage and implementation of the Affordable Care Act, as well as anticipated upcoming changes to health care coverage, it is critical that publicly funded health care providers understand how to effectively work with their states' Medicaid programs and the private health insurance plans in their service areas to provide high-quality contraceptive care to the millions of women relying on services at these sites annually. We collected survey data from a nationally representative sample of 535 clinics providing family planning services that received Title X funding and conducted semistructured interviews with 23 administrators at a subsample of surveyed clinics to explore provider-reported experiences working with health plans and to identify barriers to, and practices that lead to, adequate reimbursement for services provided. Providers report that knowledgeable staff are crucial to securing contracts with both public and private insurance plan issuers, and that the contracts they secure often include coverage restrictions on methods or services clinics offer their clients. Good staff relationships with issuers are key to obtaining adequate and consistent reimbursement for all covered services. Providers are trying to understand how insurance programs in their area knit together. Regardless of how U.S. health policies and delivery systems may change in the coming years, it is imperative that publicly funded family planning centers continue to work with health plans and maximize their third-party revenue to provide services to those in need. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Insurance-related Practices at Title X-funded Family Planning Centers under the Affordable Care Act: Survey and Interview Findings

PubMed Central

Zolna, Mia R.; Kavanaugh, Megan L.; Hasstedt, Kinsey

2018-01-01

Introduction Given the recent reforms in the United States health care system, including the passage and implementation of the Affordable Care Act, as well as anticipated upcoming changes to health care coverage, it is critical that publicly funded health care providers understand how to effectively work with their states’ Medicaid programs and the private health insurance plans in their service areas to provide high-quality contraceptive care to the millions of women relying on services at these sites annually. Methods We collected survey data from a nationally representative sample of 535 clinics providing family planning services that received Title X funding and conducted semistructured interviews with 23 administrators at a subsample of surveyed clinics to explore provider-reported experiences working with health plans and to identify barriers to, and practices that lead to, adequate reimbursement for services provided. Results Providers report that knowledgeable staff are crucial to securing contracts with both public and private insurance plan issuers, and that the contracts they secure often include coverage restrictions on methods or services clinics offer their clients. Good staff relationships with issuers are key to obtaining adequate and consistent reimbursement for all covered services. Conclusions Providers are trying to understand how insurance programs in their area knit together. Regardless of how U.S. health policies and delivery systems may change in the coming years, it is imperative that publicly funded family planning centers continue to work with health plans and maximize their third-party revenue to provide services to those in need. PMID:29108987

Studies of planning behavior of aircraft pilots in normal, abnormal and emergency situations

NASA Technical Reports Server (NTRS)

Johannsen, G.; Rouse, W. B.; Hillmann, K.

1981-01-01

A methodology for the study of planning is presented and the results of applying the methodology within two experimental investigations of planning behavior of aircraft pilots in normal, abnormal, and emergency situations are discussed. Beyond showing that the methodology yields consistent results, these experiments also lead to concepts in terms of a dichotomy between event driven and time driven planning, subtle effects of automation on planning, and the relationship of planning to workload and flight performance.

Developing Tsunami Evacuation Plans, Maps, And Procedures: Pilot Project in Central America

NASA Astrophysics Data System (ADS)

Arcos, N. P.; Kong, L. S. L.; Arcas, D.; Aliaga, B.; Coetzee, D.; Leonard, J.

2015-12-01

In the End-to-End tsunami warning chain, once a forecast is provided and a warning alert issued, communities must know what to do and where to go. The 'where to' answer would be reliable and practical community-level tsunami evacuation maps. Following the Exercise Pacific Wave 2011, a questionnaire was sent to the 46 Member States of Pacific Tsunami Warning System (PTWS). The results revealed over 42 percent of Member States lacked tsunami mass coastal evacuation plans. Additionally, a significant gap in mapping was exposed as over 55 percent of Member States lacked tsunami evacuation maps, routes, signs and assembly points. Thereby, a significant portion of countries in the Pacific lack appropriate tsunami planning and mapping for their at-risk coastal communities. While a variety of tools exist to establish tsunami inundation areas, these are inconsistent while a methodology has not been developed to assist countries develop tsunami evacuation maps, plans, and procedures. The International Tsunami Information Center (ITIC) and partners is leading a Pilot Project in Honduras demonstrating that globally standardized tools and methodologies can be applied by a country, with minimal tsunami warning and mitigation resources, towards the determination of tsunami inundation areas and subsequently community-owned tsunami evacuation maps and plans for at-risk communities. The Pilot involves a 1- to 2-year long process centered on a series of linked tsunami training workshops on: evacuation planning, evacuation map development, inundation modeling and map creation, tsunami warning & emergency response Standard Operating Procedures (SOPs), and conducting tsunami exercises (including evacuation). The Pilot's completion is capped with a UNESCO/IOC document so that other countries can replicate the process in their tsunami-prone communities.

7 CFR Exhibit L to Subpart A of... - Insured 10-Year Home Warranty Plan Requirements

Code of Federal Regulations, 2010 CFR

2010-01-01

..., construction inspection procedures, coverage provided and claims procedures. (5) A sample copy of the warranty... AGENCY, DEPARTMENT OF AGRICULTURE PROGRAM REGULATIONS CONSTRUCTION AND REPAIR Planning and Performing Construction and Other Development Pt. 1924, Subpt. A, Exh. L Exhibit L to Subpart A of Part 1924—Insured 10...

[The contradictions between the universal Unified Health System and the transfer of public funds to private health plans and insurances].

PubMed

Bahia, Ligia

2008-01-01

Trailing the whole group of trends and changes in the scenario of relations between the public and the private, this article analyses the effects of the rise in the rates of return of health plan operators and health insurance companies in 2007. Special attention is given to the segmentation of the system, the complaints about the naturalization of inequitable access to health services and to the depreciation of the original concepts of the Unified Health System. The study also gathers information regarding the production of knowledge about supplementary care with the intent to systemize the bases and methodological approaches adopted by a selected sub-group of scientific papers. Finally, the article develops conjectures and hypotheses with regard to possible associations between growth and stability of the health plan and insurance market and as refers to the nature of scientific production about this issue, taking into consideration the contradictions between the political and economical circuit in which the health plan and insurance companies are operating and the universality of the Brazilian Health System.

Connected Vehicle Pilot Deployment Program phase 1 : application deployment plan : New York City : final application deployment plan.

DOT National Transportation Integrated Search

2016-08-04

This document is the Task 7 Application Deployment Plan deliverable for the New York City Connected Vehicle Pilot Deployment. It describes the process that the deployment team will follow to acquire and test the connected vehicle safety applications....

Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

PubMed

Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

2004-05-12

Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

Intelligent Pilot Aids for Flight Re-Planning in Emergencies

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.

2002-01-01

Experimental studies were conducted with pilots to investigate the attributes of automation that would be appropriate for aiding pilots in emergencies. The specific focus of this year was on methods of mitigating automation brittleness. Brittleness occurs when the automatic system is used in circumstances it was not designed for, causing it to choose an incorrect action or make an inaccurate decision for the situation. Brittleness is impossible to avoid since it is impossible to predict every potential situation the automatic system will be exposed to over its life. However, operators are always ultimately responsible for the actions and decisions of the automation they are monitoring or using, which means they must evaluate the automation's decisions and actions for accuracy. As has been pointed out, this is a difficult thing for human operators to do. There have been various suggestions as to how to aid operators with this evaluation. In the study described in this report we studied how presentation of contextual information about an automatic system's decision might impact the ability of the human operators to evaluate that decision. This study focused on the planning of emergency descents. Fortunately, emergencies (e.g., mechanical or electrical malfunction, on-board fire, and medical emergency) happen quite rarely. However, they can be catastrophic when they do. For all predictable or conceivable emergencies, pilots have emergency procedures that they are trained on, but those procedures often end with 'determine suitable airport and land as quickly as possible.' Planning an emergency descent to an unplanned airport is a difficult task, particularly under the time pressures of an emergency. Automatic decision aids could be very efficient at the task of determining an appropriate airport and calculating an optimal trajectory to that airport. This information could be conveyed to the pilot through an emergency descent procedure listing all of the actions

Five features of value-based insurance design plans were associated with higher rates of medication adherence.

PubMed

Choudhry, Niteesh K; Fischer, Michael A; Smith, Benjamin F; Brill, Gregory; Girdish, Charmaine; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

2014-03-01

Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence. Existing plans have been structured in a variety of ways, and these variations could influence the effectiveness of VBID plans. We evaluated seventy-six plans introduced by a large pharmacy benefit manager during 2007-10. We found that after we adjusted for the other features and baseline trends, VBID plans that were more generous, targeted high-risk patients, offered wellness programs, did not offer disease management programs, and made the benefit available only for medication ordered by mail had a significantly greater impact on adherence than plans without these features. The effects were as large as 4-5 percentage points. These findings can provide guidance for the structure of future VBID plans.

Examining the influence of health insurance literacy and perception on the people preference to purchase private voluntary health insurance.

PubMed

Mathur, Tanuj; Das, Gurudas; Gupta, Hemendra

2018-01-01

Most studies have associated "un-affordability" as a plausible cause for the lower take-up of private voluntary health insurance plans. However, others refuted this claim on the pretext that when people can afford "inpatient-care" from pocket then insurance premium cost is far less than those payments. Thus, economic factors remain insufficient in clearly explaining the reason for poor private voluntary health insurance take-up. An attempt is being made by shifting the focus towards non-economic factors and understanding the role of perception and health insurance literacy in transforming people preferences to invest in private voluntary health insurance plans. The study findings will conspicuously support decision-makers in developing strategy to increase the private voluntary health insurance take-up.

Pilot-scale treatability test plan for the 200-BP-5 operable unit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This document presents the treatability test plan for pilot-scale pump and treat testing at the 200-BP-5 Operable Unit. This treatability test plan has been prepared in response to an agreement between the U.S. Department of Energy (DOE), the U.S. Environmental Protection Agency (EPA), and the State of Washington Department of Ecology (Ecology), as documented in Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement, Ecology et al. 1989a) Change Control Form M-13-93-03 (Ecology et al. 1994) and a recent 200 NPL Agreement Change Control Form (Appendix A). The agreement also requires that, following completion of the activities described in thismore » test plan, a 200-BP-5 Operable Unit Interim Remedial Measure (IRM) Proposed Plan be developed for use in preparing an Interim Action Record of Decision (ROD). The IRM Proposed Plan will be supported by the results of this treatability test plan, as well as by other 200-BP-5 Operable Unit activities (e.g., development of a qualitative risk assessment). Once issued, the Interim Action ROD will specify the interim action(s) for groundwater contamination at the 200-BP-5 Operable Unit. The treatability test approach is to conduct a pilot-scale pump and treat test for each of the two contaminant plumes associated with the 200-BP-5 Operable Unit. Primary contaminants of concern are {sup 99}Tc and {sup 60}Co for underwater affected by past discharges to the 216-BY Cribs, and {sup 90}Sr, {sup 239/240}Pu, and Cs for groundwater affected by past discharges to the 216-B-5 Reverse Well. The purpose of the pilot-scale treatability testing presented in this testplan is to provide the data basis for preparing an IRM Proposed Plan. To achieve this objective, treatability testing must: Assess the performance of groundwater pumping with respect to the ability to extract a significant amount of the primary contaminant mass present in the two contaminant plumes.« less

Group Health Insurance Plans for Public-School Personnel, 1964-65.

ERIC Educational Resources Information Center

National Education Association, Washington, DC.

This report explains the major considerations in developing group health insurance coverage for public school personnel. A general overview is given of (1) group health insurance coverage, (2) patterns of group health insurance, (3) group health insurance organizations, (4) eligibility and enrollment practices, and (5) continuous health insurance…

Pricing behaviour of nonprofit insurers in a weakly competitive social health insurance market.

PubMed

Douven, Rudy C H M; Schut, Frederik T

2011-03-01

In this paper we examine the pricing behaviour of nonprofit health insurers in the Dutch social health insurance market. Since for-profit insurers were not allowed in this market, potential spillover effects from the presence of for-profit insurers on the behaviour of nonprofit insurers were absent. Using a panel data set for all health insurers operating in the Dutch social health insurance market over the period 1996-2004, we estimate a premium model to determine which factors explain the price setting behaviour of nonprofit health insurers. We find that financial stability rather than profit maximisation offers the best explanation for health plan pricing behaviour. In the presence of weak price competition, health insurers did not set premiums to maximize profits. Nevertheless, our findings suggest that regulations on financial reserves are needed to restrict premiums. Copyright © 2011 Elsevier B.V. All rights reserved.

ARCHITECTURAL FLOOR PLAN OF OPERATING AREA HOT PILOT PLANT (CPP640). ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ARCHITECTURAL FLOOR PLAN OF OPERATING AREA HOT PILOT PLANT (CPP-640). INL DRAWING NUMBER 200-0640-00-279-111678. ALTERNATE ID NUMBER 8952-CPP-640-A-1. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

Plan Selection in the Non-Group Market in the First Year of the Health Insurance Marketplace.

PubMed

Gillen, Emily; Lich, Kristen Hassmiller; Trantham, Laurel; Silberman, Pam; Weinberger, Morris; Holmes, Mark

2017-01-01

BACKGROUND The Affordable Care Act (ACA)-created Marketplaces reduced barriers to entry in the non-group health insurance market. Although tax credits were available to individuals who enrolled in qualified health plans (QHPs) beginning in 2014, many individuals chose not to switch plans. We examined characteristics associated with switching from a non-ACA compliant plan to a QHP in 2014 and, conditional on switching, the characteristics associated with selection of a specific plan level. METHODS Using claims data from a large commercial insurer, we examined characteristics associated with switching to a QHP in 2014. For those who did switch, we used a multinomial logit model to estimate odds of selecting different metal levels-representing varying degrees of coverage-for a group of the highest and lowest risk individuals. RESULTS We found individuals most likely to benefit from the premium and benefit requirements on QHPs were more likely to switch to QHPs. Individuals at high-risk for high health care expenditures who had advance premium tax credits (APTCs) had lower odds of choosing a less generous plan compared to individuals without APTCs (odds of bronze plan over silver: 0.40, CI: 0.30 - 0.55), while individuals at low-risk of being high cost with APTCs were more likely to select a plan with a lower premium (odds bronze plan over silver: 1.35, CI: 1.09 - 1.66). LIMITATIONS This study was conducted with data from 1 health plan, limiting its national generalizability; however, this study is a good representation of activity within the state. CONCLUSIONS APTCs are important for ensuring that less healthy individuals are able to afford adequate levels of coverage. ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Adverse Selection in Community Based Health Insurance among Informal Workers in Bangladesh: An EQ-5D Assessment

PubMed Central

Sarker, Abdur Razzaque; Sultana, Marufa; Chakrovorty, Sanchita; Khan, Jahangir A. M.

2018-01-01

Community-based Health Insurance (CBHI) schemes are recommended for providing financial risk protection to low-income informal workers in Bangladesh. We assessed the problem of adverse selection in a pilot CBHI scheme in this context. In total, 1292 (646 insured and 646 uninsured) respondents were surveyed using the Bengali version of the EuroQuol-5 dimensions (EQ-5D) questionnaire for assessing their health status. The EQ-5D scores were estimated using available regional tariffs. Multiple logistic regression was applied for predicting the association between health status and CBHI scheme enrolment. A higher number of insured reported problems in mobility (7.3%; p = 0.002); self-care (7.1%; p = 0.000) and pain and discomfort (7.7%; p = 0.005) than uninsured. The average EQ-5D score was significantly lower among the insured (0.704) compared to the uninsured (0.749). The regression analysis showed that those who had a problem in mobility (OR = 1.65; 95% CI: 1.25–2.17); self-care (OR = 2.29; 95% CI: 1.62–3.25) and pain and discomfort (OR = 1.43; 95% CI: 1.13–1.81) were more likely to join the scheme. Individuals with higher EQ-5D scores (OR = 0.46; 95% CI: 0.31–0.69) were less likely to enroll in the scheme. Given that adverse selection was evident in the pilot CBHI scheme, there should be consideration of this problem when planning scale-up of these kind of schemes. PMID:29385072

76 FR 46621 - Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

...This document contains amendments to the interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.

Genetics and Personal Insurance: the Perspectives of Canadian Cancer Genetic Counselors.

PubMed

Lane, Michelle; Ngueng Feze, Ida; Joly, Yann

2015-12-01

Genetic discrimination in the context of genetic testing has been identified as a concern for symptomatic and asymptomatic individuals for more than three decades. Genetic counselors are often the health care professionals who discuss risks and benefits of genetic testing with patients, thereby making them most appropriate to address patient concerns about genetics and personal insurance (i.e., life, life as related to mortgage or group insurance, disability, critical illness and travel). A pilot study was conducted to ascertain the current practices of Canadian cancer genetic counselors in regard to their discussions with patients about genetic testing and access to personal insurance. Among the 36 counselors surveyed, 100 % reported discussing the issue of genetic testing and personal insurance with their patients. Several factors influenced the content, depth and length of these discussions including age, cancer status, family members, and patients' current and future insurance needs. Counselors reported discussing with patients the possible impact of genetic test results on access to personal insurance, possible access and use of patient genetic information by insurance companies, and whom patients should contact if they have additional questions. The most commonly reported inquiries from patients included questions about the possible impact of genetic testing on their ability to obtain insurance, and the insurability of family members. While 28 % of counselors reported having been contacted by an insurer requesting access to patient information, only one counselor was aware of or could recall the outcome of such a request. This pilot study revealed that issues concerning genetics and personal insurance are commonly discussed in Canadian cancer genetic counseling sessions. Counselors furthermore expressed a need for additional educational resources on the topic of genetics and personal insurance for themselves and their patients.

Self-insurance and the potential effects of health reform on the small-group market.

PubMed

Linehan, Kathryn

2010-12-21

The Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care Education Reconciliation Act of 2010 makes landmark changes to health insurance markets. Individual and small-group insurance plans and markets will see the biggest changes, but PPACA also affects large employer and self-insured plans by imposing rules for benefit design and health plan practices. Over half of workers--most often those in very large firms--are covered by self-insured health plans in which employers (or employee groups) bear all or some of the risk of providing insurance coverage to a defined population of workers and their dependents. As PPACA provisions become effective, some have argued that smaller firms that offer insurance may opt to self-insure their health benefits because of new small-group market rules. Such a shift could affect risk pooling in the small-group market. This paper examines the definition and prevalence of self-insured health plans, the application of PPACA provisions to these plans, and the possible effects on the broader health insurance market, should many more employers decide to self-insure.

Connected Vehicle Pilot Deployment Program phase 1 : performance measurement and evaluation support plan : Tampa (THEA) : final report.

DOT National Transportation Integrated Search

2016-03-14

The Performance Measurement and Evaluation Support Plan for the Connected Vehicle Pilot Deployment Program Phase 1, Tampa Hillsborough Expressway Authority, outlines the goals and objectives for the Pilot as well as the proposed performance metrics. ...

Seeing Health Insurance and HealthCare.gov Through the Eyes of Young Adults.

PubMed

Wong, Charlene A; Asch, David A; Vinoya, Cjloe M; Ford, Carol A; Baker, Tom; Town, Robert; Merchant, Raina M

2015-08-01

We describe young adults' perspectives on health insurance and HealthCare.gov, including their attitudes toward health insurance, health insurance literacy, and benefit and plan preferences. We observed young adults aged 19-30 years in Philadelphia from January to March 2014 as they shopped for health insurance on HealthCare.gov. Participants were then interviewed to elicit their perceived advantages and disadvantages of insurance and factors considered important for plan selection. A 1-month follow-up interview assessed participants' plan enrollment decisions and intended use of health insurance. Data were analyzed using qualitative methodology, and salience scores were calculated for free-listing responses. We enrolled 33 highly educated young adults; 27 completed the follow-up interview. The most salient advantages of health insurance for young adults were access to preventive or primary care (salience score .28) and peace of mind (.27). The most salient disadvantage was the financial strain of paying for health insurance (.72). Participants revealed poor health insurance literacy with 48% incorrectly defining deductible and 78% incorrectly defining coinsurance. The most salient factors reported to influence plan selection were deductible (.48) and premium (.45) amounts as well as preventive care (.21) coverage. The most common intended health insurance use was primary care. Eight participants enrolled in HealthCare.gov plans: six selected silver plans, and three qualified for tax credits. Young adults' perspective on health insurance and enrollment via HealthCare.gov can inform strategies to design health insurance plans and communication about these plans in a way that engages and meets the needs of young adult populations. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Dental insurance! Are we ready?

