| mmaqglolxw | Date: Friday, 29/11/2013, 15:01 | Post # 1 |
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I was aware that self-insured health plans were popular with employers, but I couldn't know just how fast they're growing -- or, more important, why -- until I happened across a current American Medical News article this is a fascinating primer for a largely unheralded but major issue in the health-insurance industry. (The complete text, unfortunately, takes a subscription.)Bottom line: The plans save employers money, allowed them to sidestep state insurance regulation, and usually stick it to traditional health insurers. Here's how.A self-insured plan (sometimes also known as a self-funded plan) is really a sort of DIY arrangement for businesses that offer health benefits with their employees. The company basically hires a traditional health insurer to control its health plan, but assumes the financial likelihood of providing health insurance itself. This arrangement essentially turns the insurer into a contractor that does nothing but process claims and oversee its network of doctors and hospitals. The business, meanwhile, saves itself the gain margin that insurers build into their premiums, albeit with the risk of losing money if it is employees rack up huge hospital bills. Companies often reinsure themselves against this prospect.The fact that employers can trim their healthcare costs is usually one big reason self-insured plans have spread so quickly. In line with the Kaiser Family Foundation, 55 percent of covered workers were in self-insured plans this past year, up from just 44 percent eight years earlier (see exhibit 10.1 in that PDF link). Healthcare premiums also have tended to rise more slowly in self-insured plans (see exhibit 1.9).It happens, however, that self-insured plans will also be exempt from many state guidelines. That's because self-insured plans are regulated by federal employee-benefits law, which frequently -- although not always -- trumps state law. As AMNews' Emily Berry reports: [S]tates cash less power to monitor, regulate or fine insurance programs which can be only administered by health plans. Self-insured plans, also sometimes called self-funded, are usually regulated by ERISA, the federal Employee Retirement Income Security Act.... Once a health plan is in the role of a TPA [third-party administrator], its dealings with doctors sometimes fall under federal as an alternative to state rules. Federal rules in many areas give a business more flexibility in coverage along with how benefits are handled. Recourse for physicians or patients that aren't served well by a self-insured plan are generally slower, and the potential therapies are often more limited.... In reality, that means many large-employer health plans can sidestep state rules that determine, for example, how quickly claims are processed or what kinds of conditions insurers must covered. Some states as well as the AMA itself -- which, needless to say, has its own self-interested beef with insurers -- are pushing back against federal pre-emption of state regulation, and also have won a few victories in states like Ohio and Texas, where federal courts have rules that state "prompt payment" laws take priority over ERISA.Obviously, not everyone wins in self-insurance. As I've noted previously, self-insured plans are less profitable for giant insurers like WellPoint and UnitedHealth Group, and so the way self-insurance is gradually edging out traditional "fully insured" plans is a second trend squeezing the dinosaurs of the profession.For what it's worth, below are a few of the other attributes of self-insured plans, as compiled by the Self-Insurance Institute of the usa: Health plans may be customized for the company's workforce; Employer sports ths financial reserves, maximizing interest income; No pre-payment for treatment improves income; Employer avoids state premium taxes (typically two or three percent). Image via Flickr user Mike Schmid, CC 2.0 green ugg boots
A Georgia man has become the first inmate offer death since the U.S. Top court upheld the constitutionality of executions by lethal injection.Convicted killer William Earl Lynd was pronounced dead at 7:51 p.m., scenario prisons official says.Lynd, 53, was found guilty of kidnapping and shooting to death his 26-year-old girlfriend a couple of days before Christmas in 1988.The Supreme Court rejected a request for a stay of execution for Lynd, Tuesday, clearing the way in which for the landmark execution.Lynd took over as the first death row inmate executed because the Supreme Court upheld the current lethal injection method recently, ending a de facto moratorium on capital punishment in the us. The last execution took place on Sept. 25.The final Court ruled last month in a Kentucky case how the state's method