Bcbs of nd rate hike

[Redneksioux]

Just heard on wday that bcbs nd had requested a 19% rate hike and the state approved a 13.5% premium increase. So much for the affordable care act providing more affordable health care. If you are under 40 and healthy you are better off with no insurance and facing the tax penalty. Wait a second....I can make less and pay less taxes? No tax penalty if I don't pay taxes right? If I decide to be even more lazy and work less I may even qualify for free health care? Hospitals cannot refuse to service me anyways regardless of ability to pay.

It's really funny how the government has motivated more people to be entitled. For the working class, this will just continue to cost more and more.

[Redneksioux]

Just think of this from bcbs' perspective. The federal government requires customers to buy out service. We are the biggest health payor in the state. Let's raise our rates!

[Oxbow6]

Just heard on wday that bcbs nd had requested a 19% rate hike and the state approved a 13.5% premium increase. So much for the affordable care act providing more affordable health care. If you are under 40 and healthy you are better off with no insurance and facing the tax penalty. Wait a second....I can make less and pay less taxes? No tax penalty if I don't pay taxes right? If I decide to be even more lazy and work less I may even qualify for free health care? Hospitals cannot refuse to service me anyways regardless of ability to pay.

It's really funny how the government has motivated more people to be entitled. For the working class, this will just continue to cost more and more.

Welcome to the ever increasing society of entitlement, unaccountability and irresponsiblility. I see every day the growing mentality that "I don't need to do anything because someone else will take care of me and pay for it". Really sad to see......................

I'm not an apologist for NDBCBS or giving them a complete pass on this but under the ACA they have to get enough funds/dollars from healthy individuals to cover an increasingly "sick" pool of people that they must now cover. The ACA in a nutshell basically is going to put the burden on those who can pay and are healthy to foot the bill for all those who aren't in either of those categories.

Cue smokey the watchmaker...oh wait, he butt was tossed of this site...again.

[UNDBIZ]

Just think of this from bcbs' perspective. The federal government requires customers to buy out service. We are the biggest health payor in the state. Let's raise our rates!

Although the ACA is a mess, insurers are definitely taking advantage of it. "Hey, we can do whatever we want and if anyone questions the move, we can just blame Obamacare!"

[UNDBIZ]

I wonder how much the increase has to do with Noridian preparing to lose millions on the Maryland ACA website they failed to build.

[Oxbow6]

Although the ACA is a mess, insurers are definitely taking advantage of it. "Hey, we can do whatever we want and if anyone questions the move, we can just blame Obamacare!"

Yup...that's what's is going on here!

[choyt3]

Have to pay for the repercussions in this: http://www.inforum.com/event/article/id/427560/publisher_ID/1/

More info here: http://www.inforum.com/event/article/id/426823/publisher_ID/1/

And then there's this:

From: http://www.inforum.com/event/article/id/427961/publisher_ID/1/

BCBSND elects four to board of directors

Two new members were elected as directors to the board of directors that governs Noridian Mutual Insurance Co., doing business as Blue Cross Blue Shield of North Dakota, and two incumbents retained their board seats at the company’s annual meeting Dec. 6 in Fargo.

Dale Klein, Mandan, and Gary Miller, Bismarck, were unopposed in their re-election bids as provider directors. A full-time family physician for 28 years, Klein works at Sanford North Mandan Clinic. Miller is the president and CEO of St. Alexius Medical Center, Bismarck.

Also elected as consumer directors were Dennis Hill, Bismarck, executive vice president and general manager of the North Dakota Association of Rural Electric Cooperatives, Mandan, and George Koeck, Fargo, senior vice president, general counsel and corporate secretary of Otter Tail Corp.

[Redneksioux]

I wonder how much the increase has to do with Noridian preparing to lose millions on the Maryland ACA website they failed to build.

According to Hamm, those costs cannot be recouped from premium payments.

[UNDBIZ]

According to Hamm, those costs cannot be recouped from premium payments.

And he's preventing it how?

[Redneksioux]

And he's preventing it how?

Obviously not by allowing a rate hike! Supposedly bcbs asked for a 19% hike and were allowed a 13.5% hike.

What's ironic is that bcbs of nd continues to increase rates all while denying more and more claims.

