How to Find and Read Health Insurance Company Annual Financial Statements
|
|
- Ashlee Bates
- 6 years ago
- Views:
Transcription
1 How to Find and Read Health Insurance Company Annual Financial Statements Joseph P. Ditré, Esq., Ex. Dir. Consumers for Affordable Health Care Advocating the right to health care for every man, woman, and child MISSION STATEMENT Consumers for Affordable Health Care is a Maine advocacy organization that strives to ensure a strong consumer voice in decision making at all levels and in all forums in order to advocate for a consumer oriented health system in Maine and the United States. Since 1988, Consumers for Affordable Health Care has provided leadership and support to consumers, businesses, organizations, and policymakers to specifically advocate for: Access to health care for all Maine residents including preventive, acute, chronic and long term care that is assured through health care coverage Affordable health care coverage that is guaranteed for all Maine residents, taking into account an individual s ability to pay An individual's right to freely choose her or his provider and method of care within the confines of quality care that is based on objective standards and supported by publicly available data on individual providers and hospitals Financing coverage from a broad variety of government and private sources Controlling rising costs while preserving quality care Consumers for Affordable Health Care provides resources to educate consumers and assist them in navigating the existing system. PO Box 2490 Augusta, ME Consumers for Affordable Health Care works with other organizations to educate them and to advocate our mission before legislative and regulatory bodies
2 Finding Health Insurance Company Annual Financial Statements 3 Where to Find Health Insurance Company Annual Financial Statements for Your State a. NAIC: b. See Endnotes How to obtain your 5 free annual financial statements from the NAIC website c. State Departments of Insurance website 4 2
3 Annual Financial Statements (Health Annual Statement) a. Typically 100 pages (or more with Schedules) b. Multiple pages may be associated with a page number (e.g.,26, 26.1, 26.2, 26.2, 26.3) c. Format is uniform and consistent (e.g., page 2 always lists Assets, page 28 always lists the Five Year Historical Data, etc.) 5 Reading Key Indicators In A Health Insurance Company s Annual Financial Statement 6 3
4 Key Financial Terms and Indicators a. Net Income (Loss) b. Medical Loss Ratio c. Reserves d. Surplus e. Investment Income f. Dividends 7 Net Income (Loss) a. Definition: Income (or loss) after all expenses paid, often called Profits (or Loss). Calculates Net Underwriting Gain (Loss) plus Net Investment Gain (Loss) minus capital gains and federal income taxes. b. Where to Find: Page 4, Statement of Revenues and Expenses (Balance Sheet), Line 32 c. See also: Page 28, Five-Year Historical Data, Line 12 d. Compare Net Underwriting Gain (Loss): Net Underwriting Gain (or Loss) calculates Total Revenues minus Total Underwriting Deductions. It is typically larger than net income (or loss). It is a pre-tax figure
5 Medical Loss Ratio a. Definition: The ratio of Medical Claims (including Quality Improvement) to Premiums Incurred b. Where to Find: Supplemental Health Care Exhibit, Line 7 c. MLR Federal Rule: 01/pdf/ pdf 9 Reserves a. Definition: Funds set aside to cover expenses which are due or will become due in the future. Reserves represent liabilities. b. Where to Find: Page 3, Liabilities, Capital, and Surplus, Line
6 Surplus a. Definition: Excess of assets over liabilities, sometimes called Capital and Surplus or Net Worth. b. Where to Find: Page 3, Liabilities, Capital and Surplus, Line 31 c. Compare to Risk Based Capital (RBC): RBC is a measure of solvency developed by the NAIC for regulatory purposes. It takes into account the risks associated with each insurance company s operations. Usually a state s insurance code sets the minimum level of surplus based on a company s risks. NOTE: RBC/2 = ACL. Actual surplus/acl = RBC ratio 11 Investment Income a. Definition: Income generated by the investment of assets. Insurers have two basic sources of income, underwriting (premiums less claims and expenses) and investment income. b. Where to Find: Page 4, Statement of Revenue and Expenses, Line 25. See also, Page 15, Exhibit of Net Investment Income, Line
7 Dividends a. Definition: Money paid to shareholders from an insurance company's earnings. b. Where to Find: Page 5, Statement of Revenue and Expenses, L Questions?
