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iPMI Magazine successfully rebranded to iPMI Global in 2023 and has moved to a new home on the internet. To visit the brand new international private medical insurance business intelligence platform, please go to www.ipmiglobal.com

GeoBlue® Announces New President and CEO

GeoBlue announced the appointment of Guillaume Deybach as President and CEO for parent company Highway to Health, Inc (HTH). This concludes the global search conducted over a period of several months for an exceptional candidate able to effectively blend industry expertise with strategic vision.

Deybach joins HTH from the role of Group Executive Vice President - Travel Business Line of the Europ Assistance Group, a subsidiary of Generali Group. His 20 years there allowed him to acquire expertise and prove his abilities through a variety of senior leadership roles, including President & CEO for Europ Assistance North America. With success in integral areas including strategy, product development, marketing, operational management and international business development, and time spent living and working in Paris, Munich, San Diego and Washington, Deybach brings a wealth of experience to the role.

Deybach holds a Business Organization Degree from Heriot-Watt University in Scotland and a Major in International Business Management from ESSCA Business School in France.

"We are very excited about this new chapter in the evolution and growth of Highway to Health. Guillaume's strong industry experience, leadership skills and strategic thinking made him the clear choice to become HTH's next CEO," said Alan Krigstein, Chairman, Board of Directors for Highway to Health, Inc.

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Health Insurance Mergers Will Raise Premiums And Harm Medicare Beneficiaries

A new analysis conducted by the Center for American Progress finds that the proposed merger between the health insurance companies Aetna Inc. and Humana Inc. would greatly reduce market competition for Medicare Advantage beneficiaries in the markets they serve.

This reduction in competition likely would result in increased premiums for seniors and raise overall costs for Medicare that would then be passed on to taxpayers. As federal and state regulators review this and other proposed insurance mergers in the coming months, CAP’s findings are a reminder to set a high bar in considering these mergers and to be mindful of other avenues to constrain health care costs and improve quality in the industry.

CAP conducted a regression analysis to measure the effect of competition between Aetna and Humana on premiums and found large and highly statistically significant effects. In markets where Medicare Advantage beneficiaries currently have a choice between the insurers, CAP found that competition lowers Aetna’s average annual premiums by up to $302 and Humana’s annual premiums by $43. Under the merger, premiums could actually increase beyond these amounts because of the greater market power of the combined company.

“Insurers commonly argue that mergers are necessary to counter the increasing consolidation among health care providers. However, the health care system cannot engage in such an arms race,” said Topher Spiro, Vice President for Health Policy at CAP. “When there are fewer insurers and fewer providers, there is less of an incentive to negotiate lower costs, leaving beneficiaries, taxpayers, and Medicare to pay the excess.”

In 2015, Aetna and Humana both offered Medicare Advantage plans in 562 counties in 28 states, according to data that CAP collected from the Centers for Medicare & Medicaid Services. This is almost 20 percent of all the counties and county equivalents in the United States and up from just 82 counties in 2012. The range of the number of counties with both issuers varies significantly by state—from just 1 county in Arizona and Nevada to 59 in Pennsylvania and 67 in Missouri. The merger also could foreclose potential future competition in the overlapping markets if other insurers are dissuaded from entering because of the advantages of the combined company, as well as potential future competition between the two insurers in markets where they do not currently overlap.

Taxpayers would feel the effect of such a merger through higher federal spending for the Medicare program. For example, if the bid for the costs needed to cover each beneficiary were higher under the merged company than when they were competitors, then the government would end up spending more money per beneficiary. An Aetna-Humana merger would also have a significant effect on the individual health insurance market, especially in the eight states where they both operate. Research indicates that marketplace costs are 3.5 percent lower for every additional insurer participating in a rating area. If this merger occurred in 2015, a family of four living in one of the eight states would pay an average of $328 more in premiums for the second-lowest-cost silver plan.

For seniors who may face higher costs under the merger, CAP’s analysis notes that just switching to traditional Medicare should not be an assumed safety valve. CAP recommends that traditional Medicare follow through on payment reforms already in the works and for all Medicare Advantage insurers to follow its lead. This would result in far greater incentives for providers than if a single large insurer, such as that of an Aetna-Humana merger, adopts payment reforms and other cost-saving strategies. The evidence of CAP’s analysis demonstrates that the bar should be very high for approving these mergers and that they should be stopped absent clear and compelling evidence that they will benefit consumers.

Read the full issue brief, “Bigger Is Not Better: Proposed Insurer Mergers Are Likely to Harm Consumers and Taxpayers” by Topher Spiro, Maura Calsyn, and Meghan O’Toole — online here.

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Uninsured Texans Say Cost Of Health Insurance Too High

Almost 70% of uninsured Texans said the high cost of health insurance is the reason they remain uninsured, according to a report released by Rice University's Baker Institute for Public Policy and the Episcopal Health Foundation (EHF). The report found less than 20 percent of uninsured Texans said they simply don't want health insurance.

