Obamacare Health Insurance Penalties To Sky Rocket

Obamacare health insurancePost Date January 19, 2014 – Obamacare Health Insurance analysts say 6 million Americans will face penalties in 2016 if they refuse to purchase Obamacare Health Insurance as President Barack Obama’s health care overhaul is being fixed.

Obamacare Health Insurance Penalties are also unaffordable

The number of scoff laws is estimated at almost 50 percent higher than the amount calculated by the Congressional Budget Office.  This is not good news for the Patient Protection and Affordable Care Act.  The OMB estimated around 4,000,000 Americans will not be able to afford Obamacare Health Insurance will be forced to pay the penalty. Most of these Americans belong to the middle class.  The penalty for not being able to afford to Obamacare Health Insurance will be $1,200. If you can’t afford to buy Obamacare Health Insurance, where does the government expect you to come up with $1200.00.

“The bad news and broken promises from Obamacare just keep piling up,” expressed Representative Dave Camp, a Republican from Michigan who chairs the House Ways and Means Committee, as he refer to the number of Americans that will possible have to pay tax penalties as they could not have the mandated health insurance. Camp wants to abolish Obama’s health care reform law.

All residents of the United States of America are mandated to to purchase Obamacare Health Insurance this year or face a penalty which will exceed $1000.00.  The Congressional Budget Office says the government will collect  nearly 7 billion dollars from tax penalties. The Obama administration stated for the last 6 years 98 percent of the American people shall not be affected by the tax penalty.  According to Health and Human Services, the tax penalty should only affect those citizens who can afford to buy health insurance but chooses not to. Most people whom don’t purchase health insurance can’t afford it.

In addition, the administration views it that most Americans shall not worry on the said mandate since most of them already have health coverage as provided by their employers and other government programs such as Medicare.

 

Obamacare Website Needs Some Help

Obamacare WebsitePost Date December 20, 2013 – There is no other individual or organization that deserves the number one spot for worst abomination Award than HealthCare.Gov Obamacare website for the Affordable Care Act. I just don’t understand why the government continues to insist they can do anything better than the Private Sector can.  Going back to 1776 when our Government was formed, they have continued to prove anything bureaucrats get their hands on becomes a tangled mess.

Obamacare Website is on life support

Not long after the official October 1st Open Enrollment Date, those users of  the HealthCare.Gov Obamacare Website reported they were having major problems.  Out of every 10 applications which consumers attempted to complete – only three HealthCare.Gov Obamacare applications were reported completion.  This does not mean those three have health insurance.  It only means they obtained a rate.  Sadly, many have now discovered the rate received was not correct.  Further, even if correct, they would need to pay a premium in order ti receive coverage.  Unfortunately, the Obamacare Website has no ability to collect premiums.

In late October, a Senate Hearing discovered that there were even problems at the Federal Exchange.  Officials of the CGI and Optum/QSSI, the two vendors which were to assign the policies to the Health Insurance Carriers reported their systems were failing.  If you are not aware of what the Federal Exchange’s is, it works very much like the Assigned Risk Auto Insurance Pool in your home state.  The HealthCare.Gov Obamacare Exchange assigns those health insurance policies in a similar fashion.

The Republican Party claim that $175 Million in Tax Payers money was spent to build one of the most important government websites in the country’s history.  The Democrates claim the Republican Party sabotaged the HealthCare.Gov Obamacare website by pressuring states to refuse to build their own online HealthCare.Gov Obamacare Exchange Website. The democrats claim is the states would have built there oun sites, as the bugs in the federal HealthCare.Gov Obamacare Website became evident, the consumer would have had a back-up.  The problem with that statement is, the states were under no obligation to build a HealthCare.Gov Obamacare type exchange website.

Based on what we have learned about the new healthcare laws under the affordable care act, the employees at InsureDirect.com will have the Health Insurance Policy with Blue Cross/Blue Shield cancelled on May 1st, 2014.

Health Insurance Exchange – Obama Care – No Bargain

Obama Care  InsureDirect.com ImagePost Date October 19, 2013 – It has been said that the Affordable Care Act popularly known as Obama Care will provide an affordable coverage through the health insurance exchange.  The health insurance exchange program will make health insurance premiums to increase to almost 50 percent more than what some are paying today.

