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Showing posts with label Convergys. Show all posts
Showing posts with label Convergys. Show all posts

Friday, November 21, 2014

OBAMACARE PRESSURES INSURANCE COMPANIES TO INFLATE ENROLLMENT NUMBERS WITH DENTAL PLANS?? HHS CONFIRMS; GOP SUES



Article Sources: Bloomberg News; Newser

***ARTICLE: "Obamacare’s Subscriber Rolls Include Unpublicized Dental Plans"

The Obama administration said it erroneously calculated the number of people with health coverage under the Affordable Care Act, incorrectly adding 380,000 dental subscribers to raise the total above 7 million.

The accurate number with full health-care plans is 6.7 million as of Oct. 15, a spokesman for the U.S. Department of Health and Human Services confirmed today, saying the U.S. won’t include dental plans in future reports.

“The mistake we made is unacceptable,” Health and Human Services Secretary Sylvia Mathews Burwell said on her verified Twitter account. “I will be communicating that clearly throughout the department.”

The error was brought to light by Republican investigators for the House Oversight and Government Reform Committee, using data they obtained from the U.S. Centers for Medicare and Medicaid Services.

“A mistake was made in calculating the number of individuals with effectuated Marketplace enrollments,” said Kevin Griffis, a spokesman for the U.S. Health and Human Services Department. “Individuals who had both Marketplace medical and dental coverage were erroneously counted in our recent announcements,” he said in an e-mail.

The new count puts enrollment short of a 2013 estimate by the Congressional Budget Office, adopted last year as a goal by the Obama administration, that 7 million people would be enrolled this year. Federal officials said in September they had 7.3 million people enrolled in coverage through new government-run insurance exchanges.

They didn’t distinguish between medical and dental plans, breaking from previous practice without notice.

No More Dental

“Moving forward only individuals with medical coverage will be included in our effectuated enrollment numbers,” Griffis said.

Blending dental and medical plans let the administration assert that enrollment was more than 7 million. The move also partly obscured the attrition of more than 1 million in the number of people enrolled in medical insurance.

The administration had supplied information about dental plans separately in earlier disclosures. In May, the government reported that 8 million were signed up for health plans and 1.1 million were in dental coverage.

Then in September, the numbers became less transparent.

The Medicare agency’s administrator, Marilyn Tavenner, released a new enrollment figure, obtained from insurance companies participating in the exchanges: 7.3 million people were “enrolled in the health insurance marketplace coverage,” she said at a hearing by the Republican-led Oversight committee.

Quietly Added

Tavenner didn’t elaborate or break out dental plans. Reporters asked a spokesman for her agency, Aaron Albright, for more detail on the number after the hearing: He said he had no additional information about it.

“After touting 8 million initial sign-ups for medical plans, four months later they engaged in a concerted effort to obscure a heavy drop-out rate of perhaps a million or more enrollees by quietly adding in dental plan sign-ups to exchange numbers,”
Republican Darrell Issa of California, chairman of the Oversight committee, said in an e-mail from a spokeswoman.

Charles Gaba, a Bloomfield Hills, Michigan-based blogger who backs the Patient Protection and Affordable Care Act and has accurately forecast enrollment, was among those who found Tavenner’s announcement encouraging.

He had predicted enrollment would suffer attrition of about 3 percent per month; Tavenner’s figure suggested the rate was lower, only about 2 percent.

“This is FANTASTIC news,” he wrote at the time.

He said yesterday that he is “appalled” to find out dental plans were included in the figure.

Shifting Estimates

“I really don’t see what the point would be of being misleading about that number,” he said in a phone interview. “Even if it had been 6.9 million, I don’t see that as being a terrible thing.”

The CBO, which forecasts enrollment under the Affordable Care Act, projected in 2013 that 7 million people would be signed up in 2014 before lowering the estimate by 1 million early this year.

The Obama administration has previously said that enrollment would erode from the 8 million figure. Some customers never paid their premiums or stopped paying. Some may have found alternative coverage, such as through a new job; others may have decided the program wasn’t worth the price.

“Instead of offering the public an accurate accounting, the administration engaged in an effort to obscure and downplay the number of dropouts,” Issa said.

Uninsured Drop

The success of the Affordable Care Act should be measured primarily by one “fundamental number,” the U.S. uninsured rate, U.S. health secretary has said. That number is down about four percentage points this year to 13.4 percent, according to Gallup Inc.

After Tavenner’s announcement in September that 7.3 million people had signed up, aides to the Oversight committee demanded the Medicare agency’s raw data. Weeks of negotiations yielded 289 password-protected Excel spreadsheets, each representing enrollment in a single insurance company’s Affordable Care Act health plans.

In addition to enrollment, the spreadsheets include information such as premium revenue each plan received and the amount of tax credits it was paid by the government, to discount premiums. Dividing total premium revenue by enrollment in the plans, the committee aides noticed that some plans had premiums of less than $60 a month.