PubMed

Toor, Ravi S S; Jindal, R

2011-01-01

Dental insurance is insurance designed to pay the costs associated with dental care. The Foreign Direct Investment (FDI) bill which was put forward in the winter session of the Lok Sabha (2008) focused on increasing the foreign investment share from the existing 26% to 49% in the insurance companies of India. This will allow the multibillion dollar international insurance companies to enter the Indian market and subsequently cover all aspects of insurance in India. Dental insurance will be an integral a part of this system. Dental insurance is a new concept in Southeast Asia as very few countries in Southeast Asia cover this aspect of insurance. It is important that the dentists in India should be acquainted with the different types of plans these companies are going to offer and about a new relationship which is going to emerge in the coming years between dentist, patient and the insurance company.

Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty.

PubMed

Korenman, Sanders D; Remler, Dahlia K

2016-12-01

We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM) - a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources - and we discuss its limitations. Building on the Census Bureau's Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot demonstrates the practicality, face validity and value of a HIPM. Results suggest that public health insurance benefits and premium subsidies accounted for a substantial, one-third reduction in the health inclusive poverty rate. Copyright © 2016 Elsevier B.V. All rights reserved.

Is Access to Outpatient Neurosurgery Affected by Narrow Insurance Networks? Results From Statewide Analysis of Marketplace Plans in Louisiana.

PubMed

Dossani, Rimal H; Kalakoti, Piyush; Nanda, Anil; Guthikonda, Bharat; Tumialán, Luis M

2018-02-06

The main objective of the Affordable Care Act (ACA) was to make health insurance affordable to all Americans while addressing the lack of coverage for 48 million people. In the face of rapidly increasing enrollment and rising demand for inexpensive plans, insurance providers are limiting in-network physicians. Provider networks offering plans with limited in-network physicians have become known as "narrow networks." To assesses the adequacy of ACA marketplace plans for outpatient neurosurgery in Louisiana. The Marketplace Public Use Files were searched for all "silver" plans. A total of 7 silver plans were identified in Louisiana. Using the plans' online directories, a search of in-network neurosurgeons in Louisiana parishes with >100 000 population was performed. The primary outcome was lack of in-network neurosurgeon(s) in silver plans within 50 miles of selected zip code for each parish with >100 000 population. Plans without in-network neurosurgeon(s) are labeled as neurosurgeon-deficient plans. Several plans in Louisiana are neurosurgeon deficient, ie no in-network neurosurgeon within 50 miles of the designated parish zip code. Company A's plan 3 is deficient in all 5 parishes, while company C and company D silver plans are deficient in 4 out of 14 (29%). Combined results from all counties and plans demonstrate that 43% (3 out of 7) of all silver plans in Louisiana are neurosurgeon deficient in at least 4 parishes with population >100 000. In Louisiana, narrow networks have limited access to neurosurgical care for those patients with ACA silver plans. Copyright © 2018 by the Congress of Neurological Surgeons

[Quality Assurance in Sociomedical Evaluation by Peer Review: A Pilot Project of the German Statutory Pension Insurance].

PubMed

Strahl, A; Gerlich, C; Wolf, H-D; Gehrke, J; Müller-Garnn, A; Vogel, H

2016-03-01

The sociomedical evaluation by the German Pension Insurance serves the purpose of determining entitlement to disability pensions. A quality assurance concept for the sociomedical evaluation was developed, which is based on a peer Review process. Peer review is an established process of external quality assurance in health care. The review is based on a hierarchically constructed manual that was evaluated in this pilot project. The database consists of 260 medical reports for disability pension of 12 pension insurance agencies. 771 reviews from 19 peers were included in the evaluation of the inter-rater reliability. Kendall's coefficient of concordance W for more than 2 raters is used as primary measure of inter-rater reliability. Reliability appeared to be heterogeneous. Kendalls W varies for the particular criteria from 0.09 to 0.88 and reached for primary criterion reproducibility a value of 0.37. The reliability of the manual seemed acceptable in the context of existing research data and is in line with existing peer review research outcomes. Nevertheless, the concordance is limited and requires optimisation. Starting points for improvement can be seen in a systematic training and regular user meetings of the peers involved. © Georg Thieme Verlag KG Stuttgart · New York.

Legislations and policies to expand mental health and substance abuse benefits in health insurance plans: a community guide systematic economic review.

PubMed

Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A; Goetzel, Ron Z; Finnie, Ramona; Thota, Anilkrishna B

2015-03-01

Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. This review is unable to determine the overall economic value of policies that expanded MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when long-term MH/SA patient-level data becomes available to researchers. A

Medicaid: Legislation Needed to Improve Collections From Private Insurers

DTIC Science & Technology

1990-11-01

health care coverage include health and liability insurers, ERISA plans, employee welfare benefit plans, workers ’ compen- sation plans, and Medicare. Up to...your office, we focused our Dint SPeaial review on out-of-stabc insurers and employee health benefit plans cov- ered under the Employee Retirement...labor organizations, and other employee organizations that wish to4 .establish welfare benefit plans, which may include health benefits, must meet

Health insurance and use of medical services by men infected with HIV.

PubMed

Katz, M H; Chang, S W; Buchbinder, S P; Hessol, N A; O'Malley, P; Doll, L S

1995-01-01

Among 178 HIV-infected men from the San Francisco City Clinic Cohort (SFCCC), we examined the association between health insurance and use of outpatient services and treatment. For men with private insurance, we also assessed the frequency of avoiding the use of health insurance. Men without private insurance reported fewer outpatient visits than men with fee-for-service or managed-care plans. Use of zidovudine for eligible men was similar for those with fee-for-service plans (74%), managed-care plans (77%), or no insurance (61%). Use of Pneumocytstis carinii pneumonia prophylaxis was similar for those with fee-for-service (93%) and managed-care plans (83%) but lower for those with no insurance (63%). Of 149 men with private insurance, 31 (21%) reported that they had avoided using their health insurance for medical expenses in the previous year. In multivariate analysis, the independent predictors of avoiding the use of insurance were working for a small company and living outside the San Francisco Bay Area. Having private insurance resulted in higher use of outpatient services, but the type of private insurance did not appear to affect the use of service or treatment. Fears of loss of coverage and confidentiality may negate some benefits of health insurance for HIV-infected persons.

Choosing the 'best' plan in a health insurance exchange: actuarial value tells only part of the story.

PubMed

Lore, Ryan; Gabel, Jon R; McDevitt, Roland; Slover, Michael

2012-08-01

In the health insurance exchanges that will come online in 2014, consumers will be able to compare health plans with respect to actuarial value, or the percentage of health care costs that a plan would pay for a standard population. This analysis illustrates the out-of-pocket costs that might result from plans with various plan designs and actuarial values. We find that average out-of-pocket expense declines as actuarial values rise, but two plans with similar actuarial values can produce very different outcomes for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies. Actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person.

Insurance Exchange Marketplace: Implications for Emergency Medicine Practice

PubMed Central

Rankey, David S.

2012-01-01

The Patient Protection and Affordable Care Act of 2010 requires states to establish healthcare insurance exchanges by 2014 to facilitate the purchase of qualified health plans. States are required to establish exchanges for small businesses and individuals. A federally operated exchange will be established, and states failing to participate in any other exchanges will be mandated to join the federal exchange. Policymakers and health economists believe that exchanges will improve healthcare at lower cost by promoting competition among insurers and by reducing burdensome transaction costs. Consumers will no longer be isolated from monthly insurance premium costs. Exchanges will increase the number of patients insured with more cost-conscious managed care and high-deductible plans. These insurance plan models have historically undervalued emergency medical services, while also underinsuring patients and limiting their healthcare system access to the emergency department. This paradoxically increases demand for emergency services while decreasing supply. The continual devaluation of emergency medical services by insurance payers will result in inadequate distribution of resources to emergency care, resulting in further emergency department closures, increases in emergency department crowding, and the demise of acute care services provided to families and communities. PMID:22900107

Nonprofit to for-profit conversions by hospitals, health insurers, and health plans.

PubMed

Needleman, J

1999-01-01

Conversion of hospitals, health insurers, and health plans from nonprofit to for-profit ownership has become a focus of national debate. The author examines why nonprofit ownership has been dominant in the US health system and assesses the strength of the argument that nonprofits provide community benefits that would be threatened by for-profit conversion. The author concludes that many of the specific community benefits offered by nonprofits, such as care for the poor, could be maintained or replaced by adequate funding of public programs and that quality and fairness in treatment can be better assured through clear standards of care and adequate monitoring systems. As health care becomes increasingly commercialized, the most difficult parts of nonprofits' historic mission to preserve are the community orientation, leadership role, and innovation that nonprofit hospitals and health plans have provided out of their commitment to a community beyond those to whom they sell services.

76 FR 37207 - Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

...This document contains amendments to interim final regulations implementing the requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets under provisions of the Affordable Care Act. These rules are intended to respond to feedback from a wide range of stakeholders on the interim final regulations and to assist plans and issuers in coming into full compliance with the law through an orderly and expeditious implementation process.

Health insurance reform and the development of health insurance plans: the case of the Emirate of Abu Dhabi, UAE.

PubMed

Hamidi, Samer; Shaban, Sami; Mahate, Ashraf A; Younis, Mustafa Z

2014-01-01

The Emirate of Abu Dhabi has taken concrete steps to reform health insurance by improving the access to health providers as well as freedom of choice. The growing cost of health care and the impact of the global financial crisis have meant that countries are no longer able to solely bear the cost. As a result many countries have sought to overhaul their health care system so as to share the burden of provision with the private sector whether it is health care plan providers or employers. This article explores and discusses how the policy issues inherent in private health care schemes have been dealt with by the Emirate of Abu Dhabi. Data was collected in early 2013 on health care plans in Abu Dhabi from government sources. The Abu Dhabi model has private sector involvement but the government sets prices and benefits. The Abu Dhabi model adequately deals with the problem of adverse selection through making insurance coverage a mandatory requirement. There are issues with moral hazards, which are a combination of individual and medical practitioner behavior that might affect the efficiency of the system. Over time there is a general increase in the usage of medical services, which may be reflective of greater awareness of the policy and its benefits as well as lifestyle change. Although the current health care system level of usage is adequate for the current population, as the level of usage increases, the government may face a financial burden. Therefore, the government needs to place safeguards in order to limit its exposure. The market for medical treatment needs to be made more competitive to reduce monopolistic behavior. The government needs to make individuals aware of a healthier lifestyle and encourage precautionary actions.

Amendment to the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Amendment to interim final rules with request for comments.

PubMed

2010-11-17

This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.

Pediatric access to dermatologists: Medicaid versus private insurance.

PubMed

Chaudhry, Sofia B; Armbrecht, Eric S; Shin, Yoon; Matula, Sarah; Caffrey, Charles; Varade, Reena; Jones, Lisa; Siegfried, Elaine

2013-05-01

There is disparity in access to outpatient care for Medicaid beneficiaries. This inequity disproportionately impacts children. Access for children with skin disease may be especially limited. We sought to compare access to dermatologists for new pediatric patients insured by Medicaid versus a private plan. We surveyed 13 metropolitan markets by conducting secret-shopper scripted telephone calls to dermatology providers listed by Medicaid health plans. Paired calls, differing by insurance type, were made to each office on the same day, portraying a parent requesting a new appointment for a child with eczema. We called the offices of 723 Medicaid-listed providers. Final analysis included 471 dermatologists practicing general dermatology. Of these, an average of 44% refused a new Medicaid-insured pediatric patient. The average wait time for an appointment did not significantly vary between insurance types. Assuming that dermatologists not listed as Medicaid providers do not see Medicaid-insured children, our data indicate that pediatric Medicaid acceptance rates ranged from 6% to 64% by market, with an overall market size-weighted average acceptance rate of 19%. Relative reimbursement levels for Medicaid-insured patients did not correlate with acceptance rates. Although the most current health plan directories were used to create calling lists, these are dynamic. The sample sizes of confirmed appointments were in part limited by a lack of referral letters and/or health plan identification numbers. Only confirmed appointments were used to calculate average wait times. Access to dermatologists is limited for Medicaid-insured children with eczema. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Your Insurance Dollar. Money Management.

ERIC Educational Resources Information Center

Baran, Nancy H., Ed.

This booklet provides some practical guidelines for determining total insurance needs, examining options, and comparing costs. It discusses how to fit insurance costs into an overall financial plan, the necessity of adequate liability coverage, and the importance of keeping policies up to date. The next four sections highlight the basic types of…

Finance, providers issue brief: insurer liability.

PubMed

Rothouse, M; Stauffer, M

2000-05-24

When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those were questions 35 states considered in 1999, and at least 32 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves.

Finance, providers issue brief: insurer liability.

PubMed

Rothouse, M

1999-07-01

When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those are questions 29 states considered in 1998, and at least 35 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves.

Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

PubMed

Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

2015-10-29

Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

Constructing an Urban Population Model for Medical Insurance Scheme Using Microsimulation Techniques

PubMed Central

Xiong, Linping; Zhang, Lulu; Tang, Weidong; Ma, Yuqin

2012-01-01

China launched a pilot project of medical insurance reform in 79 cities in 2007 to cover urban nonworking residents. An urban population model was created in this paper for China's medical insurance scheme using microsimulation model techniques. The model made it clear for the policy makers the population distributions of different groups of people, the potential urban residents entering the medical insurance scheme. The income trends of units of individuals and families were also obtained. These factors are essential in making the challenging policy decisions when considering to balance the long-term financial sustainability of the medical insurance scheme. PMID:22481973

Effects of the Affordable Care Act's young adult insurance expansion on prescription drug insurance coverage, utilization, and expenditures.

PubMed

Look, Kevin A; Arora, Prachi

2016-01-01

The US Affordable Care Act (ACA) extended the age of eligibility for young adults to remain on their parents' health insurance plans in order to address the disproportionate number of uninsured young adults in the United States. Effective September 23, 2010, the ACA has required all private health insurance plans to cover dependents until the age of 26. However, it is unknown whether the ACA dependent coverage expansion had an impact on prescription drug insurance or the use of prescription drugs. To evaluate short-term changes in prescription health insurance coverage, prescription drug insurance coverage, prescription drug use, and prescription drug expenditures following implementation of the ACA young adult insurance expansion using national data from 2009 and 2011. Full-year health insurance coverage increased 4.9 percentage points during the study period, which was mainly due to increases in private health insurance among middle- and high-income young adults. In contrast, full-year prescription drug insurance coverage increased 5.5 percentage points and was primarily concentrated among high-income young adults. Although no significant short-term changes in overall prescription drug use were observed, a 30% decrease in out-of-pocket expenditures was seen among young adults. While the main goal of the ACA's young adult insurance expansion was to increase health insurance coverage among young adults, it also had the unintended positive effect of increasing coverage for prescription drug insurance. Additionally, young adults experienced substantial decreases in out-of-pocket spending for prescription drugs. It is important for evaluations of health care policies to assess both intended and unintended outcomes to better understand the implications for the broader health system. Copyright © 2015 Elsevier Inc. All rights reserved.

Small firm self-insurance under the Affordable Care Act.

PubMed

Buettgens, Matthew; Blumberg, Linda J

2012-11-01

The Affordable Care Act changes the small-group insurance market substan­tially beginning in 2014, but most changes do not apply to self-insured plans. This exemp­tion provides an opening for small employers with healthier workers to avoid broader sharing of health care risk, isolating higher-cost groups in the fully insured market. Private stop-loss or reinsurance plans can mediate the risk of self-insurance for small employ­ers, facilitating the decision to self-insure. We simulate small-employer coverage decisions under the law and find that low-risk stop-loss policies lead to higher premiums in the fully insured small-group market. Average single premiums would be up to 25 percent higher, if stop-loss insurance with no additional risk to employers than fully insuring is allowed--an option available in most states absent further government action. Regulation of stop-loss at the federal or state level can, however, prevent such adverse selection and increase stabil­ity in small-group insurance coverage.

Show Me My Health Plans: a study protocol of a randomized trial testing a decision support tool for the federal health insurance marketplace in Missouri.

PubMed

Politi, Mary C; Barker, Abigail R; Kaphingst, Kimberly A; McBride, Timothy; Shacham, Enbal; Kebodeaux, Carey S

2016-02-16

The implementation of the ACA has improved access to quality health insurance, a necessary first step to improving health outcomes. However, access must be supplemented by education to help individuals make informed choices for plans that meet their individual financial and health needs. Drawing on a model of information processing and on prior research, we developed a health insurance decision support tool called Show Me My Health Plans. Developed with extensive stakeholder input, the current tool (1) simplifies information through plain language and graphics in an educational component; (2) assesses and reviews knowledge interactively to ensure comprehension of key material; (3) incorporates individual and/or family health status to personalize out-of-pocket cost estimates; (4) assesses preferences for plan features; and (5) helps individuals weigh information appropriate to their interests and needs through a summary page with "good fit" plans generated from a tailored algorithm. The current study will evaluate whether the online decision support tool improves health insurance decisions compared to a usual care condition (the healthcare.gov marketplace website). The trial will include 362 individuals (181 in each group) from rural, suburban, and urban settings within a 90 mile radius around St. Louis. Eligibility criteria includes English-speaking individuals 18-64 years old who are eligible for the ACA marketplace plans. They will be computer randomized to view the intervention or usual care condition. Presenting individuals with options that they can understand tailored to their needs and preferences could help improve decision quality. By helping individuals narrow down the complexity of health insurance plan options, decision support tools such as this one could prepare individuals to better navigate enrollment in a plan that meets their individual needs. The randomized trial was registered in clinicaltrials.gov (NCT02522624) on August 6, 2015.

Insurer Competition In Federally Run Marketplaces Is Associated With Lower Premiums.

PubMed

Jacobs, Paul D; Banthin, Jessica S; Trachtman, Samuel

2015-12-01

Federal subsidies for health insurance premiums sold through the Marketplaces are tied to the cost of the benchmark plan, the second-lowest-cost silver plan. According to economic theory, the presence of more competitors should lead to lower premiums, implying smaller federal outlays for premium subsidies. The long-term impact of the Affordable Care Act on government spending will depend on the cost of these premium subsidies over time, with insurer participation and the level of competition likely to influence those costs. We studied insurer participation and premiums during the first two years of the Marketplaces. We found that the addition of a single insurer in a county was associated with a 1.2 percent lower premium for the average silver plan and a 3.5 percent lower premium for the benchmark plan in the federally run Marketplaces. We found that the effect of insurer entry was muted after two or three additional entrants. These findings suggest that increased insurer participation in the federally run Marketplaces reduces federal payments for premium subsidies. Project HOPE—The People-to-People Health Foundation, Inc.

Nonprofit to for-profit conversions by hospitals, health insurers, and health plans.

PubMed Central

Needleman, J

1999-01-01

Conversion of hospitals, health insurers, and health plans from nonprofit to for-profit ownership has become a focus of national debate. The author examines why nonprofit ownership has been dominant in the US health system and assesses the strength of the argument that nonprofits provide community benefits that would be threatened by for-profit conversion. The author concludes that many of the specific community benefits offered by nonprofits, such as care for the poor, could be maintained or replaced by adequate funding of public programs and that quality and fairness in treatment can be better assured through clear standards of care and adequate monitoring systems. As health care becomes increasingly commercialized, the most difficult parts of nonprofits' historic mission to preserve are the community orientation, leadership role, and innovation that nonprofit hospitals and health plans have provided out of their commitment to a community beyond those to whom they sell services. Images p109-a p110-a p115-a p116-a PMID:10199712

Breaking Health Insurance Knowledge Barriers Through Games: Pilot Test of Health Care America

PubMed Central

James, Juli

2017-01-01

Background Having health insurance is associated with a number of beneficial health outcomes. However, previous research suggests that patients tend to avoid health insurance information and often misunderstand or lack knowledge about many health insurance terms. Health insurance knowledge is particularly low among young adults. Objective The purpose of this study was to design and test an interactive newsgame (newsgames are games that apply journalistic principles in their creation, for example, gathering stories to immerse the player in narratives) about health insurance. This game included entry-level information through scenarios and was designed through the collation of national news stories, local personal accounts, and health insurance company information. Methods A total of 72 (N=72) participants completed in-person, individual gaming sessions. Participants completed a survey before and after game play. Results Participants indicated a greater self-reported understanding of how to use health insurance from pre- (mean=3.38, SD=0.98) to postgame play (mean=3.76, SD=0.76); t71=−3.56, P=.001. For all health insurance terms, participants self-reported a greater understanding following game play. Finally, participants provided a greater number of correct definitions for terms after playing the game, (mean=3.91, SD=2.15) than they did before game play (mean=2.59, SD=1.68); t31=−3.61, P=.001. Significant differences from pre- to postgame play differed by health insurance term. Conclusions A game is a practical solution to a difficult health issue—the game can be played anywhere, including on a mobile device, is interactive and will thus engage an apathetic audience, and is cost-efficient in its execution. PMID:29146564

Church-based breast cancer screening education: impact of two approaches on Latinas enrolled in public and private health insurance plans.

