Blue Cross raising price of NC individual policies! Is this Health Care Reform?

[KoKo]

Modified Thu, Aug 19, 2010 07:18 PM
Blue Cross raising price of NC individual policies

CHAPEL HILL, N.C. North Carolina's largest health insurer plans to raise prices next year on individuals paying for their own coverage by an average of about 7 percent, the smallest increase since 2007, the company said Thursday.

Blue Cross and Blue Shield of North Carolina is asking state insurance regulators for permission to raise rates on about 300,000 of its 3.7 million customers who buy their own health insurance. This year, rates for individual coverage rose an average of 12 percent.

Blue Cross is the dominant company providing health insurance to individuals, with more than 90 percent of the market.

The company said while some individuals will see double-digit premium increases, about 70 percent will see costs rise by less than 10 percent. Almost 28,000 customers would see rate decreases.

Customers of its Blue Advantage and Blue Options HSA plans will be notified by letter in October what their specific rate increases will be in 2011, the company said.

The latest rate hike request comes almost a month after Consumers Union criticized the Chapel Hill insurer and nine other Blue Cross health plans across the country for raising rates while sitting on big cash reserves. The company responded that it was meeting a state requirement that health insurers keep up to six months' worth of costs in reserve.

Blue Cross CEO Brad Wilson said last month Wilson said he expects to cut about $200 million from the company's $1 billion annual budget by eliminating open positions, cutting jobs through attrition and early retirements, outsourcing and other streamlining efforts. The company employs about 4,400 workers.
http://www.newsobserver.com/2010/08/19/636467/blue-cross-raising-price-of-nc.html

And More:

Aug. 20--The state's largest health insurer plans to hit some members with sharp rate increases again next year, blaming changes from the health overhaul and rising medical costs.

Blue Cross and Blue Shield of North Carolina asked state regulators Thursday for permission to increase rates an average of 6.97 percent for its 300,000 individual members in the state. That's the lowest proposed annual increase since 2007. About 28,000 people would see their rates decrease, including women in their early 20s.

But rates for some children, men and older members will increase 30 percent or more.

Assuming the new premiums are approved by the N.C. Department of Insurance this fall, Blue Cross officials plan to reach out to members facing the biggest increases to discuss options such as cheaper plans with higher deductibles. Insurers set rates by using a variety of factors, including age, medical history and where you live.

The latest rate increases are significant because Blue Cross controls most of the state's market for individual health coverage. It is also the dominant provider of employer-based coverage, with 3.7 million members statewide.

"If you have health care, you're going to pay more," said John McDonnell, a principal with Progressive Benefit Solutions in Raleigh, which helps employers buy insurance.

Health law is changing

Some of his clients are facing rate increases of more than 20 percent. And not just from Blue Cross, but from other big providers, including Cigna, Aetna and United Healthcare.

It's partly because of increasing medical costs and more people using expensive services, but also because the new federal health law is forcing changes such as eliminating annual or lifetime limits on coverage, expanding dependent care for children until age 26 and more, McDonnell said.

"With everything that's been added, you can't really expect costs to go down," he said.

The situation isn't likely to improve any time soon. As more provisions of the health overhaul law take affect in 2014, Blue Cross officials said they expect rates to rise further.

"We do expect significant premium volatility in 2014 as the industry moves to an entirely new rating structure," said Patrick Getzen, Blue Cross' chief actuary.

The rising rates will likely force more people in North Carolina to cut back on coverage or go without, said Adam Linker, a policy analyst with the N.C. Justice Center's Health Access Coalition. And some of the additional "safety net" measures of the federal law won't start until 2014, he added.
"I'd like to see insurers take a small hit now and then figure out what adjustments they need to make in 2014," when federal subsidies will help the uninsured afford coverage, Linker said. At that point, health insurers also will get a boost in business from new members.

http://insurancenewsnet.com/article.aspx?id=219415

[Chipper Chat]

1. My Humana policy was $85 a month in 2006.

It just went up to $216.00 this month. That's almost a 300% increase. Bastards.

[Diane R]

12. We pay nearly $900 a month for two of us. I'd love to have your policy.

And we have a $5,000 deductible and crappy coverage. Washington state. Why is it so low in N.C.?

