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Role Of California Health Insurance Agent And How They Can Benefit You?
By Jesse Segle
Officially, an Agent is an individual or company that acts on behalf of the company to market, sell and service insurance. The Agent has a contract with the companies in order to represent a specific company. A broker is person who also contracts with company but officially acts on behalf of you the client. All agent and agencies are compensated by the companies and therefore are at no cost to you. The difference between agent and agency is that agent is individual contracted with companies and agency usually has many agent working under umbrella of the agency. In most cases agents working under agency are employees.
Agents
role is to find best possible and the most affordable option for your money. In most cases there is no incentive on the agent’s part of which company you decide to go with. How agents get paid by the company is strictly regulated by the commissioner. When looking for agency or agent make sure that they are brokers who represent as many health companies as possible. There are dozens of plans on the market, therefore finding agent who can get you the best possible plan for your money will save you thousands long term. Just looking a rate quote and benefit summary is only half of the story when choosing health insurance. Some plans exclude certain benefits or apply caps to other types of coverage. Agents know the lay of the land and you would personally not want to purchase health just based on a rate quote.
Some companies have captive agent representing them. Captive agents can only represent one company. They are essentially employees for that company. I would avoid such companies as they may not have the best interest of the client at heart. If a company cannot quote multiple carriers, beware. The major carriers in California are Blue Cross of California, Blue Shield of California, Health Net, Pacificare, and Kaiser. Beyond these five, we do not feel very secure about the others.
How are agents or brokers paid? Agents are paid a commission by the carriers for policies issued and in force. The commission tends to be about the same from carrier to carrier. This commission does not affect the rate. The rate you will get through an agent/broker is the same as you would get going directly through the company. The benefit of the agent relationship is that they navigate the company to expedite processing, help with service issues once enrolled, and act a third party. company’s main interest to keep you enrolled as policy subscriber but your interest may actually lie with another company or plan. An independent broker can help bridge the two at no additional cost to you.
What to expect from your broker/agent?
This really is the most difficult part and it is the reason that people put off getting health insurance. There are many plans and the language is pretty technical. Most people glaze over when they see the brochures or instant quote results. Let's face it....health is not a common purchase. Typically, people have not needed to shop health in years...if ever. With a few targeted questions, the plan selections can be narrowed down significantly. With great agent you wish you would have called they earlier rather than try to navigate the volumes of information provided the plans. Most agent do not sell. They listen, advise, and then it's up to you what you wish to do.
California application and enrollment.
The health application is one more reason that people procrastinate. There are sections in there are mandated by law but which are thoroughly confusing such as the HIPAA qualification. Small Group can be equally difficult in terms of qualification for Small Group health coverage. agents are happy to walk you through the application once a plan has been decided on. This is also the time to ask about the process, payment options, cancellation options, time table for enrolling in coverage.
Health Service and Membership.
Once the plan is in effect, agent is your point of contact for membership issues, claims, and future changes. Agents go in at the end of each month and make sure that faxed changes, additions, and requests have been processed correctly. The companies are pretty good but 1 out of 100 requests do not show in the system. You do not want to be that one with such a critical issues as your health insurance. We can also advise for ways to reduce costs when the rate increase occur based on your changing health needs.
Keep in mind that you can always contact the carrier directly if you choose but why would you? Let agent do the work for you since there is no additional cost to you.
Agents and brokers are required to have a license and continuing education by the California Department of Insurance. You can always research an agent's history, company contracts, and other information through them. There are different types of licenses. The two most common are Life/Health which is used to transact California health and Property and Casualty is used to transact such as auto or home insurance.
