HUMANA: One of the largest publicly traded managed healthcare companies in the United States, Humana Inc. has about 6.2 million people enrolled in its health plans, which are available in 16 states and Puerto Rico. Nearly 45 percent of these customers are in Florida, Illinois, and Texas. SCAM ? Medical loss ratio's are hardly a scam, unlike Oxford Health Plan, that failed to record expenses and related liabilities when future obligations remained. Oxford failed to increase reserves for medical losses there by increasing earnings. So, I give credit to the Humana folks for addressing a problem.
My point is, this is one of the many Insurance contracts, that the Executive management at Walgreens did not get. This will impact future earnings for the Pharmacies in the listed states, which If I am not wrong have the highest concentration of Walgreen stores. Humana is also one of the largest provider's for US Gov't workers. A Big loss for Walgreens management...
“SCAM ? Medical loss ratio's are hardly a scam, unlike Oxford Health Plan, that failed to record expenses and related liabilities when future obligations remained. Oxford failed to increase reserves for medical losses there by increasing earnings. So, I give credit to the Humana folks for addressing a problem.”>>
How nice to see that you have demonstrably shown that you are clueless as to what the med-loss ratio is and what it means. The med loss ratio is a ratio of premiums taken in against claims paid out. It by definition pertains only to “full risk” insured members in which the insurance company as a financial risk and actually pays the healthcare claims. ERISA TRUST members and other plans which are self funded do NOT show up on the med- loss ratio of an insurance company because these members are NOT a financial risk to the insurance company. The healthcare expenses of these members are paid by the PLAN (usually an employer, gov’t, pension or union) and NOT the insurance company. These plans are referred to as “no risk plans” in the industry since the insurance company has no financial risk involved with them. Med-D is just such a plan. Why do you think the premiums for Med-D on average are only $35 per month…..It’s b/c the plan (read gov’t) and NOT the insurer pays the tab….Reserves required to cover liabilities relate to “FULL RISK” plans only…..ASO (administrative services only) ERISA Trust plans and other self-funded plans do not fit into the “reserves” mandate….With the exception of “the blues,” the average large insurer is comprised of greater than 65% ASO plans….. Now….consider yourself remedially schooled on the issue of the med-loss ratio…..LMAO
You forgot to mention a reinsurance company, Perhaps you heard of AIG or you missed that one. As for Humana they have a HMO that is at Risk with there insured, I don't disagree with what you said about risk management an ERISA,(Self Funded plans)however unless you have set one of these programs up, you are presenting Medical Insurance Contracts in Black and White, so sorry thats not how these contracts are put together and won, Very large Contracts deal in issues of gray all the time. Did you ever think medical Technology is a part of the gray. Besides being clue-less you are also pompus.. Being that you are so knowledgeable tell how a insurance company calculates recidivism.
To double then triple the out-of-pockets after locking in coverage for a year at low teaser rates may not be called a scam in your neck of the woods, but it is in mine. This left a very bad taste in the mouths of millions of Medicare Part D recipients.
I'm betting they won't be back for a second screwing.
This rip-off scenario painted a very bad P.R. pictue for Walmart. I'm quite surprised they're trying the scam again after just a few years.