[Chipper Chat]

35. Whoops, sorry.

I should have clarified that it's a supplemental policy for medicare.

[WinkyDink]

65. I pay over $550 in a GROUP Plan. Where ARE you?? ETA: Just read your update.

[babylonsister]

2. Wow, they're asking if it's okay? Is that normal?

Maybe it won't be ok. And your snark aside, no, this isn't health care reform. It's the start of hcr.

[KoKo]

3. From the Second Article, with further reporting that I just posted:

"If you have health care, you're going to pay more," said John McDonnell, a principal with Progressive Benefit Solutions in Raleigh, which helps employers buy insurance.

Health law is changing

Some of his clients are facing rate increases of more than 20 percent. And not just from Blue Cross, but from other big providers, including Cigna, Aetna and United Healthcare.

It's partly because of increasing medical costs and more people using expensive services, but also because the new federal health law is forcing changes such as eliminating annual or lifetime limits on coverage, expanding dependent care for children until age 26 and more, McDonnell said.

"With everything that's been added, you can't really expect costs to go down," he said.

The situation isn't likely to improve any time soon. As more provisions of the health overhaul law take affect in 2014, Blue Cross officials said they expect rates to rise further.

"We do expect significant premium volatility in 2014 as the industry moves to an entirely new rating structure," said Patrick Getzen, Blue Cross' chief actuary.

The rising rates will likely force more people in North Carolina to cut back on coverage or go without, said Adam Linker, a policy analyst with the N.C. Justice Center's Health Access Coalition. And some of the additional "safety net" measures of the federal law won't start until 2014, he added.
"I'd like to see insurers take a small hit now and then figure out what adjustments they need to make in 2014," when federal subsidies will help the uninsured afford coverage, Linker said. At that point, health insurers also will get a boost in business from new members.

[elleng]

42. Presumably the State can say 'no,' and should do so, imo.

[elleng]

43. Right, b'sis; State should say, "No."

Yes, this is normal, that is, States do regulate insurance industry within their borders, and sure should do so with citizens in mind.

[dflprincess]

4. It is not health care reform.

It's the Insurnance Profit Protection Act and it's working just like it's suppose to. We're paying more and getting less.

Why anyone thought handing more money to the same old crooks would fix the problem and get us access to care is beyond me.

[jtrockville]

18. Yes indeed. It was predictable, and predicted.

[MikeW]

24. i predicted rates would go up and I was berated by DU

[LisaM]

61. It was predicted.

IIRC, the insurance companies basically cut a deal, where they agreed not to completely derail healthy care reform by agreeing to limit how much they raised their increases. It was very back door, though the information was out there.

[lynne]

38. It was never health care reform. It has always been about insurance -

- and controlling the expense of health care itself was never addressed. Insurance premiums will not go down until such time as the items that insurance pays for are either controlled or reduced. That didn't happen.

What did happen is that insurance rating and underwriting requirements have been changed. The companies have no established history based on the new rules and regs. As a result, premium are and will continue to increase until such time as loss and expense history can be established based on the new requirements and a revised rating structure can be established. That will be years.

It was predicted. We were forewarned. It was ignored.

[Mimosa]

5. Almost nearing 'going without coverage'

My life partner and I are both over 55. We've long been self-employed because the field of graphic design generally does not hireg full or part time employees. Most companies needing design and graphics hire independent contractors as they have since the early 1990s.

So we have long time experience with paying for our own health insurance. We've lived in 3 states. Blue Cross Blue Shield is the main company from which self employed people can purchase policies. Kaiser Permanente is another, but it's rates are similar and the provider options are more restricted.

In 2 states for well over 20 years we've paid for our health insurance policies. For the past 5 years we've had an awful struggle because when people are over 50 the age ratings go WAY UP!

Here's what we are struggling to pay. We have no money left to save for our old age or even take vacations or have any recreation because we HAVE to pay big age -rated premiums for our health insurance policies.

