Autonomous driving will change motor insurance landscape

A shift away from traditional auto insurance will be an inevitable consequence of the rise of driver assistance systems and, ultimately, autonomous driving, Hazel Yang Lee, lead, personal auto product development at ISO Solutions, a Verisk Analytics business, told PCI Today.

She added that, in the short term, insurers could have to grapple with greater uncertainty and complexities around claims that involved these types vehicles.

“As these driver assistance systems gradually bring about more autonomous driving, many consider a shift away from traditional auto insurance to be inevitable. Specifically, this shift is expected to reflect a transition from private vehicle ownership to shared fleets of commercially or publicly owned vehicles,” she said.

“When autonomous vehicles are involved in accidents, insurers may be affected in a number of ways while still evaluating traditional considerations such as liability and the circumstances of each accident.

“Currently, some major automakers have asserted that they will assume responsibility for accidents caused by their vehicles’ defects. And before full autonomy is achieved, insurers may face additional complexities in claims handling while determining whether the accident was the result of software failure or due to negligence by the human operator of the semi-autonomous vehicle.”

She stressed that in theory advanced driver assistance technologies will lead to safer driving experiences—a trend that would reduce premiums due to a reduction in the frequency and, potentially, the severity of the claims.

The National Highway Traffic Safety Administration (NHTSA) and other safety authorities have reported that approximately 94 percent of accidents are caused by human factors—a finding that supports this theory.

There are other consequences and potential business opportunities for insurers, Lee said. She said some also expect an increase in product liability insurance because defects or technical failures in automated vehicles may be attributed to the carmakers.

She added that insurers may also need to adjust their underwriting to take into account which cars have what technology, by using telematics data to understand driving behaviour, consider differences between traditional versus automated vehicles when resolving claims, and, finally, how they rate a policy.

She points out that traditional rating criteria used to assess a driver such as age, gender, marital status, and driving record would likely become less predictive, while telematics data or vehicle characteristics such as the version of the crash avoidance software on the vehicle, will have more relevance.

Lee stressed that it is difficult to foresee how the insurance landscape will adjust when driverless vehicles are ubiquitous, but notes that many industry insiders have speculated on how the insurance market and its participants can survive and thrive in the changing insurance landscape.

“Until current financial responsibility and compulsory insurance laws and regulations that require liability insurance are changed to address such fully autonomous vehicles, operators/owners will still need coverage to meet minimum driving requirements depending on the laws of a particular jurisdiction,” she said.

ISO Solutions, North America, Hazel Yang Lee, Verisk Analytics, Insurance, Property, Casualty, Risk management, PCI 2016, Technology, IT, Auto insurance

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Nancy Vaughan column: There's help available to enroll in insurance plan

The annual enrollment for health insurance through the federal marketplace begins Nov. 1, and the Covering Kids & Families Coalition of Madison County is ready to help people understand their options and make informed decisions.

The marketplace serves individuals with no other options for insurance and with incomes that are too high to qualify for public health plans; however, the Affordable Care Act does provide for tax credits to help offset costs, depending on income.

Because insurance options change every year, it’s important to shop around even if you currently have insurance through the marketplace. And for those new to the marketplace, understanding insurance options and knowing what assistance is available is crucial.

To that end, CKF partners provide enrollment specialists to help with the process. Sponsored by United Way of Madison County, the partners are organizing numerous outreach events to help reach people who may not know how to get this help.

On Nov. 12, they will be at Giant Oaks Apartments, 1312 W. Eighth St,; on Dec. 10, they will be at Cedar Ridge Townhomes & Apartments, 3634 Oaklawn Drive; and on Jan. 23, they will host the second annual MLK enrollment event at Anderson Impact Center, 630 Nichol Ave.

Outside of events, people can contact any of the partners to schedule an appointment:

• United Way of Madison County, 765-608-3062

• Community Hospital Anderson, 765-298-1775

• Jane Pauley Community Health Center, 765-298-5263

• Open Door Health Services, 765-286-7000

• St. Vincent Anderson Regional Hospital, 765-646-8240

• St. Vincent Mercy Hospital, 765-552-4630

• Madison County Community Health Center, 765-641-7499

• Family and Social Services Administration, 800-403-0864

Individuals can also call 211 for additional information and referral for health coverage and any other direct service need. You can also find a health insurance marketplace calculator and link to more information at

It is not required to use a navigator to sign up on the marketplace. Anyone can visit and review insurance options and enroll directly. The site also provides a guide and tips for enrollment. Telephone applications can also be taken at 800-318-2596.

