HEALTH BENEFIT ADVOCATE

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Published Articles

Magazine homepage

Quote from the link above:

"Nobody wants to get a $4,000 medical bill; especially if they havenít been in a hospital for years. But it can happen to anyone. According to a recent survey by the Ponemon Institute, it has already happened to 5.8% adults in America. They have been a victim of medical identity theft, which costs an average of $20,160 per case. While this has serious financial implications, the human cost is even higher..." Article in PDF format


Out of network blues...

"This problem is an old issue and is rapidly growing out of control. Hospitals contract with radiology, pathology, and anesthesia to exclusively provide services to patients at their facility. However, some facilities do not require their contracted physicians to have similar agreements with managed care organizations....." Article in PDF format

Healthcare Update

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) went into effect on April 5, 2010.


MHPAEA requires group health plans that offers both medical/surgical benefits and mental health and substance abuse benefits to eliminate restrictive financial or treatment limitations for mental health and substance abuse services. Reimbursements has to mirror medical/surgical benefits. MHPAEA defines financial requirements to include deductibles, co-payments, coinsurance, out-of-pocket expenses, and annual limits. Exemptions: MHPAEA does provide exemption for small employer plans (50 employees or less), and a cost exemption every other year if providing parity increases the costs of the plan.


Premium increase projected due to health care reform 1% to 3% is the estimated premium increase for groups that could result from elimination of lifetime insurance limits and annual limits, according to Tom Wildsmith, a consulting actuary with the Hay Group.


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