Blue Cross/Blue Shield of GA charges us $895.00 a month for our $10,000 annual (for each person) deductible, 70/30 in network policies. The deductible for presriptions is $1,000.00 each before BC/BS will kick in. So they don't. We pay for our own prescriptions. We pay 40 bucks for each office visit to MDs. We pay the 30% for all lab tests. On top of this rip off, my partner and i had pre-existing conditions to which any symptoms we ever had were linked, and excluded. That meant no coverage for any respiratory type symptoms for my partner.

We have variable incomes. Our annual incomes can vary between $20,000 up to $60,000. There is no way to control it and because we are over 50 companies in the field don't hire us if they were hiring anybody. And we're too old to start over again, iykwim.

We can't change health insurance because of pre-existing conditions. I've tried it and even had a BC/BS rep laugh at me less than 2 weeks ago. IF we could change it wouldn't be cheaper because of age related ratings. Nothing ht HCR bill of 2010 did will address age related discrimination. And even after 2014 nothing in HCR 2010 will change that. :(

I know conservative people who had voted for Obama because they believed he would work to get us affordable health insurance. Many people now are self employed.. anyway...

Partner and I can't afford to save any money for our old age because we are paying $13,000+ a year for 'access' to the health care system. :( And when we don't have any money when we are old people will smirk at us and wonder 'why didn't they save any money for their old age?'

Sad, isn't it? How many others here are in the same boat?

I REALLY want to drop the stupid BC/BS policies. But at our ages if we did another company would refuse to insure us. And if either of us had a heart attack, accident or stroke, medical costs could mean a hospital/provider could take away our home. I've read that is behind many bankruptcies and foreclosures.


How can it be that France, Germany, Australia, the UK, Canada and all civilised countries have universal health care? I don't believe republicans alone prevented real health care reform. I watched as I'd been watching for 20 years, and saw how some Democratic reps were in bed with the health care industry. We got what the health insurance, pharma and health related businesses agreed to let us have. And it's a joke. Conservatives I know -just like me and many liberals- were wanting genuine reform. But we were sold out.

[bornskeptic]

16. You're wrong about the healthcare bill and age discrimination.

Nothing ht HCR bill of 2010 did will address age related discrimination. And even after 2014 nothing in HCR 2010 will change that.
The bill restricts premium differentials based on age to 3:1, whereas they currently run far higher. Even the 3:1 ratio is irrelevant for anyone with a family income not exceeding 400% of the poverty level. For anyone eligible for a subsidy, the after subsidy cost of coverage is determined only by income and family size. A couple in their sixties with $40,000 in income will in the end pay the same as a couple in their twenties with the same income. A couple in their sixties with an income of $80,000 will of course pay more because of the 3:1 differential, but far less than they do now when the differential may be 10:1 or more.

I'm 61 myself, so I understand the complaints about age discrimination, but the truth is that a person my age is more than three times as expensive to insure as a 25-year-old, so that even allowing a 3:1 ratio means that younger people are subsidizing older people. Of course this would be true to a much greater extent if premiums were required to be the same for everyone.

[Vinca]

26. Isn't that the point of insurance? A shared risk?

Someday the 25 years old is going to wake up and find himself 61. That's why we need single-payer paid for out of common funds collected by taxation.

[Mimosa]

28. I'm talking about NOW, not 4 years from now. *smile* eom

[suzie]

59. I thought that one of a good starting point that was mentioned during the healthcare

debate was to lower the age of Medicare to 55, or at least allow some kind of buyin for people in the 55-65 age group. Made all kinds of sense for a lot of reasons, and sounded like something that might be politically feasible.

But it didn't appeal to those who were only willing to talk about "single payer", and who really didn't seem to care about passing any kind of reform.

Which is not to say that you were one of those.

Just that a lot of other people didn't seem to be able to see that lowering the age group for Medicare some would likely promote greater eventual support for "Medicare for all". And a way to enable more people in the 55-65 group to be self-employed.

[jefferson_dem]

6. That's terrible. I sure wish we had done nothing instead...

Zero reform. Status quo. Teabagger appeasement. Then and only then would the industry would have done the right thing and lowered premiums!

[dave29]

7. true that.

