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Alternative Approaches to Liability: Models for Health Plan Liability

This report looks at the different ways in which liability is handled in a number of industries, and explores how these models might apply to health plans. The report also discusses health plan liability in the context of the ongoing Consumer Protection debate.Report: Models for Health Plan Liability

Statement of Gary Claxton to NAIC Exchanges (B) Subgroup

Kaiser Family Foundation Vice President Gary Claxton, who directs the Foundation’s Marketplace Policy Project, testified July 22, 2010, at a public hearing before the National Association of Insurance Commissioners’ Exchanges (B) Subgroup established by the health reform law.  Testimony (.pdf)

Insurer Rebates under the Medical Loss Ratio: 2012 Estimates

Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at…

Implementing New Private Health Insurance Market Rules

With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance…

Health Plan Liability — Policy Brief

An 8-page policy brief to inform the policy debate in California about health plan liability issues, including barriers to lawsuits (ERISA), liability approaches used in other industries, and potential impact on premiums. The brief includes a variety of perspectives presented by speakers at a California Health Policy Roundtable held in…

Health Insurance Market Reforms: Rate Restrictions

Rate restrictions limit how much insurance companies can vary premiums charged to individuals and businesses based on factors such as health status, age, tobacco use and gender. Currently, federal law does not place any limits on the ways that insurance companies set their premium rates. However, beginning January 1, 2014,…

National Survey on Consumers’ Experiences With Patient Safety and Quality Information

National Survey on Consumers’ Experiences With Patient Safety and Quality Information This survey assesses Americans’ perceptions about the quality of health care, their awareness and reported usage of information in making their health care choices, and their experiences with their health care providers five years after the Institute of Medicine’s…

Impact of Potential Changes to ERISA: Litigation and Appeals Experience of CalPERS, Other Large Public Employers and a Large California Health Plan – Report

Impact of Potential Changes to ERISA:Litigation and Appeal Experience of CalPERS, Other Large Public Employers and a Large California Health PlanJune 1998By Coopers & Lybrand L.L.P.Sandra Hunt, M.P.A.John Saari, M.A.A.A.Kelly Traw, J.D.BackgroundThe Employee Retirement Income Security Act (ERISA) currently preempts state law related to the wrongful denial or delay of…

External Review of Health Plan Decisions in the States and Medicare

An analysis of the external review process, the formal dispute resolution process established by state or federal agencies, independent of disputing parties, that has the capacity to evaluate and resolve at least those disputes involving medical issues. This paper identifies critical features of external review systems in thirteen states and…

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.