Iindaba eziphambili zingenakuchaphazela abaninzi ababhalisile
NgoNovemba ka-2015, njengokuba kubhalisiwe ukubhalwa kwe-2016, i-UnitedHealthcare yabhengezwa ukuba ibhekene nokulahlekelwa okukhulu kwi-Obamacare ukutshintshana kwaye yaxwayisa ukuba ingenakuqhubeka nokubonelela ngeengxoxo emva kokuphela kuka-2016. Ngo-Apreli 2016, baqinisekisile ukuba baya kuphuma ezininzi zeengxoxo ekupheleni konyaka.
Impembelelo yokuphuma kweManyano
Ngo-2014, i-UnitedHealthcare yabonelela kuphela izicwangciso kwiintetho ezimalunga ezintlanu. Eye yakhula ibe ngama-23 ithi ngonyaka we-2015, kwaye i-34 ithi ngonyaka we-2016. Kwiininzi zalawo mazwe, i-UnitedHealthcare ayiyi kunika izicwangciso ekutshintshiseni ngo-2017, nangona baqinisekisile ukuba baya kuqhubeka bathatha inxaxheba " kuquka iNevada neNew York.
U-UnitedHealthcare yiyona nkampani enkulu ye-insurer, kwaye eli qiniso liye laphinda liphindwe kwiintlobo ezininzi zeendaba ezivakalisa ukuhamba komphathiswa kwiintlobo ezininzi zokutshintshiselana. Kodwa oko akuchazi ibali lonke.
Yiyinyaniso yokuba yiyona nto inqabileyo yomshuwalense, kodwa ingqalelo kwiimarike zeMediare (i- Medicare Advantage kunye ne-Medigap eyongeziweyo ) kunye nomthengiso-mali oxhaswe ngumqeshi , ngokuchasene nemarike yempilo yomshuwalense (ininzi labantu ababhalise ngokutshintshiselana kwezicwangciso zorhwebo).
Ubunonophelo beZizwe eziManyeneyo zingaba ngowona mkhulu umshwalense kwilizwe, kodwa baqinisekisa abantu abangama-795,000 kwiintengiselwano - malunga neepesenti ezingama-6 zabantu ababhalise kwizicwangciso ngokusebenzisa ukutshintshana kuwo wonke umhlaba. Kwaye i-United ilindele ukuba ubulungu babo bentsebenziswano behlele ukuya kuma-650,000 ekupheleni kwe-2016.
Ngoko uninzi lwabantu abhalise kwizicwangciso ngokudityanisana, aluyi kuthintela ngqo ngokuphuma kwe-United ekupheleni konyaka we-2016.
Iintlawulo zeNyanga kunye noKhetho lwaBathengi
Ngenxa yokuba i-UnitedHealthcare ayizange ibe ngumdlali onobudlova ekutshintshiseni, izicwangciso zabo azivumi ukuba ziphakathi kwezona zikhuphisana kakhulu. I-Kaiser Family Foundation yaqhuba uhlalutyo lwecebo le-United malunga nezinye izicwangciso ngo-2016, kwaye yafumanisa ukuba iMelika inika iiplani zesilivere ezisezantsi okanye ezisezantsi-ezithengiweyo (ezona zikhethwa kakhulu) kwiipesenti ezingama-35 kuphela zamabakala apho umphathiswa unikeza izicwangciso zokutshintshwa
Xa kuthengiselana, abathengi ngokuqhelekileyo banamanani entengo, kwaye abathwali bafumana isabelo esibalulekileyo semarike xa izicwangciso zabo zixabiso elisezantsi kunezikhuphiswano. Isikhundla seManyeneyo kwiindawo ezininzi zeemarike asikho phakathi kwezithuthi eziphantsi kwexabiso, kwaye oku kubonakalisa isabelo semarike yabo yokushintshaniswa, ephantsi kwezona zizwe.