Previous studies by the Baker Institute and EHF showed almost 20 percent of adult Texans are uninsured. This latest report shows cost was cited as the primary reason across all ethnic groups, income levels and ages for not having health insurance. Researchers found just 6 percent of uninsured Texans said a lack of information about health insurance options prevented them from becoming insured.

"An important finding of this survey is there's no significant information barrier for Texans who still don't have health insurance," said Elena Marks, EHF's president and CEO and a nonresident health-policy fellow at the Baker Institute. "Just two years ago, it was a much different story. As the Affordable Care Act (ACA) coverage options went into effect, lack of information about the law and the new health insurance options was widespread."

Funding from the federal government, some local governments and philanthropy supported successful efforts to educate the public about the ACA health insurance marketplace plans, Marks said.

"More than 1 million eligible Texans enrolled in health insurance through those plans," Marks said. "The significant drop in the state's uninsured rate is not surprising in light of those efforts. But as this latest report shows, Texas still has a long road ahead to be able to benefit from ACA coverage opportunities. Medicaid expansion alone would allow more than 1 million additional Texans to have health insurance."

Researchers found that cost was cited as a prohibiting factor of getting health insurance slightly more often among the oldest (ages 50-64) and youngest (ages 18-30) groups than the middle-aged (ages 31-49) group -- 75 percent compared with 64 percent.

"Premiums are on average higher for older groups than their younger counterparts, which would make affordability a more significant issue," said Vivian Ho, the chair in health economics at the Baker Institute and director of the institute's Center for Health and Biosciences, a professor of economics at Rice and a professor of medicine at Baylor College of Medicine. "Overall, young people earn less than older people, so even well-priced insurance plans seem less affordable."

The report also found 27 percent of uninsured adults between the ages of 31 to 49 said they did not want health insurance. This rate was more than double that of older and younger groups in Texas.

The report is the 18th in a series on the implementation of the ACA in Texas co-authored by Marks and Ho.

The Health Reform Monitoring Survey (HRMS) is a quarterly survey of adults ages 18-64 that began in 2013. This report is a summary of data extracted from the HRMS surveys in Texas administered between September 2013 and September 2015.

The HRMS is designed to provide timely information on implementation issues under the ACA and to document changes in health-insurance coverage and related health outcomes. The Baker Institute and EHF are partnering to fund and report on key factors about Texans obtained from an expanded, representative sample of Texas residents (HRMS-Texas).

The HRMS was developed by the Urban Institute, conducted by GfK and jointly funded by the Robert Wood Johnson Foundation, the Ford Foundation and the Urban Institute. The analyses and conclusions based on HRMS-Texas are those of the authors and do not represent the view of the Urban Institute, the Robert Wood Johnson Foundation or the Ford Foundation.

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International Travel Risk Security Advice, Warnings, News And Intelligence

Kenya Travel Advice: Heightened Personal Security During The Christmas Holiday Season

The Kenyan authorities have advised heightened personal security during the Christmas holiday season; on 21 December 2015, the Kenyan Ministry of Interior and Co-ordination of National Government issued a public watch notice urging citizens to play a role in counter terrorism and prevention of criminal activities by being vigilant and reporting any suspicious activity, items and people. 117,000 British residents visited Kenya in 2014. International Private Medical Insurance For Kenya Take out comprehensive international private medical insurance before you travel to Kenya, to cover the cost of any medical treatment abroad or emergency repatriation and evacuation. Be sure to read…Written on Wednesday, 23 December 2015 15:32 in iPMI Magazine Travel Warnings and Intelligence


Turkey Travel Warning: Reports Of An Explosion At Sabiha Gokcen Airport

Reports of an explosion at Sabiha Gokcen airport in Istanbul at around 2am on 23 December 2015; the circumstances of the incident are currently under investigation; the airport remains open. Over 2,500,000 British nationals visit Turkey every year. Visas British nationals need a visa to travel to Turkey, except for cruise ship passengers with ‘British Citizen’ passports who arrive at sea ports for tourist visits to the port city or nearby cities, provided that the visit doesn’t exceed 72 hours. If you’re visiting Turkey as a tourist or on business, get an e-Visa online before you travel. Only use the…Written on Wednesday, 23 December 2015 12:03 in iPMI Magazine Travel Warnings and Intelligence


Tunisia Travel Warning: State Of Emergency Has Been Extended For 2 Months

State of emergency has been extended for 2 months from 24 December until 21 February 2016. Further attacks remain highly likely, including against foreigners. Security forces are on a high state of alert in Tunis and other locations. You should be especially vigilant and avoid crowded places over the holiday period, including around Mouled (24 December), Christmas and New Year. If you choose to travel to or remain in Tunisia then you should check that your insurance policy provides adequate cover. You should be especially vigilant and follow the advice of the Tunisian security authorities. There are no direct flights…Written on Wednesday, 23 December 2015 11:08 in iPMI Magazine Travel Warnings and Intelligence


USA Travel Advice: Changes To Visa Waiver Programme (VWP)