of executing inmates using a three-drug cocktail did not violate the constitutional ban on cruel and strange punishment. Roughly three dozen states, including Georgia, make use of a similar method.Fourteen other executions are scheduled next six months across America. But as CBS News correspondent Mark Strassmann reports, more states are reconsidering capital punishment, and reaching different conclusions.Wrongful convictions is one reason why lawmakers in five states are seriously debating repealing capital punishment. But five other states have moved in a really different direction -- passing laws that expanded death row to try and do people convicted of a criminal offense other than murder.Lynd has selected his final meal: two pepper jack barbecue burgers with crisp onions; two baked potatoes with sour cream, bacon and cheese; plus a strawberry milkshake.Death penalty opponents planned vigils around Georgia ."In light of the many well-documented difficulties with our death penalty system, it can be disturbing that Georgia is rushing to guide the country in resuming the death penalty machinery," said Laura Moye, chairwoman of Georgians for Alternatives to the Death Penalty.Lynd, now 53, was sentenced to die for kidnapping and shooting his live-in girlfriend, Ginger Moore, 26, in south Georgia in 1988, following the two consumed Valium, marijuana and alcohol. Prosecutors said she a break down slow, agonizing death, regaining consciousness twice after being shot in the head.The five-member Georgia Board of Pardons and Paroles on Monday rejected Lynd's clemency appeal without comment.Texas conducted the nation's last execution, putting Michael Richard to death on Sept. 25, 2007, within 24 hours the Supreme Court opted for consider the Kentucky case, brought by two prisoners who claimed the lethal injection method violated the constitutional ban on cruel and unusual punishment.On Monday, a Texas judge set an Aug. 5 lethal injection date for Jose Medellin, 33, for his participation within the gang rape and strangulation deaths of two teenage girls when they stumbled upon a gang initiation rite Fifteen years ago in Houston.The death sentence for that Mexican-born Medellin set off an international dispute and a U.S. Supreme court rebuke of the White House as soon as the high court in March refused to know his appeal, saying President Bush overstepped his authority by ordering Texas to reopen his case as well as the cases of 50 other Mexican nationals condemned for murders inside the U.S.In Mississippi, the state of hawaii Supreme Court scheduled a May 21 execution for Earl Wesley Berry, in prison for kidnapping Mary Bounds in the parking lot of the First Baptist Church in Houston on Nov. 29, 1987. He beat her viciously then dumped her body from the woods.Attorney General Jim Hood had requested that Berry be executed Monday, his 49th birthday. However, the court set the date afterwards this month after rejecting arguments from Berry's lawyers he should be spared as he is mentally disabled understanding that the method of lethal injection is unconstitutional.The U.S. Top court had blocked Berry's last scheduled execution on Oct. 30, 2007, to think about the Kentucky case. ugg tall boots
NEW YORK (MarketWatch) -- The media scrutiny over Gov. Sarah Palin's controversies is resulted in the worst in Republican presidential nominee John McCain.At any given time when it's essential for McCain to exhibit reporters that he is accountable for an awkward situation, he's instead showing signs of panic.One of the reasons McCain rose to prominence was because reporters helped him craft a public image like a so-called maverick. His prisoner-of-war travail during the Vietnam War made him look both tough and sympathetic. His "Straight Talk Express" presidential campaign in 2000 helped cultivate a title as a defiant speaker, who wouldn't give in to the same old situation in Washington.Now, McCain is starting to look and could be seen as every other politician. When things get tough, blame the media for your woes. McCain, in accordance with the Wall Street Journal, "abruptly canceled a scheduled appearance on CNN's 'Larry King Live' in retaliation" for an earlier interview when network anchor Campbell Brown of CNN introduced questions about vice-presidential candidate Palin's foreign policy expertise.Whilst reacts by blaming journalists for his problems, McCain looks petty and churlish, not icy cool and, well, presidential. He is sending the worst possible signal towards the reporters who were to blame for telling America what he is short for.During the interview, which has been shown on Monday night, CNN's Brown asked McCain spokesman Tucker Bounds repeatedly to make available "just one decision" Palin made as commander from the Alaska National Guard. This is relevant because Bounds had