8 ENDNOTES How to Obtain Your Five Free Financial Statements or other insurance company data from NAIC Consumer Information Source Go to the NAIC Homepage at Click on the box Consumer Information Source (CIS) on the left side of the page Consumer Information Source landing page will open. It lists: o File Insurance Complaint o Do You Suspect Fraud o Download Key Financial Statements o Get More Information o Aggregate Consumer Complaint Reports Click on Download Key Financial Statements o Download Key Financial Statements page opens. On the left side of the page it offers: Information about 5 Free Requests (read for more information about what constitutes one request) o It also offers the opportunity to: Sign Up or Log In Sign up or Log In (depending on whether you re already a subscriber) Once you log in, you should still be on the Download Key Financial Statements page. On the right side of page, it asks you to enter Company Name or Company Code, the Filing Year, and the Filing Period (Enter those and submit) Next page provides the requested document by Company Name, Company Code, Home Office, Main Address Click on the document you requested The next page will provide both Key Annual Statement Page and Non key Annual Statement Pages (which you can select Add to Cart ) You can then proceed to Checkout or do a new search. You can open the documents by double clicking on each. That s it.
9 Resources Consumers for Affordable Health Care National Association of Insurance Commissioners Center for Consumer Information & Insurance Oversight (CCIIO at CMS formerly OCIIO at HHS) Thank You!
capital Affordable Care Act
WWW.FAMILIESUSA.ORG net income surplus capital Affordable Care Act An Advocate s Guide to Analyzing Insurers Financial Health ISSUE BRIEF / JUNE 2015 AN ADVOCATE S GUIDE TO ANALYZING INSURERS FINANCIAL
More informationA. The Affordable Care Act
Technical Guidance on the Medical Loss Ratio Regulation May l, 2012 The New England Council James T. Brett President & CEO Healthcare Committee Chairs Frank McDougall Dartmouth Hitchcock Medical Center
More informationU.S. Senate Committee on Banking, Housing, and Urban Affairs Subcommittee on Financial Institutions and Consumer Protection
U.S. Senate Committee on Banking, Housing, and Urban Affairs Subcommittee on Financial Institutions and Consumer Protection Hearing on Finding the Right Capital Regulation for Insurers Submitted Testimony
More informationAnalyzing the CareFirst Decision: What Does it Mean for Conversions Elsewhere?
: What Does it Mean for Conversions Elsewhere? April 2003 This report was written with support from The W.K. Kellogg Foundation. Community Catalyst, Inc. 30 Winter Street, 10th Fl. Boston, MA 02108 617-338-6035
More informationMedical Loss Ratio Rules
Brought to you by Kapnick Insurance Group Medical Loss Ratio Rules The Affordable Care Act (ACA) established the medical loss ratio (MLR) rules to help control health care coverage costs and ensure that
More informationInterim Final Rule Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements under the Patient Protection and Affordable Care Act
January 31, 2011 Office of Consumer Information and Insurance Oversight Department of Health and Human Services Attention: OCIIO-9998-IFC Room 445-G, Hubert Humphrey Building 200 Independence Avenue, SW
More informationJune 18, To Whom It May Concern:
1015 15 th Street, N.W., Suite 950 Washington, DC 20005 Tel. 202.204.7508 Fax 202.204.7517 www.communityplans.net Bob Thompson, Chairman Margaret A. Murray, Chief Executive Officer June 18, 2012 Office
More informationDocument Identifier CMS CMS Medical Loss Ratio (MLR) Annual Reporting Form
May 2, 2012 Office of Management and Budget Office of Information and Regulatory Affairs Attention: CMS Desk Officer Submitted via email to: OIRA_submission@omb.eop.gov Re: Document Identifier CMS-10418
More informationGovernment of Puerto Rico OFFICE OF THE INSURANCE COMMISSIONER OF PUERTO RICO Guaynabo, Puerto Rico TABLE OF CONTENTS RULE 92
Government of Puerto Rico OFFICE OF THE INSURANCE COMMISSIONER OF PUERTO RICO Guaynabo, Puerto Rico TABLE OF CONTENTS RULE 92 STANDARDS FOR IMPLEMENTING THE PROVISIONS RELATED TO RISK- BASED CAPITAL ARTICLE
More informationAnnual statements for years 2012 and prior did not provide sufficient granular data for us to perform similar analyses.