Unless there is a qualifying change in circumstances, the opportunity to sign up on the marketplace ends Jan. 31. After that uninsured individuals may be subject to a tax penalty.

Enrollment in Hoosier Healthwise and the Healthy Indiana Plan (HIP 2.0) is open year-round and all of the CKF partners can assist with these applications. These plans are open to individuals earning less than $1,382 for an individual; $2,827 for a family of 4. Check with an enrollment specialists for other households sizes.

Regardless of how one enrolls, the following documents/information are required: Social Security numbers for all covered individuals; employer and income information for all applicants; policy numbers for current insurance plans; completed Employer Coverage Tool for every job-based plan that an applicant may have available.

Choosing a health insurance plan can be complicated, but there is plenty of help available in Madison County.

Nancy Vaughan is president of United Way of Madison County Inc. Her column appears the 4th Sunday of each month. She can be reached at or 608-3061.

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Insurance Commissioner speaks on NMHS-United Health dispute



By Michaela Gibson Morris

Daily Journal

JACKSON – The Mississippi Insurance Department is looking for progress in efforts to resolve a dispute between North Mississippi Health Services and United Health Care.

Both NMHS and United Healthcare have complied with a request from Insurance Commissioner Mike Chaney for detailed reports on how they are working to resolve charges that the insurer failed to pay the hospital system accurately and fairly.

“We should be in a position to address whether significant progress has been made in resolving the dispute by the middle of next week,” Chaney said.

In April, North Mississippi Health Services noticed electronic reimbursements were coming across as paid, but at $0 for some United Healthcare subscribers. When the 2 companies failed to resolve the issue by the end of September, the Tupelo-based system publicly announced plans to terminate its provider agreement with the insurer for 2017.

Chaney and the state insurance department staff have spoken extensively with staff from both companies and requested reports showing significant progress by Oct. 21.

“I have significant concerns as to the impact the termination of the Facility Participation Agreement will have on consumers in North Mississippi,” Chaney wrote to the leaders of the United Healthcare Gulf States region and North Mississippi Health Services.

If a resolution can’t be reached, United Healthcare customers, including those with coverage through the insurer’s commercial products, Medicare Advantage and Mississippi Medicaid CAN coordinated care ne2rk would be out of ne2rk as contracts expire in 2017. About 7 percent of NMHS patients are covered by United Healthcare.

Leaders at both NMHS and United Healthcare have said they want to see the issue resolved.

Terminating the provider agreement would affect North Mississippi Medical Center-Tupelo on Jan. 1. NMMC community hospitals in Pontotoc, Iuka, Eupora, West Point and Hamilton, Alabama would go out of ne2rk May 22. North Mississippi Medical Clinics would be affected on Aug. 14.

Next steps

If Chaney and his staff feel there has not been significant progress, they could take further action. The department would look at the documentation and other information from United Healthcare and NMHS to determine if claims had been paid properly. The commissioner could direct payment adjustments, depending on the findings.

“Fines and other penalties could also be imposed if warranted under the facts and law,” Chaney said.

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Olvany Insurance Agency partners with Goodville

SHAMOKIN — Effective Sept. 1, Olvany Insurance Agency, 3 S. Market St.,has partnered with Goodville Mutual to become a carrier of Goodville insurance products.

Goodville Mutual, based in New Holland, has been offering insurance products and services since 1926. The company has grown to provide coverage for autos, homes, small businesses, farms and churches in 8 states.

With the support of professional independent agents, Goodville continues to provide comprehensive property and casualty insurance products.

Goodville has been recognized as one of the top 50 performing property and casualty insurance companies in the nation by the Ward Group since 2010, and Goodville has been rated A VIII (excellent) by A.M. Best.

Olvany Insurance Agency has been covering the insurance needs of central Pennsylvania since 1958. It is a full-service agency offering a full line of insurance products to handle almost any insurance need.

Both Olvany Insurance Agency and Goodville are excited about this new partnership, creating new opportunities to provide the best products and services to policy holders.

Contact Olvany Insurance Agency at 570-648-6145.