PubMed

Sauaia, Angela; Min, Sung-joon; Lack, David; Apodaca, Cecilia; Osuna, Diego; Stowe, Angela; MGinnis, Gretchen F; Latts, Lisa M; Byers, Tim

2007-10-01

The Tepeyac Project is a church-based health promotion project that was conducted from 1999 through 2005 to increase breast cancer screening rates among Latinas in Colorado. Previous reports evaluated the project among Medicare and Medicaid enrollees in the state. In this report, we evaluate the program among enrollees in the state's five major insurance plans. We compared the Tepeyac Project's two interventions: the Printed Intervention and the Promotora Intervention. In the first, we mailed culturally tailored education packages to 209 Colorado Catholic churches for their use. In the second, promotoras (peer counselors) in four Catholic churches delivered breast-health education messages personally. We compared biennial mammogram claims from the five insurance plans in the analysis at baseline (1998-1999) and during follow-up (2000-2001) for Latinas who had received the interventions. We used generalized estimating equations (GEE) analysis to adjust rates for confounders. The mammogram rate for Latinas in the Printed Intervention remained the same from baseline to follow-up (58% [2979/5130] vs 58% [3338/5708]). In the Promotora Intervention, the rate was 59% (316/536) at baseline and 61% (359/590) at follow-up. Rates increased modestly over time and varied widely by insurance type. After adjusting for age, income, urban versus rural location, disability, and insurance type, we found that women exposed to the Promotora Intervention had a significantly higher increase in biennial mammograms than did women exposed to the Printed Intervention (GEE parameter estimate = .24 [+/-.11], P = .03). For insured Latinas, personally delivering church-based education through peer counselors appears to be a better breast-health promotion method than mailing printed educational materials to churches.

Economic Effects of Legislations and Policies to Expand Mental Health and Substance Abuse Benefits in Health Insurance Plans: A Community Guide Systematic Review

PubMed Central

Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A.; Goetzel, Ron Z.; Finnie, Ramona; Thota, Anilkrishna B.

2015-01-01

Background Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. Aims of the Study This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. Methods The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. Results The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. Discussion and Limitations This review is unable to determine the overall economic value of policies that expand MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when

Assessing Early Implementation of State Autism Insurance Mandates

ERIC Educational Resources Information Center

Baller, Julia Berlin; Barry, Colleen L.; Shea, Kathleen; Walker, Megan M.; Ouellette, Rachel; Mandell, David S.

2016-01-01

In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined…

Private Health Insurance Plans in 1977: Coverage, Enrollment, and Financial Experience

PubMed Central

Carroll, Marjorie Smith; Arnett, Ross H.

1979-01-01

The private health insurance industry collected $47.1 billion in premiums in 1977 and returned $41.6 billion in benefits to their subscribers. Premiums rose 16.3 percent as a direct consequence of rapid claims growth in 1976. After operating expenses were deducted, the industry showed a small, $.4 billion underwriting loss. About 78 percent of the population were insured for hospital care, and about 76 percent for surgical services. Smaller percentages had coverage for other types of care. An estimated 61.8 percent of the aged bought private hospital insurance, and 47.1 percent bought surgical insurance, mostly to supplement Medicare benefits. About 12 percent of persons under age 65 had no protection against the cost of hospital care either through private insurance or a public program such as Medicare or Medicaid. PMID:10309113

100-OL-1 Operable Unit Field Portable X-Ray Fluorescence (XRF) Analyzer Pilot Study Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bunn, Amoret L.; Fritz, Brad G.; Wellman, Dawn M.

A pilot study is being conducted to support the approval of the Remedial Investigation/Feasibility Study (RI/FS) Work Plan to evaluate the 100-OL-1 Operable Unit (OU) pre-Hanford orchard lands. Based on comments received by the U.S. Environmental Protection Agency (EPA) and Washington State Department of Ecology, the pilot study will evaluate the use of field portable X-ray fluorescence (XRF) spectrometry measurements for evaluating lead and arsenic concentrations on the soil surface as an indicator of past use of lead arsenate pesticide residue in the OU. The work will be performed in the field during the summer of 2014, and assist inmore » the planning for the characterization activities in the RI/FS.« less

Connected vehicle pilot deployment program phase 2 : data privacy plan – New York City.

DOT National Transportation Integrated Search

2016-12-27

This document represents a data privacy plan for ensuring the data privacy and security of those participating in the New York City connected vehicle pilot. Personally Identifiable Information (PII) and Sensitive PII (SPII) will be collected from var...

How to Shop for Health Insurance

MedlinePlus

... by or be eligible for free or low-cost coverage through a public program. If you need to get insurance for ... plans cover 90% or more of health care costs. All catastrophic, bronze, ... and other services. Specific benefits differ from plan to plan, though, so you' ...

Consumer preferences in social health insurance.

PubMed

Kerssens, Jan J; Groenewegen, Peter P

2005-03-01

Allowing consumers greater choice of health plans is believed to be the key to high quality and low costs in social health insurance. This study investigates consumer preferences (361 persons, response rate 43%) for hypothetical health plans which differed in 12 characteristics (premium, deductibles, no-claim discount, extension of insurance and financial services, red tape involved, medical help-desk, choice of family physicians and hospitals, dental benefits, physical therapy benefits, benefits for prescription drugs and homeopathy). In 90% the health plan with the most attractive characteristics was preferred, indicating a predominantly rational kind of choice. The most decisive characteristics for preference were: complete dental benefits, followed by zero deductibles, and free choice of hospitals.

Germany's long-term-care insurance: putting a social insurance model into practice.

PubMed

Geraedts, M; Heller, G V; Harrington, C A

2000-01-01

A growing population of elderly has intensified the demand for long-term care (LTC) services. In response to the mounting need, Germany put into effect a LTC Insurance Act in 1995 that introduced mandatory public or private LTC insurance for the entire population of 82 million. The program was based on the organizational principles that define the German social insurance system. Those individuals in the public system and their employers each pay contributions equal to 0.85 percent of each employee's gross wages or salary. Ten percent of the population with the highest incomes have chosen the option of purchasing private long term care insurance. Provisions were made for uniform eligibility criteria, benefits based on level of care needs, cost containment, and quality assurance. Over the first four years of its operation, the system has proved financially sound and has expanded access to organized LTC services. The German system thus may serve as an example for other countries that are planning to initiate social LTC insurance systems in other nations.

Patient response to insurer-led intervention for medication adherence - a pilot study based on claims data in Korea.

PubMed

Sohn, Hyun Soon; Jang, Sunmee; Lee, Ju-Yeun; Han, Euna

2016-01-01

This study was designed to investigate patient responses to a medication counseling intervention program piloted by the National Health Insurance Service (NHIS), the national health insurer in Korea, to improve medication management in patients with hypertension, hyperlipidemia, or diabetes. Interventions were conducted from July to September 2013 through direct mailing followed by two telephone-initiated counseling sessions for the medication discontinuation group (< 80% medication possession ratio (MPR) and ≥ 2 months of discontinuation) and the medication over-possession group (≥ 150% MPR). The telephone intervention was applied through two models: model 1 (counseling by NHIS staff only) and model 2 (counseling by NHIS staff with contract-based working pharmacists in community pharmacies). Multivariate logistic regression analysis was performed to identify factors affecting favorable responses of patients to the telephone-initiated intervention. Patient responses to the telephone-initiated intervention were evaluated by a counselor. In all, 891 patients were counseledvia telephone. Patient responses to the telephone-initiated intervention were favorablein 57.6%, neutral in 17.4% and not favorable in 24.9% overall. Counseling by NHIS staff together with pharmacists (model 2) produced more favorable responses from patients than counseling by NHIS staff alone (model 1) (OR 2.73, 95% CI 1.97 - 3.77). Our findings of favorable responses to interventions support a personalized approach by the NHIS to improve patient behavior for medication adherence.

Development and pilot testing of a mobile health solution for asthma self-management: asthma action plan smartphone application pilot study.

PubMed

Licskai, Christopher; Sands, Todd W; Ferrone, Madonna

2013-01-01

Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool. To design, develop and pilot a mobile health system to support asthma self-management. The present study was a prospective, single-centre, nonrandomized, pilot preintervention-postintervention analysis. System design and development were guided by an expert steering committee. The network included an agnostic web browser-based asthma action plan smartphone application (SPA). Subjects securely transmitted symptoms and peak flow data daily, and received automated control assessment, treatment advice and environmental alerts. Twenty-two adult subjects (mean age 47 years, 82% women) completed the study. Biophysical data were received on 84% of subject days (subject day = 1 subject × 1 day). Subjects viewed their action plan current zone of control on 54% and current air quality on 61% of subject days, 86% followed self-management advice and 50% acted to reduce exposure risks. A large majority affirmed ease of use, clarity and timeliness, and 95% desired SPA use after the study. At baseline, 91% had at least one symptom criterion for uncontrolled asthma and 64% had ≥2, compared with 45% (P=0.006) and 27% (P=0.022) at study close. Mean Asthma Quality of Life Questionnaire score improved from 4.3 to 4.8 (P=0.047). A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels.

The effect of the Americans With Disabilities Act upon medical insurance and employee benefits.

PubMed

Brislin, J A

1992-03-01

The Americans With Disabilities Act will have a significant impact upon plan sponsors and the administration of an employee benefit plan. Prior to the July 26, 1992 effective date, a plan sponsor or trustee should meet with the plan's attorney, provider and other insurance advisers and review the effect ADA will have upon the plan. The EEOC will be issuing additional interpretive rules before the effective date of ADA, and there will be numerous court challenges after the effective date. Plan sponsors and trustees should keep abreast of the developments as they occur. Before a benefit change or premium adjustment is made, it should be reviewed with legal counsel to assure that it conforms to ADA's insurance exemption. Plan sponsors and trustees should have legal counsel, the provider and the plan's insurance advisers develop the documentation that will enable the plan to establish ADA's insurance exemption to defend any legal challenge.

Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the "Borda" Method: a Pilot Study.

PubMed

Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

2015-01-01

Decision-making for medicines to be accepted in Iran's public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called "Borda" in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software "Math-lab"7, "SPSS" 17 and Excel 2007 were used in this study. "Borda" estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance decision making.

Switching health insurers: the role of price, quality and consumer information search.

PubMed

Boonen, Lieke H H M; Laske-Aldershof, Trea; Schut, Frederik T

2016-04-01

We examine the impact of price, service quality and information search on people's propensity to switch health insurers in the competitive Dutch health insurance market. Using panel data from annual household surveys and data on health insurers' premiums and quality ratings over the period 2006-2012, we estimate a random effects logit model of people's switching decisions. We find that switching propensities depend on health plan price and quality, and on people's age, health, education and having supplementary or group insurance. Young people (18-35 years) are more sensitive to price, whereas older people are more sensitive to quality. Searching for health plan information has a much stronger impact on peoples' sensitivity to price than to service quality. In addition, searching for health plan information has a stronger impact on the switching propensity of higher than lower educated people, suggesting that higher educated people make better use of available health plan information. Finally, having supplementary insurance significantly reduces older people's switching propensity.

Small Group Health Insurance Reform in Rhode Island: Promises and Pitfalls of the HEALTHpact Plan

PubMed Central

Alan Miller, Edward; Trivedi, Amal; Kuo, Sylvia; Mor, Vincent

2011-01-01

Objective This study analyzes what design elements inhibited enrollment in HEALTHpact. Study Setting HEALTHpact is a high deductible plan with a premium capped at 10 percent of the average Rhode Island wage. Deductibles are reduced if enrollees meet wellness criteria. Study Design Qualitative case study. Data Collection Archival documents and 23 interviews. Principal Findings Inclusion of a subsidy would have led to lower premiums and more generous coverage. Although priced lower than other plans, HEALTHpact still did not offer good value for most firms. Wellness incentives also were too complex. Conclusions Subsidies for purchase of insurance coverage are critical to national reform of the small group market. Designers also will need to carefully balance program complexity with innovation in encouraging wellness and product appeal. PMID:21054375

Health Insurance in the Public Sector.

ERIC Educational Resources Information Center

Rubin, Richard S.

1980-01-01

In general, this survey of six midwest states revealed that health insurance plans for state government employees have moved toward employer funding, comprehensive benefits, and some recognition of the advantages of prepaid group practice plans. (Author/IRT)

Marketplace Plans With Narrow Physician Networks Feature Lower Monthly Premiums Than Plans With Larger Networks.

PubMed

Polsky, Daniel; Cidav, Zuleyha; Swanson, Ashley

2016-10-01

The introduction of health insurance Marketplaces under the Affordable Care Act has been associated with growth of restricted provider networks. The value of this plan design strategy, including its association with lower premiums, is uncertain. We used data from all silver plans offered in the 2014 health insurance exchanges in the fifty states and the District of Columbia to estimate the association between the breadth of a provider network and plan premiums. We found that within a market, for plans of otherwise equivalent design and controlling for issuer-specific pricing strategy, a plan with an extra-small network had a monthly premium that was 6.7 percent less expensive than that of a plan with a large network. Because narrow networks remain an important strategy available to insurance companies to offer lower-cost plans on health insurance Marketplaces, the success of health insurance coverage expansions may be tied to the successful implementation of narrow networks. Project HOPE—The People-to-People Health Foundation, Inc.

Insurance: An Evaluation Report for the Occupational Exploration Program.

ERIC Educational Resources Information Center

Altschuld, James W.; And Others

The evaluation report is one of seven produced for the Occupational Exploration Program (OEP), a series of simulated occupational experiences designed for junior high school students. Describing the pilot testing of the simulation dealing with the insurance field, the report contains sections describing the simulation context, evaluation…

Insurance Coverage for Weight Loss

PubMed Central

Jarlenski, Marian P.; Gudzune, Kimberly A.; Bennett, Wendy L.; Cooper, Lisa A.; Bleich, Sara N.

2013-01-01

Background Given the prevalence of obesity and associated chronic conditions among U.S. adults, wellness benefits are an increasingly popular approach to promoting weight loss. Purpose The goal of the study was to assess overweight and obese adults’ beliefs about the helpfulness of insurance coverage of weight loss–related benefits, their willingness to pay for such benefits, and whether these opinions differ by individuals’ weight or health insurance type. Methods A national survey was fielded in 2012 am ong non-pregnant, overweight and obese adults who had seen a primary care provider in the past year (n=600). Descriptive statistics summarized beliefs about which weight loss–related benefits would be helpful, willingness to pay for such benefits, and agreement about whether health insurers should be able to charge more to obese individuals. Multivariable logistic regression was employed to determine whether beliefs differed by weight category or health insurance type. Analyses were conducted in July 2012. Results The majority (83%) of respondents cited a specific benefit as helpful. Those with private health insurance had a higher probability (89%, 95% CI=86%, 93%) of endorsing any benefit as helpful relative to those with other types of health insurance. Being obese relative to overweight was associated with greater support (57% vs 39%, p<0.05) for preventing health insurers from charging higher premiums to obese individuals. Conclusions In this sample of overweight adults, a large proportion endorsed the value of weight loss–related benefits offered by health plans. However, only about one third were willing to pay extra for them, and half disagreed with the notion that health plans should charge more to obese individuals. Given evidence of their effectiveness, wellness benefits should be offered to all individuals. PMID:23597807

Cost and coverage: implications of the McCain plan to restructure health insurance.

PubMed

Buchmueller, Thomas; Glied, Sherry A; Royalty, Anne; Swartz, Katherine

2008-01-01

Senator John McCain's (R-AZ) health plan would eliminate the current tax exclusion of employer payments for health coverage, replace the exclusion with a refundable tax credit for those who purchase coverage, and encourage Americans to move to a national market for nongroup insurance. Middle-range estimates suggest that initially this change will have little impact on the number of uninsured people, although within five years this number will likely grow as the value of the tax credit falls relative to rising health care costs. Moving toward a relatively unregulated nongroup market will tend to raise costs, reduce the generosity of benefits, and leave people with fewer consumer protections.

Health Insurance and Risk of Divorce: Does Having Your Own Insurance Matter?

PubMed Central

Sohn, Heeju

2016-01-01

Most American adults under 65 obtain health insurance through their employers or their spouses’ employers. The absence of a universal healthcare system in the United States puts Americans at considerable risk for losing their coverage when transitioning out of jobs or marriages. Scholars have found evidence of reduced job mobility among individuals who are dependent on their employers for healthcare coverage. This paper finds similar relationships between insurance and divorce. I apply the hazard model to married individuals in the longitudinal Survey of Income Program Participation (N=17,388) and find lower divorce rates among people who are insured through their partners’ plans without alternative sources of their own. Furthermore, I find gender differences in the relationship between healthcare coverage and divorce rates: insurance dependent women have lower rates of divorce than men in similar situations. These findings draw attention to the importance of considering family processes when debating and evaluating health policies. PMID:26949269

Low-Income Working Families With Employer-Sponsored Insurance Turn To Public Insurance For Their Children.

PubMed

Strane, Douglas; French, Benjamin; Eder, Jennifer; Wong, Charlene A; Noonan, Kathleen G; Rubin, David M

2016-12-01

Many families rely on employer-sponsored health insurance for their children. However, the rise in the cost of such insurance has outpaced growth in family income, potentially making public insurance (Medicaid or the Children's Health Insurance Plan) an attractive alternative for affordable dependent coverage. Using data for 2008-13 from the Medical Expenditure Panel Survey, we quantified the coverage rates for children from low- or moderate-income households in which a parent was offered employer-sponsored insurance. Among families in which parents were covered by such insurance, the proportion of children without employer-sponsored coverage increased from 22.5 percent in 2008 to 25.0 percent in 2013. The percentage of children with public insurance when a parent was covered by employer-sponsored insurance increased from 12.1 percent in 2008 to 15.2 percent in 2013. This trend was most pronounced for families with incomes of 100-199 percent of the federal poverty level, for whom the share of children with public insurance increased from 22.8 percent to 29.9 percent. Among families with incomes of 200-299 percent of poverty, uninsurance rates for children increased from 6.0 percent to 9.2 percent. These findings suggest a movement away from employer-sponsored insurance and toward public insurance for children in low-income families, and growth in uninsurance among children in moderate-income families. Project HOPE—The People-to-People Health Foundation, Inc.

The U.S. health insurance marketplace: are premiums truly affordable?

PubMed

Graetz, Ilana; Kaplan, Cameron M; Kaplan, Erin K; Bailey, James E; Waters, Teresa M

2014-10-21

The Patient Protection and Affordable Care Act requires that individuals have health insurance or pay a penalty. Individuals are exempt from paying this penalty if the after-subsidy cost of the least-expensive plan available to them is greater than 8% of their income. For this study, premium data for all health plans offered on the state and federal health insurance marketplaces were collected; the after-subsidy cost of premiums for the least-expensive bronze plan for every county in the United States was calculated; and variations in premium affordability by age, income, and geographic area were assessed. Results indicated that-although marketplace subsidies ensure affordable health insurance for most persons in the United States-many individuals with incomes just above the subsidy threshold will lack affordable coverage and will be exempt from the mandate. Furthermore, young individuals with low incomes often pay as much as or more than older individuals for bronze plans. If substantial numbers of younger, healthier adults choose to remain uninsured because of cost, health insurance premiums across all ages may increase over time.

The first private sector health insurance company in Ghana.

PubMed

Huff-Rousselle, M; Akuamoah-Boateng, J

1998-01-01

This article analyses the development of Ghana's first private sector health insurance company, the Nationwide Medical Insurance Company. Taking both policy and practical considerations into account (stakeholders' perspectives, economic viability, equity and efficiency), it is structured around key questions which help to define the position and roles of stakeholders--the insurance agency itself, contributors, beneficiaries, and providers--and how they relate to one another and the insurance scheme. These relationships will to a large extent determine Nationwide's long-term success or failure. By creating a unique alliance between physician providers and private sector companies, Nationwide has used employers' interest in cost containment and physicians' interest in expanding their client base as an entrée into the virgin territory of health insurance, and created a hybrid variety of private sector insurance with some of the attributes of a health maintenance organization or managed care. The case study is unusual in that, while public sector programs are often open to academic scrutiny, researchers have rarely had access to detailed data on the establishment of a single private sector insurance company in a developing country. Given that Ghana is planning to launch a national health insurance plan, the article concludes by considering what the experience of this private sector initiative might have to offer public sector planners.

Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the “Borda” Method: a Pilot Study

PubMed Central

Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

2015-01-01

Decision-making for medicines to be accepted in Iran’s public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called “Borda” in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software “Math-lab”7, “SPSS” 17 and Excel 2007 were used in this study. “Borda” estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance

Connected Vehicle Pilot Deployment Program Phase 2 : Comprehensive Maintenance and Operations Plan - New York City

DOT National Transportation Integrated Search

2018-05-31

This Comprehensive Maintenance and Operations Plan (CMOP) describes the types and number of equipment to be operated and maintained for the proposed New York City (NYC) Connected Vehicle Pilot Deployment (CVPD) system. Its objective is to develop a p...

Slovenian national health insurance card: the next step.

PubMed

Kalin, T; Kandus, G; Trcek, D; Zupan, B

1999-01-01

The Slovenian national health insurance company started a full-scale deployment of the insurance smart card that is at the present used for insurance data and identification purpose only. There is ample capacity on the cards that were selected, to contain much more data than needed for the purely administrative and charging purposes. There are plans to include some basic medical information, donor information, etc. On the other hand, there are no firm plans to use the security infrastructure and the extensive network, connecting the insurance company with the more than 200 self service terminals positioned at the medical facilities through the country to build an integrated medical information system that would be very beneficial to the patients and the medical community. This paper is proposing some possible future developments and further discusses on the security issues involved with such countrywide medical information system.

AgRISTARS: Renewable resources inventory. Land information support system implementation plan and schedule. [San Juan National Forest pilot test

NASA Technical Reports Server (NTRS)

Yao, S. S. (Principal Investigator)

1981-01-01

The planning and scheduling of the use of remote sensing and computer technology to support the land management planning effort at the national forests level are outlined. The task planning and system capability development were reviewed. A user evaluation is presented along with technological transfer methodology. A land management planning pilot test of the San Juan National Forest is discussed.

The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums.

PubMed

Cogan, John F; Hubbard, R Glenn; Kessler, Daniel

2010-01-01

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008-that is, before versus after the plan-over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

Disaster: Planning, Preparation, Prevention.

ERIC Educational Resources Information Center

Rutherford, Christine

1990-01-01

Discusses causes of library disasters and provides several examples of disasters. Emphasis is on the importance of awareness, insurance protection, a written disaster plan, cooperation with the fire marshall and insurance agent in planning, and staff training. Several elements of the written plan are listed. (22 references) (MES)

Does Full Insurance Increase the Demand for Health Care?

PubMed

Boes, Stefan; Gerfin, Michael

2016-11-01

We estimate the causal impact of having full health insurance on healthcare expenditures. We take advantage of a unique quasi-experimental setup in which deductibles and co-payments were zero in a managed care plan and nonzero in regular insurance, until a policy change forced all individuals with an active plan to cover a minimum amount of their expenses. Using panel data and a nonlinear difference-in-differences strategy, we find a demand elasticity of about -0.14 comparing full insurance with the cost-sharing model and a significant upward shift in the likelihood to generate costs. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

22 CFR 146.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Health and insurance benefits and services. 146... the Basis of Sex in Education Programs or Activities Prohibited § 146.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

34 CFR 106.39 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Health and insurance benefits and services. 106.39... Prohibited § 106.39 Health and insurance benefits and services. In providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient shall not...

28 CFR 54.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 54.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

How the Affordable Care Act Has Helped Women Gain Insurance and Improved Their Ability to Get Health Care: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016.

PubMed

Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beautel, Sophie

2017-08-01

ISSUE: Prior to the Affordable Care Act (ACA), one-third of women who tried to buy a health plan on their own were either turned down, charged a higher premium because of their health, or had specific health problems excluded from their plans. Beginning in 2010, ACA consumer protections, particularly coverage for preventive care screenings with no cost-sharing and a ban on plan benefit limits, improved the quality of health insurance for women. In 2014, the law’s major insurance reforms helped millions of women who did not have employer insurance to gain coverage through the ACA’s marketplaces or through Medicaid. GOALS: To examine the effects of ACA health reforms on women’s coverage and access to care. METHOD: Analysis of the Commonwealth Fund Biennial Health Insurance Surveys, 2001–2016. FINDINGS AND CONCLUSIONS: Women ages 19 to 64 who shopped for new coverage on their own found it significantly easier to find affordable plans in 2016 compared to 2010. The percentage of women who reported delaying or skipping needed care because of costs fell to an all-time low. Insured women were more likely than uninsured women to receive preventive screenings, including Pap tests and mammograms.

Health Insurance and Health Status: Exploring the Causal Effect from a Policy Intervention.

PubMed

Pan, Jay; Lei, Xiaoyan; Liu, Gordon G

2016-11-01

Whether health insurance matters for health has long been a central issue for debate when assessing the full value of health insurance coverage in both developed and developing countries. In 2007, the government-led Urban Resident Basic Medical Insurance (URBMI) program was piloted in China, followed by a nationwide implementation in 2009. Different premium subsidies by government across cities and groups provide a unique opportunity to employ the instrumental variables estimation approach to identify the causal effects of health insurance on health. Using a national panel survey of the URBMI, we find that URBMI beneficiaries experience statistically better health than the uninsured. Furthermore, the insurance health benefit appears to be stronger for groups with disadvantaged education and income than for their counterparts. In addition, the insured receive more and better inpatient care, without paying more for services. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Fiscal year 1981 US corn and soybeans pilot preliminary experiment plan, phase 1

NASA Technical Reports Server (NTRS)

Livingston, G. P.; Nedelman, K. S.; Norwood, D. F.; Smith, J. H. (Principal Investigator)

1981-01-01

A draft of the preliminary experiment plan for the foreign commodity production forecasting project fiscal year 1981 is presented. This draft plan includes: definition of the phase 1 and 2 U.S. pilot objectives; the proposed experiment design to evaluate crop calendar, area estimation, and area aggregation components for corn and soybean technologies using 1978/1979 crop-year data; a description of individual sensitivity evaluations of the baseline corn and soybean segment classification procedure; and technology and data assessment in support of the corn and soybean estimation technology for use in the U.S. central corn belt.

33 CFR 385.12 - Pilot projects.

Code of Federal Regulations, 2013 CFR

2013-07-01

... management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary to... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated...-Federal sponsor shall develop a Project Management Plan as described in § 385.24. (c) Project...

22 CFR 229.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Health and insurance benefits and services. 229... on the Basis of Sex in Education Programs or Activities Prohibited § 229.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

6 CFR 17.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 17... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 17.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

31 CFR 28.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Health and insurance benefits and... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 28.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

45 CFR 2555.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Health and insurance benefits and services. 2555... Activities Prohibited § 2555.440 Health and insurance benefits and services. Subject to § 2555.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

24 CFR 3.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Health and insurance benefits and... Activities Prohibited § 3.440 Health and insurance benefits and services. Subject to § 3.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

32 CFR 196.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Health and insurance benefits and services. 196... Activities Prohibited § 196.440 Health and insurance benefits and services. Subject to § 196.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

13 CFR 113.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Health and insurance benefits and....440 Health and insurance benefits and services. Subject to § 113.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

43 CFR 41.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Health and insurance benefits and services... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 41.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

14 CFR 1253.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Health and insurance benefits and services... Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 1253.440 Health and insurance... insurance benefit, service, policy, or plan to any of its students, a recipient shall not discriminate on...

36 CFR 1211.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Health and insurance benefits... Activities Prohibited § 1211.440 Health and insurance benefits and services. Subject to § 1211.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its...

38 CFR 23.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Health and insurance... Prohibited § 23.440 Health and insurance benefits and services. Subject to § 23.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a...

42 CFR 457.65 - Effective date and duration of State plans and plan amendments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies... 42 Public Health 4 2010-10-01 2010-10-01 false Effective date and duration of State plans and plan...

18 CFR 1317.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Health and insurance... § 1317.440 Health and insurance benefits and services. Subject to § 1317.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

Employment transitions and continuity of health insurance: implications for premium assistance programs.

PubMed

Marquis, M Susan; Kapur, Kanika

2003-01-01

We use data from two nationwide panel surveys to explore whether premium assistance programs can provide stable insurance for low-income children. We estimate that low-income children who are newly enrolled in an employer-group plan would keep that coverage longer than similar children keep newly acquired public insurance. We conclude that group coverage could provide a source of insurance for eligible low-income children that is more stable than public insurance. However, only one-third of low-income uninsured children have access to group insurance, and most low-income children with access to a group plan are enrolled in it. Thus, premium assistance programs are difficult to target effectively, and other programs are necessary to reach the majority of uninsured children.

Type of Plan and Provider Network (Affordable Care Act)

MedlinePlus

... insurance plan & network types: HMOs, PPOs, and more Health insurance plan & network types: HMOs, PPOs, and more 3 things to know before you pick a health insurance plan The 'metal' categories: Bronze, Silver, Gold & Platinum ...

Health insurance, patient protection and Affordable Care Act, and young adults.

PubMed

Dodich, Colleen; Patel, Dilip

2013-12-01

In summary, the ACA aims to correct some of the shortcomings of our current health insurance systems. It aims to make health insurance more affordable and more accessible and the health insurance systems easier to navigate. For the young adult population, it aims to protect more individuals by allowing them to stay on their parent's insurance longer and by making it easier to choose an insurance plan that is right for them. Those with preexisting medical conditions do not have to worry about being excluded from a health plan because of their medical history. The law is also making health insurance mandatory, which may help prevent young adults who fall ill from incurring large medical bills. Initial outcomes from the implementation of the ACA have shown both positive and negative responses. All in all, it is giving young adults more options when it comes to obtaining health insurance. As part of discussion with adolescents and young adults, physicians may take into consideration key points summarized in Table 4.

Health insurance take-up by the near-elderly.

PubMed

Buchmueller, Thomas C; Ohri, Sabina

2006-12-01

To examine the effect of price on the demand for health insurance by early retirees between the ages of 55 and 64. Administrative health plan enrollment data from a medium-sized U.S. employer. The analysis takes advantage of a natural experiment created by the firm's health insurance contribution policy. The amount the firm contributes toward retiree health insurance coverage depends on when a person retired and her years of service at that date. As a result of this policy, there is considerable variation in out-of-pocket premiums faced by individuals in the data. This variation is independent of the nonprice attributes of the health insurance plans offered and is plausibly exogenous to individual characteristics that are likely to affect the demand for insurance. A probit model is used to estimate the decision to take-up employer-sponsored health insurance by early retirees between the ages of 55 and 64. Demand for insurance is measured as a function of out-of-pocket premiums and a set of individual characteristics. We find that price has a small but statistically significant effect on the decision to take up coverage. Estimated price elasticities range from -0.10 to -0.16, depending on the sample. The implied elasticities are comparable with results found in previous studies using very different data. Our estimates indicate that policy proposals for a Medicare buy-in or a nongroup tax credit will have a modest impact on take-up rates of near-elderly retirees.

Studies of planning behavior of aircraft pilots in normal, abnormal, and emergency situations

NASA Technical Reports Server (NTRS)

Johannsen, G.; Rouse, W. B.; Hillmann, K.

1981-01-01

A methodology for the study of human planning behavior in complex dynamic systems is presented and applied to the study of aircraft pilot behavior in normal, abnormal and emergency situations. The method measures the depth of planning, that is the level of detail employed with respect to a specific task, according to responses to a verbal questionnaire, and compares planning depth with variables relating to time, task criticality and the probability of increased task difficulty. In two series of experiments, depth of planning was measured on a five- or ten-point scale during various phases of flight in a HFB-320 simulator under normal flight conditions, abnormal scenarios involving temporary runway closure due to snow removal or temporary CAT-III conditions due to a dense fog, and emergency scenarios involving engine shut-down or hydraulic pressure loss. Results reveal a dichotomy between event-driven and time-driven planning, different effects of automation in abnormal and emergency scenarios and a low correlation between depth of planning and workload or flight performance.

Finance issue brief: insurer liability: year end report-2003.

PubMed

MacEachern, Lillian

2003-12-31

When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those were questions 35 states considered in 1999, and at least 32 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves.

Finance issue brief: insurer liability: year end report-2002.

PubMed

Morgan, Rachel; MacEachern, Lillian

2002-12-31

When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those were questions 35 states considered in 1999, and at least 32 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves.

77 FR 25788 - Request for Information Regarding Stop Loss Insurance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-01

...This document is a request for information regarding the use of stop loss insurance by group health plans and their plan sponsors, with a focus on the prevalence and consequences of stop loss insurance at low attachment points. Given the limited nature of data available, the Departments of Labor, Health and Human Services (HHS), and the Treasury (collectively, the Departments) invite public comments via this request for information.

Multiple sources of Medicare supplementary insurance.

PubMed

Short, P F; Vistnes, J P

1992-01-01

Estimates from the National Medical Expenditure Survey imply that in 1987 only two-thirds of elderly Medicare beneficiaries held the amount and type of insurance that is generally recommended to supplement Medicare, namely, 57.7% with private hospital/medical insurance from one source and 6.6% with only Medicaid. Of the remainder, 19.8% had more than one source of private insurance; slightly more than 1% had one source of extra-cash or disease-specific insurance as their only supplementary coverage; and 12.9% had no supplementary coverage at all. In addition, more than 500,000 Medicaid enrollees had purchased private insurance, despite the comprehensive coverage offered by Medicaid. Although the issue of multiple coverage has been dramatized by stories of poor, very elderly persons who have purchased numerous Medigap plans, beneficiaries who purchase coverage from more than one source are likely to be relatively young, more highly educated, and financially better off.

Behavioral health insurance parity for federal employees.

PubMed

Goldman, Howard H; Frank, Richard G; Burnam, M Audrey; Huskamp, Haiden A; Ridgely, M Susan; Normand, Sharon-Lise T; Young, Alexander S; Barry, Colleen L; Azzone, Vanessa; Busch, Alisa B; Azrin, Susan T; Moran, Garrett; Lichtenstein, Carolyn; Blasinsky, Margaret

2006-03-30

To improve insurance coverage of mental health and substance-abuse services, the Federal Employees Health Benefits (FEHB) Program offered mental health and substance-abuse benefits on a par with general medical benefits beginning in January 2001. The plans were encouraged to manage care. We compared seven FEHB plans from 1999 through 2002 with a matched set of health plans that did not have benefits on a par with mental health and substance-abuse benefits (parity of mental health and substance-abuse benefits). Using a difference-in-differences analysis, we compared the claims patterns of matched pairs of FEHB and control plans by examining the rate of use, total spending, and out-of-pocket spending among users of mental health and substance-abuse services. The difference-in-differences analysis indicated that the observed increase in the rate of use of mental health and substance-abuse services after the implementation of the parity policy was due almost entirely to a general trend in increased use that was observed in comparison health plans as well as FEHB plans. The implementation of parity was associated with a statistically significant increase in use in one plan (+0.78 percent, P<0.05) a significant decrease in use in one plan (-0.96 percent, P<0.05), and no significant difference in use in the other five plans (range, -0.38 percent to +0.23 percent; P>0.05 for each comparison). For beneficiaries who used mental health and substance-abuse services, spending attributable to the implementation of parity decreased significantly for three plans (range, -201.99 dollars to -68.97 dollars; P<0.05 for each comparison) and did not change significantly for four plans (range, -42.13 dollars to +27.11 dollars; P>0.05 for each comparison). The implementation of parity was associated with significant reductions in out-of-pocket spending in five of seven plans. When coupled with management of care, implementation of parity in insurance benefits for behavioral health care

Dropped out or pushed out? Insurance market exit and provider market power in Medicare Advantage.

PubMed

Pelech, Daria

2017-01-01

This paper explores how provider and insurer market power affect which markets an insurer chooses to operate in. A 2011 policy change required that certain private insurance plans in Medicare form provider networks de novo; in response, insurers cancelled two-thirds of the affected plans. Using detailed data on pre-policy provider and insurer market structure, I compare markets where insurers built networks to those they exited. Overall, insurers in the most concentrated hospital and physician markets were 9 and 13 percentage points more likely to exit, respectively, than those in the least concentrated markets. Conversely, insurers with more market power were less likely to exit than those with less, and an insurer's market power had the largest effect on exit in concentrated hospital markets. These findings suggest that concentrated provider markets contribute to insurer exit and that insurers with less market power have more difficulty surviving in concentrated provider markets. Published by Elsevier B.V.

42 CFR 457.50 - State plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies § 457.50 State plan. The State plan is a... 42 Public Health 4 2010-10-01 2010-10-01 false State plan. 457.50 Section 457.50 Public Health...

42 CFR 457.80 - Current State child health insurance coverage and coordination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

76 FR 76409 - Meeting of the Farm Credit System Insurance Corporation Board

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-07

... FARM CREDIT SYSTEM INSURANCE CORPORATION Meeting of the Farm Credit System Insurance Corporation... given of the regular meeting of the Farm Credit System Insurance Corporation Board (Board). DATE AND... Coverage and the Audit Committee Charter Closed Sesson Confidential Report on System Performance Audit Plan...

Stakeholders' perceptions of ways to support decisions about health insurance marketplace enrollment: a qualitative study.

PubMed

Housten, A J; Furtado, K; Kaphingst, K A; Kebodeaux, C; McBride, T; Cusanno, B; Politi, M C

2016-11-08

Approximately 29 million individuals are expected to enroll in health insurance using the Patient Protection and Affordable Care Act (ACA) Marketplace by 2022. Those seeking health insurance struggle to understand insurance options and choose a plan that best suits their needs. We interviewed stakeholders to identify the challenges associated with the ACA Marketplace health insurance enrollment and elicited feedback about what to include in health insurance decision support tools. Interviews were transcribed and themes were identified using inductive thematic analysis. Stakeholders stated that consumers felt frustrated by unclear terminology, high plan costs, and complex calculations required to assess costs. Consumers felt anxious about making the wrong choice and being unable to change plans within a calendar year. Stakeholders recommended using plain language tables defining complex terms, grouping information, and using engaging graphics to communicate information about health insurance. Stakeholders thought that narratives of how others made decisions about insurance might be helpful to consumers, but recommended that they be tailored to the needs of specific consumers. Strategies that clarify health insurance terms using plain language and graphics, acknowledge concern associated with making the wrong choice, calculate and enable cost comparison, and tailor information to consumers' unique needs could benefit those enrolling in ACA Marketplace plans, Narratives developed should be simple and inclusive enough for diverse populations.

Insurance Companies Adapting to Trends by Adopting Medical Tourism.

PubMed

Paul, David P; Barker, Tyler; Watts, Angela L; Messinger, Ashley; Coustasse, Alberto

Health care costs in the United States are rising every year, and patients are seeking new ways to control their expenditures and save money. Going abroad to receive health care is a cheaper alternative than receiving the same or similar care at home. Insurance companies are beginning to realize the benefits of medical tourism for both themselves and their beneficiaries and have therefore started to introduce medical tourism plans for their clients as an option for their beneficiaries. This research study explores the benefits and risks of medical tourism and examines the US insurance market's reaction to the trend of increasing medical tourism. The US medical tourism industry mirrors that of the United Kingdom in recent years, with more patients seeking care abroad than in the United States. Insurance companies have introduced new plans providing the option of traveling abroad to countries such as India and Costa Rica. Medical tourism is gaining popularity with US residents, and insurance companies are recognizing this trend.

Insurance and indemnification implications of future space projects

NASA Technical Reports Server (NTRS)

O'Brien, John E.

1987-01-01

NASA options regarding insurance and indemnification policies as they relate to NASA customers and contractors are described. The foundation for the discussion is the way in which NASA is planning to return the Space Shuttle fleet to safe flight as well as current U.S. policy concerning future uses of the Shuttle fleet. Issues discussed include: the nature of the Shuttle manifest; the policy regarding property damage or destruction; insurance against liability to third parties; the reduction of the scope of the risk to be insured; NASA as the insurer; a sharing arrangement between the user and NASA; and contractors and subcontractors involved in Shuttle operations.

Flood risk and insurance loss potential in the Thames Gateway

NASA Astrophysics Data System (ADS)

Eldridge, J.; Horn, D.

