Tarrant Business

Blue Cross and Blue Shield of Texas sees Tarrant partners

Blue Cross and Blue Shield of Texas is seeking Tarrant-area partners for the insurer’s campaign aimed at reducing the number of residents without health insurance, a program it calls Be Covered Texas.
The effort provides educational materials to community groups, service agencies and churches for distribution to people who might benefit from the new health insurance exchanges and subsidies mandated by the U.S. Affordable Care Act. Texas’ exchange, which will be operated by the federal government, is scheduled to go into operation Oct. 1 and policies sold through the exchange go into effect starting Jan. 1, 2014.

The educational materials do not carry the BlueCross Blue Shield brand, the Richardson-based company says. Currently the insurer has 28 partners around the state, but only the Urban League of Greater Dallas and North Central Texas has Tarrant ties. Blue Cross and Blue Shield President Bert Marshall said he expects to eventually have hundreds of partners and wants more in Tarrant County. “The focus is a grassroots educational program that serves the uninsured population,” Marshall said.

-- Jim Fuquay

DFW storms in April, June were state's biggest insured losses in 2012

The hail storm that hit mostly Dallas County in June was the state's biggest weather-related event in Texas last year in terms of insured property damage, followed closely by the tornadoes and hail that ripped through Tarrant County and other parts of North Texas in April, says the Insurance Council of Texas. The trade group said the Dallas hail storm caused an estimated $890 million in insured damages, while the April tornadoes produced an estimated $775 million in losses. Those far exceeded the No. 3 event -- an estimated $260 million in losses from wind and hail in McAllen, in the Lower Rio Grande Valley. In all, Texas last year experienced $2.3 billion in losses from seven "catastrophic weather events," defined as at least $25 million in insured losses, the council said. 

Gary Kerney, assistant vice president for property claims services with Verisk Insurance Solutions, told the ICT that Texas had a quarter of the nation’s catastrophic weather events and about 10 percent of the total insured losses.  The group cited ISO Services, which said there were 26 weather-related catastrophes in the United States last year with a total of $27 billion in insured losses. Nearly half of that, $11 billion, was from Hurricane Sandy, which hit the Northeast in October. While Sandy is expected to the the second-costliest storm since Hurricane Katrina, Kerney said "the number of weather catastrophes for the country was about average last year including the total insured losses."

    Mark Hanna, a spokesman for the ICT, said all seven of the Texas' weather catastrophes occurred between March 18 and June 13, which he said is "typically the height of the storm season in Texas."

-- Jim Fuquay

 

Baylor Health joins Aetna Medicare Advantage network

Baylor Health Care System has joined Aetna's network of participating hospitals for Medicare Advantage members, effective Nov. 1. The agreement includes Baylor Quality Alliance physicians and HealthTexas Provider Network physicians. Aetna said Baylor has been part of its commercial network for more than 20 years. Medicare Advantage is the HMO-model option offered as an alternative to traditional Medicare. Medicare Advantage typically offers beneficiaries lower out-of-pocket costs but also entails a more limited network of providers.

-- Jim Fuquay

Dallas hail storm producing rental car shortage, insurance group says

 The massive June 13 hailstorm in Dallas -- estimates of damage from insurers run between $1 billion and $2 billion -- is creating a shortage of rental cars at Love Field and elsewhere i the city, says the Insurance Council of Texas. The industry group says about 70,000 vehicles were damaged in storm, "and vehicle owners with rental reimbursement coverage are using rental cars until their vehicles are repaired in local body shops." You might want to confirm that reservation, suggests ICT's Mark Hanna. ICT quotes Ted Maniscalco, a spokesman for Enterprise Rent A Car, saying companies are pulling additional rental vehicles from around the state and outside Texas. Not only that, but "car rental companies, just like Dallas motorists, were hit by the hailstorm, putting many vehicles out of service. "Body shops are telling vehicle owners that they may have to wait six to eight weeks before their vehicles can be repaired," ICT says.. 

ICT estimates insured damages from the hailstorm at more than $1 billion. Earlier this week, Southwest Insurance Information Service, another trade group, said that when you count "tens of thousands" of homeowners' claims for roof damage, insured damages could hit $2 billion. The record for insured damage from hail in the state was $1.1 billion in 1995, according to the ICT.

-- Jim Fuquay

 

Final Texas health insurance rebates: $167 million

The federal government today said 1.5 million Texans will share $167 million in rebates from health insurers under the terms of the 2010 health reform legislation. That's a bit less than the $186 million that was estimated earlier, but still the largest for any state. A total of $1.1 billion will be returned to individuals and employers nationwide under the terms of the measure, which requires at least 80 percent of premium to be paid out for medical benefits. The rebates can be paid either with a check or a reduction in future premiums, and employers can also decide how to pass on the money to covered workers. Most of the refunds are for policies sold in the individual market. In Texas that amounts to $134.5 million, or an average of $356 per household, or more than twice the national average per household of $152 for individual policies. The average household rebate for small group and large group policies are just over $60 each. The full results by state can be found here.