April 15, 2016 Mr. Patrick McNaughton Chair, Health Risk-Based Capital Working Group National Association of Insurance Commissioners 2301 McGee Street, Suite 800 Kansas City, MO 64108-2662 Re: Recommendation
More information. ACA & Marketplace updates for OE 6
. ACA & Marketplace updates for OE 6 Presented By: Consumers for Affordable Health Care Date: October 1, 2018 www.mainecahc.org Our mission: To Advocate The Right To Quality, Affordable Health Care For
More informationThe State of Market Conduct Collaboration
The State of Market Conduct Collaboration By Sheri Marston, NAIC Collaborative Actions Coordinator, Market Regulation Introduction Interstate collaboration has been expanding, and multistate market conduct
More informationAttachment 1 Puerto Rico Rate Filing Instruction Manual
Attachment 1 Puerto Rico Rate Filing Instruction Manual March 2014 1 Overview This instruction manual supports implementation of the requirement of Ruling Letter No. CN- 2017-218-AS of March 1, 2017. For
More information2015 Small Group Health Insurance Market
2015 Small Group Health Insurance Market 6/30/2016 by Mark Farrah Associates In 2015, small group health insurers provided coverage for 13.537 million people through policies written within 1.088 million
More informationIssue Brief. Insurers Medical Loss Ratios and Quality Improvement Spending in Mark A. Hall and Michael J. McCue OVERVIEW
March 2013 Issue Brief Insurers Medical Loss Ratios and Quality Improvement Spending in 2011 Mark A. Hall and Michael J. McCue The mission of The Commonwealth Fund is to promote a high performance health
More informationJanuary 30, Dear Mr. Seeley:
January 30, 2014 Alan Seeley Chair, SMI RBC Subgroup National Association of Insurance Commissioners 2301 McGee Street, Suite 800 Kansas City, MO 64108-2662 Dear Mr. Seeley: The American Academy of Actuaries
More informationConsumer Perspective on the Health Insurance Marketplace and Medicaid Expansion. Laval Miller-Wilson Temple University School of Law April 20, 2013
Consumer Perspective on the Health Insurance Marketplace and Medicaid Expansion Laval Miller-Wilson Temple University School of Law April 20, 2013 PHLP: Oldest & Only Non-Profit Law Firm Focused Exclusively
More informationFederal and State Methodologies for Medical Loss Ratio Calculations
Seton Hall Law Center for Health & Pharmaceutical Law & Policy i Federal and State Methodologies for Medical Loss Ratio Calculations Tara Adams Ragone, J.D. 2013 Health Insurance Rate Review Forum April
More informationThe MSRB s Agenda for Remarks of Lynnette Kelly, Executive Director. at the. Bond Buyer National Municipal Bond Summit. Fort Lauderdale, FL
The MSRB s Agenda for 2015 Remarks of Lynnette Kelly, Executive Director at the Bond Buyer National Municipal Bond Summit Fort Lauderdale, FL March 2, 2015 INTRODUCTION Good afternoon and thank you for
More informationSTUDY OF STATE INSURANCE DEPARTMENTS PART 3 INTERNET WEB PAGE GRADES
Executive Summary STUDY OF STATE INSURANCE DEPARTMENTS PART 3 INTERNET WEB PAGE GRADES There is good news from state regulation of insurance. The quality of the web pages being constructed by state regulators
More informationThe Academy and Health Reform
The Academy and Health Reform Cori E. Uccello, FSA, MAAA, MPP Senior Health Fellow American Academy of Actuaries CAS Annual Meeting, Session C-25 November 10, 2010 Washington, DC Overview Key provisions
More informationSTATE REGULATION OF CAPTIVE REINSURANCE TRANSACTIONS
ZZ STATE REGULATION OF CAPTIVE REINSURANCE TRANSACTIONS Dan Schelp, Managing Counsel Josh Arpin, Sr. Accounting and Reinsurance Policy Advisor 1 Attention APIR, PIR, or SPIR Designees This presentation
More informationIncrease in Capital and Surplus Requirements for Insurers and Health Maintenance Organizations
INSURANCE DEPARTMENT OF BANKING AND INSURANCE OFFICE OF SOLVENCY REGULATION Increase in Capital and Surplus Requirements for Insurers and Health Maintenance Organizations Proposed Amendments: N.J.A.C.