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Low interest rates are killing health care insurance firms

Big health-care insurance firms are struggling to find a profit in this low-interest-rate environment, which is a cause for concern for opponents of the doctor-assisted suicide movement that is gaining momentum in the US, including New Jersey.

It is a tough market in general for insurance underwriters, which are facing escalating health-care costs.

Critics say some insurers would be satisfied to see many insured patients swiftly end their lives — that would help them save on rising industry costs that can no longer be offset by investment income.

Patrick Brannigan, executive director of the New Jersey Catholic Conference, told The Post that many oppose physician-assisted suicide because it is a direct threat to anyone viewed as a significant cost liability to a health-care provider.

A troubled health-care system and legally assisted suicide, when combined, are a “deadly mix,” according to Marilyn Golden, senior policy analyst of the Disability Rights Education & Defense Fund. Golden, a disability rights activist, warns that as soon as assisted suicide is legal, “it immediately becomes the cheapest treatment.”

“Direct coercion is not even necessary,” Golden, said, “because insurers deny, or even merely delay, approval of someone’s expensive life-sustaining treatment — they will be steered toward hastening their death.” There is already some evidence out of Oregon, the first state to legalize assisted suicide, to support this view, she added.

Health insurers seemingly refused to pay for the treatments recommended by doctors for 2 cancer patients there.

Instead, the insurers offered to pay for alternative “treatments,” which included assisted suicide, according to Golden.

This broken, profit-driven health-care system, as some call it, is anathema to many opponents of assisted suicide, which is now permitted in 5 states, with a renewed push in the Tri-State area recently.

The so-called “Aid in Dying” bill that would allow terminally ill patients to be prescribed medication to end their lives just passed the New Jersey Assembly on Thursday, but it hasn’t been posted for a vote in the state Senate yet.

Analyst say the low investment returns eked out by insurers may be behind this thinking on insurers’ role in assisted suicide. US health insurers have made money through the years by pricing their products appropriately, based on certain risk parameters, and through investment income of the reserves they must hold — as required by law — in anticipation of paying claims, according to Mike Fitzgerald, a senior analyst following the industry at Celent.

“Because of the low interest yields on government bonds, which regulators mandate they hold in significant amounts in order to reduce the investment risk, insurers can no longer count on this as a source of income,” according to Fitzgerald. “Thus, the pressure is on to improve their core operations and to grow.”

The insurers are under severe cost pressure, which can be offset either through hiking prices and premiums, or by reducing operational spending, Fitzgerald said.

US health-care spending already accounts for some 18 percent of GDP, or nearly $2.8 trillion in 2013.

But US insurance companies reject the claims.

“We haven’t taken a position on the ‘assisted-suicide’ provisions, nor has AHIP taken a role at the state or federal level on these bills,” Clare Krusing, a spokeswoman for America’s Health Insurance Plans (AHIP), the health insurance industry trade group based in Washington, told The Post.

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In insurance Big Data could lower rates for optimistic tweeters

By Brenna Hughes Neghaiwi

ZURICH When people take to Twitter to comment on the great evening they enjoyed with good food and wonderful friends, reducing their monthly insurance bill is probably the last thing on their mind.

But such tweets could help insurers to price premiums for individuals, with research suggesting a direct link between positive posts and a reduced risk of heart disease.

This could lead to future insurance cover based on “sentiment analysis”, in which Big Data and artificial intelligence make predictive models ever more accurate.

Swiss Re (SRENH.S) says technological advances will cut the price of insurance protection and help individuals and firms make better decisions through programs that offer advice and incentivise improvements in areas such as health and driving.

However, detractors fret that such developments could erode customers’; privacy or lead to increasingly personalized pricing, undermining the basic principle of insurance – sharing risk.

Social media monitoring is one of several advances insurers are examining to improve the pricing of policies.

As part of its data push, Swiss Re, the world’;s second-largest reinsurer, has invested in, a startup aiming to let consumers store personal data culled across various social media channels and beyond and to exchange their data with businesses for personalized deals.

“In a relatively short period of time, maybe a few years, most of the major insurers will have integrated lessons from behavioral research,” Swiss Re’;s head of digital analytics catalysts, Daniel Ryan, told Reuters. “Undoubtedly, it will lead to a different interaction between insurer and policyholders.”