[UNDfaninMICH]

In 2011, the Fargo Forum reported that the top three highest paid executives at BCBS of ND were compensated roughly $400,000 each. Reasonable, or no?

[Redneksioux]

In 2011, the Fargo Forum reported that the top three highest paid executives at BCBS of ND were compensated roughly $400,000 each. Reasonable, or no?

If they can influence the state insurance commissioner to allow a 10% plus rate increase every year, these guys are making their money and then some!

As long as you are not Medicare, health insurance sounds like a great business to be in.

[yzerman19]

MEDICAL LOSS RATIO...do you know what that means? It means that the money paid out as claims has to be no less than 85 percent of premium collected. With that remaining 15% you have to cover your costs...pretty slim gross margins. 15% pays salaries, real estate costs, customer service, provider and medical management...

THEN...the self insured component. Most business is self-insured. You make no money there...it is simply admin fees which are very price competitive.

Actually- medicare is about the only aspect of health insurance that is profitable for a commercial insurer.

It isn't that hard- there is no money in health insurance any more.

[Oxbow6]

MEDICAL LOSS RATIO...do you know what that means? It means that the money paid out as claims has to be no less than 85 percent of premium collected. With that remaining 15% you have to cover your costs...pretty slim gross margins. 15% pays salaries, real estate costs, customer service, provider and medical management...

THEN...the self insured component. Most business is self-insured. You make no money there...it is simply admin fees which are very price competitive.

Actually- medicare is about the only aspect of health insurance that is profitable for a commercial insurer.

It isn't that hard- there is no money in health insurance any more.

You are correct.

Without great detail I have some insight on NDBCBS and well as the ACA.

There is no $$$ in health insurance but the bigger issue is there enough money , wherever you think you can find it, to sustain the ACA if it moves forward as passed??

[UNDfaninMICH]

Where do I sign up for some of this "no money in health insurance" that reimburses relative small-timers like CEO's of BCBS of ND nearly half a million? Sure, they only get to "keep" 15% of what they collect, but they're not manufacturing a product with that other 85%, they are doing clerical work.

[yzerman19]

Where do I sign up for some of this "no money in health insurance" that reimburses relative small-timers like CEO's of BCBS of ND nearly half a million? Sure, they only get to "keep" 15% of what they collect, but they're not manufacturing a product with that other 85%, they are doing clerical work.

I guess physicians, nurses, actuaries and other professionals are clerks...

This is the most misunderstood industry on the planet, because most people have no comprehension of what goes on.

Without the insurance company, you would pay MORE for healthcare or lose access to high value healthcare.

[UNDfaninMICH]

I guess physicians, nurses, actuaries and other professionals are clerks...

This is the most misunderstood industry on the planet, because most people have no comprehension of what goes on.

Without the insurance company, you would pay MORE for healthcare or lose access to high value healthcare.

So maybe that statement was unfair. What I should say is they are doing a job which is duplicated all over our country by various organizations who are making quite a living from doing it. And I get the point that insurance companies might help keep costs down by such things as formularies and pre-approval of tests and procedures, but is there a reason that say, for example, BCBS of ND and BCBS of MN couldn't pool resources?

I stand behind my belief that the "15% to cover costs" is still one heck of a lot of money.

[yzerman19]

So maybe that statement was unfair. What I should say is they are doing a job which is duplicated all over our country by various organizations who are making quite a living from doing it. And I get the point that insurance companies might help keep costs down by such things as formularies and pre-approval of tests and procedures, but is there a reason that say, for example, BCBS of ND and BCBS of MN couldn't pool resources?

I stand behind my belief that the "15% to cover costs" is still one heck of a lot of money.

That is fully insured only remember, self-insured has a margin of 2-5% and makes up more of most plans block in terms of %.

This level of gross margin is among the lowest in all industry. Retail for example works in a 40% gross margin environment- minimum.

Providers won't allow for a pooling of resources. It creates too much leverage and would reduce their reimbursement.

I have been a consultant in this space- not with BCND, but with some national plans. It is not a panacea. If I had unlimited capital, health insurance would be the last industry I would want to go into.

[UNDfaninMICH]

That is fully insured only remember, self-insured has a margin of 2-5% and makes up more of most plans block in terms of %.

