Ritter Insurance Marketing, Craig Ritter

PACE Act Revises ACA Definition of “Small Employer”

There’s some good news for business owners with 51-100 employees. On October 7, 2015, President Obama signed the Protecting Affordable Coverage for Employees (PACE) Act into law, revising the definition of “small employer” in the ACA. Under the original ACA provision, lawmakers defined “small employer” as a business with one to 50 employees. This…

28 Oct 15
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The Value of Using In-Network Providers

It’s no secret that health care costs are in constant flux, and rising faster than anticipated. A new report from America’s Health Insurance Plans (AHIP) details the discrepancy for in-network Medicare payment versus out-of-network physician or specialist charges. According to the report, consumers can expect exorbitant charges for out-of-network medical services; we’re talking an average…

28 Oct 15
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Highmark Decreasing 2016 MA Plan Premiums

Highmark is decreasing premiums for seven of their nine 2016 Medicare Advantage (MA) plans, according to the Pittsburgh Tribune-Review. The move is part of their attempt to hang onto their existing 182,000 MA members and entice new members as their rival, UPMC, expands its insurance business. Tim Lightner, vice president of product and marketing…

28 Oct 15
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Walgreens to Acquire Rite Aid for $9.4B

In the second major pharmacy acquisition of 2015, Walgreens has agreed to acquire Rite Aid for $9.4 billion. The deal is valued at $17.2 billion including assumed debt. According to the Wall Street Journal, Walgreens will pay $9 a share for the purchase. During the recession, Rite Aid shares sold for less than a…

28 Oct 15
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Report Shows 9.9M Have Active Marketplace Policies

According to data released last month, 9.9 million consumers had paid their premium and had an active health marketplace policy at the end of June.

19 Oct 15
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ACA Insurance CO-OPs Failing Fast

With the shutdown of three more consumer operated and oriented plans (CO-OPs), more than 500,000 Americans will lose the health insurance they have now. Both Kentucky Health Cooperative (51,000 members) and Health Republic Insurance of New York (215,000) folded in October, citing insufficient premiums to cover members’ health expenses and their own operation expenses. Arches Health…

UnitedHealthcare MA Members to Have Access to UPMC

UnitedHealthcare Medicare Advantage members will now have in-network access to care at all UPMC facilities. The new access will shuffle the Medicare market in Western Pennsylvania. While Pittsburgh-based UPMC is already an in-network provider for those on UnitedHealthcare’s employer-sponsored, individual and Medicaid health plans, the network is expanding to those on UnitedHealthcare MA plans for the…

6 Oct 15
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Highmark v. UPMC Dispute Heard by Pa. Supreme Court

UPMC has kept Highmark Medicare Advantage members in-network, as ordered by a Pennsylvania Commonwealth Court judge on May 29, but an appeal to the state’s Supreme Court could still shift the market in Western Pennsylvania. Legal representatives for both companies debated a small section of their consent decree (see figure at right)…

6 Oct 15
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BCBS-TX Raising HMO Plan Premiums for 2016

BlueCross BlueShield of Texas (BCBS-TX) has announced additional changes for 2016 that may likely cause their clients to feel even more at loss for the upcoming plan year. In addition to dropping their popular PPO Plan, BCBS-TX is raising its HMO plan premiums by 20 percent for 2016. In July, BCBS-TX announced they were

5 Oct 15
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Highmark Takes Huge Financial Hit on ACA Exchange Plans

The federal health exchange hasn’t been kind to Highmark Health. After losing $318 million on health plans sold to exchange consumers, the Pittsburgh-based company reported a total operating loss of $171 million over the first six months of this year.

5 Oct 15
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