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Vertafore $1.4 billion deal complete
The sale of Bothell software company Vertafore to TPG Capital for $1.4 billion is complete.<div class="feedflare">
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Unemployment extension to kick in
The state Executive Office of Labor and Workforce Development announced Thursday that claimants with up-to-date weekly claims certifications will be issued unemployment insurance extension benefits beginning Saturday, July 31.<div class="feedflare">
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Insurance broker opens office at The Greene
Neace Lukens, a private insurance broker, has opened an office at The Greene.<div class="feedflare">
<a href="http://feeds.bizjournals.com/~ff/vertical_4?a=H2hxcf4Km3c:84Gqlxqx4so:yIl2AUoC8zA"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=yIl2AUoC8zA" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=H2hxcf4Km3c:84Gqlxqx4so:V_sGLiPBpWU"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=H2hxcf4Km3c:84Gqlxqx4so:V_sGLiPBpWU" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=H2hxcf4Km3c:84Gqlxqx4so:F7zBnMyn0Lo"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=H2hxcf4Km3c:84Gqlxqx4so:F7zBnMyn0Lo" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=H2hxcf4Km3c:84Gqlxqx4so:qj6IDK7rITs"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=qj6IDK7rITs" border="0"></img></a>
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Earnings: HealthSpring profits soar 75%, guidance raised
HealthSpring Inc. <em>(NYSE: HS)</em> (HS)<div class="feedflare">
<a href="http://feeds.bizjournals.com/~ff/vertical_4?a=NU3MEcVcsks:WbVr02Vy2LA:yIl2AUoC8zA"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=yIl2AUoC8zA" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=NU3MEcVcsks:WbVr02Vy2LA:V_sGLiPBpWU"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=NU3MEcVcsks:WbVr02Vy2LA:V_sGLiPBpWU" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=NU3MEcVcsks:WbVr02Vy2LA:F7zBnMyn0Lo"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=NU3MEcVcsks:WbVr02Vy2LA:F7zBnMyn0Lo" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=NU3MEcVcsks:WbVr02Vy2LA:qj6IDK7rITs"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=qj6IDK7rITs" border="0"></img></a>
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Assurant Employee Benefits improves quarterly premiums and income
Assurant Employee Benefits posted improvements in both income and premiums for the second quarter, helped by fewer instances of disability and death among the insurer?s clients. (AIZ)<div class="feedflare">
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BBB warns of Facebook ?phishing? scams
The Better Business Bureau serving Eastern North Carolina says a new round of ?phishing? scams are showing up on Facebook.<div class="feedflare">
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Ochsner Health: Gulf oil spill spikes mental illness reports
A survey shows the BP oil spill in the Gulf of Mexico is impacting the mental health of coastal residents in four states bordering the Gulf.<div class="feedflare">
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Storm losses balloon State Auto?s 2Q loss
Despite a boost in revenue, heavy storm claims pushed State Auto Financial Corp. to a loss of more than $26 million in the second quarter, the company told investors Thursday. (STFC)<div class="feedflare">
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Austin rotary member granted $10K
Financial advisor James Wendlandt was picked to receive one of 26 grants for top volunteers from the Northwestern Mutual Foundation.<div class="feedflare">
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Horsehead facility likely shut down for months following explosion
Zinc producer Horsehead Holding Corp. offered an update Wednesday on the investigation of a July 22 <a href="http://pittsburgh.bizjournals.com/pittsburgh/stories/2010/07/19/daily54.html" target="_blank">explosion that killed two workers</a> at its plant in Monaca, Pa., north of Pittsburgh.<div class="feedflare">
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Defendants sentenced in $9.5 million IRS fraud case
Defendants tried in a $9.5 million Internal Revenue Service fraud case in U.S. District Court in Portland were sentenced to federal prison on Wednesday.<div class="feedflare">
<a href="http://feeds.bizjournals.com/~ff/vertical_4?a=eEEtJbOajpY:0pFHcPyGm3E:yIl2AUoC8zA"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=yIl2AUoC8zA" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=eEEtJbOajpY:0pFHcPyGm3E:V_sGLiPBpWU"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=eEEtJbOajpY:0pFHcPyGm3E:V_sGLiPBpWU" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=eEEtJbOajpY:0pFHcPyGm3E:F7zBnMyn0Lo"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=eEEtJbOajpY:0pFHcPyGm3E:F7zBnMyn0Lo" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=eEEtJbOajpY:0pFHcPyGm3E:qj6IDK7rITs"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=qj6IDK7rITs" border="0"></img></a>
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City commission backs bag ban
Portland?s City Commission has agreed to support a statewide ban on single-use plastic and non-recycled paper bags.<div class="feedflare">