What were we thinking

[Mimosa]

8. Appeasement pretty much describes the fake 'HCR of 2010'

Jefferson_Dem, I wish you could walk for a while in my little family's shoes and you'd understand what it's like to never have any money or recreation (like veven weekend type vacations) because of the health insurance costs I have described.

If this country could have an advanced health care system I could quit worrying and be able to afford the medicines which our MDs prescribe. It's not right that my partner's asthma was excluded for 5 years. Can you possibly understand how frustrating it is to struggle to come up with nearly $900 a month (plus co-pays anf prescription costs) is?

IF we could save even $500 a month we wouldn't have to agonise over what our old age will be like.

Do you know that even IRAN has national health care? Most countries in South America have universal health care and all countries in Europe. But the oligarchy and corporations which have bought our politicians have corrupted the system to where we don't have a chance. So, tell me to wait, that change is incremental and all that. I don't have the time.

My partner and i have been paying into a system which makes HUGE profits for the few executives and the stock holders. The HCR act of 2010 did not substantially change anything. The exact same profit based structure remains.

Do you even get my point that the high premiums ( sometimes we miss one and have to catch up) have kept us and milions like us from being able to save for our old age? Or that we can't even have vacations? The scheme dictated by the health insurance corporations insure that the super rich profit. Mainly, supposedly, what we get for the $895 a month is access to doctors and hospitals.

We wouldn't mind paying for real health care. That might have meant being able to buy into the federal employees health insurance plans or an expanded open to all Medicare system.Why can't Americans have what citizens in other countries have? BUT our politicians solidified the system wherein profits are King and people are serfs or less.

I feel like your post was smirking at my situation. That I don't mind. But my situation is that of millions of hardworking Americans. It's not a game to us.

*edited for spelling errors*

[jefferson_dem]

32. To clarify:

I'm not smirking at or mocking anyone's personal economic condition. Like everyone else, I realize times are hard. But to blame these problems on the solutions is just ... plain stupid. Sorry.

[TheKentuckian]

11. They aren't going to lower prices at all without a boot on the neck and a gun to the head

and maybe not then either.

The same system is in effect, even after year 20 only a very few will get in the dumbass state regulated state exchanges.

The reforms are a counter-productive tax on benefits which encourages cost shifting to reduce premium costs and that the insurance industry not only gets a key to the treasury but the IRS will play Bruno the Enforcer for them to make sure we all pay our protection money.

[elleng]

44. The States have the boots and the guns, and should use them.

[TheKentuckian]

60. Even California (the 7th or 8th largest economy in the world) could not battle the insurance cartel

They are bringing library books to a gunfight.

[elleng]

62. States are closer to the PEOPLE than the feds are,

so its up to We the People to get on our State Governments to do their jobs. I recognize its not easy, but it really is a test of our system. (Prolly easier for SMALLER states to deal with than Calif, due to its size and 'power.')

[TheKentuckian]

63. The states are easily captured by corporate money, they are dirt cheap

Do you really think say West Virginia has the wherewithal to stand up to Big Coal?

Our system has been failing the test for decades and decades, that's why we are were we are Ellen. We've been trying this way for generations and now states have less resources to bring to bear than ever.

We have marched right into the same pit we were supposed to be climbing out of here. You are arguing from a perspective that seems to think we've been doing something very different and are now have a new solution.

This is why this "reform" is bullshit, you barely breath on the surface of it and the "old" system is right there.

[elleng]

67. No, I don't think WV has the wherewithal to stand up to Big Coal.

I think that the people in some states, at least, could force their state govt/commissions to stand up to insurance cos, as most states have insurance commissions, and can regulate the industry for the people, as health care is such a big issue now.

I am optimistic about an educated electorate, and think there is an opportunity here. Either we use our power w/in our states or we don't.

[eomer]

15. Was doing nothing the only other option? n/t

[LostinVA]

22. Exactly -- no, it wasn't

Even if single-payer couldn't have been achieved, a more robust, actual insurance oversight and reform could have been.

[jefferson_dem]

33. At the end of the day...

Yes.

It was "Kill the Bill!" or "Grab the progress within reach and keep working for more". Don't you remember?