More informationThe Politics and Impact of PPACA on Brokers and Employers
The Politics and Impact of PPACA on Brokers and Employers By Janet Trautwein, CEO National Association of Health Underwriters The Unintended Consequences Dependents to Age 26 and lifetime and annual limits
More informationACA Sec Annual Fee Overview. Lawrence M. Brauer Ernst & Young LLP Washington, DC
I. Background II. III. IV. ACA Sec. 9010 Annual Fee Overview Lawrence M. Brauer Ernst & Young LLP Washington, DC larry.brauer@ey.com A. The Patient Protection and Affordable Care Act (P.L. 111-148) (ACA)
More informationThe Implementation of the Affordable Care Act in Puerto Rico: Challenges and Proposals
The Implementation of the Affordable Care Act in Puerto Rico: Challenges and Proposals Ángela Weyne-Roig Puerto Rico Insurance Commissioner Mission of the Office of the Commissioner of Insurance To promote
More informationRe: State of Nevada s Request for Adjustment to Medical Loss Ratio Standard
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 200 Independence Avenue SW Washington, DC 20201 May 13, 2011 Brett J. Barratt Commissioner of Insurance Division of Insurance
More informationIMPLEMENTING HEALTH INSURANCE REFORM: NEW MEDICAL LOSS RATIO INFORMATION FOR POLICYMAKERS AND CONSUMERS
COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION OFFICE OF OVERSIGHT AND INVESTIGATIONS MAJORITY STAFF IMPLEMENTING HEALTH INSURANCE REFORM: NEW MEDICAL LOSS RATIO INFORMATION FOR POLICYMAKERS AND CONSUMERS
More informationHow To Set Up: Pre-Pay & Recurring Payments
How To Set Up: Pre-Pay & Recurring Payments How to Pre-Pay On Your Account Pre-Pay is available for customers to make payments in advance on the account before monthly tuition fees are assessed. Once the
More information[Billing Codes: P; P; P]
[Billing Codes: 4830-01-P; 4510-29-P; 4120-01-P] DEPARTMENT OF THE TREASURY Internal Revenue Service RIN 1545-BJ63 DEPARTMENT OF LABOR Employee Benefits Security Administration RIN 1210-AB45 DEPARTMENT
More informationApplication Portal Guide
Application Portal Guide June 2018 Login email johnsmith@email.co.uk password ******** Call 03333 701 101 or visit www.pepper.money to discover more. Aimed at Professional intermediaries only; not for
More informationSUMMARY: This document contains proposed regulations that would modify the
This document is scheduled to be published in the Federal Register on 12/09/2016 and available online at https://federalregister.gov/d/2016-29487, and on FDsys.gov [4830-01-p] DEPARTMENT OF THE TREASURY
More information2015 ADVOCACY AND POLICY PRIORITIES NATIONAL ASSOCIATION OF PROFESSIONAL INSURANCE AGENTS
2015 ADVOCACY AND POLICY PRIORITIES NATIONAL ASSOCIATION OF PROFESSIONAL INSURANCE AGENTS ABOUT PIA S ADVOCACY EFFORTS The National Association of Professional Insurance Agents (PIA) represents independent
More informationC1 Work Group Updated Recommendation of Corporate Bond Risk-Based Capital Factors
July 24, 2017 Via email to: jgarber@naic.org Kevin Fry Chair, Investment Risk-Based Capital (E) Working Group National Association of Insurance Commissioners c/o Julie Garber, Senior Manager Solvency Regulation
More informationNew claims administration service from Aetna for medical services rendered outside the United States of America
United Nations Secretariat 4 October 2005 English only ST/IC/2005/55 Information circular* To: From: Subject: Staff members and retired staff members residing outside the United States of America who participate
More informationNovember 27, Re: Affordable Care Act: Proposed HHS Notice of Benefit and Payment Parameters for 2019 CMS P
Charles N. Kahn III President and CEO November 27, 2017 The Honorable Seema Verma Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services 200 Independence Avenue
More informationOxford Health Plans (NY), Inc.
Oxford Health Plans (NY), Inc. Statutory Basis Financial Statements as of and for the Years Ended December 31, 2014 and 2013, Supplemental Schedules as of and for the Year Ended December 31, 2014, Independent
More informationINSTRUCTIONS FOR COMPLETING THE PRELIMINARY JUSTIFICATION
I. Overview INSTRUCTIONS FOR COMPLETING THE PRELIMINARY JUSTIFICATION Under the proposed Rate Review regulation, health insurance issuers are required to provide HHS and States with a Preliminary Justification
More informationAMCHP State Public Health Autism Resource Center TA Call
AMCHP State Public Health Autism Resource Center TA Call December 21, 2011 Meg Comeau, MHA Boston University School of Public Health The Catalyst Center: Who are we? Funded by the Maternal and Child Health
More informationINDIANA S PARTICIPATION IN HEALTH CARE REFORM & AFFORDABLE CARE ACT (ACA) IMPLEMENTATION DISCUSSIONS
INDIANA S PARTICIPATION IN HEALTH CARE REFORM & AFFORDABLE CARE ACT (ACA) IMPLEMENTATION DISCUSSIONS MARCH 15 & 16: Lawren Mills, Office of the Governor, attended the National Governor s Association (NGA)
More informationHealth Insurance Exchange Plan Management
Health Insurance Exchange Plan Management Exchange Plan Management, the NAIC and SERFF: Learning How the Pieces Fit Kelly McCumber, Product Specialist II Jon Sink, Business Analyst II The NAIC, SERFF and
More informationOffice of Insurance Regulation MEMORANDUM
Office of Insurance Regulation MEMORANDUM DATE: December 31, 2017 TO: FROM: SUBJECT: Life and Health Fraternal Societies Financial Statement Contact Person Carolyn Morgan, Director Life & Health Financial
More informationHospital networks: Perspective from four years of the individual market exchanges
Hospital networks: Perspective from four years of the individual market exchanges McKinsey Center for U.S. Health System Reform May 017 Any use of this material without specific permission of is strictly
More informationProviding Accessible Enrollment Assistance Under the ACA
Providing Accessible Enrollment Assistance Under the ACA Association of University Centers on Disabilities Conference Elaine Saly Families USA March 13, 2013 The Need for Assistance 75% of those eligible
More informationREGULATORY ELECTRONIC FILING SYSTEM
REGULATORY ELECTRONIC FILING SYSTEM FOR FILINGS DUE IN 2014 Fraternal Societies FLORIDA DEPARTMENT OF FINANCIAL SERVICES OFFICE OF INSURANCE REGULATION LIFE & HEALTH FINANCIAL OVERSIGHT M E M O R A N D
More informationOxford Health Plans (NJ), Inc.