<a href="http://feeds.bizjournals.com/~ff/vertical_4?a=LU57fstkK8E:yrgbtTy_FYg:yIl2AUoC8zA"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=yIl2AUoC8zA" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=LU57fstkK8E:yrgbtTy_FYg:V_sGLiPBpWU"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=LU57fstkK8E:yrgbtTy_FYg:V_sGLiPBpWU" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=LU57fstkK8E:yrgbtTy_FYg:F7zBnMyn0Lo"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=LU57fstkK8E:yrgbtTy_FYg:F7zBnMyn0Lo" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=LU57fstkK8E:yrgbtTy_FYg:qj6IDK7rITs"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=qj6IDK7rITs" border="0"></img></a>
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WellCare gets national accreditation
WellCare Health Plans Inc. was awarded a full health plan accreditation for its HealthEase of Florida and WellCare of Florida subsidiaries. (WCG)<div class="feedflare">
<a href="http://feeds.bizjournals.com/~ff/vertical_4?a=9WK59i0gKV8:ekDA5R96dlI:yIl2AUoC8zA"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=yIl2AUoC8zA" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=9WK59i0gKV8:ekDA5R96dlI:V_sGLiPBpWU"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=9WK59i0gKV8:ekDA5R96dlI:V_sGLiPBpWU" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=9WK59i0gKV8:ekDA5R96dlI:F7zBnMyn0Lo"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=9WK59i0gKV8:ekDA5R96dlI:F7zBnMyn0Lo" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=9WK59i0gKV8:ekDA5R96dlI:qj6IDK7rITs"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=qj6IDK7rITs" border="0"></img></a>
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Georgia tax reform council begins task
A panel of academic economists and business leaders Wednesday launched five months of work that could lead to an overhaul of Georgia?s tax laws.<div class="feedflare">
<a href="http://feeds.bizjournals.com/~ff/vertical_4?a=n46dxP-mz0E:lfTMy_2ljPc:yIl2AUoC8zA"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=yIl2AUoC8zA" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=n46dxP-mz0E:lfTMy_2ljPc:V_sGLiPBpWU"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=n46dxP-mz0E:lfTMy_2ljPc:V_sGLiPBpWU" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=n46dxP-mz0E:lfTMy_2ljPc:F7zBnMyn0Lo"><img src="http://feeds.feedburner.com/~ff/vertical_4?i=n46dxP-mz0E:lfTMy_2ljPc:F7zBnMyn0Lo" border="0"></img></a> <a href="http://feeds.bizjournals.com/~ff/vertical_4?a=n46dxP-mz0E:lfTMy_2ljPc:qj6IDK7rITs"><img src="http://feeds.feedburner.com/~ff/vertical_4?d=qj6IDK7rITs" border="0"></img></a>
</div>
Report says adultBasic coverage in Pa. endangered
Nearly 46,000 Pennsylvanians enrolled in Pennsylvania?s adultBasic subsidized health insurance plan could lose their coverage next year if an agreement with the state's Blue Cross and Blue Shield providers is not renewed, according to a report issued Wednesday by the Pennsylvania Budget and Policy Center and the Pennsylvania Health Access Network.<div class="feedflare">
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WellPoint income inches up 4% in 2Q
WellPoint Inc., the parent of St. Louis-based Anthem Blue Cross and Blue Shield in Missouri, reported a 4 percent increase in second-quarter net income, despite a decline in revenue. (WLP)<div class="feedflare">
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Judge blocks parts of immigration law
A federal judge in Phoenix has blocked parts of the state?s new immigration law from going into effect on Thursday.<div class="feedflare">
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WellPoint earnings nudge up in 2Q
The parent of Anthem Blue Cross & Blue Shield of Ohio told investors Wednesday it boosted second-quarter earnings 4 percent despite a decline in revenue. (WLP)<div class="feedflare">
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State Fund taps new CEO
The State Compensation Insurance Fund picked Thomas Rowe as its president and CEO, starting Aug. 2.<div class="feedflare">
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WellPoint income up 4%, revenue down 6% in 2Q
WellPoint Inc. reported a 4 percent increase in second quarter income, despite a decline in revenue. (WLP)<div class="feedflare">
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American Nat?l Insurance reports $26M in net income for 2Q
American National Insurance Co. reported net income of $26.2 million, or $1 a share, for the second quarter.<div class="feedflare">
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Humana names Fla. commercial president
Humana Inc. has named Tim Love president of its Florida commercial operations.<div class="feedflare">
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Report: UnitedHealth nears $1.5B acquisition
UnitedHealth Group Inc. is nearing a $1.5 billion acquisition of Executive Health Resources Inc., according to a report from Bloomberg Businessweek. (UNH)<div class="feedflare">
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Farmers Insurance agrees to 10% one-time rate cut for some auto insurance customers
Some Farmers Insurance customers will get a 10 percent break on their auto insurance under an agreement reached by the insurance giant and the California Department of Insurance.<div class="feedflare">