18 December 2015 and the US Congress passed a Bill updating the requirements for the Visa Waiver Programme (VWP). Under the new rules, with effect from 1 April 2016, all travellers wishing to enter the US under the VWP will need to hold a passport with an integrated chip. Around 3.8 million British nationals visit the United States every year. Most visits are trouble free. Take out comprehensive travel and medical insurance before you travel. The US Visa Waiver Programme (VWP) allows most British Citizen passport holders to visit the US for up to 90 days without a visa, but…Written on Tuesday, 22 December 2015 11:05 in iPMI Magazine Travel Warnings and Intelligence


Brazil Travel Warning: Cases Of Zika Virus Reported

Cases of Zika virus have been reported in a number of states; you should take steps to avoid being bitten by mosquitoes. Take out comprehensive travel and medical insurance before you travel to Brazil. Foreign nationals are entitled to emergency medical treatment in Brazilian public hospitals. Public hospitals in Brazil, especially in major cities, tend to be crowded. Private hospitals will not accept you unless you can present evidence of sufficient funds or insurance. Make sure you have adequate travel health insurance and accessible funds to cover the cost of any medical treatment abroad and repatriation. If you need emergency…Written on Monday, 14 December 2015 15:20 in iPMI Magazine Travel Warnings and Intelligence


Philippines Travel Warning: Typhoon Melor (Nona)

Typhoon Melor (Nona) forecast to bring hazardous sea and weather conditions to parts of the country from 14 December 2015. Around 20 typhoons hit the Philippines each year. Most typhoons occur from June to December. There may be flooding and landslides. You should monitor the progress of approaching storms and follow the advice of the local authorities, including any evacuation orders. Typhoon Melor (Nona) is forecast to bring hazardous sea and weather conditions to parts of the country, in particular northern Visayas and southern Luzon, from 14 December. Around 133,665 British nationals visited the Philippines in 2014. Take out comprehensive…Written on Monday, 14 December 2015 12:26 in iPMI Magazine Travel Warnings and Intelligence


Lebanon Travel Security Warning: Explosions In Southern Suburb Area Beirut

12 November 2015 and there were explosions in the southern suburb area of Beirut. Reports indicate that many people have been killed and injured. iPMIM advises against all travel to the southern suburbs of Beirut. Avoid this area and monitor local media for updates. On 10 January 2015, 9 people were killed and over 30 wounded in a suicide bomb attack in the Jebel Mohsen area of Tripoli. On 28 January 2015, there was an attack on the Israeli military in the Shebaa Farms area with reports of cross-border shelling near the towns of Majidiyeh, Kfarshouba, Abbasiye and Wazzani. A…Written on Friday, 13 November 2015 14:00 in iPMI Magazine Travel Warnings and Intelligence

iPMIM Advises Against All But Essential Travel By Air To Or From Sharm El Sheikh Airport

Over 900,000 British nationals visit Egypt every year. Most visits are trouble-free. 31 October 2015, a flight from Sharm el Sheikh to St Petersburg crashed in North Sinai. Egyptian and Russian authorities are conducting an investigation. There is a significant possibility that the crash was caused by an explosive device. As a precautionary measure, we are now advising against all but essential travel by air to or from Sharm el Sheikh. UK carriers will not take passengers directly to Sharm el Sheikh airport. FCO are working with the Egyptian authorities and air carriers to put special security measures in place…Written on Thursday, 05 November 2015 07:39 in iPMI Magazine Travel Warnings and Intelligence
Philippines Travel Advice: Security Ramped Up For APEC Summit

The Philippines hosts the Asia Pacific Economic Co-operation (APEC) summit in Manila on 16 to 20 November. There will be a heightened security presence across the city including at Ninoy Aquino International Airport. Scheduled road closures and security checkpoints will cause delays in travel across the city and many schools, government offices and businesses will be closed. If you are flying to or from Manila during this period check with your airline, as flight delays, diversions and cancellations may occur. Around 133,665 British nationals visited the Philippines in 2014. Most visits are trouble-free. Take out comprehensive travel and medical insurance…Written on Monday, 02 November 2015 14:14 in iPMI Magazine Travel Warnings and Intelligence

Egypt Travel Advice

31 October 2015, a flight from Sharm el Sheikh to St Petersburg crashed in North Sinai; Egyptian and Russian authorities are conducting an investigation. Over 900,000 British nationals visit Egypt every year. Most visits are trouble-free. Parliamentary elections are scheduled to take place from 18 October to 23 November. There may be rallies around the country in the run up to the elections. You should avoid all rallies and demonstrations. On election days tight controls will be in place around polling stations with access restricted to voters and officially accredited observers. In previous elections British nationals have been arrested close…Written on Monday, 02 November 2015 11:20 in iPMI Magazine Travel Warnings and Intelligence