[eomer]

48. That's what I'm complaining about. Duh.

The reason that would be true is because there are so many members of Congress who are working for the corporations who own them rather than for the people. But the other reality is that President Obama also has been working for the corporations who own him on many issues, including this one. So your reasoning is a bit circular isn't it? I'm complaining because we couldn't get something better done and you're saying, "oh but you're forgetting we couldn't get something better done." No, I'm not forgetting that. That is what sucks. An overwhelming majority of the American people were in favor of getting something better done but that couldn't happen because there wasn't enough support among their elected representatives, including the President, because they were working for the corporations rather than for the people who elected them.

[uponit7771]

40. yes, occording to the number of congress votes to do "something"

[Milo_Bloom]

21. I wish they had used it as a rallying point

Instead of passing a "historic" bill that doesn't really accomplish anything.

I completely fail to understand why they were entirely unable to sell a SIMPLE plan to the public and make it the rallying cry of the 2010 midterms when the GOP blocked it.

In many many ways... doing nothing in attempt to do more is far better than something that amounts to nothing.

[jefferson_dem]

34. Here's your version of not accomplishing anything...

With images...

http://www.huffingtonpost.com/2010/03/22/health-reform-bill-summary_n_508315.html#s75157

[Mimosa]

53. Much of that is window dressing.

J.D., those reforms don't happen until 2014 -2018 and may be changed before then. People who now have high cost insurance cannot drop it because the pools don't exist, there are no present subsidies and all insurance companies can still exclude adults with pre-existing conditions. Costs are making insurance for the self-emplyed out of reach for many.

No, the alternative was not 'doing nothing'. The alternative was to enact change which would help people, not corporations. And why was a public option considered unpassable when 70% of citizens wanted it? The politicians refused to do what their 'funders' didn't want them to do. You know it. You know why. It's always about the money, not the principles.

[Milo_Bloom]

58. All of which are EASY to get around for the insurance industry.

That is the problem.

[dflprincess]

27. By passing faux reform and delaying the full impact of the bill

with it's mandated premiums the Democrats can pretend they did something and, despite their empty promises to "fix it later", continue to ignore the real problems for many years to come. All the while their campaign contributors continue to rake in the bucks - both directly from us and from the government in the form of premium subsidies.

Meanwhile, many Americans will still have limited, if any, access to care as the number of underinsured explodes and, per the CBO, the number of without any "coverage" at all starts to rise again after the initial drop.

[IndianaGreen]

37. We could have had Medicare for all

but the folks that love the for-profit system for reasons of their own investments, would have none of it!

[uponit7771]

39. +1

[Skittles]

46. the bill is absolute garbage

now we just have more crap we will be REQUIRED to buy

[Mimosa]

9. K&R n/t

[autorank]

10. This IS what they knew would happen - self employed are screwed

I'm one of them and I'm really pissed off about it. But enough about me.

I predicted this on Aug 24, 2009

Screwing the Self Employed Out of Health Insurance By Michael Collins

It was true then and it's true now.

15,000,000 self employed at risk for their health insurance

[Mimosa]

25. ^ Superb article link, Autorank ^

I hadn't read it before. Thank you. The article perfectly describes what self-employed are dealing with.

http://www.apj.us/index.php?option=com_content&task=view&id=2567&Itemid=2

[valerief]

13. America is not a civilized country. It's a facist state. That means they

shit on us and if we don't like it, they put us in one of their many, many taxpayer-paid prisons.

[crazylikafox]

17. +1

[pecwae]

14. Kicking and rec.

[ProSense]

19. "customers...are not yet supported by safety nets such as federal subsidies...insurance exchange"

Blue Cross: Hikes below medical trends

By Monica Chen

DURHAM -- Blue Cross and Blue Shield of North Carolina said rate increases proposed this week are below the medical trends for the Blue Advantage and Blue Options HSA individual plans in part because of changes brought about by health care reform.

Medical trends, which is a combination of number of services used and the cost of each service, is currently 13.90 percent for Blue Advantage and 11.98 percent for Blue Options HSA -- meaning that the cost of the plans double every six years.

<...>

Grandfathered plans -- those in place when the bill was signed in March 2010 -- will include the new health care reform regulations of dependent coverage to 26, no pre-existing conditions limitations on members under 19, no lifetime limits.