Oxford Health Plans (NJ), Inc. Statutory Basis Financial Statements as of and for the Years Ended December 31, 2014 and 2013, Supplemental Schedules as of and for the Year Ended December 31, 2014, Independent
More informationHealth Care Receivables Follow-up Study
Health Care Receivables Follow-up Study Session 29PD Health Annual Statement New Exhibit 3A Health Care Receivables Follow-up Study F. Kevin Russell, FSA, MAAA Chairperson, Health Care Receivables Factors
More informationHealth Insurance Cost Report. The Colorado General Assembly. for. Calendar year in accordance with (4)(c) & (d), C.R.S.
Health Insurance Cost Report to The Colorado General Assembly for Calendar year 2015 in accordance with 10-16-111(4)(c) & (d), C.R.S. Published January 3, 2016 Marguerite Salazar Commissioner January 3,
More informationRATE FILING DISCLOSURE
Attachment Three Jt. Executive (EX) Committee/Plenary 12/16/10 Rate Filing Disclosure Form Background and Project Summary December 2010 Background State insurance regulators were asked to assist the Department
More informationMedicaid managed care financial results for 2017
Medicaid managed care financial results for 2017 May 2018 Jeremy D. Palmer, FSA, MAAA Christopher T. Pettit, FSA, MAAA Ian M. McCulla, FSA, MAAA Table of Contents INTRODUCTION...1 TEN YEARS OF ANALYSIS...3
More informationDraft: 5/9/11 HEALTH INSURANCE EXCHANGES UNDER THE AFFORDABLE CARE ACT: GOVERNANCE OPTIONS AND ISSUES I. INTRODUCTION
Draft: 5/9/11 Comments are being requested on this draft White Paper on or before May 16, 2011. Comments should be sent only by email to Jolie Matthews at jmatthew@naic.org. I. INTRODUCTION HEALTH INSURANCE
More informationMaine Association of Health Underwriters 2010 Health Care Reform Position Paper
Maine Association of Health Underwriters 2010 Health Care Reform Position Paper The Maine Association of Health Underwriters (MAHU) represents health insurance brokers and consultants advising thousands
More informationState of New Jersey DEPARTMENT OF BANKING AND INSURANCE DIVISION OF INSURANCE OFFICE OF SOLVENCY REGULATION PO BOX 325 TRENTON, NJ
PHIL MURPHY Governor SHEILA OLIVER Lt. Governor State of New Jersey DEPARTMENT OF BANKING AND INSURANCE DIVISION OF INSURANCE OFFICE OF SOLVENCY REGULATION PO BOX 325 TRENTON, NJ 08625-0325 TEL (609) 292-5350
More informationChapter XX Health Reform
Chapter XX Health Reform Health Reform Guaranteed Renewability 5/02/14 Federal law defers enforcement of health reform to state insurance regulators. To help ensure strong consumer protections remain in
More informationCOMPARING THE HEALTH PROTECTION PROGRAM REAUTHORIZATION PROPOSALS
Revised January 27, 2016 COMPARING THE HEALTH PROTECTION PROGRAM REAUTHORIZATION PROPOSALS Few issues will occupy the attention of Granite State policymakers during the 2016 legislative session as much
More informationMedicare Supplement Insurance In Maryland October 12, 2018
Medicare Supplement Insurance In Maryland October 12, 2018 Mary Kwei, Life and Health mary.kwei@maryland.gov Patricia Dorn, Consumer Education and Advocacy patricia.dorn@maryland.gov Agenda: Medicare Supplement
More informationReport of the Joint Risk-Based Capital Work Group To the NAIC Risk-Based Capital (E) Task Force Atlanta March 2003
Report of the Joint Risk-Based Capital Work Group To the NAIC Risk-Based Capital (E) Task Force Atlanta March 2003 The American Academy of Actuaries is the public policy organization for actuaries practicing
More informationEnhancing the Patient-Centeredness of State Health Insurance Markets State Progress Reports
Enhancing the Patient-Centeredness of State Health Insurance Markets State Progress Reports ENHANCING THE PATIENT-CENTEREDNESS OF STATE HEALTH INSURANCE MARKETS 1 Founded in 1920, the NHC is the only organization
More informationArticle from: Health Watch. October 2012 Issue 70