The low-priced plans also received little in the way of tax credits. Dental coverage sold under the ACA isn’t eligible for the credits, unless it’s combined with a health plan. In that case, the credit first subsidizes the premium for medical coverage, and anything left over goes to the dental plan.

Critical Threshold

The 7 million threshold appears to be important for the administration, said Douglas Holtz-Eakin, president of the American Action Forum, a Washington advocacy group aligned with Republicans that has opposed the health law.
“It’s a little weird,” Holtz-Eakin, a former CBO director, said. “Usually, the goal is for the forecast to hit the reality, but here the reality is being massaged to hit the forecast.”

The dental-plan data may add to a growing credibility problem for the Obama administration, Holtz-Eakin said. Recently, the administration has rebutted remarks by a former adviser, Massachusetts Institute of Technology economics professor Jonathan Gruber, suggesting that Democrats deceived the public when the law was passed in 2010.

‘They Lied’

“The No. 1 most effective message against the Affordable Care Act is: they lied to you to get it through,” Holtz-Eakin said in a phone interview. “People believe that years now after its passage. The distrust is already there, and they’re doing nothing but exacerbate it.”

Burwell, the health secretary, said at a Nov. 10 event that Obamacare enrollment was 7.1 million in October, 200,000 less than in August, again without breaking out dental plans. “That’s the number of people currently enrolled and paying in the marketplace,” Burwell said at the event, which was hosted by the Democratic-aligned Center for American Progress.

Burwell reported the October number after Ted Strickland, the former Democratic governor of Ohio who moderated the event, asked her to respond to critics who say the Obama administration has not been transparent about enrollment or premiums under the Affordable Care Act.

“In terms of this transparency issue, what we’re trying to do is make sure we’re clear,” Burwell said. “What we try and do is give you information when we have it that’s accurate.”

***ARTICLE: "House GOP Sues Obama Over ObamaCare"

As Republicans plot strategy on how to oppose President Obama's immigration changes, they're moving ahead with a plan to go after another signature policy: ObamaCare.

House Republicans today filed their expected lawsuit against the White House, arguing that the president overstepped his authority on certain parts of the legislation (including his postponement of the controversial employer mandate), reports the Wall Street Journal.

Though the suit had been threatened for a while, the filing seemed imminent when Republicans announced earlier this week that they had hired constitutional attorney Jonathan Turley.

Republicans had previously threatened to add their immigration objections to the ObamaCare lawsuit, given that both involve allegations of executive overreach, but today's suit addresses only the health care law, reports New York Times.

John Boehner lays out his main complaint: "If this president can get away with making his own laws, future presidents will have the ability to as well.

The House has an obligation to stand up for the Constitution, and that is exactly why we are pursuing this course of action." The suit was filed against the Health and Human Services and Treasury departments.



Thursday, November 20, 2014

WELLPOINT AND CONVERGYS PANDER FOR OBAMACARE DOLLAR$ BUT TREAT INSURANCE AGENTS LIKE DIRT




I concur with the premise that every Human Being should have Health Care Insurance, but unfortunately the AFFORDABLE CARE ACT Law (OBAMACARE) places the Jobs of all Licensed Insurance Agents at risk.

WELLPOINT Insurance company and CONVERGYS Call Center CEOs pander to Politicians for OBAMACARE Funding but they treat their Licensed Insurance Agents like DIRT!

Especially in Right-to-Work states like NORTH CAROLINA where companies such as WELLPOINT and CONVERGYS force Licensed Insurance Agents to illegally Solicit & Sell Health Care Insurance in States where they are NOT Appointed!

Article Sources: Forbes, Fool.com

**ARTICLE: "Insurance Agents Lose Job Security With Obamacare Ruling"**

Much has been discussed in the media about most of the aspects of the Supreme Court ruling on the Affordable Care Act, or “Obamacare.” I have not seen much about the plight of more than 100,000 insurance agents and brokers.

The floodgates are about to open for the mass firing of Healthcare Insurance Agents.

The Patient Protection and Affordable Care Act dictates that health insurers must spend at least $0.80 of every $1.00 in premiums collected on health care in the individual and small group markets, and $0.85 in the large group market.

Insurance agents represented by National Association of Health Underwriters tried hard for the government to define their commissions as part of the medical expense and failed. The argument by insurance agents was a senseless argument.

Obviously, financial constraints are such that health insurance companies are being forced to develop new products that are suitable for the 30 million uninsured Americans who will soon be insured under the law. There will be no room for commissions in the new lower cost products.

The other big development is the advent of healthcare exchanges under the new law. These exchanges are not yet up and running but it is easy to picture them to be akin to Amazon.com (AMZN) by necessity and by law, insurance companies will have to display their products in easy to understand and easy to compare formats. There will be a huge migration of business from traditional healthcare insurance agents and brokers to the exchanges.

