Self Insured Employer Health Plans

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Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA)

Author : Suzanne M. Kirchhoff
Publisher : CreateSpace
ISBN 13 : 9781508902300
Total Pages : 32 pages
Book Rating : 4.9/5 (23 download)

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Book Synopsis Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA) by : Suzanne M. Kirchhoff

Download or read book Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care ACT (ACA) written by Suzanne M. Kirchhoff and published by CreateSpace. This book was released on 2015-06-26 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: The 2010 Patient Protection and Affordable Care Act (ACA, P.L. 111-148) requires certain health insurers to provide consumer rebates if they do not meet a set financial target known as a medical loss ratio (MLR). At its most basic, a MLR measures the share of health care premium dollars spent on medical benefits, as opposed to company expenses such as overhead or profits. For example, if an insurer collects $100,000 in premiums and spends $85,000 on medical care, the MLR is 85%. In general, the higher the MLR, the more value a policyholder receives for his or her premium dollar. The ACA requires an annual, minimum 80% MLR for individual and small group insurance plans, and an annual, minimum 85% MLR for large group plans. Congress imposed the MLR to provide "greater transparency and accountability around the expenditures made by health insurers and to help bring down the cost of health care."

Handbook of Insurance

Author : Georges Dionne
Publisher : Springer Science & Business Media
ISBN 13 : 1461401550
Total Pages : 1133 pages
Book Rating : 4.4/5 (614 download)

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Book Synopsis Handbook of Insurance by : Georges Dionne

Download or read book Handbook of Insurance written by Georges Dionne and published by Springer Science & Business Media. This book was released on 2013-12-02 with total page 1133 pages. Available in PDF, EPUB and Kindle. Book excerpt: This new edition of the Handbook of Insurance reviews the last forty years of research developments in insurance and its related fields. A single reference source for professors, researchers, graduate students, regulators, consultants and practitioners, the book starts with the history and foundations of risk and insurance theory, followed by a review of prevention and precaution, asymmetric information, risk management, insurance pricing, new financial innovations, reinsurance, corporate governance, capital allocation, securitization, systemic risk, insurance regulation, the industrial organization of insurance markets and other insurance market applications. It ends with health insurance, longevity risk, long-term care insurance, life insurance financial products and social insurance. This second version of the Handbook contains 15 new chapters. Each of the 37 chapters has been written by leading authorities in risk and insurance research, all contributions have been peer reviewed, and each chapter can be read independently of the others.

Employment and Health Benefits

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309048273
Total Pages : 381 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Employment and Health Benefits by : Institute of Medicine

Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.

An Employee's Guide to Health Benefits Under COBRA

Author :
Publisher :
ISBN 13 :
Total Pages : 36 pages
Book Rating : 4.:/5 (11 download)

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Book Synopsis An Employee's Guide to Health Benefits Under COBRA by :

Download or read book An Employee's Guide to Health Benefits Under COBRA written by and published by . This book was released on 2010 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Health Benefits Coverage Under Federal Law--.

Author :
Publisher :
ISBN 13 :
Total Pages : 108 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Health Benefits Coverage Under Federal Law--. by :

Download or read book Health Benefits Coverage Under Federal Law--. written by and published by . This book was released on 2010 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Care Without Coverage

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309083435
Total Pages : 213 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Care Without Coverage by : Institute of Medicine

Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Coverage Matters

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309076099
Total Pages : 204 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Coverage Matters by : Institute of Medicine

Download or read book Coverage Matters written by Institute of Medicine and published by National Academies Press. This book was released on 2001-10-27 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.

Health-Care Utilization as a Proxy in Disability Determination

Author : National Academies of Sciences, Engineering, and Medicine
Publisher : National Academies Press
ISBN 13 : 030946921X
Total Pages : 161 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine

Download or read book Health-Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Medical and Dental Expenses

Author :
Publisher :
ISBN 13 :
Total Pages : 20 pages
Book Rating : 4.:/5 (3 download)

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Book Synopsis Medical and Dental Expenses by :

Download or read book Medical and Dental Expenses written by and published by . This book was released on 1990 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Self-funding of Health Care Benefits

Author : Carlton Harker
Publisher :
ISBN 13 :
Total Pages : 852 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Self-funding of Health Care Benefits by : Carlton Harker

