Ritter Insurance Marketing, Craig Ritter

Advantage Health Ends MA After $46.3M Loss in 2015

Indiana-based Advantage Health will leave the Medicare Advantage market after posting $46.3 million in losses during the first eight months of 2015. Though this news comes nearly halfway through the Annual Enrollment Period that runs until December 7, all 22,500 Advantage Health customers will be given until late February to switch to another policy….

9 Nov 15
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UPMC Settles with U.S. Justice Department for $5.4M

UPMC reached a $5.4 million settlement with the U.S. Justice Department as part of a massive investigation into implantation of cardiac devices against Medicare guidelines. The whistleblower-driven lawsuit accused 457 hospitals in 43 states of submitting claims for nearly $258 million for the procedures in violation between 2003 and 2010. Implantation of cardiovector defibrillators…

9 Nov 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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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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ACA Startup Oscar Struggles, Retains Value

When new insurance markets emerged from the Affordable Care Act (ACA), investors put their money into Oscar, an insurance startup that approached health care with a modern website, design, and easy-to-use app. It purports itself as a health insurance company as the founders would want for themselves – simple, intuitive, and human. This kind…

5 Oct 15
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BCBS-LA Launching MA Plan for 2016 AEP

On September 3, 2015, HMO Louisiana, a subsidiary of Blue Cross Blue Shield of Louisiana (BCBS-LA), signed a contract with the Centers for Medicare and Medicaid Services (CMS), allowing the health insurer to start selling Medicare Advantage plans. Read the full story here. BCBS-LA’s Blue Advantage HMO plan will launch just in time…

5 Oct 15
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