Americans who’ve arranged health coverage through governmental exchanges could face dramatic leaps of pricing as early as next year.
According to the most recent projections submitted by the country’s top insurance providers, state marketplaces from Oregon to New York might soon face rate upticks of more than twenty percent, and residents of Pennsylvania and Georgia may see the costs of their premiums skyrocket by more than a third above 2016 levels.
Few households will notice such price jumps directly. The Patient Protection and Affordable Care Act (PPACA) sought to protect individuals from the rigors of an untamed marketplace by guaranteeing federal funds to soften any undue financial hardships placed upon the consumer, but their availability depends greatly upon income and expenses as relates to a given region.
Representatives of the insurance providers have defended such increases as necessary balances to cope with unforeseen expenditures. They point to the substantial growth of both consumer usage of medical plans and the charges assessed by medical facilities. In addition, there are industry-wide concerns over the consequences that will follow the imminent disappearance of federal coverage for outsized medical bills currently subsidized through a temporary PPACA provision.
As well, many analysts believe the blame for corporate losses stems less from elevated expenditures than shrunken revenues. Since enrollment figures for younger Americans without significant health concerns have been markedly lower than anticipated, corporate executives contend that the actuarial models originally utilized to set rates no longer apply. At the same time, however, industry analysts believe higher individual costs would most likely further dissuade healthy members of the uninsured from shopping for coverage and thereby worsen the dilemma.
According to Teresa Miller, commissioner of Pennsylvania’s State Insurance Department, care providers eager to corner the new market were initially “pricing their plans very aggressively trying to get consumers in, and, now that they have more experience, they’re increasing the rates because they learned that those rates just weren’t sustainable…”
Federal regulations demand providers maintain the monetary resources necessary to fund all potential treatment necessitated through existing claims. Nevertheless, public advocacy organizations concerned about the negative effects of sharply rising rates are pressuring state officials for price controls that would safeguard policy-holders.
Arkansas Governor Asa Hutchinson already threatened governmental scrutiny of the state’s largest health care provider following the Blue Cross prediction of a nearly 15 percent jump in premium costs for plans involving more than 200,000 subscribers. BCBS representatives countered that the proposed hikes were wholly justifiable under ACA guidelines.
A May 25th press release from U.S. Health and Human Services spokesman Jonathan Gold urges caution. Gold emphasizes that these initial estimations represent “just the beginning of the rates process … consumers will have the final word when they vote with their feet during Open Enrollment.”
Not all business entities are created equal. Furthermore, the structures within each type of business entity are also not created equal. So regardless of whether your business would be best-served through use of a corporation, limited liability company (LLC), or some form of partnership, be sure you obtain competent legal advice in selecting and setting-up the legal entity through which your business will operate.
Everyone knows (or should know) that it is extremely important to keep records for business tax purposes. It is also important to keep records in the ordinary course of business that are unrelated to taxes. Although the type and nature of such records will depend on the type and nature of the business, suffice it to say that there are few (very few) businesses that cannot manage or reduce its exposure litigation risk by keeping proper records.
We live in a digital and data-driven world. Digital evidence is an ever-present and ever-growing component of business-related litigation, both for plaintiff and defense. Don’t lose the litigation battle over data by default.
and that one very profitable way to decrease expenses is to use independent contractors instead of employees. While there are many advantages to using independent contractors, there are many more disadvantages if it is not done correctly. Make sure you use independent contractors properly.
If your business does require employees, make sure appropriate employee policies and procedures are in place to facilitate a good employer-employee experience for all involved. Not only is it the right thing to do, it also makes good business sense to do so.
properly maintain proper customer/client controls. Proper customer/client controls include such matters as ensuring reasonable expectations, such as through the use of written contracts, policies and other business and industry-specific controls.
Vendors must also be managed. Just as appropriate controls should be implemented to prevent or reduce the magnitude of legal disputes between workers and customers, so too should appropriate controls be used to reduce the likelihood and magnitude of disputes with vendors. This, too, is a business/industry-specific analysis.
Simply put: learn from your mistakes. After your business experiences and works through a problem, make appropriate changes to your business controls so that the likelihood of that same problem being repeated is reduced, if not eliminated altogether.
Insurance is cheap, compared to most risks. Lawsuits can often be settled before trial for an amount equal to or less than the “policy limits” of the defendant’s insurance policy. However, if the defendant is uninsured — or under insured — well, enough said about that.
Lastly, there are many legal strategies that can be implemented prior to the threat of a lawsuit that will either discourage the plaintiff from suing in the first place or, if the plaintiff does sue, provide the defendant with legal tools to terminate the lawsuit, before the lawsuit gets too out-of-control. Many of these asset protection planning tools, however, are either unavailable after a claim arises, or will be of reduced effectiveness after a claim has arisen.
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