 

Health Insurance Exchange is no bargain…..

The sad truth is individuals who will be buying health insurance through many of the Federal government’s health insurance exchange programs next year will have to pay an average of 41 percent more than they have paid for Health Insurance in the previous year. The State of Ohio has long been considered a very competitive for health insurance, auto insurance and Homeowners Insurance. Lieutenant Governor Mary Taylor said that the level of diversity which had made health insurance prices in the state to be low has been outlawed by the Affordable Care Act. Ohio’s health insurance rates and premiums are soaring higher, and even going higher than other states that have long had pricey health insurance rates. The expected 41 percent increase on individual health insurance exchange plans Is based on the premium comparison reports from Ohio insurance companies in 2012. The ODI also said that aside from individual exchange plans, exchange plans for small businesses will also suffer an increase of 18 percent in average. According to the ODI, the current premiums in the individual market have an average cost of $239.29 per month. This is expected to increase to $332.58 next year. For small businesses, the current average premium is $341.03 per month but may become $401.99 next year. The reason for this increase is the cost of providing health insurance (or claims) that the Health Insurance exchange will face. Accordingly, based on the rate filings approved by the ODI, the average cost in providing coverage for individuals next year under the new Health Insurance exchange will be $409. The current cost of providing health insurance coverage today in Ohio is only at $223.

New Jersey Insurance Agent Bribes Mayor

New Jersey Mayor ConvictedPost Date November 26, 2012 –  John Bencivengo, Mayor of Hamilton Township, New Jersey was convicted on November 22,  2012 in connection with nearly$13,000 in bribes that he solicited in exchange for his influence for a New Jersey Insurance Agent.  The bribe was in connection to the townships group health insurance contract  with the Hamilton Township School District.  U.S. Attorney for the District of New Jersey said the jury handed down a guilty verdict against Bencivengo after a week-long trial which was heard before U.S. District Judge Anne E. Thompson in Trenton.

New Jersey Insurance Agent assists in mayor’s conviction 

The charges against Bencivengo resulted in guilty verdicts for two counts of violating the Federal Travel Act, attempted obstruction of commerce by extortion under color of official right and  money laundering.  The  Mayor perpetrated his crimes between the period of May 2011 and July 2011, 2012;  he accepted bribe payments from New Jersey Insurance Agent Marliese Ljuba. In exchange for the bribe, the mayor agreed to use his influence to assist the Ljuba in retaining her as the Hamilton Township School District New Jersey insurance agent.

Bencivengo agreed to speak to a school board member to lobby that Ljuba must be retained as their New Jersey Insurance Agent.   He also agreed that Ljuba will choose the next individual who will replace another school board member if that member will run for the New Jersey Assembly and left the board. Ljuba later turned into a cooperating witness against Bencivengo.  He received the bribe cash in multiple payments.  First through a $5,000 check that the broker passed on to the mayor. The remaining $7,400 was received by the mayor in two cash payments in July 2011. U.S. Attorney Paul J. Fishman credited the Federal Bureau of Investigations for their investigations that led to the ultimate conviction of the New Jersey Mayor.

-Mike

Michael E. Dortch
President &  Managing Agent
InsureDirect.com
Corporate Home Office
618 South Broad Street
Lansdale, Pennsylvania  19446
(800) 807-0762  ext. 206

 

Car Insurance Broker Defrauds Perth Amboy, NJ

Car Insurance Broker
Post Date July, 26 2012 –
 A car insurance broker whom also marketed health insurance products from Baltimore, Maryland pleaded guilty recently to stealing more than $2 million from the Perth Amboy Board of Education and the City of Perth Amboy in New Jersey. Francis Gartland of Gartland and Co. along with his other two companies, the Federal Hill Risk Management and E-Administrative Systems pleaded guilty before the superior court in Middlesex County, to charges of second-degree theft by deception and first-degree money laundering. Since the Health Insurance Premiums were on an agency bill basis, it was obviously easy to invoice the health insurance premium and collect the money.  Of course a car insurance broker would have a very difficult time stealing car insurance premiums since most companies collect on  their own monthly bills.

