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The Oxlo Individual and Small Group Health Insurance and Exchange Integration Solutions Blog

Software Shows the Actual Health Insurance Rate Changes in Hollywood

Posted by Andrew Day on Thu, Nov 10, 2011 @ 10:18 AM

Business Intelligence Software Gives Insurance Companies Visibility Into the Hollywood Market

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Tags: Health Insurance, Business Intelligence, Software for Insurance Companies, California

The Straight Forward Definition of Health Insurance

Posted by Andrew Day on Mon, Oct 24, 2011 @ 02:19 PM

Understanding What Health Insurance Actually Is

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Tags: Health Insurance

The Simple Truth About Health Insurance Plan Rates

Posted by Andrew Day on Mon, Oct 17, 2011 @ 11:36 AM

Health Insurance Plan Rates Simple Truths

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Tags: Health Insurance

Top Influencing Factors on Health Insurance Rates

Posted by Andrew Day on Tue, Oct 11, 2011 @ 03:36 PM

Factors That Influence Health Insurance Rates

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There are many opinions about why health insurance rates are increasing. Seldom do you hear that insurance costs are directly related to the cost of care, but it is absolutely true. To look at the cost of insurance, we need to consider what factors into the cost of care.

The following are the major factors influencing the cost of health care and are paid for by the party who gains the most benefit, the patient:

    • Cost of medication and equipment used
      • Development
      • Approval
      • Manufacturing
      • Shipping
    • Cost of medical personnel as it relates to the importance and gravity of performing flawlessly in their profession.

Most often these factors are paid through an insurance company or government entity (Medicare/Medicaid). Both of which are programs designed to decrease the volatility of the costs. If the cost of care increases, the cost of insurance or any other medical program must increase.

Understanding the underlying factors of what determines the cost of insurance is the first step to making the overarching healthcare system more efficient and less costly. Placing blame squarely on insurance companies, Medicare and Medicaid as the reason for raising health insurance rates is simply not going to fix the problem.

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Tags: Health Insurance

Normalize The Health Insurance Plan Data of Your Competitors

Posted by Andrew Day on Mon, Sep 19, 2011 @ 05:28 PM

Normalizing Health Insurance Plan Data

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Insurance companies post their health insurance plan data online in order to make the buying experience simpler for their customers.  Allowing the customer to easily navigate a website and find a plan that best suits their needs has become a necessity in the individual health insurance market.

However, insurers often use differing terminology to define similar coverage. This makes apples to apples comparisons difficult. 

If the data is normalized through the application of business rules, plans can be placed side by side for straightforward and meaningful comparisons. 

Rate Convert all Rates to a Monthly Rate
Deductible Fairly Standard
Is it an HSA? Simple Yes or No
Coinsurance Change all percentages to what is covered by the company
Out of Pocket Limit Display Out of Pocket Limit and what it would be if deductible is added (unless deductible is included)
Office Visit Cost Change all percentages to what is covered by the company
Maternity Coverage Change all percentages to what is covered by the company
Lifetime Max Convert values to use the same terminology and format
Prescriptions  
     Tiers How Generic Brand, Brand Name, Non-Formulary, and Specialty drugs are covered.  Separated, and with the same verbiage
     Annual Max Convert values to use the same terminology and format
     Deductible Fairly Standard
     Category Either Comprehensive, Generic/Limited Brands, or Not Covered

Better yet, use a data service that provides good clean normalized individual health insurance plan data out of the box and forget about the heavy lifting.

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Tags: Health Insurance

3 Things to Pay Attention to When Comparing Health Insurance Plans

Posted by Andrew Day on Thu, Sep 15, 2011 @ 01:54 PM

3 Things to Pay Attention to When Comparing Health Insurance Plans

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Tags: Health Insurance

Easily Master the Art of Comparing Health Insurance Competitors

Posted by Andrew Day on Mon, Sep 12, 2011 @ 05:44 PM

Easily Master the Art of Comparing Health Insurance Competitors

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Tags: Health Insurance

Health Insurance Market Analysis: Reality Vs. Rhetoric

Posted by Andrew Day on Mon, Aug 29, 2011 @ 10:45 AM

Health Insurance Market Analysis: Separating Reality From Rhetoric

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Health insurance has been a hot topic over the past couple of years. Many opinions have been made about what should be done to reduce the cost of care and insurance alike. But how much do we actually know to be fact?