Isiphumo saloo nto kukuba uhlalutyo lwe-Kaiser Family Foundation lufumene ukuba isicwangciso-mali esiphezulu esiphakamileyo sesicwangciso-mali ( iplani yesibini-esezantsi-indleko yesilivere) i-premium yayiza kuba yinye ipesenti ephakamileyo ngo-2016 ukuba iMelika ayingenathatha inxaxheba kulo nyaka .
Kodwa ke ngumyinge wesizwe. Kukho ezinye iindawo apho impembelelo yephamm premium yayiza kubaluleke ngakumbi ukuba iUn ingazange ifake izicwangciso ngo-2016 (ngokukhawuleza ukuxelela ngokuchanekileyo indlela oku kuza kudlalwa ngayo ngo-2017, kuba ixabiso alivunyelwanga ngo-2017 okwamanje) . Kukho iindawo ezine apho ama-premium ayimfuneko ukuba ubuncinane ama-$ 25 / inyanga ephakamileyo ubuncinane kwi-40 ekhulwini yamanqanaba karhulumente ukuba i-United ayingenathatha inxaxheba kwimicimbi yokutshintshana ngo-2016: Alabama, Iowa, Nebraska, naseNorth Carolina.
Kwaye ukhetho lwabathengi luyinto ebalulekileyo yezo mpi. Ngokutsho kohlalutyo lwe-Kaiser Family Foundation, kukho iibalo ezili-1,121 e-US apho kukho kuphela omnye okanye ababini banshurensi ababonelela ngeesicwangciso ekutshintshisweni.
Ukuba iMelika yayiza kuhoxiswa kuzo zonke iinguqu (ezingabonakaliyo, njengokuba ezinye iindawo ziqinisekisile ukuba i-United isele ekutshintshiseni kwabo), uhlalutyo lwe-Kaiser Family Foundation lufumene ukuba uphando olongezelelweyo lwama-532 lwaluza kuhlaselwa kwicandelo lokuba omnye okanye ababini abathatha inxaxheba ekutshintshiselwano (kwaye ngaphezu koko, ama-536 kumabhunga okwangoku abathwali abathandathu abaza kuhlaselwa kuphela ukuba abe neyodwa). Isiphumo siza kuba ama-53 eepesenti zamabakala ase-US ayeza kuba neyodwa okanye ababini abathintela umshwalense kwintsebenziswano.
Ngona kunjalo nangona i-UnitedHealthcare engekho phakathi kweendlela ezincinci kakhulu kwiindawo ezihlala kuyo apho ziqhuba khona, zizisa ukhetho oluphezulu lwabantu abaye bathengisa kwiintengiso, kwaye ngokuqinisekileyo kuya kuncitshiswa ngo-2017.
Ngelo xesha, kubalulekile ukugcina engqondweni ukuba abanye abathwali abanokungenakwenzeka ukuba bangene kwiimarike zotshintsho kwezinye iindawo apho i-United iphuma khona. Ngokomzekelo, eVirginia, i-UnitedHealthcare iya kuqhubeka nokubonelela ngezicwangciso ngo-2017, kodwa kungekhona kwiibalo ezininzi njengoko zinikeza izicwangciso ngo-2016 (oko kukuthi, ziphuma kuphela kwiindawo zokutshintshiselwa kombuso). Kodwa iCigna ijoyina i-Virginia yokushintshisana okokuqala ngo-2017.
Kukho amabini amabini - eKorea naseKansas - apho i-UnitedHealthcare okwangoku nje kuphela yontsimbi ehambisa izicwangciso ekutshintshiseni (ngokoqobo, i-Kansas inabathwali abaninzi, kodwa ngaphandle kwe-UnitedHealthcare, bonke baxhamli beBlue Cross Blue Shield). I-United iyaphuma zombini ezo zintengiselwano zombuso ekupheleni konyaka we-2016. Ngaphandle kokuba omnye u-inshurensi ajoyine, i-Oklahoma neKansas ziza kushiywa ngunyaka-mali omnye kuphela ngo-2017 (i-Wyoming iloo meko ngo-2016, kwaye iWest Virginia yayinomnye umphathiswa wokutshintshiselana 2014 no-2015).
Kutheni Ubumbano Lokubambisana?