Article from: Health Watch October 2012 Issue 70 Enterprise Risk Management: One Size Does Not Fit All By Mark Whitford Mark Whitford, FSA, CERA, MAAA, is Director, Business Development and Insurance Strategy,
More informationSecureLife Universal Life Death Benefit (UL DB)
SecureLife Universal Life Death Benefit (UL DB) A 20-year guarantee with flexibility For Agent training only. Not for consumer solicitation purposes. Form 2992-C; Rev. 8-2012 1 SecureLife UL DB Insurance
More informationHealth Care Reform Laws and their Impact on Individuals with Disabilities (Part one)
Health Care Reform Laws and their Impact on Individuals with Disabilities (Part one) ONE STRONG VOICE Disabilities Leadership Coalition Of Alabama Montgomery, Alabama December 8, 2010 Allan I. Bergman
More informationRe: Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans. File Code CMS 9989 P
October 24, 2011 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-9989-P P.O. Box 8010 Baltimore, MD 21244-8010 Re: Patient Protection and Affordable Care
More information2016 Medicaid Managed Care Final Rule 1 Summary
2016 Medicaid Managed Care Final Rule 1 Summary The final Medicaid Managed Care rule retains nearly all of the requirements of the proposed rule and does not make substantial changes to it. In particular,
More informationRSM THE POWER OF BEING UNDERSTOOD AUDIT I TAX I CONSULTING
THE POWER OF BEING UNDERSTOOD AUDIT I TAX I CONSULTING RSM Contents Independent Auditor's Report 1-2 Financial Statements Statutory statements of admitted assets, liabilities, and capital and surplus 3
More informationQUARTERLY STATEMENT AS OF MARCH 31, 2017 OF THE CONDITION AND AFFAIRS OF THE Neighborhood Health Plan of Rhode Island
95422172111 217 Document Code: 21 QUARTERLY STATEMENT AS OF MARCH 31, 217 CONDITION AND AFFAIRS NAIC Group Code, NAIC Company Code 9542 Employer s ID Number 5-47752 (Current Period) (Prior Period) Organized
More informationRate Component Overview
Oxford Health Plans (NY), Inc. Oxford Health Insurance, Inc. New York Small Group POS Plans Narrative Summary of Requested Rate Changes Effective 4th quarter 2013 We have prepared this Narrative Summary
More informationWhat is Rate Review. Approving Insurance Rates: File and Use. Rate Review. Insurers can implement rate increases at any time with notice to DOI
RATE REVIEW What is Rate Review Approving Insurance Rates: File and Use Insurers can implement rate increases at any time with notice to DOI Rate Review States are required to get prior approval of any
More informationReport of the American Academy of Actuaries Long Term Care Risk Based Capital Work Group. NAIC Capital Adequacy Task Force
Supplement to the Report of the American Academy of Actuaries Long Term Care Risk Based Capital Work Group To the NAIC Capital Adequacy Task Force September 2004 The American Academy of Actuaries is the
More informationProperty & Casualty Insurance Reform Committee Final Recommendations November 15, 2006
Property & Casualty Insurance Reform Committee Final Recommendations November 15, 2006 Residential Insurance Market/Consumer Issues 1. Transparency for consumers (residential and commercial). Require the
More informationKevin Lewis Chief Executive Officer Maine Community Health Options
Kevin Lewis Chief Executive Officer Maine Community Health Options B Creation of Consumer Operated and Oriented Plans (CO-OPs) CO-OP program created by ACA, s. 1322, to introduce greater competition and
More informationOverview of New Reform Law. Federal Healthcare Reform: Impacts on Employer-Sponsored Plans. Agenda
: Impacts on Employer-Sponsored Plans June 3, 2010 Employee Benefits Planning Association Jack McRae SVP, Congressional and Legislative Affairs Premera Blue Cross Jim Grazko VP and General Manager, Underwriting
More informationKey Trends within the Individual and Small Group Health Insurance Segments
Key Trends within the Individual and Small Group Health Insurance Segments 5/26/2016 by Mark Farrah Associates With two full years of health insurance activity under the Affordable Care Act (ACA), some