UK FCO: Concerns About Quality Of Medical Treatment In Holiday Resorts In Egypt

The South Sinai Hospital in Sharm el Sheikh is currently under investigation by the Egyptian Ministry of Health; there are alternative state and private hospitals in Sharm el Sheikh. You can find a list of most commonly used hospitals in Egypt on the British Embassy website. In an emergency dial 123 and ask for an ambulance. You should contact your travel company and your insurance/medical assistance company promptly if you are referred to a medical facility for treatment. There are reports of some hotel doctors overcharging for treatment and medicines. Examine your bill closely and challenge excessive charges. Pharmacies outside…Written on Monday, 05 October 2015 11:21 in iPMI Magazine Travel Warnings and Intelligence


Tajikistan Travel Warning: Armed Clashes Involving Security Forces Resulting In A Number Of Deaths Reported Close To Dushanbe International Airport

4 September, armed clashes involving security forces resulting in a number of deaths were reported close to Dushanbe International Airport. Tajik authorities are investigating and there is an increased security presence in the area. Given the possibility of further incidents, you should take extra care and monitor the local media. Tourism, health and transport infrastructure is poor and travel requires careful planning. Avoid off-road areas immediately adjoining the Afghan, Uzbek and Kyrgyz borders, which may be mined. Take out comprehensive travel and medical insurance including evacuation by air ambulance before you travel.Written on Friday, 04 September 2015 10:56 in iPMI Magazine Travel Warnings and Intelligence


International Trains From Budapest Have Been Suspended Until Further Notice

International trains from Budapest Keleti train station have been suspended until further notice due to disruption. Monitor the local media, and check with your carrier and the Hungarian Railways (MÁV) website for further information. Since the end of August 2015 there has been considerable disruption to rail and road transport from Budapest to the Austrian border. This is due to police and border enforcement action as a result of significant numbers of people seeking to transit through Hungary. Around 400,000 British nationals visit Hungary each year. Take out comprehensive travel and medical insurance before you travel.Written on Friday, 04 September 2015 10:53 in iPMI Magazine Travel Warnings and Intelligence


India Travel Warning: Flood Warnings For Uttar Pradesh, Bihar, Assam And West Bengal

A flood warning has been issued to Uttar Pradesh, Bihar, Assam and West Bengal due to the possibility of heavy rainfall in the foothills of the Himalayas over the next few days. The rainfall will also lead to swelling of rivers Kosi, Gandak and Ghaghara, tributaries of Ganga and all tributaries of Brahmaputra. You should monitor local and international weather updates from the Indian Meteorological Department and follow the advice of local authorities and your travel company. Over 800,000 British nationals visit India every year. Before you travel to India, take out comprehensive medical and travel insurance and read the…Written on Wednesday, 19 August 2015 06:20 in iPMI Magazine Travel Warnings and Intelligence

SOURCE

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Bupa's Global Expansion To Drive Growth In Profits, Offsetting Difficult Market Conditions

According to Moody's Investors Service, Bupa Group's successful global expansion in recent years, strong track record in generating capital via retained earnings and good access to debt markets continue to strengthen the British based private health insurer's credit profile.

Moody's report titled "Bupa Group Growing Profitably Despite Difficult Market Conditions" is now available on www.moodys.com. Moody's subscribers can access this report via the link provided at the end of this press release. This report presents our responses to the most frequently asked questions about the approach we use to rate Bupa's debt obligations, what factors could lead to an upgrade and how the group stacks up against its peers.

"Bupa is a dominant player in various private medical insurance markets globally, including Australia, the UK and Spain", says Helena Pavicic, a Moody's Analyst. "These operations are also complimented by its leading position in a number of emerging markets such as Chile, Thailand, Saudi Arabia and Poland, which should provide the group with material organic growth opportunities", added Pavicic.

Bupa's rating currently carries a positive outlook. Factors which could drive an upgrade in Bupa's ratings by one notch include, but are not limited to, a Solvency II ratio sustained above 180%; sustained profitability improvements, notwithstanding tough market conditions; and the continued growth and integration of recently acquired businesses.

Bupa's Baa2 debt rating is derived using standard notching practice from the insurance financial strength rating (IFSR) on Bupa's UK operating entity, Bupa Insurance Ltd (BINS). BINS' A2 IFSR, and consequently Bupa's debt ratings, also incorporate parental support to reflect the growing diversity of Bupa's cash-flows outside the UK, which continue to strengthen the group's ability to service its debt obligations.

Relative to its peers, Moody's believes that Bupa's business profile benefits from the group's strong market position in its chosen healthcare markets and relatively low underwriting risk. Its profitability track record, historically weak relative to peers, continues to improve and better align the group's financial profile with Moody's expectations for an A1 rated group.

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OMNIASIG Maintains Its Profitable Growth Trend

OMNIASIG Vienna Insurance Group (VIG) maintains its upward trend in the first three quarters of 2015 and reports a total gross written premium value of 694.31 million lei, which represents an increase of 19.47% compared with the same period last year.

OMNIASIG’s profit during this period was 9.57 million lei, according to IFRS standards. The Property insurances line (Fire and Allied Perils) registered, in the first nine months of the year, a gross written premiums’ value of 134.91 million lei, an amount almost equal to that of the same period of 2014.