Isinqumo seManyeneyo sokuphuma kwezona zinto zitshintshiselwano zisekelwe kwilahleko zezimali eziye zenzeke-kwaye zilindele ukuba zibe neengxoxo. Phakathi kokulahlekelwa kwabo ngo-2015 kunye noko bakulindele ukulahlekelwa yintengiselwano ngo-2016, ilahleko zabo zonke zelo marike ziya kufikelela kwi-1 billion yezigidi.
Ukuze kucace, i-UnitedHealthcare isebe yinkampani enenzuzo. Kodwa baye baqikelela ukuba abanako ukuvumela amacandelo abo emakethi azuzayo ancedise inxalenye yabo yemakethe yokutshintshiselana engenzi nzuzo ngaphezu kwexesha elide. Abantu ababhalise kwiiplani zokunxibelelana zaseMelika baye bagula ngakumbi kunabanye ababhalise kwezinye iigqeba zeemarike, okubangele iindleko eziphezulu ze-insurer (le ngxaki ayifani neyodwa kwi-United; abaninzi abathwali baye bafumanisa ukuba abhaliso lwabo babhalisa ukusebenzisa lindele).
Ngasekupheleni kuka-2015, i-UnitedHealthcare yabhengezwa ukuba abayi kuhlawula iikomishoni zecwangciso ezithengiswa kwimarike nganye emva kokuphela kuka-2015. Lo ngumzamo wokunciphisa ukubhaliswa ngo-2016, njengoko bebenokufumanisa ukuba i-market share exchange market ukuze kube nenzuzo.
Yintoni endiyifuna ukuyenza?
Ukuba ubhalise kwisicwangciso sokutshintshiselwa kwi-UnitedHealthcare ngo-2016, uya kukwazi ukuwugcina ekupheleni konyaka nje ngokuba uqhubeka uhlawula iipriyamu zakho. Uya kufumana isaziso esivela kwi-United kunye nokutshintshaniswa kamva kunyaka ukunika ulwazi malunga namanyathelo oya kudingeka ukuthatha ngexesha lokubhalisa okuvulekileyo (into efanayo eyenzekayo kubantu abaninzi kwiiplani ze-CO-OP ekupheleni kuka-2015 ).
Unokwazi ukugcina inguqu ephumayo yecebo lakho le-UnitedHealthcare, kodwa kubalulekile ukwazi ukuba inkxaso-mali ye-premium kunye neenkxaso -mali zokwabelana ngeendleko azifumaneki nakwiziphi na izicwangciso zokutshintshiselana. Ubuninzi babantu abhalisele kwizicwangciso ngokudityanisana banokufumana inkxaso-mali ye-premium.
Ngexesha lobhaliso oluvulekile, uya kuba nethuba lokukhetha isicwangciso esitshintshiselwano esivela kwiphathi-mpahla eyahlukileyo ukufaka isicwangciso sakho seNationalHealthcare plan. Ukwenza inkqubo ibonakale ngokukhawuleza, inkqubo efanelekileyo yokubhalisa iya kuba kubhaliso kwisicwangciso esitsha ngo-Disemba 15, ukwenzela ukuba uqinisekise ukuguquka okungahambi kakuhle kunye nomhla wokuqala kaJanuwari 1 wesicwangciso sakho esitsha (eMassachusetts, Rhode Island, kunye Uhulumeni waseWashington avumela ukubhaliswa ukuba kugqitywe ngokukhawuleza ngo-Dec. 23 ngoJan. 1 imihla efanelekileyo, kunye ne-United iphuma kwimashishini kuwo onke amathathu kwala mazwe).
Unako ukufumana ithuba lokubhalisa okhethekileyo elibangelwa ukulahlekelwa kwamanye amajelo, kwaye ngoko uvumeleke ukubhalisa ngokukhawuleza ngo-Dec. 31 ngomhla wokuqalisa kaJan. 1. Kodwa oku kuyinkimbinkimbi , kwaye inkqubo iya kuba lula xa ukhetha isicwangciso sakho esitsha ngoDisemba 15.