2009-04-01

The Thames Gateway, currently Europe's largest regeneration project, is an area of redevelopment located in the South East of England, with Government plans to create up to 160,000 new homes and 180,000 new jobs by 2016. Although the new development is intended to contribute £12bn annually to the economy, the potential flood risk is high, with much of the area situated on Thames tidal floodplain and vulnerable to both storm surges and peak river flows. This poses significant hazard to those inhabiting the area and has raised concern amongst the UK insurance industry, who would be liable for significant financial claims if a large flood event were to occur, particularly with respect to the number of new homes and businesses being built in flood risk areas. Flood risk and the potential damage to both lives and assets in vulnerable areas have gained substantial recognition, in light of recent flooding events, from both governmental agencies and in the public's awareness of flood hazard. This has resulted in a change in UK policy with planning policy for flood risk (PPS25, Planning Policy Statement 25) adopting a more strategic approach to development, as well as a new Flooding and Water Bill which is due for consultation in 2009. The Government and the Association of British Insurers, who represent the UK insurance industry, have also recently changed their Statement of Principles which guides provision of flood insurance in the future. This PhD research project aims to quantify flood risk in the Thames Gateway area with a view to evaluating the insurance loss potential under different insurance and planning scenarios. Using current sources of inundation extent, and incorporating varying insurance penetration rates and degrees of adoption of planning policy and guidance, it focuses on estimating flood risk under these different scenarios. This presentation introduces the development of the project and the theory and methodology which will be used to address the

DOE's Notification of Planned Change to the EPA 40 CFR Part 194 Certification of the Waste Isolation Pilot Plant: Remote-Handled Transuranic Waste Characterization Plan

EPA Pesticide Factsheets

The U.S. Department of Energy's Carlsbad Field Office (DOE/CBFO) provided the U.S. Environmental Protection Agency (EPA) this Notification of Planned Change to accept remote-handled (RH) transuranic (TRU) waste at the Waste Isolation Pilot Plant (WIPP).

Health Insurance Take-up by the Near-Elderly

PubMed Central

Buchmueller, Thomas C; Ohri, Sabina

2006-01-01

Objective To examine the effect of price on the demand for health insurance by early retirees between the ages of 55 and 64. Data Source Administrative health plan enrollment data from a medium-sized U.S. employer. Study Design The analysis takes advantage of a natural experiment created by the firm's health insurance contribution policy. The amount the firm contributes toward retiree health insurance coverage depends on when a person retired and her years of service at that date. As a result of this policy, there is considerable variation in out-of-pocket premiums faced by individuals in the data. This variation is independent of the nonprice attributes of the health insurance plans offered and is plausibly exogenous to individual characteristics that are likely to affect the demand for insurance. A probit model is used to estimate the decision to take-up employer-sponsored health insurance by early retirees between the ages of 55 and 64. Demand for insurance is measured as a function of out-of-pocket premiums and a set of individual characteristics. Principal Findings We find that price has a small but statistically significant effect on the decision to take up coverage. Estimated price elasticities range from −0.10 to −0.16, depending on the sample. Conclusions The implied elasticities are comparable with results found in previous studies using very different data. Our estimates indicate that policy proposals for a Medicare buy-in or a nongroup tax credit will have a modest impact on take-up rates of near-elderly retirees. PMID:17116109

Life cycle responses to health insurance status.

PubMed

Pelgrin, Florian; St-Amour, Pascal

2016-09-01

This paper studies the lifetime effects of exogenous changes in health insurance coverage (e.g. Medicare, PPACA, termination of employer-provided plans) on the dynamic optimal allocation (consumption, leisure, health expenditures), status (health and wealth), and welfare. We solve, simulate, and structurally estimate a parsimonious life cycle model with endogenous exposure to morbidity and mortality risks, and exogenous health insurance. By varying coverage, we identify the marginal effects of insurance when young and/or when old on allocations, statuses, and welfare. Our results highlight positive effects of insurance on health, wealth and welfare, as well as mid-life substitution away from healthy leisure in favor of more health expenses, caused by peaking wages, and accelerating health issues. Copyright © 2016 Elsevier B.V. All rights reserved.

Draft Plan of Operation for a Functional Literacy Pilot Program in Swaziland June-July 1971.

ERIC Educational Resources Information Center

Sebenta National Inst. (Swaziland).

A planned full-time "functional literacy" course that was to be held during June and July 1971 in Ekuhlamukeni and Nqabaneni (Swaziland) is discussed. The experimental pilot project was to be sponsored by the Sebenta National Institute, the University of Botswana, Lesotho and Swaziland Division of Extra Mural Services, and by the…

Insurers Relax Rules, Help Members After Hurricanes Harvey, Irma.

PubMed

Greene, Jan

2017-10-01

Some health plans responded by making it easier to see an out-of-network doctor, get a new copy of an insurance card or replace prescriptions lost in the chaos. Insurers also set up telephone help lines and made it easier to get a referral to a specialist.

Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Final rules.

PubMed

2012-02-15

These regulations finalize, without change, interim final regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services under provisions of the Patient Protection and Affordable Care Act.

[Work place health promotion programmes of the statutory German Pension Insurance].

PubMed

Meffert, C; Mittag, O; Jäckel, W H

2013-12-01

In 2009, the amendment of § 31 Abs. 1 Nr. 2 SGB VI gave the German Pension Insurance the opportunity to provide outpatient medical treatments for insured people who have an occupation with particularly high risk of health. Ever since, the German Pension Insurance has developed various work place prevention programmes, which have been implemented as pilot projects. This article aims at systematically recording and comparatively analyzing these programmes in a synopsis which meets the current state of knowledge. We developed an 8 page questionnaire focusing on work place prevention programmes by the German Pension Insurance. This questionnaire was sent to people in charge of all programmes known to us. All programmes have been drafted -across indications. They are aiming at insured people who already suffer from first health disorders but who are not in imminent need of rehabilitation. However, the concrete target groups at which the specific programmes are aimed differ (shift workers, nurses, elderly employees). Another difference between the various programmes is the setting (in- or outpatients) as well as the duration. All programmes are using existing structures offered by the German Pension Insurance. They provide measures in pension insurance owned rehabilitation centers. It would be desirable to link these performances with internal work place health promotion and offers of other social insurances. © Georg Thieme Verlag KG Stuttgart · New York.

Estimating workers' marginal valuation of employer health benefits: would insured workers prefer more health insurance or higher wages?

PubMed

Royalty, Anne Beeson

2008-01-01

In recent years the cost of health insurance has been increasing much faster than wages. In the face of these rising costs, many employers will have to make difficult decisions about whether to cut back health benefits or to compensate workers with lower wages or lower wage growth. In this paper, we ask the question, "Which do workers value more -- one additional dollar's worth of health benefits or one more dollar in their pockets?" Using a new approach to obtaining estimates of insured workers' marginal valuation of health benefits this paper estimates how much, on average, employees value the marginal dollar paid by employers for their workers' health insurance. We find that insured workers value the marginal health premium dollar at significantly less than the marginal wage dollar. However, workers value insurance generosity very highly. The marginal dollar spent on health insurance that adds an additional dollar's worth of observable dimensions of plan generosity, such as lower deductibles or coverage of additional services, is valued at significantly more than one dollar.

Employment-based health insurance: a look at tax issues and public opinion.

PubMed

Fronstin, P

1999-07-01

This Issue Brief provides background information on the employment-based health insurance system and its alternatives. The report discusses the advantages and disadvantages of the current employment-based health insurance system, the current tax treatment of health insurance, and the strength and weaknesses of recent proposals to introduce tax credits. It presents findings from the public opinion survey conducted by the Employee Benefit Research Institute on public attitudes toward health insurance and summarizes recent research on the effects of tax changes on employment-based health benefits and the uninsured. Employment-based health plans are the most common source of health insurance among nonelderly individuals in the United States, providing coverage to nearly two-thirds of this population in 1997. Health insurance is probably the benefit most used and valued by workers and their families. Sixty-four percent of respondents to a recent survey rated employment-based health insurance benefits as the most important benefit. Despite essentially five years of very low health care cost increases and the recent increase in the percentage of Americans with employment-based health insurance coverage, the uninsured population has continued to rise. This has resulted in a new interest among policymakers in finding ways to reverse this trend. One question that continues to be asked is whether the employment-based health insurance system is the appropriate mechanism for expanding health insurance to the uninsured. Employment-based health plans are popular because they offer many advantages over other forms of health insurance and types of delivery systems. However, there are also potential drawbacks to the employment-based system. The advantages include reduced risk of adverse selection, group-purchasing efficiencies, employers acting as a workers' advocate, delivery innovation, and health care quality. The disadvantages include an unfair tax treatment, lack of portability

Geographic variation in premiums in health insurance marketplaces.

PubMed

Barker, Abigail R; McBride, Timothy D; Kemper, Leah M; Mueller, Keith

2014-08-01

This policy brief analyzes the 2014 premiums associated with qualified health plans (QHPs) made available through new health insurance marketplaces (HIMs), an implementation of the Patient Protection and Affordable Care Act (ACA) of 2010. We report differences in premiums by insurance rating areas while controlling for other important factors such as the actuarial value of the plan (metal level), cost-of-living differences, and state-level decisions over type of rating area. While market equilibrium, based on experience and understanding of the characteristics of the new market, should not be expected this soon, preliminary results give policymakers key issues to monitor.

Incorporating the Six Core Elements of Health Care Transition Into a Medicaid Managed Care Plan: Lessons Learned From a Pilot Project.

PubMed

McManus, Margaret; White, Patience; Pirtle, Robin; Hancock, Catina; Ablan, Michael; Corona-Parra, Raquel

2015-01-01

This pediatric-to-adult health care transition pilot project describes the process and results of incorporating the "Six Core Elements of Health Care Transition (2.0)" into a Medicaid managed care plan with a group of 35 18-23 year olds who have chronic mental health, developmental, and complex medical conditions. The pilot project demonstrated an effective approach for customizing and delivering recommended transition services. At the start of the 18-month project, the Medicaid plan was at the basic level (1) of transition implementation of the Six Core Elements with no transition policy, member transition readiness assessment results, health care transition plans of care, updated medical summaries, transfer package for the adult-focused provider, and assurance of transfer completion and consumer feedback. At the conclusion of the pilot project, the plan scored at level 3 on each core element. The primary reason for not scoring at the highest level (4) was because the transition elements have not been incorporated into services for all enrollees within the plan. Future efforts in managed care will benefit from starting the transition process much earlier (ages 12-14), expanding the role of nurse care managers and participating pediatric and adult-focused clinicians in transition, and offering payment incentives to clinicians to implement the Six Core Elements of Health Care Transition. Copyright © 2015 Elsevier Inc. All rights reserved.

Variation in Prescription Drug Coverage for Triptans: Analysis of Insurance Formularies.

PubMed

Minen, Mia T; Lindberg, Kate; Langford, Aisha; Loder, Elizabeth

2017-09-01

To analyze triptan coverage by insurers to examine (1) possible disparities in coverage for different formulations (oral, intranasal, etc) and (2) quantity limits and stepped care requirements to obtain triptans. Triptans are FDA approved migraine abortive medications. Patients frequently state that they have difficulty accessing triptans prescribed to them. We searched the 2015 drug formularies of commercial and government health insurers providing coverage in NY State. We created a spreadsheet with all of the commercially available triptans and included information about covered formulations, tier numbers and quantity limits for each drug. We then calculated the number of listed plans that cover or do not cover each triptan or triptan formulation, the total number of medications not covered by an insurance provided across all of its plans, as well as the percentage of plans offered by individual companies and across all companies that covered each drug. We also calculated the number and proportion of plans that imposed quantity limits or step therapy for each drug. Of the 100 formularies searched, generic sumatriptan (all formulations), naratriptan, and zolmitriptan tablets were covered by all plans, and rizatriptan tablets and ODTs were covered by 98% of plans. Brand triptans were less likely to be covered: 4/36 Medicaid plans covered brand triptans. Commercial insurers were more likely to cover brand triptans. All plans imposed quantity limits on 1+ triptan formulations, with >80% imposing quantity limits on 14/19 formulations studied. Almost all plans used tiers for cost allocation for different medications. Generic triptans were almost always in Tier 1. Brand triptans were most commonly in Tier 3. Approximately 40% of brand triptans required step therapy, compared with 11% of generic triptans. There are substantial variations in coverage and quantity limits and a high degree of complexity in triptan coverage for both government and commercial plans. © 2017

Determinants of Coverage Decisions in Health Insurance Marketplaces: Consumers' Decision-Making Abilities and the Amount of Information in Their Choice Environment

PubMed Central

Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas

2015-01-01

Objective To investigate the determinants and quality of coverage decisions among uninsured choosing plans in a hypothetical health insurance marketplace. Study Setting Two samples of uninsured individuals: one from an Internet-based sample comprised largely of young, healthy, tech-savvy individuals (n = 276), and the other from low-income, rural Virginians (n = 161). Study Design We assessed whether health insurance comprehension, numeracy, choice consistency, and the number of plan choices were associated with participants' ability to choose a cost-minimizing plan, given their expected health care needs (defined as choosing a plan costing no more than $500 in excess of the total estimated annual costs of the cheapest plan available). Data Collection Primary data were collected using an online questionnaire. Principal Findings Uninsured who were more numerate showed higher health insurance comprehension; those with more health insurance comprehension made choices of health insurance plans more consistent with their stated preferences; and those who made choices more concordant with their stated preferences were less likely to choose a plan that cost more than $500 in excess of the cheapest plan available. Conclusions Increasing health insurance comprehension and designing exchanges to facilitate plan comparison will be critical to ensuring the success of health insurance marketplaces. PMID:24779769

Health Insurance: Most College Students Are Covered through Employer-Sponsored Plans, and Some Colleges and States Are Taking Steps to Increase Coverage. Report to the Committee on Health, Education, Labor, and Pensions, U.S. Senate. GAO-08-389

ERIC Educational Resources Information Center

Dicken, John E.

2008-01-01

College students face challenges obtaining health insurance: they may not have access to insurance through an employer, and as they get older, they may lose dependent coverage obtained through a parent's plan. Federal law ensures continued access to health insurance for some, but not all, such students. Without health insurance, college students…

The impact of Gonoshasthaya Kendra's Micro Health Insurance plan on antenatal care among poor women in rural Bangladesh.

PubMed

Islam, Mohammad Touhidul; Igarashi, Isao; Kawabuchi, Koichi

2012-08-01

Low utilization of antenatal care (ANC) by pregnant women, particularly in rural areas, is an obstacle to ensuring safe motherhood in Bangladesh. Currently, Micro Health Insurance (MHI) is being considered in many developing countries as a potential method for assuring greater access to health care, especially for the poor. So far, there is only limited evidence evaluating MHI schemes. This study assesses the impact of MHI administered by Gonoshasthaya Kendra (GK) on ANC utilization by poor women in rural Bangladesh. We conducted a questionnaire survey and collected 321 valid responses from women enrolled in GK's MHI scheme and 271 from women not enrolled in any health insurance plan. We used a two-part model in which dependent variables were whether or not women utilized ANC and the number of times ANC was used. The model consisted of logistic regression analysis and ordinary least squares regression analysis. The main independent variables were dummies for socioeconomic classes according to GK, each of which represented the premiums and co-payments charged by class. The results showed that destitute, ultra-poor, and poor women enrolled in MHI used ANC significantly more than women not enrolled in health insurance. Women enrolled in MHI, except for those who were destitute or ultra-poor, utilized ANC significantly more times than women not enrolled in health insurance. We assume that GK's sliding premium and co-payment scales are key to ANC utilization by women. Expanding the MHI scheme may enhance ANC utilization among poor women in rural Bangladesh.

Health insurance premium tax credit. Final regulations.

PubMed

2013-02-01

This document contains final regulations relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010.These final regulations provide guidance to individuals related to employees who may enroll in eligible employer-sponsored coverage and who wish to enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit.

Self-Insurance (Waukegan Style).

ERIC Educational Resources Information Center

Falkinham, Ken

The health and dental self-insurance program instituted in the Waukegan (Illinois) Public Schools can credit three major factors for much of its success. First, claims are processed in-house by the district, resulting in improved communications about claim decisions, faster payments, and higher employee satisfaction. Second, the plan is…

The individual insurance market before reform: low premiums and low benefits.

PubMed

Whitmore, Heidi; Gabel, Jon R; Pickreign, Jeremy; McDevitt, Roland

2011-10-01

Based on analyses of individual market health plans sold through ehealthinsurance and enrollment information collected from individual market carriers, this article profiles the individual health insurance market in 2007, before health reform. The article examines premiums, plan enrollment, cost sharing, and covered benefits and compares individual and group markets. Premiums for the young are lower than in the group market but higher for older people. Cost sharing is substantial in the individual insurance market. Seventy-eight percent of people were enrolled in plans with deductibles for single coverage, which averaged $2,117. Annual out-of-pocket maximums averaged $5,271. Many plans do not cover important benefits. Twelve percent of individually insured persons had no coverage for office visits and only 43% have maternity benefits in their basic coverage. With the advent of health exchanges and new market rules in 2014, covered benefits may become richer, cost sharing will decline, but premiums for the young will rise.

Consolidation and the transformation of competition in health insurance.

PubMed

Robinson, James C

2004-01-01

This paper presents data on fifty state and substate insurance markets, in terms of the 2003 relative shares of the largest health plans and the antitrust index of concentration. It presents 2000-03 data on rates of growth in premiums, costs, operating earnings, returns on equity, and share prices for the nation's largest health plans (Well-Point, Anthem, Aetna, and CIGNA). Private insurers face renewed price and profit pressures in the short term, but long-term prospects depend on the emergence of new products and new competitors in an increasingly consolidated industry.

Safe teleradiology: information assurance as project planning methodology.

PubMed

Collmann, Jeff; Alaoui, Adil; Nguyen, Dan; Lindisch, David

2005-01-01

The Georgetown University Medical Center Department of Radiology used a tailored version of OCTAVE, a self-directed information security risk assessment method, to design a teleradiology system that complied with the regulation implementing the security provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The system addressed threats to and vulnerabilities in the privacy and security of protected health information. By using OCTAVE, Georgetown identified the teleradiology program's critical assets, described threats to the assurance of those assets, developed and ran vulnerability scans of a system pilot, evaluated the consequences of security breaches, and developed a risk management plan to mitigate threats to program assets, thereby implementing good information assurance practices. This case study illustrates the basic point that prospective, comprehensive planning to protect the privacy and security of an information system strategically benefits program management as well as system security.

The Fermilab Isdn Pilot Project: Experiences and Future Plans

NASA Astrophysics Data System (ADS)

Martin, D. E.; Lego, A. J.; Clifford, A. E.

Fully operational in June of 1994, the Fermilab ISDN Pilot Project was started to gain insight into the costs and benefits of providing ISDN service to the homes of Fermilab researchers. Fourteen users were chosen from throughout Fermilab, but the number of Fermilab-employed spouses pushed the total user count to 20. Each home was equipped with a basic rate ISDN (BRI) line, a BRI Ethernet half-bridge, and an NT-1. An inter-departmental team coordinated the project. Usage at each home was tracked and frequent surveys were attempted. Lessons learned include: working with Ameritech can be difficult; careful monitoring is essential; and configuration of home computing equipment is very time consuming. Plans include moving entirely to primary rate ISDN hubs, support for different home ISDN equipment and better usage and performance tracking.

Using payroll deduction to shelter individual health insurance from income tax.

PubMed

Hall, Mark A; Hager, Christie L; Orentlicher, David

2011-02-01

To assess the impact of state laws requiring or encouraging employers to establish "section 125" cafeteria plans that shelter employees' premium contributions from tax. Available descriptive statistics, 65 key-informant interviews, and relevant documents in study states and nationally, 2008-2009. Case studies were conducted in Indiana, Massachusetts, and Missouri--three states adopting laws in 2007. Descriptive quantitative information came from insurers, regulators, and surveys of employers. In each state, 15-17 semistructured but open-ended interviews were conducted with insurance agents, insurers, government officials, and third-party administration firms, and 29 informed sources were interviewed from a national perspective or other states. Key informants were selected based on their known or reported experience, in a "snowball" fashion until saturation was reached. Interview notes were coded for systematic analysis. Finally, relevant rulings, brochures, instructions, marketing materials, and other documents were collected and analyzed. Despite the potential for substantial cost savings, use of section 125 plans to purchase individual insurance remained low in these states after 1 or 2 years. Absent a mandate, few employers were strongly motivated to offer these plans in order to retain an adequate workforce, and uncertainty about federal legality deterred doing so. For smaller employers, benefits to owners did not outweigh administrative complexities. Nevertheless, few downsides were found to states mandating or encouraging these plans. In particular, there is little evidence that many employers dropped group coverage as a result. Section 125 plans remain a limited tool for states to reduce the inequitable tax treatment of individually purchased insurance, but a complete remedy requires reform of federal tax law. © Health Research and Educational Trust.