Conducting a Health Insurance Market Analysis on the industry allows you to look past the rhetoric and find out what is actually driving the cost of services. As the winds of the market shift, how are companies reacting? Is their reaction appropriate? Tracking the data of health insurance companies opens a window into what is driving costs. This knowledge can be obtained by monitoring information like:

    • Rates
    • Deductibles
    • Premiums
    • Regions in which a company operates

Observing how those items have changed in conjunction with the changes in the market provides all the insight necessary to determine the reality of what is happening. Rather than speculating based upon theories, using facts to back up your points places you in a more powerful position.

Focusing on pricing and benefit details of insurers will not tell you everything that is driving costs, but it will certainly give you a better idea of what health insurance companies are doing.

We hear far too many talking points about health insurance and not enough facts. Whether you are a consumer or a company, it is important to differentiate between what is being said and what is being done.

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Tags: Health Insurance

3 Health Insurance Market Intelligence Tips – Conclusion

Posted by Andrew Day on Thu, Aug 18, 2011 @ 09:30 AM

3 Health Insurance Market Intelligence Tips – Conclusion

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Wrap It Up: Know Your Competition, Turn Data Into Information and Stay Current

The health insurance market is changing at an incredible rate. Staying on top of every facet of the market is crucial to your company’s success. Each month, your health insurance market intelligence team should be doing research on which companies are entering and leaving markets, and knowing where and why they’re moving.  This will grant you the foresight necessary to avoid a potential pitfall. Does their reason for moving also affect you?

We often hear that failure is the best teacher.  I personally believe that is true, but would you rather learn from your own failures, or the failures of your competitors?

By understanding what has and has not worked for your competitors, you will reap the benefit of having their experience while minimizing your own risk.  By obtaining product and service data of your competitors over time, you will gain that powerful perspective.

Individual health insurance market intelligence software can obtain and uncover short and long term rate and coverage changes. Many other important questions can be answered by this kind of service:

    • How have my competitors built their product ranges?
    • Where are rates changing the most?
    • What plans are experiencing the most change?
    • What portions of the health care bill are having the greatest impact?

In the end, it is not enough to get a snapshot of what the market has done. With all the changes to the marketplace, it would be foolhardy not to keep up to date information. Getting constant updates on changes in the market gives you both an overview and the specific details of what is happening.

    • Know your competition
    • Obtain data and turn it into information
    • Stay current

Those are three challenges that any health insurance market intelligence team faces, and researching every tool available to gain the most information will greatly assist your company survive these trying times. The most important question you can ask yourself is:

Do I know more than my competitors?

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Tags: Health Insurance

3 Health Insurance Market Intelligence Tips - Part 3

Posted by Andrew Day on Thu, Aug 11, 2011 @ 02:55 PM

Health Insurance Market Intelligence Tips – Part 3

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Stay Current

It is incredibly easy to become complacent in your intelligence gathering.  It is unacceptable to assume your data will always be relevant and useful.

Keeping your health insurance market intelligence data current allows you to keep your data in context.  This context will assist you in making high-level decisions based on preceding events.

    • What happened before?
    • How did we react then?
    • What were the results of that reaction?

The important questions then become:

    • How can I keep so much information up to date?
    • How will this help me stay ahead of the competition?

How can I keep so much information up to date?  The software programs mentioned in Part 2 can be scheduled to run as often as you'd like. Since most health insurance companies update their data once a month, I would recommend gathering data just as often. Rates and coverage are constantly changing, which is why it is so important to keep current.

How will this help me stay ahead of the competition?  The data and information gained from health insurance market intelligence software can often be used however you wish. The departments listed in the introduction can each use the information uniquely, and all of them will assist in making more informed decisions about how to maximize value and ultimately gain market share. It can also be used for long term tracking to determine how volatile specific individual plans are to certain changes in the market.

For example, the pre-existing condition change in the health care legislation might have a greater impact on one company and/or plan when compared to another.  And tracking changes that occurred with you and your competitors when that provision went active will show you how they dealt with that challenge.

Knowing how your competitors react to certain changes in the market is important to understand.  This knowledge will allow you to gain more insight into how to position your company for maximum growth potential and minimizing the risks incurred to achieve that growth. The more you know, the better your position will be.

To put this all into perspective, please stand by for the last installment which will be the summary and conclusion.

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Tags: Health Insurance