More informationCHAPTER 1 INTRODUCTION... 1
CHAPTER 1 INTRODUCTION... 1 A. Purpose of this Handbook... 1 B. What is Market Analysis?... 2 C. Role of the Market Actions (D) Working Group... 3 D. The Players and Their Tools... 3 E. Resources Within
More informationACA IMPLEMENTATION IMPLEMENTATION TIMELINE JOSHUA GOLDBERG NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS MAY 4, 2013
JOSHUA GOLDBERG NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS MAY 4, 2013 ACA IMPLEMENTATION UPDATE IMPLEMENTATION TIMELINE 2010 2011 2012 2013 2014 2015 2016 2017 Temporary High Risk Pool Program Temporary
More informationFebruary 6, Dear Ms. Vullo:
February 6, 2018 Reinsurance Task Force Chair Maria T. Vullo National Association of Insurance Commissioners VIA Email Transmission: Jake Stultz (jstultz@naic.org), RE: NAMIC Comments Bilateral Agreement
More informationEvidence of Insurability
Evidence of Insurability User Guide About This Guide The links and functionality described in this guide assume you are logged into the secure portal and are on the MyLibertyConnection employee homepage.
More informationAchieving CAQH Adoption in Rhode Island
Achieving CAQH Adoption in Rhode Island Christopher Dooley, MBA, FACHE Executive Director Women & Infants PHO, Inc. & Kent County Health Services, Inc. Rhode Island Health Care Market Overview 11 Acute
More informationMILLIMAN RESEARCH REPORT Medicaid risk-based managed care: Analysis of financial results for June 2017
Medicaid risk-based managed care: Analysis of financial results for 2016 June 2017 Jeremy D. Palmer, FSA, MAAA Christopher T. Pettit, FSA, MAAA Table of Contents INTRODUCTION... 1 SUMMARY OF RESULTS...
More informationTHE AHP, SHORT-TERM DURATION AND HRA RULES: WHAT S THE LATEST?
THE AHP, SHORT-TERM DURATION AND HRA RULES: WHAT S THE LATEST? Panel Al Bingham, Chair, Academy Risk Sharing Subcommittee Joyce Bohl, Vice-chair, Academy Individual & Small Group Markets Comm. Juan Herrera,
More informationActuarial equivalence will be confirmed via an actuary s letter from the health insurance issuer to the State
Essential Health Benefits Draft proposed rules on November 20, 2012 outlining the EHBs that qualified health plans must cover Based on section 1302 of the Affordable Care Act 10 EHB categories (emergency,
More informationMedicare claim adjustment reason codes 2016
Medicare claim adjustment reason codes 2016 Search Claim Adjustment Reason Codes 2017.. 2016. Uniform Use of Claim Adjustment Reason Codes. How to submit a Medicare-Medicaid claim.... Adjustment Remittance
More informationJanuary 16, Seema Verma Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244
Seema Verma Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 RE: CMS-4182-P: Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare
More informationDepartment of Health and Human Services, file code OCIIO-9993-IFC Department of Labor, RIN 1210-AB45 Internal Revenue Service, REG
Office of Consumer Information and Insurance Oversight Department of Health and Human Services Room 445-G, Hubert H. Humphrey Building 200 Independence Avenue, SW. Washington, DC 20201 Office of Health
More informationRe: Proposed Operational Risk Factors and Growth Charge for the Life RBC Formula
December 19, 2016 Mr. Alan Seeley Chair, Operational Risk (E) Subgroup National Association of Insurance Commissioners Re: Proposed Operational Risk Factors and Growth Charge for the Life RBC Formula Dear
More informationBlueCard Tutorial Using Medical Policy and Prior Authorization Routers
BlueCard Tutorial Using Medical Policy and Learn to Check Medical Policies and Prior Authorizations of other Blue plans After completing the BlueCard Medical Policy and Prior Authorization Routers tutorial,
More information44 NJR 2(2) February 21, 2012 Filed January 26, Proposed New Rules: N.J.A.C. 11:2-28.7A through 28.7D, 28.13, 28.