During the same period, the Health insurances line registered a gross written premiums growth of 30.07%, reaching a total value of 4.04 million lei.

Also, the results achieved in these three quarters on other important lines were:

  • Accidents and illness insurance: gross written premiums – 6.36 million lei;
  • Aircraft Insurance: gross written premiums – 6.13 million lei; 
  • General Third Party Liability Insurance: gross written premiums – 23.06 million lei;
  • Travel insurance: Gross written premiums – 4.86 million lei;

Motor Insurance (MTPL and Motor Hull, cumulated) registered revenues of 481.64 million lei, up by 26.43%, as follows: -

  • MTPL: Gross written premiums in value of 254.28 million lei
  • Motor Hull: Gross written premiums in value of 227.35 million lei

The total claims paid on these segments amounted to 316.30 million lei, cumulated.

Mihai Tecău, President of the Managing Board of OMNIASIG VIG commented, "We are glad that, on the occasion of the 20 years anniversary in 2015, our company has joined a determinant upward trend. OMNIASIG is a financially stable company that enjoys the trust of our customers and partners. This fact is also shown by the level of satisfaction registered among policyholders, which demonstrates that our concern for continuous improvement of the services we offer and for strenghtening the trust of our clients brings forth fruit. We will move forward with the same strategy based on prudent risk underwriting on all product lines, coupled with permanent and prompt response to our customers' specific needs. Our goal remains the support and the development of non-motor product lines."

With a 65% higher score compared to the industry’s benchmark, OMNIASIG recorded an extremely positive level of satisfaction among customers Starting August 2015 OMNIASIG implemented a system for measuring and evaluating the quality of customer services – the Net Promoter Score (NPS), an internationally validated standard. Customers who had a claim file at OMNIASIG were therefore asked to answer one question about their experience and how the case was handled, the policyholder’s satisfaction and the services quality being measured in an effective manner, on a scale from 1 to 10.

In the first three months from the system’s implementation, the NPS general indicator was 72.96%, of which 72.37% for Motor Hull and 76.94% for household insurances, according to the answers provided by insures. These results show a high degree of satisfaction among our policyholders. Please note that currently 95% of all claim files open by OMNIASIG are paid in less than 5 days after submitting the last document in the file.

As the satisfaction of our customers is the most important aspect of our services quality, this monitoring system will continue to operate on a permanent basis from now on. Also, for the continuous improvement of customer services, the call center line – 021.9669, available for reporting claims and scheduling the ascertainment, has now extended its functioning program, including Saturdays and Sundays.

Powerful downward trend for complaints

The total number of complaints received by OMNIASIG in the first three quarters was 580 (registered per unique claimant and per single case), which represents a decrease of 41.77% compared to the same period of last year. At the same time, justified petitions decreased by 55.80% compared to the first nine months of 2014. The justified petitions received by the company in the first nine months of the year represent 17.07% of the total registered ones, per unique claimant and per unique case.

Compared to the total number of insurance policies issued by OMNIASIG in the first nine months of this year, the volume of registered complaints, per unique claimant and per unique case, represents within this period less than 0.04% and compared with the total number of claim files paid by the company in this period – only 0.97%.

The company continues to prove its financial stability, by maintaining its solvency and liquidity indicators at high levels. The company's share capital is in value of 439.65 million lei, the available solvency margin is 227 million lei, the solvency degree is 164% and liquidity coefficient is 1.80, far above legally required financial indicators.

OMNIASIG Vienna Insurance Group has a complex reinsurance program that covers all the important underwritten portfolios and allows the risk transfer towards the international specialized markets, thus contributing to the strengthening of the company’s financial stability. Companies situated in the world ranking of reinsurers are participating in reinsurance contracts of OMNIASIG VIG. OMNIASIG VIG is a company administered through a dualist system, led by a Managing Board, which is supervised and coordinated by the Supervisory Board. The company has a portfolio of over 100 products and an extended territorial network, of which 32 branches, organized in 6 regions and 85 agencies.

OMNIASIG has a strong sales network, represented by 1,200 agents and 400 brokers. Complaints are declining - only 0.97% of the paid claims

Vienna Insurance Group (VIG) is the leading insurance player in Austria as well as in Central and Eastern Europe. About 50 companies in 25 countries form a Group with a long-standing tradition, strong brands and close customer relations. VIG has had 190 years of experience in the insurance business. With about 23,000 employees, Vienna Insurance Group is the market leader on the insurance markets. It is excellently positioned to take advantage of the long-term growth opportunities in a region with 180 million people. Vienna Insurance Group is the best-rated company of ATX members, the main index of Vienna Stock Exchange. Vienna Insurance Group is also listed on the Prague Stock Exchange..

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Health Insurers Accelerate Digital Transformation

Recent analysis from Frost & Sullivan's Health Insurance Information Technology: US Overview and Outlook, 2014-2020: Changing IT Priorities for Next Generation Health Plans (http://www.healthcareIT.frost.com) finds health insurers are actively deploying new types of information technology as a lever for needed improvements in operational efficiency and transformation to more consumer-focused business models.