Using Payroll Deduction to Shelter Individual Health Insurance from Income Tax

PubMed Central

Hall, Mark A; Hager, Christie L; Orentlicher, David

2011-01-01

Objective To assess the impact of state laws requiring or encouraging employers to establish “section 125” cafeteria plans that shelter employees' premium contributions from tax. Data Sources Available descriptive statistics, 65 key-informant interviews, and relevant documents in study states and nationally, 2008–2009. Study Design Case studies were conducted in Indiana, Massachusetts, and Missouri—three states adopting laws in 2007. Descriptive quantitative information came from insurers, regulators, and surveys of employers. In each state, 15–17 semistructured but open-ended interviews were conducted with insurance agents, insurers, government officials, and third-party administration firms, and 29 informed sources were interviewed from a national perspective or other states. Key informants were selected based on their known or reported experience, in a “snowball” fashion until saturation was reached. Interview notes were coded for systematic analysis. Finally, relevant rulings, brochures, instructions, marketing materials, and other documents were collected and analyzed. Findings Despite the potential for substantial cost savings, use of section 125 plans to purchase individual insurance remained low in these states after 1 or 2 years. Absent a mandate, few employers were strongly motivated to offer these plans in order to retain an adequate workforce, and uncertainty about federal legality deterred doing so. For smaller employers, benefits to owners did not outweigh administrative complexities. Nevertheless, few downsides were found to states mandating or encouraging these plans. In particular, there is little evidence that many employers dropped group coverage as a result. Conclusions Section 125 plans remain a limited tool for states to reduce the inequitable tax treatment of individually purchased insurance, but a complete remedy requires reform of federal tax law. PMID:21054377

Demand for Long-Term Care Insurance in China.

PubMed

Wang, Qun; Zhou, Yi; Ding, Xinrui; Ying, Xiaohua

2017-12-22

The aim of this study was to estimate willingness to pay (WTP) for long-term care insurance (LTCI) and to explore the determinants of demand for LTCI in China. We collected data from a household survey conducted in Qinghai and Zhejiang on a sample of 1842 households. We relied on contingent valuation methods to elicit the demand for LTCI and random effects logistic regression to analyze the factors associated with the demand for LTCI. Complementarily, we used document analysis to compare the LTCI designed in this study and the current LTCI policies in the pilot cities. More than 90% of the respondents expressed their willingness to buy LTCI. The median WTP for LTCI was estimated at 370.14 RMB/year, accounting for 2.29% of average annual per capita disposable income. Price, age, education status, and income were significantly associated with demand for LTCI. Most pilot cities were found to mainly rely on Urban Employees Basic Medical Insurance funds as the financing source for LTCI. Considering that financing is one of the greatest challenges in the development of China's LTCI, we suggest that policy makers consider individual contribution as an important and possible option as a source of financing for LTCI.

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

20 CFR 323.4 - Guidelines for content of a nongovernmental plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.4 Guidelines for content of a nongovernmental plan. At a minimum, a nongovernmental plan for unemployment or sickness insurance should contain the following features: (a) The title of the plan (e.g., Supplemental Unemployment...

Connected Vehicle Pilot Deployment Program phase 1 : performance measurement and evaluation support plan : New York City : final report.

DOT National Transportation Integrated Search

2016-07-12

This document describes the Performance Measurement and Evaluation Support Plan for the New York City Department of Transportation New York City (NYC) Connected Vehicle Pilot Deployment (CVPD) Project. The report documents the performance metrics tha...

The Social Life of Health Insurance in Low- to Middle-income Countries: An Anthropological Research Agenda.

PubMed

Dao, Amy; Nichter, Mark

2016-03-01

The following article identifies new areas for engaged medical anthropological research on health insurance in low- and middle-income countries (LMICs). Based on a review of the literature and pilot research, we identify gaps in how insurance is understood, administered, used, and abused. We provide a historical overview of insurance as an emerging global health panacea and then offer brief assessments of three high-profile attempts to provide universal health coverage. Considerable research on health insurance in LMICs has been quantitative and focused on a limited set of outcomes. To advance the field, we identify eight productive areas for future ethnographic research that will add depth to our understanding of the social life and impact of health insurance in LMICs. Anthropologists can provide unique insights into shifting health and financial practices that accompany insurance coverage, while documenting insurance programs as they evolve and respond to contingencies. © 2015 by the American Anthropological Association.

Selection on Moral Hazard in Health Insurance

PubMed Central

Einav, Liran; Finkelstein, Amy; Ryan, Stephen; Schrimpf, Paul

2012-01-01

We use employee-level panel data from a single firm to explore the possibility that individuals may select insurance coverage in part based on their anticipated behavioral (“moral hazard”) response to insurance, a phenomenon we label “selection on moral hazard.” Using a model of plan choice and medical utilization, we present evidence of heterogeneous moral hazard as well as selection on it, and explore some of its implications. For example, we show that, at least in our context, abstracting from selection on moral hazard could lead to over-estimates of the spending reduction associated with introducing a high-deductible health insurance option. PMID:24748682

Knowledge and understanding of health insurance: challenges and remedies.

PubMed

Barnes, Andrew J; Hanoch, Yaniv

2017-07-13

As coverage is expanded in health systems that rely on consumers to choose health insurance plans that best meet their needs, interest in whether consumers possess sufficient understanding of health insurance to make good coverage decisions is growing. The recent IJHPR article by Green and colleagues-examining understanding of supplementary health insurance (SHI) among Israeli consumers-provides an important and timely answer to the above question. Indeed, their study addresses similar problems to the ones identified in the US health care market, with two notable findings. First, they show that overall-regardless of demographic variables-there are low levels of knowledge about SHI, which the literature has come to refer to more broadly as "health insurance literacy." Second, they find a significant disparity in health insurance literacy between different SES groups, where Jews were significantly more knowledgeable about SHI compared to their Arab counterparts.The authors' findings are consistent with a growing body of literature from the U.S. and elsewhere, including our own, presenting evidence that consumers struggle with understanding and using health insurance. Studies in the U.S. have also found that difficulties are generally more acute for populations considered the most vulnerable and consequently most in need of adequate and affordable health insurance coverage.The authors' findings call attention to the need to tailor communication strategies aimed at mitigating health insurance literacy and, ultimately, access and outcomes disparities among vulnerable populations in Israel and elsewhere. It also raises the importance of creating insurance choice environments in health systems relying on consumers to make coverage decisions that facilitate the decision process by using "choice architecture" to, among other things, simplify plan information and highlight meaningful differences between coverage options.

Redefining private insurance in a changing market structure.

PubMed

Chollet, D J

1996-01-01

This discussion on likely changes and challenges for the health insurance industry over the coming decade assumes that significant national reform of health care financing for the privately insured population will not occur--or, if it does, that it will mirror the insurance market reforms that many states already have undertaken. First, the changes in private insurance coverage during the past several years are considered, with particular attention to the erosion of employer-based coverage and to the rising influence of public insurance programs--especially Medicaid--on the private insurance market. Next is a description of the changing web of state laws and regulations governing private health insurance. At this writing, virtually every state has enacted or is considering reforms of the small group market to limit what many perceive as unfair or destructive insurer practices and to set new ground rules for competition among insurance arrangements. The changing nature of private insurance contracts in the United States is considered next. Evolving from conventional fee-for-service contracts, private insurance is increasingly a complex mixture of capitation, partial capitation, and reinsurance of capitated arrangements. Finally, this chapter discusses three issues of increasing importance in shaping the marketplace for private insurers: (1) the federal preemption of states' regulatory authority over self-insured employer plans; (2) emerging state regulation to restructure competition in the health insurance and health care markets; and (3) the growing interest of both federal and state governments in medical savings accounts to finance health insurance and health care spending.

Assessing early implementation of state autism insurance mandates.

PubMed

Baller, Julia Berlin; Barry, Colleen L; Shea, Kathleen; Walker, Megan M; Ouellette, Rachel; Mandell, David S

2016-10-01

In the United States, health insurance coverage for autism spectrum disorder treatments has been historically limited. In response, as of 2015, 40 states and Washington, DC, have passed state autism insurance mandates requiring many health plans in the private insurance market to cover autism diagnostic and treatment services. This study examined five states' experiences implementing autism insurance mandates. Semi-structured, key-informant interviews were conducted with 17 participants representing consumer advocacy organizations, provider organizations, and health insurance companies. Overall, participants thought that the mandates substantially affected the delivery of autism services. While access to autism treatment services has increased as a result of implementation of state mandates, states have struggled to keep up with the demand for services. Participants provided specific information about barriers and facilitators to meeting this demand. Understanding of key informants' perceptions about states' experiences implementing autism insurance mandates is useful for other states considering adopting or expanding mandates or other policies to expand access to autism treatment services. © The Author(s) 2015.

20 CFR 323.5 - Submitting proposed plan for Board approval.

Code of Federal Regulations, 2010 CFR

2010-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844 Rush...

20 CFR 323.5 - Submitting proposed plan for Board approval.

Code of Federal Regulations, 2012 CFR

2012-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844 Rush...

20 CFR 323.5 - Submitting proposed plan for Board approval.

Code of Federal Regulations, 2014 CFR

2014-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844 Rush...

20 CFR 323.5 - Submitting proposed plan for Board approval.

Code of Federal Regulations, 2011 CFR

2011-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844 Rush...

20 CFR 323.5 - Submitting proposed plan for Board approval.

Code of Federal Regulations, 2013 CFR

2013-04-01

... UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.5 Submitting... existing plan, to the Director of Unemployment and Sickness Insurance, Railroad Retirement Board, 844 Rush...

Health insurance and the demand for medical care: Instrumental variable estimates using health insurer claims data.

PubMed

Dunn, Abe

2016-07-01

This paper takes a different approach to estimating demand for medical care that uses the negotiated prices between insurers and providers as an instrument. The instrument is viewed as a textbook "cost shifting" instrument that impacts plan offerings, but is unobserved by consumers. The paper finds a price elasticity of demand of around -0.20, matching the elasticity found in the RAND Health Insurance Experiment. The paper also studies within-market variation in demand for prescription drugs and other medical care services and obtains comparable price elasticity estimates. Published by Elsevier B.V.

44 CFR 19.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Health and insurance benefits... Education Programs or Activities Prohibited § 19.440 Health and insurance benefits and services. Subject to..., including family planning services. However, any recipient that provides full coverage health service shall...

44 CFR 19.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Health and insurance benefits... Education Programs or Activities Prohibited § 19.440 Health and insurance benefits and services. Subject to..., including family planning services. However, any recipient that provides full coverage health service shall...

Public subsidies for employees' contributions to employer-sponsored insurance.

PubMed

Merlis, M

2001-01-01

Proposals to provide or subsidize health insurance for low-income families must take account of the fact that many workers have access to employer-sponsored insurance (ESI), but decline it because of required employee premium contributions. This article considers a tax credit for the employee share of ESI in the context of a broader program of income-based health insurance tax credits. Helping uninsured workers pay for available ESI could be more cost-effective than subsidizing their coverage in the nongroup market. The credit would also be available to workers who were already covered, both for equity reasons and to reduce the incentives for employers to drop coverage or for workers to shift to subsidized individual plans. One key issue is how to prevent employers from reducing their current health plan contributions to take advantage of the new funding. Other design questions considered by the article include whether workers should be able to choose between ESI and nongroup coverage, whether minimum benefit standards should apply for employer plans, and how to achieve a fair balance in subsidies for group and nongroup coverage.

How to choose a health plan

MedlinePlus

... please enable JavaScript. When it comes to getting health insurance, you may have more than one option. Many ... one plan. If you are buying from the Health Insurance Marketplace, you may have several plans to choose ...

Planning outstanding reserves in general insurance

NASA Astrophysics Data System (ADS)

Raeva, E.; Pavlov, V.

2017-10-01

Each insurance company have to ensure its solvency through presentation of accounts for its own reserves in the start of the year. Usually the task of the actuary is to estimate the state of the company on an annual basis and the expectation of the status of the company for a future period. One of the major problem when calculating the liabilities of the incurred claims, is related to the delay of payments. Object of consideration in the present note are the outstanding claim reserves, which are set aside to cover claims, occurred before the date of the annual account, but still not paid, and related with them expenses. There may be different reasons for the delay of claims settlement. For example, continuation the process of the liquidation of the damage waiting for necessary documents or the presence of controversial cases whose permission takes time, etc. Thus the claims, which determine the outstanding reserves could be divided in the following types: claims, which are reported, but not settled (RBNS); claims, which are incurred but not reported (IBNR); claims, whose case is finished, but it is possible to be reopened. When calculating the reserves for IBNR claims, most widely used is the Chain-ladder method and its modification presented by the Bornhuetter - Ferguson method. For modeling the outstanding claims, the available data should be presented in so called run-off triangle, which underlies in the basis of such methods. The present work provides a review of the algorithm for calculating insurance outstanding claim reserves according to the Chain-ladder method. Using available data for claims related to liability of drivers, registered in Bulgaria an example is constructed to illustrate the methodology of the Chain-Ladder method. Back-testing approach is used for validating the results.

Insurance: Teacher's Guide. IIC.

ERIC Educational Resources Information Center

University of the South Pacific, Suva (Fiji).

The document presents a guide for teaching insurance protection based on the needs of students in the South Pacific. It is presented as a unit of study within the area of consumer education. Suggestions for unit objectives, student activities, time allocation, teaching methods, and reference materials are offered. A lesson plan is outlined based…

The Addiction Benefits Scorecard: A Framework to Promote Health Insurer Accountability and Support Consumer Engagement.

PubMed

Danovitch, Itai; Kan, David

2017-01-01

Health care insurance plans covering treatment for substance use disorders (SUD) offer a wide range of benefits. Distinctions between health plan benefits are confusing, and consumers making selections may not adequately understand the characteristics or significance of the choices they have. The California Society of Addiction Medicine sought to help consumers make informed decisions about plan selections by providing education on the standard of care for SUD and presenting findings from an expert analysis of selected health plans. We developed an assessment framework, based on criteria endorsed by the American Society of Addiction Medicine, to rate the quality of SUD treatment benefits offered by a sample of insurance plans. We convened an expert panel of physicians to rate 16 policies of 10 insurance providers across seven categories. Data from published resources for 2014 insurance plans were extracted, categorized, and rated. The framework and ratings were summarized in a consumer-facing white paper. We found significant heterogeneity in benefits across comparable plans, as well as variation in the characterization and clarity of published services. This article presents findings and implications of the project. There is a pressing need to define requirements for SUD benefits and to hold health plans accountable for offering quality services in accordance with those benefits.

Personal Financial Planning: Failure to Plan Properly May Have Dire Consequences.

ERIC Educational Resources Information Center

Rosenbloom, Jerry

1988-01-01

Effective personal financial planning results in sound decisions in the areas of insurance, accumulating capital, retirement planning, and tax planning. Appropriate financial planning concerns everyone--regardless of his or her stage in life. (MLW)

CHIP Utilization in South Texas: A Prospective Longitudinal Study of the Children's Health Insurance Program. JSRI Research Report No. 33

ERIC Educational Resources Information Center

Millard, Ann V.; Mier, Nelda; Gabriel, Olga; Flores, Soledad

2004-01-01

The Children's Health Insurance Program (CHIP) began as a federal stopgap measure to assist families whose incomes were too high to qualify for Medicaid, but too low to make health insurance for their children affordable. In 2002, efforts were launched around the United States to recruit eligible children into the program. This pilot study…

Health insurance selection in Chile: a cross-sectional and panel analysis

PubMed Central

Pardo, Cristian; Schott, Whitney

2014-01-01

In Chile, workers are mandated to choose either public or private health insurance coverage. Although private insurance premiums depend on health risk, public insurance premiums are solely linked to income. This structure implies that individuals with higher health risks may tend to avoid private insurance, leaving the public insurance system responsible for their care. This article attempts to explore the determinants of health insurance selection (private vs public) by individuals in Chile and to test empirically whether adverse selection indeed exists. We use panel data from Chile’s ‘Encuesta de Proteccion Social’ survey, which allows us to control for a rich set of individual observed and unobserved characteristics using both a cross-sectional analysis and fixed-effect methods. Results suggest that age, sex, job type, income quintile and self-reported health are the most important factors in explaining the type of insurance selected by individuals. Asymmetry in insurance mobility caused by restrictions on pre-existing conditions may explain why specific illnesses have an unambiguous relationship with insurance selection. Empirical evidence tends to indicate that some sorting by health risk and income levels takes place in Chile. In addition, by covering a less healthy population with higher utilization of general health consultations, the public insurance system may be incurring disproportionate expenses. Results suggest that if decreasing segmentation and unequal access to health services are important policy objectives, special emphasis should be placed on asymmetries in the premium structure and inter-system mobility within the health care system. Preliminary analysis of the impact of the ‘Garantias Explicitas de Salud’ plan (explicit guarantees on health care plan) on insurance selection is also considered. PMID:23558960

Patient Protection and Affordable Care Act; health insurance market rules. Final rule.

PubMed

2013-02-27

This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The final rule clarifies the approach used to enforce the applicable requirements of the Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal governmental plans. This final rule also amends the standards for health insurance issuers and states regarding reporting, utilization, and collection of data under the federal rate review program, and revises the timeline for states to propose state-specific thresholds for review and approval by the Centers for Medicare & Medicaid Services (CMS).

An early examination of access to select orphan drugs treating rare diseases in health insurance exchange plans.

PubMed

Robinson, Sandy W; Brantley, Kelly; Liow, Christine; Teagarden, J Russell

2014-10-01

Patients with rare diseases often face significant health care access challenges, particularly since the number of available treatment options for rare diseases is limited. The implementation of health insurance exchanges promises improved access to health care. However, when purchasing a plan, patients with rare diseases need to consider multiple factors, such as insurance premium, access to providers, coverage of a specific medication or treatment, tier placement of drug, and out-of-pocket costs.  To provide an early snapshot of the exchange plan landscape from the perspective of patients with select rare diseases by evaluating the degree of access to medications in a subset of exchange plans based on coverage, tier placement, associated cost sharing, and utilization management (UM) applied.  The selection of drugs for this analysis began by identifying rare diseases with FDA-approved treatment options using the National Institutes of Health Office of Rare Diseases' webpage and further identification of a subset of drugs based on select criteria to ensure a varied sample, including the characteristics and prevalence of the condition. The medications were categorized based on whether alternative therapies have FDA approval for the same indication and whether there are comparators based on class or therapeutic area. The list was narrowed to 11 medications across 7 diseases, and the analysis was based on how these drugs are listed in exchange plan outpatient pharmacy benefit formularies. This analysis focused on 84 plans in 15 states with the highest expected exchange enrollment and included a variety of plan types to ensure that variability in the marketplace was represented. To best approximate plans that will have the greatest enrollment, the analysis focused on silver and bronze plan formularies because consumers in this market are expected to be sensitive to premiums. Data on drug coverage, tier placement, cost, and UM were collected from these plans

29 CFR 36.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Health and insurance benefits and services. 36.440 Section... Education Programs or Activities Prohibited § 36.440 Health and insurance benefits and services. Subject to..., including family planning services. However, any recipient that provides full coverage health service shall...

10 CFR 5.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Health and insurance benefits and services. 5.440 Section... Education Programs or Activities Prohibited § 5.440 Health and insurance benefits and services. Subject to..., including family planning services. However, any recipient that provides full coverage health service shall...

45 CFR 618.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Health and insurance benefits and services. 618.440 Section 618.440 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE..., hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

45 CFR 618.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Health and insurance benefits and services. 618.440 Section 618.440 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE..., hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

45 CFR 618.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false Health and insurance benefits and services. 618.440 Section 618.440 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE..., hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

45 CFR 618.440 - Health and insurance benefits and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Health and insurance benefits and services. 618.440 Section 618.440 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE..., hospital, accident, or life insurance benefit, service, policy, or plan to any of its students, a recipient...