highlighted it proof of her governing experience. Bounds "dodged the question, saying 'Campbell, certainly that you do not mean to belittle every -- every judgment that they makes' in that role,'" in accordance with the Journal.ScapegoatsPeople can believe that this example is an isolated case and it's really unfair to make conclusions with different single incident. I disagree. McCain developed a highly public gesture by attempting to punish CNN -- and the media, in general.He established that he will use the media as scapegoats if he must.When journalists see someone publicly showing warning signs of distress, they will commence to suspect that a presidential candidate is panicking. McCain is facing uncomfortable questions regarding his decision-making process amongst the choice of Palin.At first blush, Palin is classified to be a largely untested Alaska governor along with a relative unknown quantity around the national scene. Campbell Brown was completely justified to ask the McCain campaign to protect her experience. The American voters are asking the same sorts of questions, and Brown, like other journalists, is becoming the voters' proxy.The timing is unfortunate, too. McCain is definitely getting blasted for the purpose appears to be a deficient vetting process. The media, despite what naysayers wish to believe, will answer hard news, not preconceived notions regarding the candidates. The media could be writing and talking in triumphant tones in the event the Republican convention in St. Paul been going smoothly and showed signs and symptoms of triumph, not chaos.No biasThere is much claptrap about CNN like a liberal outlet, and it is a fair point to argue when it comes to. CNN was once dubbed the Clinton News Network by the right during Bill Clinton's presidency -- with possible justification.But CNN wasn't acting within the interest of liberals or wanting to hurt McCain's prospects by asking tough questions. If critics of CNN believe this, these are missing the point.CNN planned to break news and the network raised legitimate issues.And today, it is also fair to suspect that McCain reacted poorly. By shunning CNN at the same time when he most needed to clear the air, he made it appear like he had something to hide. McCain and his aides must be eager to appear on television news to clarify why Palin is qalified, of their view. They're squandering a large opportunity.Now, McCain looks, in a word, unpresidential. Should McCain have gone on CNN to talk about Palin's foreign policy credentials?By Jon Friedman ugg wellington boots
All of the bad news coming from Wall Street may have you wondering what to do to protect your money. Early Show financial adviser Ray Martin has five actions you can take today to help keep your hard earned money safe.Make sure the take advantage you bank accounts feel safe."I've been a financial adviser to my private clients for 22 years. I'd should be a hundred years old to state I've seen this before," Martin says. "First thing to do on my checklist is confirm the safety of your cash in banks. I can't say this enough together with the failure of IndieMac bank per month or so ago, there are $1 billion deposits which are not FDIC insured. What now ?? Go to the FDIC.gov Web site and check the EDIE calculator, devote all your bank account information to see what is insured and what's not. The insurance limits are $100,000 per account and $200,000 per joint account."Check the protection of your money market fund. "It was obviously a shocker earlier this week once we heard that the reserve's primary money market fund - a $68 billion money market fund -- broke the buck. They had dealings with Lehman Brothers and they also had Lehman commercial paper plus they paid a high interest rate," Martin says. "Check your cash market fund. If it pays more than 2.Five percent, that's a warning sign it's paying excessive interest because it's risky. It should be lower than that. Or ask your broker agent for a money market fund in government securities. A U.S. government money market fund to the ultimate safety." You recommend buying treasury bills?"If you've more than $100,000 in cash, and you're simply concerned about its safety, seek the ultimate in safety, buy U.S. Treasury bills, 30, 60 and Three months maturity and buy them directly at auction in the TreasuryDirect Web site, or in your brokerage account. You'll have the ultimate in safety and you'll better sleep in the evening." Martin says. Next tip, establish a home equity personal line of credit. You know, if you have a good credit score, more than a 700 credit rating, no late payments, your property is worth significantly more than you borrowed from on it and you posess zero line of credit, you should get a credit facility here -- a line of credit," Martin said. "It won't hurt to your credit rating, it might even actually improve it and you'll have a source to borrow but if your money in banks and brokerage accounts is disrupted due to a failure of your agent or bank, you've got a source to be able to borrow and have cash on a short-term basis." The 5th tip is -- don't panic. "Absolutely don't here. Now is not the time to sell," Martin said. "Great investors are defined by moments honestly. They look at things to buy. You know, we've were built with a bear market for 11 months now. The typical bear market -- Eighteen months, down 19 to 32 percent, we're down 27. Lots of people saying maybe this is near the end with this bear market, this systemic bear market that we are having here and they are looking at things and saying we've got great valuations on the likes of GE, Johnson & Johnson, Proctor & Gamble, Apple, and you will probably want to start considering a portfolio. Don't purchase yet, but take into consideration how you're gonna restructure your long-term investments and there should be great bargains once we pull through on this. Await some stability first to return to the markets." mulberry bayswater tote
This is where you can find excerpts of numerous of the books discussed for the Early Show in April 2008. April 28, 2008"Chalked Up: Inside Elite Gymnastics' Merciless Coaching, Overzealous Parents, Seating disorder for you, and Elusive Olympic Dreams," by Jennifer SeyVideo of Early Show segmentApril 25, 2008"Bringing Home the Birkin," by Michael TonelloThe Hermes Birkin bag -- the ultimate status symbol. Even the rich and famous have to wait to have their hands on one. Enter Michael Tonello -- Robin Hood to the rich, famous, and intensely desperate! It's all in the new book, "Bringing Home the Birkin," that they discussed on The Early Show . To find out the segment, click the link. To enter a sweepstakes related to the book, click here.Thursday, April 24, 2008"The Place To Be: Washington, CBS, and also the Glory Days of Television News," by Roger MuddThroughout the 1960s and '70s, Roger Mudd covered the majority of the major stories in Washington for CBS News. In his memoir, "The Place to Be: Washington, CBS as well as the Glory Days of Television News," he recounts the history-making stories he covered, as well as the great journalists who have been his colleagues. Mudd discussed all this on The Early Show . To see the interview, click here. Monday, April 21, 2008"Certain Girls," by Jennifer WeinerNine million readers love Jennifer Weiner. She burst in this area in 2001 with "Good while having sex." Another book of hers, "In Her Shoes," is made into a movie starring Cameron Diaz, and the like. And now she's is back with the sequel to "Good in Bed" called "Certain Girls." Weiner visited Earlier Show to chat about this. To see the video with the interview, click here. Editor's note: "Certain Girls" is published by Atria Books, an imprint of Simon & Schuster, that's owned by CBS Corporation, as is also CBSNews.com. Friday, April 18, 2008"Covert: My Years Infiltrating the Mob," by Bob Delaney and Dave Scheiber, and Bill Walton, who wrote the forewordBeing a referee inside the National Basketball Association is a tough job. Nevertheless for Bob Delaney, it's a lot safer than his previous one! Delaney was an undercover New Jersey state trooper who helped arrest over 35 organized crime figures inside the 1970s. He wrote about it in "Covert: My Years Infiltrating the Mob," and spoke over it on The Early Show . To see the interview, click here.Wednesday, April 16, 2008"Ask For this," by Linda BabcockLinda Babcock visited The first Show to tell the way to ask for a raise although economy is shaky. She also mentioned her book, which relates to how women can use the power of negotiation to obtain what they really want. In "Ask Correctly," she says women don't negotiate by themselves as much as they should, and explains why they must negotiate more -- because of their own good. To watch the segment, click here.Tuesday, April 15, 2008"Hold Tight," by Harlan CobenIn his latest thriller, "Hold Tight," best-selling author Harlan Coben weighs a child's right to privacy against a parent's to certainly know what their child is doing online. In a recent Ny Times op-ed, Coben defends the parents' side. He addressed all of it, on The Early Show . To find out the segment, click here.Monday, April 14, 2008"Madness: A Bipolar Life," by Marya HornbacherBest-selling author Marya Hornbacher writes about her battle with a mental illness that affects some 6 000 0000 Americans. She spoke about her book, and her very personal struggle, about the Early Show . To see the segment, click here.Friday, April 11, 2008"The Big Field," by Mike LupicaFor years, Ny Daily News columnist Mike Lupica's award-winning writing focused on professional athletes. Only a few years ago, Lupica began a similarly successful career writing books for youngsters when he's not doing his thing for the News. His latest offering is "The Big Field," about lessons about sharing that are learned by Little Leaguers. He spoke regarding it on The Early Show . To observe the segment, just click here.Thursdsay, April 10, 2008"Who's Your City?: What sort of Creative Economy Is Making Where you can Live the Most Important Decision you will ever have," by Richard FloridaNearly 40 million Americans who'll move this year. If you're one of them, or even thinking about moving, and it's to a city, make sure you understand what your new one has to offer, suggests Richard Florida in "Who's Your City." He discussed it on The Early Show . To see the segment, click the link. buy mulberry bag
A U.S. border inspector who allowed an Atlanta lawyer have contracted a dangerous strain of tuberculosis into the country, disregarding some type of computer warning to stop the guy and don protective equipment, has been removed from border duty, officials said Thursday.The unidentified inspector explained that he was no doctor however that the infected man seemed perfectly healthy anf the husband thought the warning was merely "discretionary," officials briefed involved told The Associated Press. They spoke on condition of anonymity since the matter is still under investigation.The person was identified as Andrew Speaker, a 31-year-old personal injury attorney who returned the other day from his honeymoon in Europe. His new father-in-law, Robert C. Cooksey, is a U.S. Centers for Disease Control and Prevention microbiologist devoted to TB and other bacteria.Speaker is under quarantine at a hospital in Denver. He could be first infected person to get quarantined by the U.S. government since 1963.Speaker will stay in a room with engineered ventilation to prevent germs from escaping, and doctors will attempt as many as five different antibiotics first, reports CBS News correspondent Kelly Cobiella. If that doesn't work, they'll turn to surgery.Cooksey would not discuss whether he reported his son-in-law to federal health authorities. Nor did the CDC inform you of that the case came to their attention. However, Cooksey said that neither he nor his CDC laboratory was the foundation of his son-in-law's infection.The disclosure how the patient is a lawyer — and specifically an injury lawyer — outraged many people online and elsewhere. Some travelers who flew about the same planes with Speaker angrily accused him of selfishly putting numerous other people's lives in danger."It's still very stressful," 21-year-old Laney Wiggins, one of over two dozen University of South Carolina-Aiken students who're getting skin tests for TB. "That can be an outrageous number of people that they was very reckless using health. It's not fair. It's selfish."Speaker had told The Atlanta Journal-Constitution that he knew he had TB when he flew from Atlanta to Europe in mid-May for his wedding and honeymoon, but that he did not learn until he had been in Rome it's an extensively drug-resistant strain considered especially dangerous. He was quoted saying that doctors initially didn't order him to not fly and only suggested he delay his wedding.Despite later warnings from federal health officials not to board another long flight, he chose to fly to Canada and sneak away from there to the U.S. instead of flying, believing he would not survive if he would not reach the U.S., he said.He was quarantined May 25, a day after he was in a position to pass through the border crossing at Champlain, N.Y., along the Canadian border.The inspector ran Speaker's passport by having a computer, and a warning — including instructions to carry the traveler, don a protective mask in dealing with him, and telephone health authorities — popped up, officials said. 60 seconds or so later, Speaker was instead cleared to carry on on his journey, as outlined by officials familiar with the records.The Homeland Security Department is investigating."The border agent who questioned that individual is at present performing administrative duties," said Homeland Security spokesman Russ Knocke, adding those duties tend not to include checking people on the land border crossing.Colleen Kelley, president in the union that represents customs and border agents, declined to comment on the specifics of the truth, but said "public health issues were not receiving adequate attention and training" within the agency.On Thursday, a tan and healthy-looking Speaker was flown from Atlanta to Denver, accompanied by his wife and federal marshals, to Denver's National Jewish Medical and Research Center, where doctors planned to isolate him and treat him with oral and intravenous antibiotics. no previous page next 1/2 selfridges mulberry
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