The Affordable Care Act (ACA) has brought new regulatory and compliance obligations to the insurance industry, upending traditional business practices and changing established IT priorities. Furthermore, the pace and extent of industry change demands fresh approaches that require embracing cultural change on a wide scale.

In addition to ACA, key issues health insurers are grappling today with include:

  • Continued cost inflation driven by hospitals, pharmaceutical companies and technology vendors.
  • Tougher contract negotiations with large employers and provider systems.
  • The rise of individual consumers demanding a higher level of service and lower premiums.
  • Growing experimentation with changing reimbursement models and risk-sharing arrangements, which require a more cohesive approach to sharing information with members and providers.

As health insurers pivot to new market realities, IT will be at the center of enabling their transition to new business models dependent upon maximizing consumer engagement and containing financial risk. While total IT spending for the industry is expected to grow in line with premium growth, reflecting a surge of new covered lives due to ACA, Frost & Sullivan predicts the industry standard percentage of the total premium devoted to IT will not significantly increase overall due to growing margin pressures and the need to contain rising administrative costs.

"ACA is an overwhelmingly disruptive force for the U.S. healthcare system. Health insurance organizations will continue to respond by aggressively containing administrative costs including IT purchasing," explains Frost & Sullivan's Principal Connected Health Analyst,Nancy Fabozzi. "Significant shifts in how spending is allocated across IT market segments will force many vendors to develop new strategies and capabilities, particularly for consumer and analytics IT, which is imperative to remain competitive."

Frost & Sullivan predicts the U.S. Health Insurance IT market will grow at a compound annual growth rate of 5.5 percent between 2015 and 2020. While IT spending will increase overall, allocation of the spending will shift with less capital devoted to IT infrastructure and core administrative systems to more spending on analytics and consumer engagement solutions.

Thus, the allocation of spend among various health insurance IT segments will shift to focus on new business priorities arising from the shift to a direct-to-consumer model.

"IT spending priorities for the health insurance industry will increasingly focus on new tools for data analytics, consumer engagement, as well as population health and care management, especially building out new capabilities capable of improving communication and engagement with members, including mobile and real-time decision support," according to Fabozzi.

The drivers of this trend include greater consumer access to medical information via the Internet as well as the need for patients to take on increased financial responsibility for their healthcare costs; particularly with the rise of high-deductible health plans.

Thus, there is a strong uptick in incentives from payers, providers and employers designed to grow and build consumer health awareness, cultural shifts in attitudes about patients' right to access their personal health information, as well as the growing use of mobile devices and apps among consumers and healthcare providers alike.

Health Insurance Information Technology: US Overview and Outlook, 2014-2020: Changing IT Priorities for Next Generation Health Plans is part of the Connected Health (http://www.connectedhealth.frost.com) Growth Partnership Service program, which also includes research in the following markets: health information exchange, health data analytics, telehealth, emerging wireless technologies, acute care information systems, enterprise clinical information systems, and billing and revenue cycle management systems. All research services included in subscriptions provide detailed market opportunities and industry trends evaluated following extensive interviews with market participants.

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Aon Reports Third Quarter 2015 Results

Aon plc (NYSE: AON) reported results for the three months ended September 30, 2015.

Net income attributable to Aon shareholders was $295 million, or $1.04 per share, compared to $309 million, or $1.04 per share, for the prior year quarter.  Net income per share attributable to Aon shareholders, adjusted for certain items, decreased 4% to $1.24, compared to $1.29 in the prior year quarter, including a $0.09 per share unfavorable impact on adjusted net income from continuing operations if the Company were to translate prior year quarter results at current quarter foreign exchange rates ("foreign currency translation").  The prior year quarter included a $25 million pre-tax, or $0.07 per share after tax, gain related to the sale of a business.  Certain items that impacted third quarter results and comparisons with the prior year quarter are detailed in the "Reconciliation of Non-GAAP Measures - Operating Income and Diluted Earnings per Share" on page 12 of this press release. 

"In our seasonally weakest quarter, our results reflect organic revenue growth and operating margin expansion across both segments, effective capital management and significant free cash flow generation, despite the impact of unfavorable foreign currency translation and macroeconomic challenges," said Greg Case, president and chief executive officer.  "Driven by our industry-leading portfolio and investments across data and analytics, we expect a strong fourth quarter and finish to the year across each of our key metrics, further positioning the firm for free cash flow generation and shareholder value creation."

THIRD QUARTER FINANCIAL SUMMARY

Total revenue decreased 5% to $2.7 billion compared to the prior year quarter driven primarily by a 7% unfavorable impact from foreign currency translation, partially offset by 2% organic revenue growth.

Total operating expenses for the third quarter decreased 5% to $2.3 billion compared to the prior year quarter due primarily to a $162 million favorable impact from foreign currency translation and a $12 million decrease in intangible asset amortization, partially offset by an increase in expense to support 2% organic revenue growth.