Non-grandfathered plans will include no annual limits on essential benefits, preventive coverage with no member cost sharing.

Additional details on Blue Cross' rate increase distribution proposed for 2011:

n 70 percent of customers would see rate changes of less than 10 percent

n 84 members turning 66 years old will see increases of 50 percent

n Males turning 50 or turning 60 will see increases of 30-39 percent

n Females turning 26 and males turning 45 will see increases of 20-29 percent

n 28,000 customers will see rate decreases

Adam Linker, a health care expert with the N.C. Justice Center, said that while it's good that Blue Cross is making changes ahead of time, customers seeing increases are not yet supported by safety nets such as federal subsidies and the insurance exchanges, which won't be in place until 2014.

"I can see it from both sides. They have to do what they have to do as a business," Linker added. "But before 2014 has come around and we don't have those premium subsidies and exchanges, those premiums might be hard to handle, especially in this economy."

[KoKo]

23. And, what assurances can we have that "Safety Net" will kick in 2014?

What if Obama isn't re-elected? What if we lose the House in Mid-Terms and the Senate becomes closer Repugs to Dems?

I always thought pushing off some of the best of the bill until 2014 was foolish because it would leave the "kick in's" so vulnerable to political shifts. And, what about the people having to deal with the increases for three more years who still have a partial "doughnut hole" lack of coverage or who are self employed or losing their jobs because of the economy. The bill has turned out to be very confusing in practice and it's not making anyone happy in it's totality. Some kids will be covered longer but what if their parents lose their insurance. Some folks who didn't have care before will now have it available but there are turning out to be loopholes in even that coverage that are showing up. There are too many "what ifs" that seemed to be based on a fast economic recover that isn't looking likely

[Milo_Bloom]

20. Should anyone be surprised?

HCR has no EFFECTIVE cost controls, since all the industry has to do is act in concert or shift job titles and they can justify rate increases and not ACTUALLY spending more on care.

[boppers]

29. "the smallest increase since 2007"

"North Carolina's largest health insurer plans to raise prices next year on individuals paying for their own coverage by an average of about 7 percent, the smallest increase since 2007, the company said Thursday."

Sounds like it's a good thing.

[KoKo]

30. Key WORD: "The Company Said." Talk to NC'linians who've seen Increaces EVERY YEAR!

As small Business Owners both "We" and those we employ have had to eat these increases. There were many employers who fired people because of this.

[Mimosa]

31. I know a few people who've been fired.

Then the ones which remain have to do 2 jobs for the price of 1. :(

[dflprincess]

36. And will those individuals be seeing 7% increase in their incomes?

Just because it's lower than past years doesn't make a big jump (and 7% is still big) a good thing.

And note the 7% is an average there will be people seeing larger increases.

[wisteria]

41. Insurance costs were expected to rise-but not as high or as quickly as they would have without

health Care Reform. This is being played this way to hurt the Democrats. And, of course the Dem's will not know how to frame it to reflect in actuality what reform has done, which is to stopping the bleeding and prevent it from getting worse.

[Skittles]

47. LOLOL

:rofl:

[KoKo]

57. Well...then it should have been framed as: "You Will Pay More...but it's GOOD FOR YOU"

because it could have been worse. We could have had McCain Health Care. Oh...wait...! What was McCain's health care plan?

[Skittles]

45. NOTHING in that "reform" crap reins in costs

it's just plain garbage

[CTLawGuy]

49. what would the increase have been

WITHOUT health care reform?

[jefferson_dem]

51. Hush now...

Logic is not allowed around here.

[Mimosa]

52. There is plenty of logic, knowledge and truth around here

It's just not coming from you, J.D. You do not appear to understand or sympathise with the painful realities which DU members and millions of others are struggling with on a daily basis. You must have a good job, solid health insurance and not be in any financial stress. All the more reason you should be humble and thankful but your contempt for many of us is apparent. It's you who is being illogical in your defense of the indefensible.

AS I said, even Iran has national health care.

[jefferson_dem]

54. Sorry, i'm blown away at the irony of your sanctimony.

You say I do not understand or sympathize with the painful realities while you scoff at, and mock as "window dressing," the *real* benefits provided to *real* people under this reform package. Shame on you.