Car Insurance Broker Defrauds Perth Amboy, NJ

According to the Office of the Attorney General in New Jersey, Gartland defrauded the Perth Amboy New Jersey Board Education from November 2003 to July 2009 through  his insurance agency, Gartland and Co., obtaining $2,593,400 for charging it with non-existent healthcare related services that included employee assistance and wellness programs. In addition to this, from January 2005 to July 2009, Gartland and others through the Federal Hill Risk Management were said to have fraudulently obtained $216,495 from the City of Perth Amboy by making false representations to Perth Amboy’s medical insurance carrier. Under Gartland’s plea agreement, he will be recommended for 15 years sentence in a state prison for the money laundering charge, and seven years for the theft charge. The sentences is said to run concurrently. Gartland will not be eligible for parole for 7.5 years. Sentencing is set on September 10, 2012. Although the insurance broker was charged with retaining health insurance premiums, at no time was being a car insurance broker or car insurance products part of the charges.

-Mike

Michael E. Dortch
President &  Managing Agent
InsureDirect.com
Corporate Home Office
618 South Broad Street
Lansdale, Pennsylvania  19446
(800) 807-0762  ext. 602

 

Who Approves New Jersey Health Insurance Rates

Post Date July 10, 2012 – Contrary to popular opinion, individual New Jersey Health Insurance Rates(IHIC)  in are decided solely by it’s NJ insurance companies. Of

Who Approves New Jersey Health Insurance Rates

Who Approves New Jersey Health Insurance Rates

course is true for all auto insurance rates and homeowners insurance rates.  Its only the insurance company which knows how much it needs in premium to pay claims and stay profitable.   The NJ Department of Banking and Insurance (DOBI) only has the authority to monitor and disapprove the proposed rates, but not to set them. In New Jersey,  New Jersey Health Insurance Rates  providers may increase their rates monthly, quarterly, or in a yearly basis provided that they comply with both New Jersey and Federal law.  Though New Jersey Insurance Department has no authority in setting  rates, Health Insurance Companies are still required to submit an informational rate filing  to the State of New Jersey before they can start charging their clients with the new rates.  New Jersey Health Insurance Rates increases and decreases may only be approved by DOBI for the following reasons:

a)       Increase filing is incomplete wherein the insurance provider failed to put all the necessary information as required by law;

b)       ) If rates increased does not comply with specific provision of the law such as when one provision requires that rates shall only vary by specific rating factors but the increase filing intends to use an “impermissible factor” like occupation; and

c)       If the increase filing will not meet New Jersey’s minimum loss ratio requirement which shall not be below 80%.

Who Approves New Jersey Health Insurance Rates

As the government agency tasked to regulate the insurance industry in New Jersey, the NJ DOBI has the responsibility to verify New Jersey Health Insurance Rates increases and to ensure that such increase is reasonable and must meet what is required by law. DOBI must see to it that the insurance provider’s assumption on the growing costs of medical services is appropriate and that the proposed rates shall meet the state’s minimum loss requirement of 80%, and all other legal requirements.

In addition, New Jersey Health Insurance rates providers who wished to increase their IHC premium rates to 10% or more are required to inform the United States Department of Health and Human Services. Health insurance rate increases is an avoidable occurrence. Rates may increase due to the increasing use and cost of medical services. As for particular policyholders, health insurance rates may also increase when there’s a change in the clients rating factors such as age and geographic area.

-Mike

Michael E. Dortch
President &  Managing Agent
InsureDirect.com
Corporate Home Office
618 South Broad Street
Lansdale, Pennsylvania  19446
(800) 807-0762

 

Pennsylvania Health Insurance Carrier Names New CEO

Post Date July 1, 2012 –  Anyone whom follows my Blog read a few weeks ago read about the demise of a Health Insurance Carriers CEO over an extra marital affair

Insurance Carrier Names New CEO

Insurance Carrier Names New CEO

with a fellow co-workers wife.  Highmark Inc., the largest health insurance company in Pennsylvania recently named Kenneth Melani’s successor as its new chief executive officer.