By highlighting “safe behaviors”, insurers believe they can reduce claims by helping clients to lead healthier, safer lives.

Programs such as Discovery’;s (DSYJ.J) Vitality and Allstate’;s (ALL.N) Drivewise are already putting these policies into practice.


The Vitality health and life insurance program assesses a customer’;s overall health based on factors from age and blood pressure to diet, exercise and self-assessed happiness levels. It then establishes a personalized health improvement plan, tracking users’; progress via purchases and wearable devices.

Customers gain rewards for making healthier choices, from premium reductions to cash back on health food and discounts on travel bookings.

Insurers like Allstate and Britain’;s Drive Like a Girl offer discounts to motorists who exhibit safe driving behavior after installing a ‘telematics’; tracking device –which collects data on speed, abruptness of braking and time and frequency of use — in their cars.

“The focus of Drivewise is to give you feedback that can only help your driving and your rates,” Allstate says of the program. Rates will never be raised — only reduced or maintained — based on the data, the U.S. insurer says.

But big data and artificial intelligence do not simply serve to identify ‘best users’;.

While some insurers won’;t penalize customers for joining data programs, bad performers in others — those who drive more like a “boy racer” in the British telematics program, for example — will face rate hikes.

And as data-sharing programs become more ubiquitous, some groups worry that those who are unwilling or unable to make improvements in personal circumstances will ultimately lose out.

In September, Britain’;s markets watchdog dropped plans for a formal market review of whether Big Data might make it harder or more expensive for some customers to buy car and home insurance, saying there was no evidence of that so far. [nL8N1BX21Z]

But in Germany, with its strong stance on data vigilance and privacy rights, consumer advocates are more reserved. The Federation of German Consumer Organisations (VZBV) sees risks from Big Data in personal insurance outweighing benefits.


By assessing individuals’; risk more and more accurately, insurers could cherry-pick the ‘good risk’; from the bad, leading to increasingly differentiated pricing or coverage denial for some individuals.

Such personalized developments would undo the traditional principle of solidarity at the core of insurance, which is designed to spread the financial burden of illness or misfortune between the fit and fortunate and those who face unexpected hurdles or higher medical bills later in life.

“If I calculate every individual’;s personal premiums and personal risk, I’;m no longer spreading risk out collectively,” VZBV insurance expert Lars Gatschke said.

Insurance could instead become an arbiter of social norms, penalizing individuals for snacking on junk food or taking too few steps, for example, irrespective of their particular circumstances, Gatschke said.

“On the one hand, there’;s more and more that can be done and more and more that can be recognized,” said Patrick Maeder, finance expert at advisory firm PwC.

“But on the other hand it’;s also a matter of protecting the individual and recognizing that certain data is ultimately very personal. It comes down to striking the right balance.”

Swiss Re’;s Ryan saw “greater reliance on data sets based on consenting contributions by individuals” as the way forward.

Many reinsurers like Swiss Re also focus on collective — as opposed to personalized — results in their business models.

In a study cited by the Swiss group last month, researchers found Twitter data alone a more reliable predictor of heart disease than all standard health and socioeconomic measures combined.

Geographic regions represented by particularly high use of negative-emotion and expletive words corresponded to higher occurrences of fatal heart disease in those communities.

Twitter monitoring remains outside Swiss Re’;s purview, executives said. It would first need rigorous ethical checks before the reinsurer would consider adding it to its underwriting scheme.

Even so, as new inputs ranging from social media to call center recordings offer information that could be relevant in ways that individuals may not realize, Chief Executive Christian Mumenthaler saw reason to exercise personal judgment as well.

“I personally would be cautious what I publish on the internet,” Mumenthaler has said.

(Reporting by Brenna Hughes Neghaiwi; additional reporting by Carolyn Cohn; Editing by Gareth Jones)

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Coming penalties for uninsured may boost Obamacare

ALBUQUERQUE, N.M. — From its enactment in 2010, the Affordable Care Act was designed to achieve 2 goals that, while not necessarily contradictory, aren’t all that complementary either.

First, the ACA, or Obamacare, was intended to reduce the nation’s uninsured population. It would do this by outlawing the insurance industry’s practice of denying coverage to people with pre-existing conditions, by setting standards for coverage and premium affordability and by ending price discrimination based on the health or sex of the customer. The ACA subsidized purchase of insurance for people below certain income levels when it was bought on a state or federal insurance exchange, and it provided federal money to states that are willing, as New Mexico was, to extend Medicaid to all low-income able-bodied working-age citizens.