20 CFR 323.3 - Standards for Board approval of a nongovernmental plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.3 Standards for Board approval of a nongovernmental plan. An unemployment or sickness benefit plan qualifies... conditions governing payment of benefits under the Railroad Unemployment Insurance Act. However, a plan will...

20 CFR 323.3 - Standards for Board approval of a nongovernmental plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.3 Standards for Board approval of a nongovernmental plan. An unemployment or sickness benefit plan qualifies... conditions governing payment of benefits under the Railroad Unemployment Insurance Act. However, a plan will...

20 CFR 323.3 - Standards for Board approval of a nongovernmental plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.3 Standards for Board approval of a nongovernmental plan. An unemployment or sickness benefit plan qualifies... conditions governing payment of benefits under the Railroad Unemployment Insurance Act. However, a plan will...

20 CFR 323.3 - Standards for Board approval of a nongovernmental plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... RAILROAD UNEMPLOYMENT INSURANCE ACT NONGOVERNMENTAL PLANS FOR UNEMPLOYMENT OR SICKNESS INSURANCE § 323.3 Standards for Board approval of a nongovernmental plan. An unemployment or sickness benefit plan qualifies... conditions governing payment of benefits under the Railroad Unemployment Insurance Act. However, a plan will...

Commercial insurance vs community-based health plans: time for a policy option with clinical emphasis to address the cost spiral.

PubMed

Amundson, Bruce

2005-01-01

The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship between various clinical strategies and reductions in utilization and costs. This article describes the organization of health services, including integration of delivery and financing systems, at the community level as a model that effectively addresses the critical structural flaws that have frustrated control of costs. Community-based health plans (CHPs) have been developed and have demonstrated viability. The key elements of CHPs are a legal organizational structure, a full provider network, advanced care-management systems, and the ability to assume financial risk. Common misconceptions regarding obstacles to CHP development are the complexity of the undertaking, difficulty assuming the insurance function, and insured pools that are too small to be viable. The characteristics of successful CHPs and 2 case studies are described, including the types of advanced care-management systems that have resulted in strong financial performance. The demonstrated ability of CHPs to establish financial viability with small numbers of enrollees challenges the common assumption that there is a fixed relationship between health plan enrollment size and financial performance. Organizing the health system at the community/regional level provides an attractive alternative model in the health-reform debate. There is an opportunity for clinical systems and state and federal leaders to support the development of community-based integrated delivery and financing system models that, among other advantages, have significant potential to modulate the pernicious cost spiral.

[Primary and secondary data on dementia care as an example of regional health planning].

PubMed

Ulrich, Lisa-R; Schatz, Tanja R; Lappe, Veronika; Ihle, Peter; Barthen, Linda; Gerlach, Ferdinand M; Erler, Antje

2017-12-01

Health service planning that takes into account as far as possible the regional needs and regional discrepancies is a controversial health issue in Germany. In a pilot scheme, we tested a planning process for regional healthcare services, based on the example of dementia care. The aim of this article is to present the strengths and limitations of this planning process. We developed an indicator set for dementia care based on routine regional data obtained from two German statutory health insurance companies. Additionally, primary data based on a questionnaire sent to all GPs in the area were evaluated. These data were expanded through the addition of official socio-demographic population data. Procedures and evaluation strategies, discussion of the results and the derivation of planning measures followed, in close agreement with a group of local experts. Few epidemiological data on regional variations in health care planning are publicly available. Secondary data from statutory health insurance companies can be assessed to support the estimation of regional health care needs, but interpretation is difficult. The use of surveys to collect primary data, and the assessment of results by the local health board may facilitate interpretation and may contribute towards more valid statements regarding regional health planning. Despite the limited availability of data and the considerable efforts involved in data analysis, the project demonstrates how needs-based health service planning can be carried out in a small region, taking into account the increasing demands of the local health care providers and the special local features.

The Fermilab ISDN Pilot Project: Experiences and future plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martin, D.E.; Lego, A.J.; Clifford, A.E.

1995-12-31

Fully operational in June of 1994, the Fermilab ISDN Pilot Project was started to gain insight into the costs and benefits of providing ISDN service to the homes of Fermilab researchers. Fourteen users were chosen from throughout Fermilab, but the number of Fermilab-employed spouses pushed the total user count to 20. Each home was equipped with a basic rate ISDN (BRI) line, a BRI Ethernet half-bridge, and an NT-1. An inter-departmental team coordinated the project. Usage at each home was tracked and frequent surveys were attempted. Lessons learned include: working with Ameritech can be difficult; careful monitoring is essential; andmore » configuration of home computing equipment is very time consuming. Plans include moving entirely to primary rate ISDN hubs, support for different home ISDN equipment and better usage and performance tracking.« less

33 CFR 385.12 - Pilot projects.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Pilot projects. 385.12 Section... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated... management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary to...

33 CFR 385.12 - Pilot projects.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Pilot projects. 385.12 Section... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated... management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary to...

33 CFR 385.12 - Pilot projects.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Pilot projects. 385.12 Section... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated... management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary to...

33 CFR 385.12 - Pilot projects.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Pilot projects. 385.12 Section... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated... management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary to...

Employer health insurance offerings and employee enrollment decisions.

PubMed

Polsky, Daniel; Stein, Rebecca; Nicholson, Sean; Bundorf, M Kate

2005-10-01

To determine how the characteristics of the health benefits offered by employers affect worker insurance coverage decisions. The 1996-1997 and the 1998-1999 rounds of the nationally representative Community Tracking Study Household Survey. We use multinomial logistic regression to analyze the choice between own-employer coverage, alternative source coverage, and no coverage among employees offered health insurance by their employer. The key explanatory variables are the types of health plans offered and the net premium offered. The models include controls for personal, health plan, and job characteristics. When an employer offers only a health maintenance organization married employees are more likely to decline coverage from their employer and take-up another offer (odds ratio (OR)=1.27, p<.001), while singles are more likely to accept the coverage offered by their employer and less likely to be uninsured (OR=0.650, p<.001). Higher net premiums increase the odds of declining the coverage offered by an employer and remaining uninsured for both married (OR=1.023, p<.01) and single (OR=1.035, p<.001) workers. The type of health plan coverage an employer offers affects whether its employees take-up insurance, but has a smaller effect on overall coverage rates for workers and their families because of the availability of alternative sources of coverage. Relative to offering only a non-HMO plan, employers offering only an HMO may reduce take-up among those with alternative sources of coverage, but increase take-up among those who would otherwise go uninsured. By modeling the possibility of take-up through the health insurance offers from the employer of the spouse, the decline in coverage rates from higher net premiums is less than previous estimates.

Employer Health Insurance Offerings and Employee Enrollment Decisions

PubMed Central

Polsky, Daniel; Stein, Rebecca; Nicholson, Sean; Bundorf, M Kate

2005-01-01

Objective To determine how the characteristics of the health benefits offered by employers affect worker insurance coverage decisions. Data Sources The 1996–1997 and the 1998–1999 rounds of the nationally representative Community Tracking Study Household Survey. Study Design We use multinomial logistic regression to analyze the choice between own-employer coverage, alternative source coverage, and no coverage among employees offered health insurance by their employer. The key explanatory variables are the types of health plans offered and the net premium offered. The models include controls for personal, health plan, and job characteristics. Principal Findings When an employer offers only a health maintenance organization married employees are more likely to decline coverage from their employer and take-up another offer (odds ratio (OR)=1.27, p<.001), while singles are more likely to accept the coverage offered by their employer and less likely to be uninsured (OR=0.650, p<.001). Higher net premiums increase the odds of declining the coverage offered by an employer and remaining uninsured for both married (OR=1.023, p<.01) and single (OR=1.035, p<.001) workers. Conclusions The type of health plan coverage an employer offers affects whether its employees take-up insurance, but has a smaller effect on overall coverage rates for workers and their families because of the availability of alternative sources of coverage. Relative to offering only a non-HMO plan, employers offering only an HMO may reduce take-up among those with alternative sources of coverage, but increase take-up among those who would otherwise go uninsured. By modeling the possibility of take-up through the health insurance offers from the employer of the spouse, the decline in coverage rates from higher net premiums is less than previous estimates. PMID:16174133

44 CFR Appendix B to Part 62 - National Flood Insurance Program

Code of Federal Regulations, 2014 CFR

2014-10-01

... quality control departments, or both, and independent Certified Public Accountant (CPA) firms. This Plan... individual State Insurance Departments, NAIC Zone examinations, and independent CPA firms. (c) Standards... company must— (A) Have a biennial audit of the flood insurance financial statements conducted by a CPA...

44 CFR Appendix B to Part 62 - National Flood Insurance Program

Code of Federal Regulations, 2013 CFR

2013-10-01

... quality control departments, or both, and independent Certified Public Accountant (CPA) firms. This Plan... individual State Insurance Departments, NAIC Zone examinations, and independent CPA firms. (c) Standards... company must— (A) Have a biennial audit of the flood insurance financial statements conducted by a CPA...

48 CFR 212.7102 - Pilot program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Pilot program. 212.7102... OF DEFENSE ACQUISITION PLANNING ACQUISITION OF COMMERCIAL ITEMS Pilot Program for Acquisition of Military-Purpose Nondevelopmental Items 212.7102 Pilot program. ...

75 FR 81544 - Request for Information Regarding Value-Based Insurance Design in Connection With Preventive Care...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

..., Department of Labor; Office of Consumer Information and Insurance Oversight, Department of Health and Human... group health plans and health insurance issuers can employ value-based insurance design in the coverage... Insurance Oversight, Department of Health and Human Services, Attention: HHS-OS- 2010-002, Room 445-G...

Health insurance exchanges of past and present offer examples of features that could attract small-business customers.

PubMed

Gardiner, Terry

2012-02-01

The Affordable Care Act calls on states to create health insurance exchanges serving small businesses by 2014. These exchanges will allow small-business owners to pool their buying power, have more choices of health plans, and buy affordable health insurance. However, creating an exchange that appeals to small-business owners poses several challenges. Past and current exchanges provide valuable insights into the role exchanges can play, services they can offer, and design features that can make them successful. For example, states should allow insurance brokers to provide employers with advice and analysis regarding plans offered in the exchanges. Exchanges should also provide services to ease enrollment, such as a single application for all of the plans they offer, and make additional benefits, such as wellness programs, available on a stand-alone basis or within insurance plans.

Not All Insurance Is Equal: Differential Treatment and Health Outcomes by Insurance Coverage Among Nonelderly Adult Patients With Heart Attack.

PubMed

Niedzwiecki, Matthew J; Hsia, Renee Y; Shen, Yu-Chu

2018-06-05

The Affordable Care Act has provided health insurance to a large portion of the uninsured in the United States. However, different types of health insurance provide varying amounts of reimbursements to providers, which may lead to different types of treatment, potentially worsening health outcomes in patients covered by low-reimbursement insurance plans, such as Medicaid. The objective was to determine differences in access, treatment, and health outcomes by insurance type, using hospital fixed effects. We conducted a multivariate regression analysis using patient-level data for nonelderly adult patients with acute myocardial infarction in California from January 1, 2001, to December 31, 2014, as well as hospital-level information to control for differences between hospitals. The probability of Medicaid-insured and uninsured patients having access to catheterization laboratory was higher by 4.50 and 3.75 percentage points, respectively, relative to privately insured patients. When controlling for access to percutaneous coronary intervention facilities, however, Medicaid-insured and uninsured patients had a 4.24- and 0.85-percentage point lower probability, respectively, in receiving percutaneous coronary intervention treatment compared with privately insured patients. They also had higher mortality and readmission rates relative to privately insured patients. Although Medicaid-insured and uninsured patients with acute myocardial infarction had better access to catheterization laboratories, they had significantly lower probabilities of receiving percutaneous coronary intervention treatment and a higher likelihood of death and readmission compared with privately insured patients. This provides empirical evidence that treatment received and health outcomes strongly vary between Medicaid-insured, uninsured, and privately insured patients, with Medicaid-insured patients most disproportionately affected, despite having better access to cardiac technology. © 2018 The

Sharing of track by transit and freight railroads : liability and insurance issues

DOT National Transportation Integrated Search

2005-09-21

This report explores the issues of liability and insurance that arise in planning and operating track shared between light rail transit and freight railroads. Shared track operations involve some unique risks, and insurance is used to mitigate or man...

A distributional assessment of Rhode Island's Catastrophic Health Insurance Plan (CHIP)

PubMed Central

Lord, Blair M.

1984-01-01

Since 1975, Rhode Island has operated a government-sponsored catastrophic health insurance program that is consistent in spirit with several of the national health insurance proposals. An important but often overlooked effect of such a program is its effect on the distribution of income. Actual claims data for the years 1975-79 are available for the Rhode Island program permitting direct estimation of an average benefit per family and an average tax burden per family in each of 12 income classes. This permits an assessment of the program's redistributional effects. PMID:10310850

76 FR 20668 - Farm Credit System Insurance Corporation Board; Regular Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

... Plan. C. New Business Presentation of 2010 Audits Results. Closed Sesson FCSIC Report on System... Meeting AGENCY: Farm Credit System Insurance Corporation. SUMMARY: Notice is hereby given of the regular meeting of the Farm Credit System Insurance Corporation Board (Board). Date and Time: The meeting of the...

44 CFR 78.5 - Flood Mitigation Plan development.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Flood Mitigation Plan..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.5 Flood Mitigation Plan development. A Flood Mitigation Plan will articulate a...

44 CFR 78.5 - Flood Mitigation Plan development.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Flood Mitigation Plan..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.5 Flood Mitigation Plan development. A Flood Mitigation Plan will articulate a...

44 CFR 78.5 - Flood Mitigation Plan development.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Flood Mitigation Plan..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.5 Flood Mitigation Plan development. A Flood Mitigation Plan will articulate a...

Connected Vehicle Pilot Deployment Program phase 1 : comprehensive deployment plan : New York City : volume 1 : technical application : part I : technical and management approach.

DOT National Transportation Integrated Search

2016-08-01

This document describes the Deployment Plan for the New York City Department of Transportation (NYC) Connected Vehicle Pilot Deployment (CVPD) Project. This plan describes the approach to complete Phase 2 Design/Build/Test, and Phase 3 Operate and Ma...

Automated detection of case clusters of waterborne acute gastroenteritis from health insurance data - pilot study in three French districts.

PubMed

Rambaud, Loïc; Galey, Catherine; Beaudeau, Pascal

2016-04-01

This pilot study was conducted to assess the utility of using a health insurance database for the automated detection of waterborne outbreaks of acute gastroenteritis (AGE). The weekly number of AGE cases for which the patient consulted a doctor (cAGE) was derived from this database for 1,543 towns in three French districts during the 2009-2012 period. The method we used is based on a spatial comparison of incidence rates and of their time trends between the target town and the district. Each municipality was tested, week by week, for the entire study period. Overall, 193 clusters were identified, 10% of the municipalities were involved in at least one cluster and less than 2% in several. We can infer that nationwide more than 1,000 clusters involving 30,000 cases of cAGE each year may be linked to tap water. The clusters discovered with this automated detection system will be reported to local operators for investigation of the situations at highest risk. This method will be compared with others before automated detection is implemented on a national level.

12 CFR 330.14 - Retirement and other employee benefit plan accounts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Retirement and other employee benefit plan... STATEMENTS OF GENERAL POLICY DEPOSIT INSURANCE COVERAGE § 330.14 Retirement and other employee benefit plan accounts. (a) “Pass-through” insurance. Any deposits of an employee benefit plan in an insured depository...

48 CFR 212.7002 - Pilot program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Pilot program. 212.7002... OF DEFENSE ACQUISITION PLANNING ACQUISITION OF COMMERCIAL ITEMS Pilot Program for Transition to Follow-On Contracting After Use of Other Transaction Authority 212.7002 Pilot program. ...

48 CFR 212.7002 - Pilot program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Pilot program. 212.7002... OF DEFENSE ACQUISITION PLANNING ACQUISITION OF COMMERCIAL ITEMS Pilot Program for Transition to Follow-On Contracting After Use of Other Transaction Authority 212.7002 Pilot program. ...

Personal transportation plan pilot program phase 1 : exploring the transportation behaviors and needs of veterans and people with physical disabilities and mobility constraints.

DOT National Transportation Integrated Search

2017-06-01

This report summarizes the initial phase of the Personal Transportation Plan Pilot Program (PTP3). The purpose of the PTP3 initiative is to develop a personal transportation planning tool that can be used by disabled Vermonters and Vermont veterans t...

Dropping out of Ethiopia's community-based health insurance scheme.

PubMed

Mebratie, Anagaw D; Sparrow, Robert; Yilma, Zelalem; Alemu, Getnet; Bedi, Arjun S

2015-12-01

Low contract renewal rates have been identified as one of the challenges facing the development of community-based health insurance (CBHI) schemes. This article uses longitudinal household survey data gathered in 2012 and 2013 to examine dropout in the case of Ethiopia's pilot CBHI scheme. We treat dropout as a function of scheme affordability, health status, scheme understanding and quality of care. The scheme saw enrolment increase from 41% 1 year after inception to 48% a year later. An impressive 82% of those who enrolled in the first year renewed their subscriptions, while 25% who had not enrolled joined the scheme. The analysis shows that socioeconomic status, a greater understanding of health insurance and experience with and knowledge of the CBHI scheme are associated with lower dropout rates. While there are concerns about the quality of care and the treatment meted out to the insured by providers, the overall picture is that returns from the scheme are overwhelmingly positive. For the bulk of households, premiums do not seem to be onerous, basic understanding of health insurance is high and almost all those who are currently enrolled signalled their desire to renew contracts. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

44 CFR 78.9 - Planning grant approval process.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.9 Planning grant approval process. The State POC will evaluate and approve applications for Planning Grants. Funds will be provided only for the flood portion of any mitigation plan, and...

44 CFR 78.9 - Planning grant approval process.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.9 Planning grant approval process. The State POC will evaluate and approve applications for Planning Grants. Funds will be provided only for the flood portion of any mitigation plan, and...

44 CFR 78.9 - Planning grant approval process.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.9 Planning grant approval process. The State POC will evaluate and approve applications for Planning Grants. Funds will be provided only for the flood portion of any mitigation plan, and...

44 CFR 78.9 - Planning grant approval process.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.9 Planning grant approval process. The State POC will evaluate and approve applications for Planning Grants. Funds will be provided only for the flood portion of any mitigation plan, and...

44 CFR 78.9 - Planning grant approval process.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program FLOOD MITIGATION ASSISTANCE § 78.9 Planning grant approval process. The State POC will evaluate and approve applications for Planning Grants. Funds will be provided only for the flood portion of any mitigation plan, and...

45 CFR 146.145 - Special rules relating to group health plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH INSURANCE MARKET Preemption and Special Rules § 146... group health insurance coverage) for any plan year, if on the first day of the plan year, the plan has...— (A) Medicare supplemental health insurance (as defined under section 1882(g)(1) of the Social...

Global warming and the insurance industry

NASA Astrophysics Data System (ADS)

Berz, G. A.

1992-06-01

In the last few decades, the international insurance industry has been confronted with a drastic increase in the scope and frequency of great natural disasters. The trend is primarily attributable to the continuing steady growth of the world population and the increasing concentration of people and economic values in urban areas. An additional factor is the global migration of populations and industries into areas like the coastal regions which are particularly exposed to natural hazards. The natural hazards themselves, on the other hand, have not yet shown any significant increase. In addition to the problems the insurance industry has with regard to pricing, capacity and loss reserves, the assessment of insured liabilities, preventive planning and the proper adjustment of catastrophe losses are gaining importance. The present problems will be dramatically aggravated if the greenhouse predictions come true. The increased intensity of all convective processes in the atmosphere will force up the frequency and severity of tropical cyclones, tornados, hailstorms, floods and storm surges in many parts of the world with serious consequences for all types of property insurance. Rates will have to be raised and in certain coastal areas insurance coverage will only be available after considerable restrictions have been imposed, e.g., significant deductibles and/or liability or loss limits. In areas of high insurance density the loss potential of individual catastrophes can reach a level where the national and international insurance industries run into serious capacity problems. Recent disasters showed the disproportionately high participation of reinsurers in extreme disaster losses and the need for more risk transparency if the insurance industry is to fulfill its obligations in an increasingly hostile environment.

Connected Vehicle Pilot Deployment Program Independent Evaluation: Mobility, Environmental, and Public Agency Efficiency Refined Evaluation Plan - New York City

DOT National Transportation Integrated Search

2018-03-01

The purpose of this report is to provide a refined evaluation plan detailing the approach to be used by the Texas A&M Transportation Institute Connected Vehicle Pilot Deployment Evaluation Team for evaluating the mobility, environmental, and public a...