Health Insurance Carrier Names New CEO

Coming in to Highmark’ Inc., Dr. William Winkenwerder   is expected to bring along with him his substantial experience in health insurance operations, medical care delivery, and the national health policy. Prior to his recent appointment, Winkenwerder served as CEO to Winkenwerder Company, an Alexandria, Va.-based consultancy firm which he founded in 2007.  His company offered strategic consultancy services to various health care companies throughout America.

Before building his own company, Winkenwerder served as Asst. Secretary of Defense for Health Affairs in the United States Department of Defense from 2001 to 2007 where he was tasked to led the US military’s health care system overseeing its network of physicians and hospitals all over the globe.  Aside from those experiences, Winkenwerder also held various significant roles in the health insurance industry including senior executive posts at the Blue Cross Blue Shield of Massachusetts, the Kaiser Permanente, and the Academic Medical Center of Emory University.  As a health professional, Winkenwerder is an internist and a family doctor. He also holds an MBA from the University of Pennsylvania’s Wharton School.

Winkenwerder replaced Highmark former CEO, Kenneth Melani, who was fired in the middle of a scandal involving an illicit affair with an employee. Melani was arrested in March 2012 after figuring out in a brawl with Mark Myler, husband of Melissa Myler to whom Melani was having an affair with. The fight took place at Myler’s residence. After being charged criminally, Melani was placed under unpaid administrative leave. A week after, Highmark came into deciding of having the CEO fired. Dr. J. Robert Baum, Highmark’s Chairman of the Board temporarily took over as acting CEO. Highmark started as a health insurance provider in Pennsylvania since 1930s and is now being considered as one of the biggest providers of health insurance policies in the United States.  Highmark Insurance does not market car insurance but does  have locations in Harrisburg, PA,  Pittsburgh, PA, Philadelphia, PA and Erie, PA.

-Mike

Michael E. Dortch
President &  Managing Agent
InsureDirect.com
Corporate Home Office
618 South Broad Street
Lansdale, Pennsylvania  19446
(800) 807-0762  ext. 602

 

 

 

New Jersey Social Worker Confesses to Insurance Fraud

Post Date June 27, 2012 –  A New Jersey social worker will be facing a probation sentence after pleading guilty to committing third degree health insurance –related fraud.   State Attorney General Jeffrey Chiesa had announced recently that Rashmi Gupta, 39 years old, had pleaded guilty to the act of defrauding Medicaid by submitting unscrupulous time sheets pertaining to counseling services of troubled teenagers.  Gupta’s sentencing was scheduled on June 22 before Judge Clark. With her pleading guilty, New Jersey’s Office of the Insurance Fraud Prosecutor had recommended her to probation, and that she will be banned from reimbursement through the Medicaid for five years. With regards to her profession, Gupta’s case has already been brought up to the New Jersey Board of Social Work Examiners for possible actions on her social work license.

Gupta who worked with the TYSN (The Youth Success Network) in Passaic, had disclosed that between July and December 2010, time sheets for counseling services even if none was provided.  With her fraudulent time sheets, TYSN demanded claims from the Medicaid and then paid Gupta. Based on the social worker’s timesheets, she was paid for $10,177.50 for services that never existed.  Ronald Chillemi, Insurance Fraud Prosecutor, had said Gupta’s fraud schemes and other fraud on health insurance in NJ continues to thrive, stealing huge amounts of the state’s tax dollars.

Gupta’s scheme was discovered when one client reported to TYSN that the social worker did not render them such services. With this information, TYSN notified the Office of the Insurance Fraud Prosecutor. The case was then thoroughly investigated by Medicaid Fraud Control through unit acting chief Nicole Rizzolo, Deputy Atty. Gen. Dolores Blackburn, and Detective Luisa Sanchez. Gupta’s probation sentence is due to a state law that if a person is found guilty with a third-degree crime but not previously convicted of any indictable offense, that person’s incarceration sentence can be presumed against.