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Business health group saving costs
New data released by the Business Health Care Group shows that the group?s self-funded member companies saw a four-year aggregate health care cost decrease of 5.4 percent per health plan member when compared with 2005 base-year costs.<div class="feedflare">
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Aflac net income rises in second quarter
Aflac Inc.?s profit soared 85.3 percent in the second quarter. (AFL)<div class="feedflare">
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SeaBright blames California for big Q2 loss
SeaBright Holdings Inc. reported a second-quarter loss of $15.5 million, or a loss of 74 cents per share, compared with net income of $4.3 million, or 20 cents a share a year earlier. (SBX)<div class="feedflare">
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EHealth may buy back $30M of stock
EHealth Inc. said Tuesday its board authorized the repurchase of up to $30 million of its common stock. (EHTH)<div class="feedflare">
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Citizens board approves insurance rate hikes
Florida homeowners insured through Citizens Property Insurance can expect to see their rates go up by an average of 10.2 percent.<div class="feedflare">
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Sachdeva enters guilty plea in Koss embezzlement case
Sujata Sachdeva acknowledged responsibility for embezzling $34 million from Koss Corp. to pay for her ?irrational? buying sprees and expressed regret for its impact on the company, its shareholders and her family. (KOSS)<div class="feedflare">
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Aetna, Novant resolve coverage dispute
Aetna Health Inc. has reached a two-year agreement with Novant Health Inc. to continue its medical-insurance coverage for the health-care system?s patients, resolving a dispute that had landed in court. (AET)<div class="feedflare">
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Clarke to take over as CEO of Weiss Group
<a href="http://www.weissgroupinc.com/" target="_blank">Weiss Group</a> said on Tuesday that Thomas J. Clarke Jr. will take over as CEO, replacing Martin D. Weiss, who began serving as the Jupiter-based company?s CEO in 1971. (TSCM)<div class="feedflare">
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State Fund hires new president-CEO
California?s State Compensation Insurance Fund has tagged a new president and chief executive officer.<div class="feedflare">
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Lincoln Financial issues education grants
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Humana taps Tim Love Florida president
Humana Inc. named Tim Love president of its Florida commercial operations. (HUM)<div class="feedflare">
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Census Bureau: Chatham, Orange post highest uninsured rates in Triangle
Orange County and Chatham County posted the Triangle?s highest rates of residents without health insurance in 2007, according to new Census Bureau estimates released Tuesday.<div class="feedflare">
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Blue Cross launches health reform site
Blue Cross and Blue Shield of North Carolina has launched the first phase of a website dedicated to health care reform.<div class="feedflare">
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Centene profit rises in Q2
Centene posted a profit of $22.8 million, or 45 cents a share, for the second quarter, up 13 percent from $20.2 million, or 46 cents a share, in the prior-year period, as its managed care at-risk membership rose. (CNC)<div class="feedflare">
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Reinsurance Group Q2 profit falls
Reinsurance Group of America Inc. saw its second-quarter profit fall 17 percent, despite a more than 6 percent revenue increase. (RGA)<div class="feedflare">
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Gordon Ito named insurance commissioner
Gordon Ito has been appointed Hawaii state insurance commissioner.<div class="feedflare">
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Ex-Allied Roofing manager stole $140,000, indictment alleges
The former general manager of Allied Roofing & Exteriors in Fenton has been indicted on fraud charges involving the theft of more than $140,000.<div class="feedflare">
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Comair fined by DOT for oversold flight violations
The U.S. Department of Transportation said Monday that it fined Comair for violating federal rules regarding passengers denied boarding on oversold flights. (DAL)<div class="feedflare">
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IRS: 4,500 Alabama nonprofits eligible for tax extension
More than 4,500 small nonprofit organizations in Alabama are being given an extension on past due tax returns this year, the Internal Revenue Service announced Monday.<div class="feedflare">
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Facades at 26 county buildings need work
Facade inspections of 66 Milwaukee County buildings found 26 that required additional investigation or minor repairs.<div class="feedflare">
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Floods damage 49 Milw. County properties
