Ensure Data Solutions’ Post

Another one bites the dust. Cigna+Oscar who writes small group fully insured ACA business, is pulling out of the healthcare market effective 1/1/2025 due to losses. Healthcare reform and its mandates has hurt the small group health insurance market. Good news! There are other options for small employers. We work with 16 PEOs, can create association health plans and have unique offerings through other creative level-funded programs. https://lnkd.in/eKeFVkY6

(MODERN HEALTHCare) - " Cigna Scaling Back Medicare Advantage Offerings In 8 States In 2025." News reports that the move by group's health insurance unit will affect members of certain health plans in Colorado, Florida, Illinois, Missouri, North Carolina, Tennessee, Texas, and Utah. Find The Most AFFORDABLE Health Insurance Plans At: HI4E.org #CignaMedicareAdvantagePlans #CignaSaleOfMedicareAdvantageUnit #MedicareManagedCare #MedicareAdvantagePlans #MedicareAdvantageComplaints #MedicareAdvantageEnrollment #BidenHealthcare #BidenMedicare #MedicarePremiumIncreases #CignaCuttingBackMedicareAdvantagePlans #MedicareReform #MedicareCostOfLivingIncreases #Inflation #BidenInflation #MedicalCostIncreases #MedicareBenefits #HI4E.Org #HealthInsurance4Everyone #SocialSecurityInsolvency #MedicareAdvantagePlans #MedicareFundingDepleted #MedicareTaxes #CostOfLivingIncreasesForSSI #Retirees #SeniorBenefits #ModernHealthcare #HealthAndLifeSolutions #HealthInsuranceForEveryone

A new AMA study reveals that 95% of metropolitan statistical area-level commercial health insurance markets remain "highly concentrated" under federal standards, a figure that has persisted since 2014. Nearly half of these markets became even more concentrated by 2023, with a single payer holding at least 30% market share in 89% of regions and over 50% in 47%. Blue Cross Blue Shield dominates 83% of MSAs, while UnitedHealth leads nationally in both commercial insurance and Medicare Advantage, where 97% of markets are also highly concentrated.

Private insurance is crucial to the health of covered entities’ patient bases & 340B programs. Avita’s Mary Jane Hardman and Glen Pietrandoni offer actionable tips to navigate the open enrollment process in 340B Report. #340B #ACA #OpenEnrollment

At this point, a bipartisan agreement on anything would be welcome. But a bipartisan agreement aimed at addressing our dysfunctional health insurance marketplace would be a development to truly celebrate, especially for pre-Medicare retirees and the self-employed. #retirementplanning #smallbusinessowners

Office of the Commissioner of Insurance (OCI) Commissioner Nathan Houdek recently celebrated the launch of the 12th annual ‘Open Enrollment’ period on Fri., Nov. 1, 2024. This period is crucial for ensuring people have access to the coverage they need through employer-sponsored plans or government programs like the Affordable Care Act (ACA). Additionally, thanks to the ACA, Wisconsonites have passed legislation that ensures lower health insurance rates. During open enrollment, participants can review their options, compare different plans, and make informed decisions based on their healthcare needs and financial situations. It’s an opportunity to assess coverage levels, premiums, deductibles, and provider networks. #OpenEnrollment #ACA #Healthcare

If you needed another sign that substantially higher insurance costs are on the horizon, here it is. A few key takeaways: Insurance carriers in the Medicare Advantage space receive the majority of their funding from Medicare each month per participant. This means that if they can contain costs well, they get to keep whatever is left. Profits are being squeezed in this division due to higher costs and it is likely that Medicare will not provide an equivalent increase in support. On the group health side, carriers like CVS/Aetna rely on premiums to cover expenses and claims are going up equally there. Translation, higher premiums are going to be required to offset these losses. CVS/Aetna are not alone.

Today's Healthcare News: Mississippi Insurance Chief May Sue Feds Over State Health Exchange ⚖️🌐 Mississippi Insurance Commissioner Mike Chaney is prepared to sue the Centers for Medicare & Medicaid Services (CMS) if Governor Tate Reeves doesn’t support the state’s move to establish a state-based health insurance exchange. Mississippi’s legislature passed a law enabling the creation of a state-run exchange, potentially lowering costs and reducing federal payments. However, #CMS requires approval from the governor for the transition. Mississippi’s Advantage: A state-based exchange could increase competition, lowering premiums and attracting more insurers. Legal Action: If Governor Reeves, who has been unresponsive, does not endorse the plan post-election, Chaney will consider legal action to secure CMS approval. Support from Other States: Chaney anticipates other states may join Mississippi in a potential lawsuit. #HealthcarePolicy #StateHealthExchange #InsuranceReform #MississippiNews #MCG #SBMU #SBM101 #ACA https://lnkd.in/emyYh8td

https://lnkd.in/g5wZADER The statement from the ASA illustrated Dr. Arnold's point by noting that Anthem reported a 24.12% increase in its year-over-year net income, along with a 24.29% increase in its net profit margin. It feels like the public is finally waking up! That’s why we’ve introduced a health-sharing plan through our agency—a smarter, more affordable alternative that costs 30% to 70% less than traditional health insurance. Here’s the big question: What could this mean for the insurance industry in the year ahead? If rising health insurance costs are straining your budget, let’s talk—you might discover a better way! 📢 Attention Life and Health Insurance Agents: This opportunity could be a game-changer, especially with the challenges 2025 may bring to the insurance industry. Don’t miss your chance to get ahead!

Soon, all health insurance claims will be processed through a single window - the National Health Claims Exchange (NHCX). Developed by the National Health Authority (NHA), NHCX is currently under trial and will have a standardised format for insurance companies to process claims. This will be a welcome change from the current system where patients have to provide their insurance policy details or a card issued by the third-party administrator (TPA) or insurance company when visiting a hospital. The hospital then accesses the claim processing portal of the company and uploads the required documents for pre-authorisation or claim approval. However, this process is often complicated, leading to long wait times for approvals and complaints about denied claims. NHCX will help to eradicate these challenges by extensively using ABHA IDs to access patient information for clearing insurance claims. With NHCX, the processing of health insurance claims will be more efficient, reducing processing times and the risk of errors. This will ultimately benefit patients and insurance companies alike. This will be a game-changer for the health insurance sector, enhancing efficienc .. (Source: Health Ministry) #healthinsurance #claim #simplifyinginsurance #LIPostingChallengeIndia