For those with health insurance, the final three months of the annual calendar year may ignite a sense of urgency to schedule appointments and utilize benefits, such as a free eye exam or 100% coverage after a deductible is paid. In the case of two now-deceased elderly insurance holders, however, conflict may arise if owed benefits are not honored. According to a recent lawsuit filed against UnitedHealth, elderly patients were not provided the care afforded under their Medicare Advantage Plans. An artificial intelligence (AI) algorithm is the alleged reason for the denial.Continue reading
The main purpose of antitrust laws in the United States is to encourage competition among businesses and help eliminate monopolies. The intent is to allow consumers the opportunity to decide which business or distributer best meets their needs. Otherwise, consumers may be left with limited options and may become victim to destructive business practices. Recently, the announcement of the $2.7 billion settlement between claimants and Blue Cross Blue Shield relates to antitrust laws and violations of fair competition. Policyholders who may be eligible to receive a piece of this class action lawsuit include those who were covered by Blue Cross Blue Shield plans from February 2008 to October 2020. Continue reading
Many businesses have struggled to stay afloat during these trying economic times. Amidst the recent campaign season, the buzz was surrounded around middle-class America and small businesses, but we are slowly learning that small businesses aren’t the only ones hurting. Zane Tankel, chairman and CEO of Apple-Metro and owner of 40 Applebee’s restaurants expressed his concern for the Applebee’s chain to the Fox Business Network. Due to the Affordable Care Act, more commonly known as Obamacare, businesses who employ more than 50 people must provide each employee with an approved insurance plan. The penalty for not providing insurance is a $2,000 fine for every worker over the 30 worker mark. Tankel’s smallest Applebee’s staff consists of at least 80 employees, so you can see why he’s upset.
Aetna, an health insurance agency, has recently agreed to settle with the State of Missouri for $1.5 million after violating strict requirements regarding abortions, contraception, and autism in insurance policies. Missouri has unique laws that outline what insurance agencies are allowed to do and what they are not allowed to do involving these three touchy subjects. In 1983 a law was made that prohibits abortion coverage from basic insurance policies and instead requires payment of an additional premium. A 2001 Missouri law states that birth control prescriptions should be covered under policies with pharmaceutical benefits. That law also allows people to purchase a plan with contraception coverage if their employer’s plan does not offer it. Aetna provided coverage for contraceptives and abortions without allowing employers to opt out. According to officials, Aetna had also excluded coverage for autism spectrum disorders.
The mortgage insurer MGIC Investment Group has settled a federal lawsuit alleging that they refused to sell mortgage insurance to women on maternity leave. The suit claimed that the company required 70 women to return to work before they would sell them the insurance, which “allows homebuyers to take out loans with down payments of less than 20%”, according to the Wall Street Journal. Yesterday, the company settled for $550,000, with $511,000 to be compensation for the women and $39,000 as a civil penalty to the government. In addition, MGIC will have to train its employees on discrimination law and revamp its policies concerning customers on maternity leave. The company has also entered a preliminary settlement in a related class action suit in order to avoid spending any more money on a lawsuit they will likely lose.