Employer contribution and premium growth in health insurance.

PubMed

Liu, Yiyan; Jin, Ginger Zhe

2015-01-01

We study whether employer premium contribution schemes could impact the pricing behavior of health plans and contribute to rising premiums. Using 1991-2011 data before and after a 1999 premium subsidy policy change in the Federal Employees Health Benefits Program (FEHBP), we find that the employer premium contribution scheme has a differential impact on health plan pricing based on two market incentives: 1) consumers are less price sensitive when they only need to pay part of the premium increase, and 2) each health plan has an incentive to increase the employer's premium contribution to that plan. Both incentives are found to contribute to premium growth. Counterfactual simulation shows that average premium would have been 10% less than observed and the federal government would have saved 15% per year on its premium contribution had the subsidy policy change not occurred in the FEHBP. We discuss the potential of similar incentives in other government-subsidized insurance systems such as the Medicare Part D and the Health Insurance Marketplace under the Affordable Care Act. Copyright © 2014 Elsevier B.V. All rights reserved.

The effect of premiums on the decision to participate in health insurance and other fringe benefits offered by the employer: evidence from a real-world experiment.

PubMed

Royalty, Anne Beeson; Hagens, John

2005-01-01

In this paper, we investigate the effect of the out-of-pocket premium on the decision to enroll in employer health insurance and other benefits plans including dental insurance, vision care, long-term care insurance, and wellness benefits. Previous estimates of the effects of premium on takeup of health insurance could be biased toward zero due to a correlation between premium and unobservable demand or plan quality. We solve this problem using data representing hypothetical choices by employees under three different price regimes, providing price variation uncorrelated with either individual-specific or plan-specific unobservables. We find that workers are insensitive to price in health insurance takeup. Workers show much greater price sensitivity to decisions about dental insurance, vision plans, long-term care insurance, and wellness benefits. We conclude that premium subsidies are unlikely to have a substantial impact on increasing insurance rates of workers already offered employer insurance.

Evaluating the Impact of Health Insurance Industry Consolidation: Learning from Experience.

PubMed

Dafny, Leemore S

2015-11-01

Research shows consolidation in the private health insurance industry leads to premium increases, even though insurers with larger local market shares generally obtain lower prices from health care providers. Additional research is needed to understand how to protect against harms and unlock benefits from scale. Data on enrollment, premiums, and costs of commercial health insurance--by insurer, plan, customer segment, and local market--would help us understand whether, when, and for whom consolidation is harmful or beneficial. Such transparency is common where there is a strong public interest and substantial public regulation, both of which characterize this vital sector.

Fixing flaws in Medicare drug coverage that prompt insurers to avoid low-income patients.

PubMed

Hsu, John; Fung, Vicki; Huang, Jie; Price, Mary; Brand, Richard; Hui, Rita; Fireman, Bruce; Dow, William H; Bertko, John; Newhouse, Joseph P

2010-12-01

Since 2006 numerous insurers have stopped serving the low-income segment of the Medicare Part D program, forcing millions of beneficiaries to change prescription drug plans. Using data from participating plans, we found that Medicare payments do not sufficiently reimburse insurers for the relatively high medication use among this population, creating perverse incentives for plans to avoid this part of the Part D market. Plans can accomplish this by increasing their premiums for all beneficiaries to an amount above regional benchmarks. We demonstrate that improving the accuracy of Medicare's risk and subsidy adjustments could mitigate these perverse incentives.

26 CFR 1.72-16 - Life insurance contracts purchased under qualified employee plans.

Code of Federal Regulations, 2011 CFR

2011-04-01

... insurance policy at the end of the year, the entire amount of such excess is considered current life... under which the benefits are paid at a date or dates later than the death of the employee, section 101(d... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Life insurance contracts purchased under...

Employee responses to health insurance premium increases.

PubMed

Goldman, Dana P; Leibowitz, Arleen A; Robalino, David A

2004-01-01

To determine the sensitivity of employees' health insurance decisions--including the decision to not choose health maintenance organization or fee-for-service coverage--during periods of rapidly escalating healthcare costs. A retrospective cohort study of employee plan choices at a single large firm with a "cafeteria-style" benefits plan wherein employees paid all the additional cost of purchasing more generous insurance. We modeled the probability that an employee would drop coverage or switch plans in response to employee premium increases using data from a single large US company with employees across 47 states during the 3-year period of 1989 through 1991, a time of large premium increases within and across plans. Premium increases induced substantial plan switching. Single employees were more likely to respond to premium increases by dropping coverage, whereas families tended to switch to another plan. Premium increases of 10% induced 7% of single employees to drop or severely cut back on coverage; 13% to switch to another plan; and 80% to remain in their existing plan. Similar figures for those with family coverage were 11%, 12%, and 77%, respectively. Simulation results that control for known covariates show similar increases. When faced with a dramatic increase in premiums--on the order of 20%--nearly one fifth of the single employees dropped coverage compared with 10% of those with family coverage. Employee coverage decisions are sensitive to rapidly increasing premiums, and single employees may be likely to drop coverage. This finding suggests that sustained premium increases could induce substantial increases in the number of uninsured individuals.

Drug Plan Coverage Rules

MedlinePlus

... the first time Filling a prescription without your new plan card Costs for Medicare drug coverage Joining a health or drug plan How Part D works with other insurance Find health & drug plans Drug plan coverage rules Note Call your Medicare drug plan to find ...

[The state and health insurance].

PubMed

Lagrave, Michel

2003-01-01

The relationship between the State and the health insurance passes through an institutional and financial crisis, leading the government to decide a new governance of the health care system and of the health insurance. The onset of the institutional crisis is the consequence of the confusion of the roles played by the State and the social partners. The social democracy installed by the French plan in 1945 and the autonomy of management of the health insurance established by the 1967 ordinances have failed. The administration parity (union and MEDEF) flew into pieces. The State had to step in by failing. The light is put on the financial crisis by the evolution of ONDAM (National Objective of the Health Insurance Expenses) which appears in the yearly law financing Social Security. The drift of the real expenses as compared to the passed ONDAM bill is constant and worsening. The question of reform includes the link between social democracy to be restored (social partners) and political democracy (Parliament and Government) to establish a contractual democracy. The Government made the announcement of an ONDAM sincere and medically oriented, based on tools agreed upon by all parties. The region could become a regulating step involving a regional health council. An accounting magistrate would be needed to consider not only the legal aspect but to include economic fallouts of health insurance. The role and the missions of the Social Security Accounting Committee should be reinforced.

Multistate Health Plans: Agents for Competition or Consolidation?

PubMed

Moffit, Robert E; Meredith, Neil R

2015-01-01

We discuss and evaluate the Multi-State Plan (MSP) Program, a provision of the Affordable Care Act that has not been the subject of much debate as yet. The MSP Program provides the Office of Personnel Management with new authority to negotiate and implement multistate insurance plans on all health insurance exchanges within the United States. We raise the concern that the MSP Program may lead to further consolidation of the health insurance industry despite the program's stated goal of increasing competition by means of health insurance exchanges. The MSP Program arguably gives a competitive advantage to large insurers, which already dominate health insurance markets. We also contend that the MSP Program's failure to produce increased competition may motivate a new effort for a public health insurance option. © The Author(s) 2015.

Marketing Services: Insurance. Marketing and Distributive Education Curriculum Guide.

ERIC Educational Resources Information Center

Luft, Roger L.; And Others

This guide is designed to provide the curriculum coordinator with a basis for planning a comprehensive program in the field of marketing as well as to provide marketing and distributive education teacher/coordinators with maximum flexibility in planning an insurance marketing curriculum. The guide was constructed by identifying the competencies…

[Insurance system. Prevention from viewpoint of the insurer].

PubMed

Brechtbühl, P

1978-12-01

The purpose of an insurance must not be restricted to the payment of claims to those insured persons who suffered a loss, for loss prevention is much preferable to claim settlement. A whole range of different institutions and measures has been established by the Swiss insurers, in which many insurance branches participate. The loss preventing activities can be listed as follows:--Activities of the fire insurers to prevent and fight fires. This is the prevailing duty of the Consulting Agency for Fire Prevention (BfB) as well as the Fire Prevention Service for Industry and Trade (BVD).--Activities of the accident insurers to prevent accidents. The fight against accidents, mostly traffic accidents, in sports and at home is the foremost task of the Swiss Council for the Prevention of Accidents (BfU), an institution created by the Conference of Accident Insurance Managers (UDK) and the Swiss National Accident Insurance Fund (SUVA).--The Health Service in life insurance, after all the periodical medical examinations and consultations granted by many insurers to their insured persons, as well as the pamphlets aiming at health education published by several Companies and finally institutions and measures to promote fitness, e.g. VITA-Parcours.

Breast Health Services: Accuracy of Benefit Coverage Information in the Individual Insurance Marketplace.

PubMed

Hamid, Mariam S; Kolenic, Giselle E; Dozier, Jessica; Dalton, Vanessa K; Carlos, Ruth C

2017-04-01

The aim of this study was to determine if breast health coverage information provided by customer service representatives employed by insurers offering plans in the 2015 federal and state health insurance marketplaces is consistent with Patient Protection and Affordable Care Act (ACA) and state-specific legislation. One hundred fifty-eight unique customer service numbers were identified for insurers offering plans through the federal marketplace, augmented with four additional numbers representing the Connecticut state-run exchange. Using a standardized patient biography and the mystery-shopper technique, a single investigator posed as a purchaser and contacted each number, requesting information on breast health services coverage. Consistency of information provided by the representative with the ACA mandates (BRCA testing in high-risk women) or state-specific legislation (screening ultrasound in women with dense breasts) was determined. Insurer representatives gave BRCA test coverage information that was not consistent with the ACA mandate in 60.8% of cases, and 22.8% could not provide any information regarding coverage. Nearly half (48.1%) of insurer representatives gave coverage information about ultrasound screening for dense breasts that was not consistent with state-specific legislation, and 18.5% could not provide any information. Insurance customer service representatives in the federal and state marketplaces frequently provide inaccurate coverage information about breast health services that should be covered under the ACA and state-specific legislation. Misinformation can inadvertently lead to the purchase of a plan that does not meet the needs of the insured. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A new dental insurance scheme--effects on the treatment provided and costs.

PubMed

Andås, Charlotte Andrén; Ostberg, Anna-Lena; Berggren, Pontus; Hakeberg, Magnus

2014-01-01

The aim of this study was to investigate whether the revenues cover the costs in a pilot capitation plan, a dental insurance scheme, and to compare this capitation plan (CP) with the original fee-for-service system (FFS), in terms of the amount and type of dental care provided. Data was collected longitudinally over a period of three years from 1,650 CP patients in five risk groups at a test clinic, and from 1,609 (from the test clinic) and 3,434 (from a matched control clinic) FFS patients, in Göteborg, Sweden. The care investigated was the number of total treatments provided and the number of examinations by dentists and dental hygienists, together with preventive, restorative and emergency treatments. The economic outcome was positive from the administrator's perspective, in all risk groups for the three-year period. The amount and type of care provided differed between the payment models, as CP patients received more preventive treatments, less restorative treatments, and more examinations by dental hygienists than the FFS patients. Emergency treatment was performed more often on CP patients, and the difference was due to a higher frequency of such treatments among women in the CP group. The difference between clinics concerning certain treatment measures was sometimes greater than the difference between payment models. The results from this study indicate a net positive economic outcome for the pilot CP system over three years. The payment model and the clinic affiliation had impact on what type and amount of dental care the patients received. This might suggest that the risk of skewed selection and its consequences as well as the influence of clinic-specific practice need further investigation, to ensure economic sustainability in a longer perspective.

The role of insurance claims databases in drug therapy outcomes research.

PubMed

Lewis, N J; Patwell, J T; Briesacher, B A

1993-11-01

The use of insurance claims databases in drug therapy outcomes research holds great promise as a cost-effective alternative to post-marketing clinical trials. Claims databases uniquely capture information about episodes of care across healthcare services and settings. They also facilitate the examination of drug therapy effects on cohorts of patients and specific patient subpopulations. However, there are limitations to the use of insurance claims databases including incomplete diagnostic and provider identification data. The characteristics of the population included in the insurance plan, the plan benefit design, and the variables of the database itself can influence the research results. Given the current concerns regarding the completeness of insurance claims databases, and the validity of their data, outcomes research usually requires original data to validate claims data or to obtain additional information. Improvements to claims databases such as standardisation of claims information reporting, addition of pertinent clinical and economic variables, and inclusion of information relative to patient severity of illness, quality of life, and satisfaction with provided care will enhance the benefit of such databases for outcomes research.

24 CFR 266.602 - Mortgage insurance premium: Insured advances.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

24 CFR 266.602 - Mortgage insurance premium: Insured advances.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

12 CFR 745.9-2 - Retirement and other employee benefit plan accounts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Retirement and other employee benefit plan... Coverage § 745.9-2 Retirement and other employee benefit plan accounts. (a) Pass-through share insurance. Any shares of an employee benefit plan in an insured credit union shall be insured on a “pass-through...

45 CFR 146.180 - Treatment of non-Federal governmental plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH INSURANCE MARKET Exclusion of Plans and Enforcement... plan is not provided through health insurance coverage, (that is, it is self-funded), from any or all... regulated as group health insurance under an applicable State law, then for purposes of this section, a non...

Reimbursement for Supportive Cancer Medications Through Private Insurance in Saskatchewan

PubMed Central

Forte, Lindy; Olson, Colleen; Atchison, Carolyn; Gesy, Kathy

2009-01-01

Background: As demand for cancer treatment grows, and newer, more expensive drugs become available, public payers in Canada are finding it increasingly difficult to fund the full range of available cancer drugs. Objective: To determine the extent of private drug coverage for supportive cancer treatments in Saskatchewan, preparatory to exploring the potential for cost-sharing. Methods: Patients who presented for chemotherapy and who provided informed consent for participation were surveyed regarding their access to private insurance. Insurers were contacted to verify patients' level of coverage for supportive cancer medications. Groups with specified types of insurance were compared statistically in terms of age, income bracket, time required to assess insurance status, and amount of deductible. Logistic regression was used to determine the effect of patients' age and income on the probability of having insurance. Results: Of 169 patients approached to participate, 156 provided consent and completed the survey. Their mean age was 58.5 years. About two-fifths of all patients (64 or 41%) were in the lowest income bracket (up to $30 000). Sixty-three (40%) of the patients had private insurance for drugs, and 36 (57%) of these plans included reimbursement for supportive cancer medications. A deductible was in effect in 31 (49%) of the plans, a copayment in 28 (44%), and a maximum payment in 8 (13%). Income over $50 000 was a significant predictor of access to drug insurance (p = 0.003), but age was not significantly related to insurance status. Conclusions: A substantial proportion of cancer patients in this study had access to private insurance for supportive cancer drugs for which reimbursement is currently provided by the Saskatchewan Cancer Agency. Cost-sharing and optimal utilization of the multipayer environment might offer a greater opportunity for public payers to cover future innovative and supportive therapies for cancer, but further study is required to

The Affordable Care Act and health insurance exchanges: effects on the pediatric dental benefit.

PubMed

Orynich, C Ashley; Casamassimo, Paul S; Seale, N Sue; Reggiardo, Paul; Litch, C Scott

2015-01-01

To examine the relationship between state health insurance Exchange selection and pediatric dental benefit design, regulation and cost. Medical and dental plans were analyzed across three types of state health insurance Exchanges: State-based (SB), State-partnered (SP), and Federally-facilitated (FF). Cost-analysis was completed for 10,427 insurance plans, and health policy expert interviews were conducted. One-way ANOVA compared the cost-sharing structure of stand-alone dental plans (SADP). T-test statistics compared differences in average total monthly pediatric premium costs. No causal relationships were identified between Exchange selection and the pediatric dental benefit's design, regulation or cost. Pediatric medical and dental coverage offered through the embedded plan design exhibited comparable average total monthly premium costs to aggregate cost estimates for the separately purchased SADP and traditional medical plan (P=0.11). Plan designs and regulatory policies demonstrated greater correlation between the SP and FF Exchanges, as compared to the SB Exchange. Parameters defining the pediatric dental benefit are complex and vary across states. Each state Exchange was subject to barriers in improving the quality of the pediatric dental benefit due to a lack of defined, standardized policy parameters and further legislative maturation is required.

MORAL HAZARD IN HEALTH INSURANCE: DO DYNAMIC INCENTIVES MATTER?

PubMed Central

Aron-Dine, Aviva; Einav, Liran; Finkelstein, Amy; Cullen, Mark

2016-01-01

Using data from employer-provided health insurance and Medicare Part D, we investigate whether healthcare utilization responds to the dynamic incentives created by the nonlinear nature of health insurance contracts. We exploit the fact that, because annual coverage usually resets every January, individuals who join a plan later in the year face the same initial (“spot”) price of healthcare but a higher expected end-of-year (“future”) price. We find a statistically significant response of initial utilization to the future price, rejecting the null that individuals respond only to the spot price. We discuss implications for analysis of moral hazard in health insurance. PMID:26769985

The potential and peril of health insurance tobacco surcharge programs: evidence from Georgia's State Employees' Health Benefit Plan.

PubMed

Liber, Alex C; Hockenberry, Jason M; Gaydos, Laura M; Lipscomb, Joseph

2014-06-01

A rapidly growing number of U.S. employers are charging health insurance surcharges for tobacco use to their employees. Despite their potential to price-discriminate, little systematic empirical evidence of the impacts of these tobacco surcharges has been published. We attempted to assess the impact of a health insurance surcharge for tobacco use on cessation among enrollees in Georgia's State Health Benefit Plan (GSHBP). We identified a group of enrollees in GSHBP who began paying the tobacco surcharge at the program's inception in July 2005. We examined the proportion of these enrollees who certified themselves and their family members as tobacco-free and no longer paid the surcharge through April 2011, and we defined this as implied cessation. We compared this proportion to a national expected annual 2.6% cessation rate. We also compared our observation group to a comparison group to assess surcharge avoidance. By April 2011, 45% of enrollees who paid a tobacco surcharge starting in July 2005 had certified themselves as tobacco-free. This proportion exceeded the expected cessation based on 3 times the national rate (p < .001). The length of enrollment was not statistically different between our observation and comparison groups (p = .427). The reported rates of tobacco cessation among GSHBP enrollees resulting from a tobacco surcharge substantially exceed national rates. These surcharges appear to be effective, but the value of these results, and the effectiveness of health insurance surcharges in changing behavior, are tempered by the important limitation that enrollees' certification of quitting was self-reported and not subject to additional, clinical verification.

[Acoustic conditions in open plan offices - Pilot test results].

PubMed

Mikulski, Witold

The main source of noise in open plan office are conversations. Office work standards in such premises are attained by applying specific acoustic adaptation. This article presents the results of pilot tests and acoustic evaluation of open space rooms. Acoustic properties of 6 open plan office rooms were the subject of the tests. Evaluation parameters, measurement methods and criterial values were adopted according to the following standards: PN-EN ISO 3382- 3:2012, PN-EN ISO 3382-2:2010, PN-B-02151-4:2015-06 and PN-B-02151-3:2015-10. The reverberation time was 0.33- 0.55 s (maximum permissible value in offices - 0.6 s; the criterion was met), sound absorption coefficient in relation to 1 m2 of the room's plan was 0.77-1.58 m2 (minimum permissible value - 1.1 m2; 2 out of 6 rooms met the criterion), distraction distance was 8.5-14 m (maximum permissible value - 5 m; none of the rooms met the criterion), A-weighted sound pressure level of speech at a distance of 4 m was 43.8-54.7 dB (maximum permissible value - 48 dB; 2 out of 6 rooms met the criterion), spatial decay rate of the speech was 1.8-6.3 dB (minimum permissible value - 7 dB; none of the rooms met the criterion). Standard acoustic treatment, containing sound absorbing suspended ceiling, sound absorbing materials on the walls, carpet flooring and sound absorbing workplace barriers, is not sufficient. These rooms require specific advanced acoustic solutions. Med Pr 2016;67(5):653-662. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

5 CFR 870.502 - Basic insurance: Waiver/cancellation of insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... insurance: Waiver/cancellation of insurance. (a) An insured individual may cancel his/her Basic insurance at... cancel the insurance. (b) An individual who cancels his/her Basic insurance automatically cancels all...