INSURANCE 44 NJR 2(2) February 21, 2012 Filed January 26, 2012 DEPARTMENT OF BANKING AND INSURANCE OFFICE OF SOLVENCY REGULATION Credit for Reinsurance Proposed New Rules: N.J.A.C. 11:2-28.7A through 28.7D,
More informationHERE TO SERVE YOU GUIDE TO DOING BUSINESS WITH TRANSAMERICA
HERE TO SERVE YOU GUIDE TO DOING BUSINESS WITH TRANSAMERICA GUIDE TO DOING BUSINESS WITH TRANSAMERICA Thank you for working with us at Transamerica. We know you work hard to serve your clients, and we
More informationHHS Releases Guidance on Medical Loss Ratio Requirement under PPACA
Client Alert. HHS Releases Guidance on Medical Loss Ratio Requirement under PPACA Client Alert December 3, 2010 On November 22, 2010, the Secretary of the Department of Health and Human Services ( HHS
More informationCENTER FOR HEALTH INFORMATION AND ANALYSIS PERFORMANCE OF THE MASSACHUSETTS HEALTH CARE SYSTEM PRIVATE COMMERCIAL CONTRACT ENROLLMENT COVERAGE COSTS
CENTER FOR HEALTH INFORMATION AND ANALYSIS PERFORMANCE OF THE MASSACHUSETTS HEALTH CARE SYSTEM PRIVATE COMMERCIAL CONTRACT ENROLLMENT COVERAGE COSTS COST-SHARING PAYER USE OF FUNDS TECHNICAL APPENDIX 2018
More informationTable of Contents. Introduction Definition of Loss Ratio Notes on Using the Results How Rates are Regulated... 3
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Report of 2011 Loss
More informationSENATE, No. 551 STATE OF NEW JERSEY. 215th LEGISLATURE PRE-FILED FOR INTRODUCTION IN THE 2012 SESSION
SENATE, No. STATE OF NEW JERSEY th LEGISLATURE PRE-FILED FOR INTRODUCTION IN THE 0 SESSION Sponsored by: Senator NIA H. GILL District (Essex and Passaic) Senator JOSEPH F. VITALE District (Middlesex) SYNOPSIS
More informationHealtH Care reform 2012 and beyond
HealtH Care reform 2012 and beyond A guide to the major provisions of health care reform legislation affecting employers in 2012 and 2013 and a timeline of the reforms to be introduced through 2018. Employers
More informationMedical Loss Ratio. Institute for Health Plan Counsel May 8, Presenters:
Medical Loss Ratio Institute for Health Plan Counsel May 8, 2013 Presenters: Melissa J. Hulke, CPA, ABV, CFF Navigant, Phoenix, AZ melissa.hulke@navigant.com Scott O. Jones, FSA, MAAA Milliman, Seattle,
More informationParents Guide to School Gateway
Parents Guide to School Gateway Account Activation Open the email invitation from your school. Follow the link in the email as instructed Select Send a PIN to my mobile. Wait a few minutes for the PIN
More informationMedicaid Managed Care Final Rule: Analysis & Implications
Medicaid Managed Care Final Rule: Analysis & Implications Joe Greenman, Shareholder, LanePowell Mark Reagan, Managing Partner, Hooper, Lundy & Bookman P.C. Narda Ipakchi, Director of Managed Markets, AHCA
More informationASSISTANT DIRECTOR MANAGED CARE PROGRAMS
The County of Santa Clara Invites applications for ASSISTANT DIRECTOR MANAGED CARE PROGRAMS VALLEY HEALTH PLAN An Executive Leadership Career Opportunity Reflecting the spirit of Silicon Valley, the County
More informationMay Link Richardson, CERA, FSA, MAAA, Chairperson
Recommended Approach for Updating Regulatory Risk-Based Capital Requirements for Interest Rate Risk for Fixed Annuities and Single Premium Life Insurance (C-3 Phase I) Presented by the American Academy
More informationOffice of Insurance Regulation M E M O R A N D U M
Office of Insurance Regulation M E M O R A N D U M DATE: December 31, 2017 TO: FROM: SUBJECT: Life and Health Insurance Companies and Accredited Reinsurers Filing on the Life Blank - Financial Statement
More informationGovernance and Oversight. Implementing Exchanges. Part of a Families USA series on implementing state health insurance exchanges
Implementing Exchanges Part of a Families USA series on implementing state health insurance exchanges Options for Governance and Oversight This brief highlights key issues to consider in the creation of
More informationTables on Referrals and Payment Rates for Services For American Indians and Alaska Natives Enrolled in Marketplace Plans
Tables on Referrals and Payment Rates for Services For American Indians and Alaska Natives Enrolled in Marketplace Plans Medicare, Medicaid and Health Reform Policy Committee (MMPC) National Indian Health
More information