On a personal note; insurance fraud is on the rise.  Anyone whom has followed my Blog knows I focus a fair amount of attention to car insurance fraud and the effect this has on the auto insurance industry. Sadly, there are far more people whom are aware of those whom commit insurance fraud than actually perpetrate the crime.  The sad thing is; the cost of insurance fraud is built into the premium of every car insurance policy in New Jersey.  Believe it or not, a $1000.00 auto insurance premium would be less than $700.00 if there was no insurance fraud.  The next time you hear about someone about to defraud an insurance company – think about how much that act has cost you over the last 10 years.

-Mike

Michael E. Dortch
President &  Managing Agent
InsureDirect.com
Corporate Home Office
618 South Broad Street
Lansdale, Pennsylvania  19446
(800) 807-0762  ext. 602


 

 

PA Insurance Company Chief Faces Assault Charges

Post Date June 14, 2012 – After figuring out the husband of an employee to whom he alleged to having an affair with his wife, the chief executive officer of an established insurance company in Pennsylvania is now facing charges of defiant trespass and simple assault.  The insurance CEO identified as Kenneth Melani, 58 years old, of Highmark Inc., was charged on May 30 this year of the said cases by the Oakmont police force in Allegheny County. As stated in the local media reports, Melani allegedly went to the house of Mark Mayler, where the assault took place on Sunday. Mark is married to Melissa Myler who told authorities that her affair with the Highmark CEO started shortly after she was hired at the company on October last year. The affair was discovered on January by Melani’s wife who later then told Mark Myler.

According to the criminal complaint, after the affair was discovered, Melissa moved out from their house in Oakmont and moved in with Melani.  Highmark Inc., through their spokesperson, Michael Weinstein released a statement to the media stating that Melani’s case is a personal matter and that the CEO is already on an unpaid leave of absences from the insurance company to resolve the issue.  If convicted, his termination is assured. The Pittsburgh-based insurance company is a licensee of the Blue Cross and Blue Shield Association. It provides insurance coverage to about 4.8 million Pennsylvania and West Virginia residents. In 2010, Highmark had revenues of $14.6 billion.

 -Mike 

Michael E. Dortch
President &  Managing Agent
InsureDirect.com
Corporate Home Office
618 South Broad Street
Lansdale, Pennsylvania  19446
(800) 807-0762  ext. 602

 


Pennsylvania University Researches Risk And Insurance

Post Date June 10, 2012 – In order to further promote and circulate research materials on risk and insurance, University of Pennsylvania’s Wharton School recently establishes the new Wharton/Penn Risk and Insurance Program (WPRIP).  According to a university press release, WPRIP will promote the interdisciplinary study on the theoretical, empirical, domestic and global topics on the area of insurance and risk management. The topics will include government risk management, as well as corporate and household risk management, health and longevity risk management, property risk and casualty insurance. WPRIP will also promote research on Pennsylvania health and life insurance, pensions, and the legal aspects of risks management and insurance.  Scott Harrington, a Wharton professor of the University of Pennsylvania on Insurance and Risk Management and Health Care Management, also the current WRIP academic director, stated that crisis related to health, financial, and meteorological had underscored the need for a much comprehensive insurance and risk management study. Harrington as quoted said, “Our goal (WPRIP) is to provide new insights that will provide valuable to policy makers, consumers, and insurance and risk management professionals alike.”  The new program has been established in conjunction with the said university’s Law school and the Leonard Davis Institute of Health Economics. WPRIP activities will showcase workshops and conferences, working paper series, white papers, funded research and periodic research briefs.

Wharton School is a business school of the University of Pennsylvania with campuses in Philadelphia and San Francisco. It is being considered to be first business school in the United States. One of their already-existing global initiatives pertaining to the insurance industry are the: S.S. Huebner Foundation for Insurance Education that was named after the pioneer of insurance education, Solomon S. Huebner; Boettner Center for Pensions and Retirement Research; and the Pension Research Council. WPRIP will work closely with this existing Wharton centers to leverage each other’s capabilities.

– Mike

Michael E. Dortch
President &  Managing Agent
InsureDirect.com
Corporate Home Office
618 South Broad Street
Lansdale, Pennsylvania  19446
(800) 807-0762  ext. 602


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