In some ways, the migration will be similar to the migration of retail from the likes of Best Buy (BBY), Barnes & Noble (BKS), and Borders to Amazon.com. At least in retail there are numerous good reasons for the masses to go to the brick and mortar stores. With regard to health insurance the argument for procurement through agents is very weak. Some consumers may continue to use agents simply because they are creatures of habits.

Make no mistake: the volume of business underwritten by agents will dramatically drop.

To date, large insurance companies such as WellPoint (WLP), United Health (UNH), Aetna (AET), Humana (HUM), and Cigna (CI) have been reluctant to fire agents but it is all going to change after the Supreme Court’s ruling. Before the ruling, an insurance company would have justifiably been concerned that if it fired agents or cut their commissions deeply, they would simply promote products of their competitors. If the Supreme Court were to have overturned Obamacare, the decision to terminate agents would have backfired.

Now with the clarity of the Supreme Court ruling, the floodgates for the mass firing of healthcare insurance agents are about to open.


**ARTICLE: "What Obamacare May Mean for WellPoint in 2015"**

Few health insurers cozied up more closely to Obamacare than WellPoint (NYSE: WLP ) , the nation's second-largest health insurer.

WellPoint already serves millions of people through its widely known Anthem brand, and the company participated in 14 state health insurance exchanges during the Affordable Care Act's first open enrollment period.

WellPoint's shoot-first approach to the exchanges and the company's good fortune in managing Medicaid plans in multiple states that embraced Medicaid expansion are expected boost the company's membership rolls by as many as 1.65 million people this year.

That would be well above the company's January prediction for 1 million new members.

That membership surge is resulting in better than anticipated sales and profit for the company, so let's takes a closer look.

The Affordable Care Act health insurance exchanges held their first open enrollment from Oct. 1, 2013, to March 31 of this year. Despite a disastrous launch riddled with technical glitches, few would argue that the exchanges failed in their mission to enroll the uninsured. More than 7 million people signed up (and paid) for health insurance through the exchanges during that six-month period.

But Obamacare did not rely solely on the exchanges to boost insurance membership. The ACA also included a state opt-in Medicaid expansion that resulted in membership in that healthcare program growing by more than 8 million people, too.

The combination of spiking health insurance and Medicaid enrollment is mostly offsetting widespread fear leading up to the ACA's implementation that insurers would sag under the weight of new, more costly members.

Instead, insurers such as WellPoint appear to be thriving. In the third quarter, WellPoint's sales advanced 4.3% year over year to $18.4 billion, leading to earnings per share of $2.36.

WellPoint's membership grew by 259,000 people from the second to third quarters of 2014, bringing total membership served to 37.5 million, an increase of about 2 million from the year-ago period.

The company's commercial and individual markets business, which provides insurance plans through employers and directly to individuals both on and off the exchanges, delivered sales that were essentially unchanged from last year. The flatlining top-line results for the segment are due to employers casting off part-time workers, which offset growth in exchange enrollment. Nonetheless, the ACA appears to have delivered for the segment in terms of operating gains. During the third quarter, segment profit jumped 28.7% year over year to $915.7 million thanks to margin growing from 7.2% to 9.3%.

The ACA had a reverse impact on WellPoint's government business. Sales tied to Medicare, Medicaid, and other state plans grew from $7.77 billion a year ago to $8.55 billion this past quarter, but its operating gain dipped by 3.6% to $284 million. Medicaid costs tied to expensive next-generation medicines like the hepatitis C drug Sovaldi, along with falling Medicare enrollment, were behind the unit's sluggish operating profit.

However, the two business units combined to present a broadly healthy -- and growing -- company with middle single-digit sales growth and 19% operating profit growth last quarter.

WellPoint has steadily bumped up its earnings outlook this year as it has become increasingly confident in its post-reform patient mix.

Heading into 2014, the company thought it might deliver full-year EPS of at least $8; however, the company's 2014 forecast in exiting the third quarter now stands at no less than $8.83. WellPoint has also increased its full-year revenue forecast from $73 billion exiting 2013 to between $73.25 and $73.5 billion. While worries persist that enrolling higher-cost members through the exchanges will create a significant expense headwind for WellPoint, the company's guidance for benefits expense of 83.3% this year suggests those concerns remain overblown.

As the second open enrollment period for the healthcare insurance exchanges begins on Nov. 15, and more states will expand Medicaid coverage under the ACA for 2015, WellPoint appears positioned nicely to capture additional growth next year. As many as 14 million Americans might be covered through the exchanges next year and state Medicaid officials expect enrollment growth to accelerate, rather than decelerate, through next June.

According to a Kaiser Family Foundation survey, Medicaid enrollment in fiscal 2015 ending next June will have jumped by 18% in the 28 states participating in expansion of the program; that would be up from 8.3% growth reported for fiscal 2014.

The key for insurer profitability will remain to price plans appropriately to cover medical care costs while maintaining margin. Given that WellPoint has a full year of experience under its belt, it wouldn't surprise me if plan pricing provides more margin support next year. If so, industry watchers might find that their estimate of $9.31 in EPS for WellPoint next year is too low.

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