Entries by David Anderson

Whats in a number Part 2

What’s in the enrollment numbers that are starting to circulate: Politico has good news and bad news: Bad news: 40,000 to 50,000 people have enrolled in private health care plans using HealthCare.gov — a range far short of White House hopes, according to new numbers reported by the Wall Street Journal Monday. That figure does […]

Cost sharing subsidies and the near poor

By now, I think most people know that the sticker price on Exchange insurance policies is not the price most people will pay for their policy.  Most people know that subsidies are available to lower the out of pocket monthly premium price for the working middle class.  However, there is another class of subsidies that […]

Interfacing is a PITA part 2

Sarah Kliff at the Washington Post has a good account of the first week of the Obamacare Exchange Federal war room: Thirty-four states decided to either operate an insurance marketplace in partnership with the federal government, or leave the entire task to the Obama administration. That means, that in about two of every three states, […]

Network manipulations

Networks are a key feature of all insurance plans as every provider has a network. A network is a group of providers who have contracted with an insurer to get paid a certain set of rates for a certain set of services performed on the people who are insured by the company. Networks can be […]

FI or ASO, I don’t know

When an employee group goes to insurance company to cover its members, it has two basic types of contracts it can buy. The bells and whistles will change dramatically within the type, but there are only two types.  The first type is a full insurance model where the insurance company takes on the medical cost […]