Archive for July 28th, 2010

Insurance Agent’s Sentencing Postponed Again

Wednesday, July 28th, 2010

Aaron Gonzalez, a former South Texas insurance agent, was to be sentenced for his crimes on July 23. His sentencing, however, was postponed again “until further notice.” The Wheels of Justice, it seems, turns ever so slowly.

One wonders why sentencing takes so long. Could it have to do with an on-going investigation assisted by cooperating witnesses?

“Half Guilty, Half Pregnant” Arnulfo Olivarez, another South Texas insurance agent, has had his sentencing postponed numerous times during the past two years. His next scheduled sentencing is August 22 in McAllen, Texas.

Published Friday, April 04, 2008 2:12 AM

Insurance agent accused of bribery

Associated Press

HARLINGEN — A Harlingen insurance agent is accused in a federal indictment of providing cash, plane tickets and condo rentals to some Edcouch-Elsa school district officials in exchange for public contracts.

Arnulfo Olivarez was named in a three-count federal indictment returned last month.

According to the indictment, the bribes were made to then-school board President Aaron Luiz Gonzalez and other district officials between 1999 and 2005 in exchange for votes on insurance contracts with the district.

Investigators said the kickbacks were valued at more than $26,000.

Olivarez, owner of Insurance Associates of the Valley, is one of three contractors indicted in connection with a similar scheme with the Pharr-San Juan-Alamo school board.

Federal prosecutors say Olivarez often used illegal means to get business for the insurance companies that employed him.

Gonzalez, who pleaded guilty to extortion charges in a similar case in June 2006, was not charged in the latest case under a plea deal with prosecutors, The Monitor in McAllen reported in its Friday editions.

Olivarez faces charges of conspiracy, bribery and mail fraud in the Edcouch-Elsa and PSJA cases and has pleaded not guilty in both. If convicted on all counts, he could face 20 years in prison and $250,000 in fines.

J.J. Ybarra, the current Edcouch-Elsa school board president, said the district now brokers its contracts directly with insurance companies.

“This activity is all from several years back,” he told the newspaper. “We had a lot of obstacles, but we just keep moving on.”

Strongest & Weakest Health Insurance Companies

Wednesday, July 28th, 2010

JUPITER, FL, Jul 22 (MARKET WIRE) —  The new Patient Protection and Affordable Care Act is expected to squeeze the profits and finances of the nation’s smaller health insurers, forcing many to withdraw from the market, be acquired, or fail. However, most of the nation’s largest insurers have the capital and efficiencies needed to handle the expanded coverage and buy out the smaller companies, according to a new study by Weiss Ratings, the nation’s only provider of independent insurance company ratings. “Sweeping changes mandated by health care reform, such as the removal of certain limits and mandated coverage for pre-existing conditions, will inevitably force health insurers to spend more on medical care,” commented Martin D. Weiss, president of Weiss Ratings. “Most large health insurers will be able to handle it. But we are concerned that weaker, less profitable insurers will be forced out of the market, reducing competition and ultimately leading to fewer choices and higher premiums for consumers.”

The Weiss Ratings study covers 585 of the nation’s health insurers, including 353 companies that already meet the mandated requirement going into effect next year to pay out at least 85% of their premium dollars in medical expenses.

Among the 585 companies, 95, or 16.2%, received a Weiss Rating of D+ (weak) or lower, putting them at risk of future financial difficulties caused by higher medical costs, a weaker economy or other pressures. In addition, another 186, or 31.8% of the industry, are rated C+, C or C- (fair), many of which could also have some difficulty absorbing the additional costs mandated by health care reform.

Weiss added: “Smaller insurers with less capital and fewer efficiencies of scale are more likely to suffer difficulties or even go out of business due to health care reform. Already, even before any additional expenses mandated by health care reform, 174 health insurers reported losses last year. In contrast, the largest, most efficient insurers with abundant capital and solid profits are not only in a position to absorb the higher expenses mandated by reform but could also expand their market share by buying up the weaker companies.” 

Among the nation’s 16 largest health insurers, controlling 45.7% of the industry’s assets, the nation’s largest health insurer, Kaiser Foundation Health Plan Inc. with $37.8 billion in assets merited a Weiss rating of A- (excellent), while the second largest, Health Care Service Corp., with $11.4 billion in assets, was rated A+. Also receiving excellent grades were Blue Cross Blue Shield of NC (A+), Blue Cross Blue Shield of SC (A-), Blue Cross of California (A+), California Physicians’ Service (A), Community Insurance Co (A-) plus two New York companies — Empire HealthChoice Assurance (A-) and Excellus Health Plan (A+). None of the 16 largest were in the weak (D+ or lower) or fair (C, C+, C-) category. 

To help consumers avoid the weakest health insurers and find the strongest licensed to do business in their state, Weiss Ratings has released its lists of the 118 strongest and 100 weakest health insurance companies. Consumers can immediately receive both lists at no charge by providing their email address at www.weissratings.com/healthlists

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Oklahoma Insurance Tax Unconstitutional?

Wednesday, July 28th, 2010

 

Extract from Aetna’s Health Reform Weekly (Week of 7/26/10) Following is an update to the status of OK HB 2437-

 OKLAHOMA: Insurance Commissioner Kim Holland filed a petition with the Oklahoma Supreme Court last week seeking to prevent the application of a new tax on health plans enacted earlier this year. The petition challenges the new law’s constitutionality. The legislation creates the Health Carrier Access Payment Revolving Fund and imposes a tax of 1 percent on all paid claims for individual and employment-based health plans, to be collected by the Insurance Department beginning August 27. The Oklahoma Health Care Authority will disperse an estimated $240 million in additional funds to pay for the state’s Medicaid program. The petition argues that the state constitution requires that any revenue measures must pass at least three-quarters of the legislature or be submitted to a vote of the people. The new health plan tax did not. Additionally, the petition argues that the bill violates the state law that prohibits the passage of any revenue bill within five days of adjournment. Commissioner Holland also questioned the transparency and accountability of the legislation as well as the state’s authority to tax self-insured plans that are fully funded by employers and subject to federal ERISA law. Other large self-funded plan entities are expected to join her lawsuit and challenge the law on ERISA grounds as well. Aetna will be closely monitoring the litigation going forward.