-- Jim Fuquay

$160 million in insurance rebates due by August

 The U.S. Health and Human Services Department today rejected Texas’ effort to phase in federal standards requiring insurers selling health insurance to individuals to pay at least 80 percent of premiums in medical-related expenses. As a result of the decision, Texans who purchased those policies last year will receive $160 million in total rebates from the 22 insurers who did not meet that standard. A dozen of the 34 insurers active in the state met or exceeded the 80 percent threshold.

Gary Cohen, director of oversight for HHS, said the new standard, part of the Affordable Care Act passed in 2009, will not destabilize the state’s market for individual health insurance, which he termed “very robust.” The new standard, called the medical loss ratio 80/20 rule, went into effect Jan. 1, 2011. The rebates, which apply to policies sold last year, are payable in August, said Cowan.

The largest rebate, $89.6 million, will come from Blue Cross Blue Shield, by far the state's largest writer of individual health policies with about 55 percent of the market. That comes to an average of about $220 for each of the insurer’s 407,187 covered lives. Cowan said HHS has now denied 10 states’ requests for a waiver from the rule, while at least partly granting six. Two others are pending.

-- Jim Fuquay

 

MetLife to lay off more than 800 in Irving

More than 800 Irving employees of MetLife Inc.’s mortgage origination operation will lose their jobs when the country’s biggest life insurer closes the unit, which has 4,300 workers nationwide. “The majority will no longer have a position,” said John Calagna, a spokesman for New York-based MetLife, told Bloomberg News Tuesday. About 20 percent of the unit’s employees work in  Irving, and the rest are scattered throughout the U.S., he said.

MetLife in October announced plans to sell its mortgage unit. Last month it sold $7.5 billion of bank deposits to General Electric Co. The Federal Reserve, which oversees MetLife because of its size and banking operations, rejected its plan last year to raise the dividend and resume share buybacks.

-- Jim Fuquay

 

THR, physician group picked for Medicare program

Texas Health Resources, one of North Texas' largest hospital groups, and North Texas Specialty Physicians said today they were selected to participate in a new federal effort to treat Medicare patients using a collaborative system called an Accountable Care Organization. Arlington-based THR and the Fort Worth-based physicians' group are among 32 organizations nationwide that will operate under Medicare's Pioneer ACO Model, which aims to provide more coordinated care at lower cost. THR and NTSP said they already use a health information exchange that allows them to share patient records electronically. The only other Texas party in the Pioneer program is Seton Health Alliance in Austin.

Jim Fuquay

MEGA Life and Health insurance pays $2.5 million settlement

MEGA Life and Health Insurance Co., part of North Richland Hills-based HealthMarkets, paid $2.5 million to settle charges by Rhode Island regulators that the company violated state laws with its policies aimed at small employers.

It's the latest in a string of fines and settlements with state authorities over the marketing and underwriting of HealthMarkets insurance plans. Since 2008, the company and its subsidiaries have paid more than $40 million to settle complaints with more than 30 states, most involving cases brought several years earlier.

The Rhode Island settlement stems from an examination of MEGA policies written after Oct. 1, 2004. The state's Office of the Health Insurance Commissioner said MEGA used improper underwriting standards, such as declining to write policies when state law required that a small employer be offered a plan, overcharging on policies and imposing excessive fees.

In a statement, HealthMarkets said Thursday that "MEGA Life and Health Insurance Co. voluntarily discontinued marketing health insurance products in the state of Rhode Island in 2007" and cooperated with regulators "to resolve issues during the market conduct examination that commenced in 2006. The Company is pleased to have this matter finally brought to a conclusion and will fully comply with all aspects of the settlement agreement."

The agreement calls for MEGA to return $2.3 million to about 5,500 small businesses in the state. It will also pay the state a penalty of $225,000 and suspend writing health insurance in Rhode Island for three years.

HealthMarkets also faces a Los Angeles lawsuit brought by the city a year ago that alleges that its subsidiaries sold coverage that was marketed as comprehensive but which included "hidden and obscure exclusions and limitations." The suit names HealthMarkets and its owners, Blackstone Group and Goldman Sachs Group, which acquired the company in 2006 for $850 million.

John Franklin, a spokesman for Los Angeles' city attorney, said Thursday that the case remains in litigation.

-- Jim Fuquay