Depreciation expense decreased 8%, or $5 million, to $56 million compared to the prior year period.

Intangible asset amortization expense decreased 13%, or $12 million, to $78 million compared to the prior year quarter, consisting of a $10 million decrease in HR Solutions and a $2 million decrease in Risk Solutions.

Foreign currency exchange rates in the third quarter had a $0.09 per share, or $30 million pretax, unfavorable impact (-$25 million in Risk Solutions and -$5 million in HR Solutions) on adjusted net income from continuing operations, if the Company were to translate prior year quarter results at current quarter foreign exchange rates.

Effective tax rate used in the U.S. GAAP financial statements in the third quarter was 14.0%, compared to the prior year quarter of 19.1%.  After adjusting to exclude the applicable tax impact associated with expenses for legacy litigation incurred in the second quarter, the adjusted effective tax rate for the third quarter of 2015 declined to 16.0% compared to 19.1% in the prior year quarter, due primarily to certain favorable discrete items. 

Average diluted shares outstanding decreased to 283.8 million in the third quarter compared to 296.1 million in the prior year quarter.  The Company repurchased 6.3 million Class A Ordinary Shares for approximately $600 million in the third quarter.  As ofSeptember 30, 2015, the Company had $4.5 billion of remaining authorization under its share repurchase program.

Cash flow from operations for the first nine months of 2015 increased 22%, or $192 million, to $1.1 billion driven by working capital improvements and a decline in cash paid for pension contributions, taxes, and restructuring.

Free cash flow, defined as cash flow from operations less capital expenditures, for the first nine months of 2015 increased 21%, or $146 million, to $850 million driven by an increase in cash flow from operations, partially offset by a $46 million increase in capital expenditures primarily due to real estate related projects.  

THIRD QUARTER SEGMENT REVIEW

Certain noteworthy items impacted operating income and operating margins in the third quarters of 2015 and 2014.  The third quarter segment reviews provided below include supplemental information related to organic revenue, adjusted operating income and operating margin.

Risk Solutions total revenue decreased 8% to $1.7 billion compared to the prior year quarter due to an 8% unfavorable impact from foreign currency translation and a 1% decrease in commissions and fees related to acquisitions, net of divestitures, partially offset by 1% organic growth in commissions and fees.

Retail organic revenue increased 2% reflecting revenue growth in both the Americas and International businesses.  Americas organic revenue increased 4% driven by growth across all region and product lines, including strong new business generation in US Retail andCanada and effective management of the renewal book portfolio in Latin America.  International organic revenue increased 1% driven by growth in New Zealand and across Asia. 

Reinsurance organic revenue decreased 4% compared to the prior year quarter due primarily to an unfavorable market impact globally, a modest decline in facultative placements, and unfavorable timing, partially offset by record new business growth in treaty placements.

   

Three Months Ended

   

(millions)

 

Sep 30,
 2015

 

Sep 30,
 2014

 

%

 Change

Revenue

 

$

1,689

 

$

1,836

 

(8)%

Expenses

           

Compensation and benefits

 

979

 

1,055

 

(7)

Other general expenses

 

386

 

438

 

(12)

Total operating expenses

 

1,365

 

1,493

 

(9)

Operating income

 

$

324

 

$

343

 

(6)%

Operating margin

 

19.2%

 

18.7%

   

Operating income - adjusted

 

$

351

 

$

372

 

(6)%

Operating margin - adjusted

 

20.8%

 

20.3%

   

Compensation and benefits for the third quarter decreased 7%, or $76 million, compared to the prior year quarter due primarily to an $84 million favorable impact from foreign currency translation and a $9 million decrease in expenses related to acquisitions, net of divestitures, partially offset by an increase in expense to support 1% organic growth.

Other general expenses for the third quarter decreased 12%, or $52 million, compared to the prior year quarter due primarily to a $46 million favorable impact from foreign currency translation.

Third quarter operating income decreased 6% to $324 million compared to the prior year quarter. 

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Anthem Blue Cross Blue Shield Emphasizes Better Health through New $0 Premium Medicare Advantage Plans, Provider Collaboration, Extra Benefits

As Medicare’s primary sales season gets under way, Anthem Blue Cross and Blue Shield (Anthem), is bringing $0 premium Medicare Advantage plans – with extra benefits – back to Denver and Douglas counties in Colorado through provider collaboration agreements with Centura Health, UCHealth and University of Colorado School of Medicine Doctors (CU Doctors).

This includes launching Dual-Eligible Special Needs Plans (DSNPs) for people eligible for both Medicare and Medicaid, and traditional HMOs for the general population. For a $0 premium, Anthem Medicare Advantage Prescription Drug (MAPD) plans offer significant benefits not available in Original Medicare, including $0 copays for preventive dental, vision and hearing benefits and a free fitness program.