Nobody said it's perfect. But to deny that is *real* progress - to say that doing nothing would have been preferable - is to publicly express ignorance.

[Mimosa]

55. I'm not scoffing but saying there is no help for me and millions like me

You don't get it. I am telling the truth about the programs as well as the time table. What are my partner and I supposed to do? Go without insurance until 2014 because we can no longer afford it?

There aren't any programs to help us. We are above the poverty level, over 50 and have a highly variable income but not enough to keep paying over $13,000 a year plus medicines, etc.

You are mocking me and people like me for political reasons. And you are being insulting and hurtful.



*edited for spelling*

[agentS]

50. Instead of raising prices, maybe they should cut back on CEO pay

and those stupid TV ads.

[Mimosa]

56. Here is a link with rates and facts for a state sponsored HCR plan

The rates for the state plans will be similar to the BC/BS hellacious plan my partner and I now struugle to pay: high deductibles, high premiums and one can get kicked out easily. The GA plan is the same but more expensive. Now here's the kicker: one has to go without insurance for 6 months before applying! WHAT IF SOMETHING HAPPENS TO YOU WITHIN 6 MONTHS?

http://www.state.nj.us/dobi/division_insurance/njprotect/index.htm

Excerpt:

NJ Protect coverage is intended to remain in place until December 31, 2013. However, there are reasons it would end earlier, as explained below.

NJ Protect coverage will end if you do not pay the monthly premiums when due. There is a 31 day grace period for each premium payment, but if the premium is not paid by the end of the grace period the coverage will be retroactively terminated to the last day for which premium was paid. There is no opportunity to reinstate the coverage so be sure to pay your premiums on time!

NJ Protect will end when you become covered under Medicare or under a group plan.

The Federal dollars that are helping reduce the cost of coverage for NJ Protect are expected to allow the coverage to continue until December 31, 2013. However, it is possible the money available to New Jersey will be used up before December 31, 2013. Persons covered under NJ Protect will be given as much advance notice as possible if the NJ Protect coverage will end before December 31, 2013.



Can my insurance agent help me get NJ Protect?


Your agent may tell you about the coverage if he or she thinks it might be a good option for you. Because of the special eligibility requirements for NJ Protect agents will not have copies of the applications and will not be submitting the applications to the insurance companies. For the most part you will be dealing directly with the insurance company.


Monthly Ratesline

Horizon Blue Cross and Blue Shield of New Jersey's monthly rates are for coverage effective beginning August 1, 2010.

Age Ranges


Plan C + NJ Protect Rider 80%/70%, $2500/$5000


Plan C + NJ Protect Rider 100%/70%, $0/$7500

• must be a U.S. citizen or national or lawfully present in the U.S.

• must be a New Jersey resident

• must be uninsured for at least 6 months

• must have a prior (pre-existing) medical condition.

You will have to submit documentation that supports each requirement.

< 25


$212.63


$285.53

25 to 29


$238.07


$319.68

30 to 34


$281.30


$377.75

35 to 39


$302.24


$405.85

40 to 44


$310.43


$416.86

45 to 49


$320.80


$430.78

50 to 54


$363.24


$487.78
55 to 59

$415.44

$557.86
60 to 64

$491.34

$659.81
65+

$571.87

$767.95

Plan C + NJ Protect Rider provides coverage of the following services: office visits (preventative and treatment-related, including most medically-necessary specialist's care), hospital care, prenatal and maternity care, immunizations and well-child care, screenings (including mammograms, pap smears and prostate exams), x-ray and lab services, treatment for mental illness and substance abuse, many therapy services, and prescription drugs. These are plans with both "in-network" and "out-of-network" benefits, so you may choose to obtain healthcare services through the carrier's network of health care providers, or may go outside of the network. You will pay more to go out-of-network because of greater cost-sharing requirements, plus health care providers may charge more than what the carrier considers reasonable and customary. In-network providers charge a negotiated rate.

[Milo_Bloom]

64. If this is the good plan, I'd hate to see a bad one!!

[Rosa Luxemburg]

66. Call your Congressmen