This level of gross margin is among the lowest in all industry. Retail for example works in a 40% gross margin environment- minimum.

Providers won't allow for a pooling of resources. It creates too much leverage and would reduce their reimbursement.

I have been a consultant in this space- not with BCND, but with some national plans. It is not a panacea. If I had unlimited capital, health insurance would be the last industry I would want to go into.

I'm not trying to be obtuse, I truly know little of the finance world. Comparing a health plan to retail seems like apples and oranges to me. At some point doesn't the absolute margin (if that's a thing) matter more than the percentage? For example, car dealers apparently sell their vehicles for a relatively smaller margin by percentage, but since it's a $40,000 vehicle, those small percentages add up and may easily exceed the profit made by the Mom and Pop grocery store on the corner (acknowledging here that those don't exist).

A retail store also has to stock inventory, and they are responsible for acquiring it and paying for it. If, for example, the car dealership wants to sell more cars, they have to buy some wholesale to then sell to the public. Some of those cars may go unsold, and the dealership eats the cost.

In healthcare, the insurer is serving more as a broker... they have the access to the commodity (contracts with physicians, hospitals, etc. to accept their payment), but they don't pay for it until there is a buyer for it. This would be like a Chevy dealer who has relationships with the manufacturer, and only acquires a car when there is a customer for it. In the retail setting, when the dealer has success, the manufacturer has success. In healthcare, when the insurer has financial success, the manufacturer of the commodity (the physicians, hospitals, etc.) does not have financial success.

It seems to me that although many people rail against socialized medicine, we have it. Healthier people (and their employers) are paying for healthcare at a rate beyond which they are consuming it, because sicker people (and poorer people) are using healthcare at a rate beyond which they are paying for it. Unfortunately, if we allowed people to pay as they go, we would find that people don't save for the healthcare they're going to demand in their later years. We have the insurance companies in the middle which makes many people feel that there is not socialism in health care. I'm not saying this socialism is bad, because I don't know of any other good means to fund it.

Count me as a "provider" who would skeptically welcome pooling of resources (single payer). Medicare is already a huge single payer, and last I knew, most docs who care for adults still accept it. Allow people to get a rough idea of how much they'll get paid based on how much work they do, and let them decide if incurring the debt of medical school and stress of medical school is worth it. It works for the military, right? I like the fact that I have a reasonable income and can comfortably repay my student loans, but healthcare as a business makes me a little bit uncomfortable. It makes me beyond a little bit uncomfortable to know how much the brokers of that healthcare (and medical executives, for that matter) are lining their pockets from it.

[UNDBIZ]

Obviously not by allowing a rate hike! Supposedly bcbs asked for a 19% hike and were allowed a 13.5% hike.

Ah yes, the classic "ask for twice what you really need" approach.

[Redneksioux]

Ah yes, the classic "ask for twice what you really need" approach.

It seems that's been how all of their rate increases have gone as of recent that I recall.

[Oxbow6]

For all of you who seem to want to use an ignorant broad brush on this issue please READ yzerman19's posts.

[gfhockey]

I have stayed out of this debate long enough. I consulted my lawer and he emailed me this.

A: Pays his part of his premium with untaxed dollars. Subsidy.

B: Employer writes off his share of premium. Subsidy.

C: Untaxed benefit for so and so. Subsidy.

D: Mortgage interest write off. Big homeowner subsidy.

Simply in the end he is getting more from the government than the people he calls a moocher.

When the ACA gives a subsidy to people that is socialism.

[Oxbow6]

I have stayed out of this debate long enough. I consulted my lawer and he emailed me this.

A: Pays his part of his premium with untaxed dollars. Subsidy.

B: Employer writes off his share of premium. Subsidy.

C: Untaxed benefit for so and so. Subsidy.

D: Mortgage interest write off. Big homeowner subsidy.

Simply in the end he is getting more from the government than the people he calls a moocher.

When the ACA gives a subsidy to people that is socialism.

Hmmmmmmmmmmm...I guess that's one take on this albeit a misinformed and misguided one.

[chicagolandsioux]

Hmmmmmmmmmmm...I guess that's one take on this albeit a misinformed and misguided one.

Why?