“Even with the Medicare reimbursement environment changing, we think it’s critical to structure our plans to provide our members with real value over Original Medicare, including extra benefits and strong local alliances,” said Josh Martin, president of Anthem’s Medicare west region.

Following are some specifics on Anthem MAPD plans that will be available for the Annual Election Period, or AEP, which began Oct. 15 and continues through Dec. 7. Plans are effective Jan. 1, 2016.

MAPD market return. Anthem’s new MAPD offerings include a traditional HMO plan, called Anthem MediBlue Plus (HMO), and a Dual-Eligible Special Needs Plan (DSNP), called Anthem MediBlue Dual Advantage (HMO SNP), in Denver and Douglas counties. Both plans are available for a $0 premium.

DSNPs serve those beneficiaries eligible for both Medicaid and Medicare. They are the largest and fastest growing type of the special needs plans1. The Colorado DSNP features dental, vision and hearing benefits, podiatry services, transportation to doctor’s appointments, a free fitness program and a monthly allowance for health care items purchased over the counter, such as cold and allergy products, dental products and vitamins, all at no extra cost to the member. Unlike most plans, people who qualify for a DSNP have a continuous Special Election Period, which means they can elect to join a new plan at any time throughout the year.

Provider collaboration. To improve member health and lower member costs, Anthem will re-enter Colorado with key Medicare provider collaboration agreements that include Centura Health, UCHealth and University of Colorado School of Medicine Doctors (CU Doctors).

$0 generics. Both Prescription Drug Plans (PDP) and MAPD plans will feature a “Select Tier” with selected generic drugs for a $0 copay at preferred pharmacies, including some drugs that treat high blood pressure, high cholesterol and diabetes. Both Anthem MAPD plans and several PDP plans will offer certain generics in the coverage gap for a $0 copay. Anthem has nearly 200 preferred pharmacies in Colorado, including Kroger affiliates City Market and King Soopers, Target and Wal-Mart (Sam’s Club).

In addition to MAPD plans, Anthem offers Medicare Supplement plans and standalone PDP plans across all Colorado counties. Medicare Supplement plans help cover costs Original Medicare doesn’t, such as copayments, coinsurance and deductibles. These plans offer access to any doctor or medical facility that accepts Medicare, generally for a higher premium than an MAPD. They are generally paired with a PDP.

“We pride ourselves in being one of the nation’s only insurers that can offer a full continuum of Medicare products, including something for every budget and lifestyle,” Martin said.

For details about Anthem Medicare plans in your area, call (855) 866-3979 or visit Anthem’s Medicare online store at www.anthem.com/shop. Anthem will be holding educational events and home visits throughout AEP. Anthem-affiliated agents will be available at some locations of City Market and King Soopers. Days and hours ours vary.

Anthem is an HMO plan and a PDP plan with a Medicare contract. Enrollment in Anthem depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on Jan. 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

You must continue to pay your Medicare Part B premium.

This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

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Anthem's Profits Boom While California Consumers Still Have No Protection Over Rate Hike

Anthem's announcement of increased third quarter profits is the latest in a string of hefty health insurer profit reports that illustrate why consumers need protections against unreasonable and unjustified rate hikes, Consumer Watchdog said today. The advocacy group announced that it has endorsed legislation by Sen.Dianne Feinstein and Rep. Jan Schakowsky that would protect consumers from unreasonable rates.

S 2172, Protecting Consumers from Unreasonable Rates Act, which has a companion bill in the House, would give the Secretary of Health and Human Services the authority to modify or block premium insurance increases that are considered unreasonable in states where insurance regulators do not have the power to do so.

"Insurance companies answer to Wall Street, not consumers demanding quality healthcare at an affordable price. Lawmakers need to give regulators a shield to protect consumers, and we believe Sen. Feinstein's bill will do exactly that," said Edward Barrera, from Consumer Watchdog.

Anthem Blue Cross has repeatedly been criticized by state regulators for failing to justify rate increases on consumers. Unlike 35 other states, California regulators do not have the legal authority to reject excessive health insurance rate increases.

Since 2013, Anthem has imposed $145 million in rate hikes deemed by California regulators to be unjustified. In 2014, Anthem spent$18.7 million of the $56 million insurance companies kicked in to defeat Proposition 45, which would have regulated health insurance rates the way that auto, home and business rates are in California.

A recent national study found that those states with the authority to regulate health insurance rates had lower rate increases as compared to states like California that do not have the authority to regulate health insurance rates.

In the third quarter, Anthem posted a profit of $654.8 million, up from $630.9 million a year earlier. Anthem expects full-year revenue to be an estimated $78 billion. Anthem and others, including Kaiser Permanente, UnitedHealth Group, Health Net and Aetna, have posted sterling profits in the past few years as consumers are forced to buy health insurance or be penalized.

Consolidation will only exacerbate the situation, said Consumer Watchdog. In July, Anthem agreed to buy Cigna Corp. for $48 billion. If approved, the deal would combine the second- and fifth-largest health insurers. Aetna and Humana have also proposed a  $37 billion merger.

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