Milwaukee County crews on Monday morning continued to work on the 49 county-owned properties damaged in last week's floods.<div class="feedflare">
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Bravo Health achieves milestone in Medicare Advantage program
Bravo Health has broken the 100,000 Medicare Advantage membership mark in all the markets the company?s serves.<div class="feedflare">
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SJC upends 100 years of slip-and-slide law
People who slip and fall from ?natural accumulations? of snow and ice in Massachusetts now have better legal footing, thanks to a recent decision by the state?s highest court.<div class="feedflare">
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SBLI gets law executives said was key
Two years after scuttling a bill that Savings Bank Life Insurance said was essential to keeping the company competitive and headquartered in Massachusetts, the Patrick administration has signed off on a new, broader proposal aimed at keeping SBLI in the Bay State.<div class="feedflare">
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Maryland expects to save $829M in health insurance costs over next decade
Maryland will see nearly $830 million in cost savings from federal health care reform over the next 10 years, according to a report presented to Gov. Martin O?Malley on Monday.<div class="feedflare">
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HealthPlan Services partners with Freelancers Union
HealthPlan Services entered an agreement to provide comprehensive business process services to Freelancers Union.<div class="feedflare">
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WellCare plans a healthy future
<strong>TAMPA </strong>? Like a motorist with one eye on the rear view mirror and another on the road ahead, WellCare Health Plans Inc. is navigating a tricky highway of legal issues, regulatory scrutiny and opportunities under national health care reform. (WCG) (MOH)<div class="feedflare">
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Payment dispute pits Florida Hospital against UnitedHealthcare
Florida Hospital and UnitedHealthcare may sever their decade-long relationship on Aug. 15, when their current contract is set to expire.<div class="feedflare">
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Flood insurance: Haves, have nots provide a hard lesson
The Great Escape collectible shop on Charlotte Avenue in Nashville is beginning to look right again.<div class="feedflare">
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Make your business waterproof: Answers to key questions about flood insurance
<em>The surging floodwaters of May brought with them a deluge of questions for businesses about flood insurance. Here?s a look at some key concerns:</em><div class="feedflare">
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Wage and compensation claim filings surge
In the past few years, with businesses being squeezed and the ranks of unemployed Americans climbing, the number of wage-and-hour lawsuits, along with gender-based and other types of discrimination claims, has been surging. In metro Atlanta, labor and employment attorneys are busier than ever, devising strategies to help organizations cope with the unpleasant realities of the ongoing recession.<div class="feedflare">
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Jobless benefits extension could cost companies
The unemployment insurance tax rates of businesses that have cut jobs in the past year may rise even more because of the federal unemployment benefits extension that President Barack Obama soon will sign into law.<div class="feedflare">
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Pennsylvania budget brings tax on hospitals, but boost in reimbursement
Legislation passed with Pennsylvania?s new budget includes a pair of changes that tax hospitals for the first time while boosting hospital reimbursement for treating people on Medicaid.<div class="feedflare">
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Small pharmacies brace for ?explosion in prescriptions?
Local and community pharmacies are holding their breath as health care reform is ushered in.<div class="feedflare">
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Federal grants may bulk up Washington state's community health centers
Community health centers, which mainly serve minorities and the poor, are eyeing billions of dollars in federal funds to expand their capacity to serve more Medicaid patients and more uninsured residents.<div class="feedflare">
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Kaiser Permanente, Anthem Blue Cross walk away from new high-risk pool
California is moving ahead with plans for a federally sponsored health insurance program for folks with pre-existing health conditions that?s far better funded than the longtime state program and expected to serve at least three times as many people. (MMS)<div class="feedflare">
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Waianae clinic turns to technology for help
Waianae Coast Comprehensive Health Center has developed call centers in its four satellite clinics to assist patients in applying for Quest, the state?s Medicaid program.<div class="feedflare">
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