Second, the ACA sought to preserve the private health insurance industry, despite the costly reforms it enacted to achieve its first goal. It imposed a financial penalty on most individuals who did not have coverage and most larger companies that did not offer coverage. It set up online shopping for health insurance to give insurers easier access to customers. It gave insurers temporary financial relief to overcome the short-term costs of adjusting to the new world.

The ACA has disappointed in many ways. A couple of weeks ago, no less a Democrat than former President Bill Clinton called the result “the craziest thing in the world.”


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The law has resulted in “people who are there busting it, sometimes 60 hours a week, (who) wind up with their premiums doubled and their coverage cut in half,” Clinton said.

As for its 2 main goals, the law has been very good at extending coverage to millions of Americans and not so great at satisfying the insurance industry.

A big part of the problem is that insurers have never been very good at anticipating how much individual customers (as opposed to groups like those covered by employers) will cost when it comes time to pay health care bills. On top of that, health care costs in general continue to grow faster than the economy grows.

The Centers for Disease Control and Prevention reported last month that the percentage of our country’s population without health care coverage is at historic lows, down to 8.6 percent as of the first quarter of this year from 16 percent in 2010. CDC surveys found that 27.3 million more people are insured since ACA took effect.

The most recent data show that New Mexico’s uninsured rate fell from a little more than 20 percent in 2010 to about 14.5 percent. That is largely due to a big jump in Medicaid enrollment, which offers coverage few private insurance customers would ever receive, let alone afford.

The bad news for insurers is that those 27.3 million people are mostly older and, therefore, presumably less healthy customers. The CDC found that, while the uninsured rate is down to 8.1 percent for people 45 to 64 years old, it is 13.7 percent for 18- to 24-year-olds, 15.9 percent for 25- to 34-year-olds, and 14.3 percent for 35- to 44-year-olds. Only 0.5 percent of our 65-and-older population is uninsured, thanks to Medicare coverage.

The ACA concept has always been that, with everyone forced into one large national insurance pool, insurers would be able to predict their costs with some accuracy and use the money they save on young and healthy customers to pay the costs of caring for older and sicker customers. The hope for a national pool would have been more easily achieved if insurance companies could sell their products across state lines. It is a rare state insurance regulator who will endorse that idea.

The pool still doesn’t have enough young and healthy customers, and insurers are having a devil of a time pricing their products properly to recover costs. Blue Cross and Blue Shield of New Mexico early in the life of the ACA insurance exchanges found it had to request huge premium increases to cover health care costs. Presbyterian Health Plan has announced it won’t participate in the state insurance exchange in the coming plan year because of the cost.


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Several large insurers have abandoned insurance exchanges around the country. Most recently, Aetna said it would drop coverage in 2-thirds of the counties where it offered insurance on the exchanges. The company said it has lost more than $430 million since January 2014 on individual insurance products. What Aetna called “individuals in need of high-cost care” were sinking the plans. The ACA requires insurers to spend 80 percent of the premiums they collect on health care (state regulators require New Mexico’s plans to spend up to 85 percent of premiums), and they can’t charge more expensive patients higher premiums to offset their cost of care.

Insurance, popular opinion to the contrary, is not a very profitable business to begin with. Aetna’s 2015 net profit margin was less than 4 percent. Compare that to the Coca-Cola Co.’s almost 17 percent margin.

Even with the withdrawal of companies like Aetna and UnitedHealthcare, the nonpartisan Kaiser Family Foundation says this doesn’t mean the ACA is failing as a public policy. Writing in The Wall Street Journal, foundation CEO Drew Altman said, “The (insurance exchanges) have a special role in health insurance, and they face real challenges, but they are a modest part of the overall insurance system. They are also only one part of the ACA – if an important part – and they are not having trouble in all states.”

Penalties in 2016 for not having individual coverage might begin to solve insurers’ problems. Penalties can be as much as the national annual average premium of the cheapest category of plans sold on insurance exchanges. The hope is that individuals would rather buy insurance than pay the same money to Uncle Sam.

UpFront is a daily front-page news and opinion column. Comment directly to Winthrop Quigley at 823-3896 or Go to to submit a letter to the editor.