Download or read book Self-funding of Health Care Benefits written by Carlton Harker and published by . This book was released on 1993 with total page 852 pages. Available in PDF, EPUB and Kindle. Book excerpt:

MEWAs, multiple employer welfare arrangements under the Employee Retirement Income Security Act (ERISA)

Author :
Publisher :
ISBN 13 :
Total Pages : 80 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis MEWAs, multiple employer welfare arrangements under the Employee Retirement Income Security Act (ERISA) by :

Download or read book MEWAs, multiple employer welfare arrangements under the Employee Retirement Income Security Act (ERISA) written by and published by . This book was released on 2003 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Eliminating Health Disparities

Author : National Research Council
Publisher : National Academies Press
ISBN 13 : 0309166136
Total Pages : 310 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Eliminating Health Disparities by : National Research Council

Download or read book Eliminating Health Disparities written by National Research Council and published by National Academies Press. This book was released on 2004-08-09 with total page 310 pages. Available in PDF, EPUB and Kindle. Book excerpt: Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations.

The Affordable Care Act

Author : Tamara Thompson
Publisher : Greenhaven Publishing LLC
ISBN 13 : 0737771496
Total Pages : 130 pages
Book Rating : 4.7/5 (377 download)

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Book Synopsis The Affordable Care Act by : Tamara Thompson

Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

The Future of Disability in America

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309104726
Total Pages : 619 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Future of Disability in America by : Institute of Medicine

Download or read book The Future of Disability in America written by Institute of Medicine and published by National Academies Press. This book was released on 2007-10-24 with total page 619 pages. Available in PDF, EPUB and Kindle. Book excerpt: The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.

Vital Directions for Health & Health Care

Author : Victor J. Dzau
Publisher :
ISBN 13 : 9781947103009
Total Pages : 471 pages
Book Rating : 4.1/5 (3 download)

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Book Synopsis Vital Directions for Health & Health Care by : Victor J. Dzau

Download or read book Vital Directions for Health & Health Care written by Victor J. Dzau and published by . This book was released on 2018-01-18 with total page 471 pages. Available in PDF, EPUB and Kindle. Book excerpt: What can be more vital to each of us than our health? Yet, despite unprecedented health care spending, the U.S. health system is substantially underperforming, especially with respect to what should be possible, given current knowledge. Although the United States is currently devoting 18% of its Gross Domestic Product to delivering medical care¿more than $3 trillion annually and nearly double the expenditure of other advanced industrialized countries¿the U.S. health system ranked only 37th in performance in a World Health Organization assessment of member nations. In Vital Directions for Health & Health Care: An Initiative of the National Academy of Medicine, the U.S. National Academy of Medicine (NAM, formerly the Institute of Medicine), which has long stood as the nation¿s most trusted independent source of guidance in health, health care, and biomedical science, has marshaled the wisdom of more than 150 of the nation¿s best researchers and health policy experts to assess opportunities for substantially improving the health and well-being of Americans, the quality of care delivered, and the contributions of science and technology. This publication identifies practical and affordable steps that can and must be taken across eight action and infrastructure priorities, ranging from paying for value and connecting care, to measuring what matters most and accelerating the capture of real-world evidence. Without obscuring the difficulty of the changes needed, in Vital Directions, the NAM offers an important blueprint and resource for health, policy, and leaders at all levels to achieve much better health outcomes at much lower cost.

Estimates of Federal Tax Expenditures

Author : United States. Department of the Treasury
Publisher :
ISBN 13 :
Total Pages : 12 pages
Book Rating : 4.:/5 (327 download)

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Book Synopsis Estimates of Federal Tax Expenditures by : United States. Department of the Treasury

Download or read book Estimates of Federal Tax Expenditures written by United States. Department of the Treasury and published by . This book was released on 1975 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Self-insurance and Health Benefits

Author : United States. Congress. House. Committee on Small Business. Subcommittee on Health and Technology
Publisher :
ISBN 13 :
Total Pages : 96 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis Self-insurance and Health Benefits by : United States. Congress. House. Committee on Small Business. Subcommittee on Health and Technology

Download or read book Self-insurance and Health Benefits written by United States. Congress. House. Committee on Small Business. Subcommittee on Health and Technology and published by . This book was released on 2014 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt: