well being insurers made cash in 2020

Vermont health insurers made “excess profits” in 2020 as a result of the pandemic as non-essential medical and surgical procedures were postponed, but could lose money this year if patients return to hospitals, according to a Department of Financial Regulation report.

The report focused on the financial performance of BlueCross BlueShield of Vermont, the MVP Health Group, the Vermont Education Health Initiative and Cigna during the pandemic.

“The pandemic has severely affected our daily lives, including preventing Vermonters from intermittently receiving unnecessary medical care while they continued to pay their health insurance premiums,” DFR Commissioner Michael Pieciak said in a press release.

Pieciak said it was important to make sure Vermonters don’t overpay for health insurance during the pandemic. He said the DFR found in most cases this was not the case, but where they did they would receive “premium relief”.

Money back to policyholders

Cigna has already repaid approximately $ 118,000 to its eligible large group policyholders, and Pieciak said his division will require BlueCross BlueShield Vermont to provide approximately $ 2.1 million in “consumer relief” in the upcoming Medicare supplement filing for To be included in 2022.

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The DFR plans to review other Medicare supplement requests for 2022 and the upcoming Vermont Education Health Initiative tariff proposal to see if additional COVID-19-related tariff relief is warranted.

According to the DFR report, the pandemic also had “favorable financial effects” on other insurance providers, which justified a reduction in premiums.

DFR previously approved a $ 24 million premium relief for Vermont auto insurance policyholders due to significant driving bans during the pandemic and $ 3.2 million for dental insurance policyholders due to pandemic restrictions on routine dental care.

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Contact Dan D’Ambrosio at 660-1841 or ddambrosio@freepressmedia.com. Follow him on Twitter @DanDambrosioVT. This reporting is only possible with the support of our readers.

Auto insurers profited unfairly from pandemic and may return cash to shoppers, AG says

The agency is committed to “fair and actuarially reasonable” tariffs, including taking into account “changes in consumer driving behavior”.

There is ample evidence that the crisis triggered by the coronavirus caused consumers to drive far fewer kilometers than they did before the pandemic.

Healey’s office claims data shows a reduction in driving behavior of about 50 percent in 2020 and, as a result, there have been fewer accidents, fewer claims, and fewer insurer payouts.

A key economic indicator in the insurance industry is what is known as the loss ratio – the amount an insurer pays for claims (losses) compared to the amount it receives for premiums.

The total pre-pandemic loss rate was around 62, according to the Attorney General’s office, which meant insurers withholding 38 cents of every dollar they received as profit, after administrative and other expenses. Last year, however, the claims ratio dropped to 49, which earned insurers 51 cents of every dollar they received – an increase of 34.2 percent.

“This decline in the claims ratio resulted in approximately $ 700 million in additional profits for insurance companies,” said the letter signed by Glenn Kaplan, chief of the attorney general’s department dealing with insurance matters.

The auto insurance industry in Massachusetts was deregulated in 2008. The insurance officer previously checked by how much insurers could increase their premiums.

Now insurers can set their own rates, but the agent has the power to review them to make sure they are not excessively high. In this case, approval can be refused.

During the pandemic, the insurance department touted its role in encouraging insurers to provide voluntary reimbursement. It also encouraged insurers to defer premiums if drivers got into economic trouble due to the pandemic.

According to a recent report by the Massachusetts Public Interest Research Group (MassPIRG), discounts last year ranged from 15 percent for two months to 15 percent for six months.

The average annual premium in Massachusetts is approximately $ 1,200. As such, the average discounts ranged from $ 30 to $ 90, far less than 10 percent, even on the most generous of refunds. (MAPFRE, the dominant insurer in Massachusetts, with about a quarter of all policies in the state, returned about $ 30 million to its customers last year as part of a premium giveback, it said.)

In their letter, the attorney general warned that insurers would set high premiums in the future.

“We believe that you need to act to prevent insurers from trying to raise tariffs any further,” based on the assumption that “things are going back to normal,” the letter said.

Healey’s position is backed by a dozen lawmakers, spearheaded by Senator Barry Finegold, who wrote to the commission in December that high premiums disproportionately high in “communities hardest hit by COVID-19” as “low” in light of reduced driving behavior harm -income urban communities and communities of color. ”

Finegold’s district includes Lawrence, one of the communities hardest hit by the pandemic.

“The numbers speak for themselves,” said Finegold in an interview. “It’s only fair to give a discount.”

MassPIRG also requested consumer relief in a letter to the insurance officer.

“People drive less so their costs should be significantly lower,” Deirdre Cummings, Legislative Director of MassPIRG, said in an interview. “That’s common sense.”

Some refund advocates pointed to California, where the Insurance Commission found that auto insurers have overloaded drivers and ordered them to report by April 30 “how to return additional premiums to drivers,” according to a recent press release this agency.

Christopher Stark, executive director of the Massachusetts Insurance Federation, a lobby group, said auto insurers had done their part in issuing refunds, suspending policy cancellations, and offering payment plans for policyholders who cannot pay premiums immediately.

Doubting the attorney general’s calculations, he said the insurance industry’s losses for 2020 are still being worked on and may be higher than the numbers cited by others.

Stark also pointed out that insurers do not ask for premium increases retrospectively after losses have exceeded expected levels.

Have a problem? Submit your consumer problem to sean.murphy@globe.com. Follow him on Twitter @spmurphyboston.

Insurers add meals to protection as method to enhance well being and lower your expenses

When COVID-19 first flooded the United States, a health insurer called some customers asking: Do you have enough to eat?

Oscar Health wanted to know if people would have enough to eat for the next few weeks and how they planned to stock up at home.

“We have seen time and time again that the lack of good and nutritional food leads to members being re-admitted to hospitals,” said Oscar manager Ananth Lalithakumar.

Grocery has become a bigger focus for health insurers as they seek to expand their coverage beyond care in a doctor’s office. Other plans pay for temporary food deliveries and some teach people how to cook and eat healthier foods.

According to social benefits experts, insurers and policy makers are increasingly used to treating food as a form of medicine that can help patients lower blood sugar or pressure and stay away from expensive hospitals.

“People are finally starting to feel comfortable with the idea that everyone saves money by preventing things from happening or someone’s condition from getting worse,” said Andrew Shea, senior vice president of online insurance broker eHealth.

This advance is still relatively small and is mostly taking place in government-funded programs such as Medicaid or Medicare Advantage, the privately run versions of the government health program for people 65 years of age or older or with disabilities. But some employers who offer coverage for their employees are also increasingly interested.

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Medicaid programs in several states are testing or developing food coverage. In the next year, Medicare will begin testing coupons for meal programs for patients with malnutrition to improve care and reduce costs.

Nearly 7 million people were enrolled on a Medicare Advantage plan last year, which research by consultancy Avalere Health found offered some sort of food benefit. That is more than twice as much as from 2018.

Insurers usually cover temporary food deliveries so that patients have something to eat when they return from hospital. And for a number of years now, many have also paid for meals tailored to patients with conditions like diabetes.

But now insurers and other bill payers are taking a more nuanced approach. This is because the coronavirus pandemic is causing millions of Americans to seek help from local grocery banks or food pantries.

For example, Oscar Health found that nearly 3 in 10 of its Medicare Advantage customers had food supply issues at the beginning of the pandemic, so arranged temporary food deliveries from a local store at no cost to the recipient.

Medicare Advantage specialist Humana started giving some customers with low-income debit cards $ 25 or $ 50 to help them purchase healthy groceries.

The insurer is also testing the food deliveries in the second half of the month. Then the money from government nutrition programs can run out. Research shows that diabetes patients then make more emergency rooms, said Humana manager Dr. Andrew Renda.

“They may still be on their medication but not have enough to eat. And so their blood sugar goes crazy and they end up in the hospital,” he said.

David Berwick of Somerville, Massachusetts credits a meal delivery program with improving his blood sugar and wishes he could stick to it. The 64-year-old has diabetes and started the program last year at the suggestion of his doctor. The Medicaid MassHealth program covered this.

Berwick said the nonprofit Community Servings provided him with dry cereals and prepackaged meals to warm up on a weekly basis. This included soups and turkey meatloaf, which Berwick described as “absolutely delicious”.

“These are not things that I would certainly do on my own,” he said. “It was a gift, it was a real privilege.”

These programs typically last a few weeks or months and are often aimed at customers with an illness or low income who are struggling to obtain nutritious foods. However, you are not limited to these groups.

Indianapolis-based Preventia Group is starting supplying groceries to some employers looking to improve the eating habits of those covered by their health plans. People who sign up work with a health coach to learn more about nutrition.

Then they can either start with short term deliveries of meals or large amounts of food and recipes to try. The employer pays the costs.

It’s not just about hunger or a lack of good food, said Susan Rider, chief operating officer. They also educate people about what healthy, nutritious food is and how to prepare it.

A 2019 study of Massachusetts residents with similar medical conditions found that those who received meals tailored for their condition had fewer hospitalizations and generated fewer health care expenses than those who did not.

The study author Dr. Seth Berkowitz of the University of North Carolina noted that these meals are just one method of treating food or nutritional problems. He said there is much more to be learned about “which interventions work in which situations and for whom”.

Lack of healthy eating “is clearly linked to poor health, so we know we need to do something about it,” said Berkowitz.