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Census: More residents insured in Pennsylvania

New data show the number of people without insurance has dropped across the country and in Pennsylvania in recent years, with the Altoona area ranked among the top in the state.

Census estimates released last month show the uninsured rate dropped by 5 percentage points in Altoona between 2013 and 2015.

Altoona is outranked only by East Stroudsburg, where the uninsured rate dropped 5.6 percentage points.

Overall, the percentage of people without health insurance in Pennsylvania declined from 9.7 percent to 6.4 percent in the same time period.

The Pennsylvania State Data Center’s report showed Altoona’s decline is in line with the country’s overall drop: “The nation as a whole had a 5.1 (percentage point) decline in the percent without coverage during the time period, going from 14.5 percent in 2013 to 9.4 percent in 2015.”

John Maurer, data center coordinator, said that the Affordable Care Act is the primary driver of the trend and that Altoona’s ranking is noteworthy.

“This was a major, statistically significant change … that rarely occurs in a year-to-year outlook,” he said.

The data center ranked other metropolitan areas including Johnstown, which was ranked among the areas with the smallest declines, having dropped only 2.6 percentage points.

The number of uninsured people in the State College area did not significantly change between 2013 and 2015, the center reported.

Economic trends, demographic shifts and policy changes all impact health insurance rates, according to the data center, but the report noted that more people likely picked up health insurance during the measured time period because many provisions of the Affordable Care Act went into effect in 2014.

The state Department of Human Services credited Gov. Tom Wolf with the drop because he discarded the HealthyPA plan instituted by his predecessor, Gov. Tom Corbett, in favor of fully expanding Medicaid as permitted by the Affordable Care Act.

HealthyPA allowed the state to accept federal funds to expand Medicaid but only allowed them to be used for private insurance plans.

While that may explain the statewide drop, it does not show why Altoona outranked almost everywhere else in the state.

Maurer, of the data center, said there are many reasons why similar areas have different uninsured rates.

Health system outreach to customers or a large employer moving in that offers health care plans could both impact how many people choose to obtain insurance.

Susan Manko of UPMC Pittsburgh said health plan membership in Altoona has increased significantly in the last few years and the hospital system continues to reach out to people.

Problems linger with health plans, however: Manko noted that there are people who now have insurance but still do not seek treatment because they have a high deductible.

UPMC also tracks those people who have insurance but do not use medical services, she said.

“We have a huge financial assistance center … that does nothing but help people figure out how they’ll pay for their health care,” she said.

Gina Pferdehirt, public relations director for insurance services, said UPMC works with Enroll America as well to expand outreach.

Pferdehirt also credited the Medicaid expansion as a factor that would impact how many people are insured.

Amy Bradley, marketing director for Conemaugh Health System, said the hospital employs counselors who help enroll people through the Affordable Care Act.

They “walk people through the process, enroll them, help (with) the exchanges and/or to find out if they qualify for free medical care through Medicaid,” she said.

While Bradley said she could not explain why Johnstown’s uninsured rate had not dropped as much as other places, she said the hospital system tracks how many people contact them for help obtaining insurance.

And the hospital is kicking off a campaign now during the open enrollment period — Nov. 1 through Jan. 31 — to reach those people.

“We’re getting flyers and enrollment pamphlets out to all our physicians offices and hospitals,” she said.

The hospital also maintains an email account and toll-free phone number to answer questions and help people set up appointments with counselors.

Jolene Calla, vice president of health care, finance and insurance for the Hospital and Healthsystem Association of Penn­sylvania, said hospital outreach has played a big role in helping people obtain insurance — especially those who are looking at plans for the first time.

“People were tending to choose the lowest plan, but it wasn’t necessarily the best plan for their needs,” Calla said. “They want coverage. They know they need the care, but they’re being very conscious of costs. They’re not looking down the horizon.”

That’s where an insurance counselor, or so-called patient navigator, comes in.

With help, counselors might help patients choose a plan that’s a little more expensive upfront but has a lower deductible or more adequately covers a health condition or necessary medications, Calla said.

According to the association, more than 1 million people have enrolled for insurance since implementation of the Affordable Care Act and Medicaid expansion.

Mirror Staff Writer Kelly Cernetich Brown is at 946-7520.



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