Senior Health Insurance Company Of Pennsylvania

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Senior Health Insurance Company Of Pennsylvania Ratings And Reviews

Insurance Company Sued for Denying Elderly & Sick The Benefits They Paid For

In mid-2009, the Senior Health Insurance Company of Pennsylvania asked A.M. Best Company to withdraw its ratings for the company. A.M. Best had given SHIP a C financial strength rating and a ccc+ issuer credit rating, both of which are weak marks. It had also given the insurance provider a negative rating for its outlook for both ratings.

Ratings from A.M. Best are a good gauge about an insurance companys financial outlook and strength, both in the present and going into the years ahead. SHIP, operating formerly as Conseco, had obviously encountered extensive financial difficulties. In May of 2008, Conseco agreed to a settlement with the state insurance regulators from 40 U.S. jurisdictions. The company had to pay a fine of $2.3 million, as well as $30 million as restitution for claims mishandling.

Going forward, Senior Health Insurance Company of Pennsylvania will likely have to raise its rates and reduce its benefits. A simple Internet search already yields complaints from the children of current policyholders, who cite poor customer service and mishandling of their parents claims.

If youre looking for health insurance coverage, SHIP is obviously not the company for you. Instead, type your ZIP into the free box below and youll be able to check out health insurance quotes from other providers in your area.

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What Is A Direction To Pay Form

A Direction to Pay form allows us to pay your care provider directly. This is not a permanent assignment of policy benefits you have the right to change your mind at any time in the future. This form is only required if you would like us to send any payable benefits directly to your provider. In order to assign benefits, please be advised that we will only accept the Direction to Payform. In addition, your provider must send us a completed W-9 form .

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Senior Health Insurance Company Of Pennsylvania Products

The Senior Health Insurance Company of Pennsylvania is no longer selling health insurance policies. Instead, the company only exists to maintain and keep the long-term care insurance policies of its current customers running.

When ownership of SHIP was moved to the Trust, it was with the sole purpose of keeping the company in business for all of its current policyholders who have paid premiums on their long-term care insurance for years. It is not the Board of Trustees intention or obligation for SHIP to make a profit.

What Is Senior Health Insurance Company Of Pennsylvania

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Senior Health Insurance Company of Pennsylvania is a Pennsylvania stock, limited life insurance company that administers a closed block of long-term care insurance policies. SHIP has not sold new policies since 2003. SHIPs corporate office is located in Carmel, Indiana. SHIPs administrative office is located in St. Paul, Minnesota. 381 long-term care policies were issued in the State of South Carolina. Not all policies are subject to the Rehabilitation Plan that has been proposed by the Pennsylvania Rehabilitator.

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States Battling Senior Health Insurance Co Of Pennsylvania

Three states are each taking their own approach to combat Senior Health Insurance Co. of Pennsylvania’s planned rate hikes and benefit cuts.

The payer has been operating through a rehabilitation program under former Pennsylvania Insurance Commissioner Jessica Altman after a court order made her responsible for making the company solvent. The company is allegedly facing a $1.2 billion deficit and shrinking benefits while increasing premiums to recoup losses.

Louisiana was one of the first states to challenge the move, which impacts members in states around the country. In December 2021, Louisiana Insurance Commissioner Jim Donelon threatened to file a lawsuit to block the rehabilitation plan, saying if left unchecked, could result in “potentially disastrous rate increases or benefit reductions,” according to Biz New Orleans.

Iowa followed suit, filing a petition in court to block the move. Iowa Insurance Commissioner Douglas Ommen said that rates could rise as much as 675 percent.

Most recently, Washington state Insurance Commissioner Mike Kreidler announced March 1 that he did not approve the increases, which will affect 1,200 members in the state.

He said the plan “disproportionately puts the burden of the companys insolvency unfairly onto policyholders and ignores their rights under states guaranty fund associations,” and ordered the payer to stop asking Washington stakeholders to sign letters accepting the rate and benefit changes.

I Have Heard There Are Lawsuits Pending Involving Ships Rehabilitation Is That True

Yes. Three states, Massachusetts, Maine, and Washington state intervened in the rehabilitation action to protect SHIP policyholders. They challenged the authority of the Pennsylvania Rehabilitator to set rates and change policy forms in other states. The Pennsylvania Commonwealth Court approved the Second Amended Plan over their objection. Those states are appealing that ruling.

South Carolina and Louisiana took similar actions to prevent the implementation of the Plan in their states. Louisianas action was brought in Federal Court and South Carolinas action is still pending in the Richland County Court of Common Pleas in Columbia, South Carolina. Other states have also expressed concerns about the courts ruling because it impacts their ability to protect policyholders in their states.

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If All Ship Policyholders Pay The If

No. Even if all SHIP policyholders paid the higher If-Knew premium, SHIP would not collect enough in premiums to cure its $1.2 billion deficit. Many states, including South Carolina, believe this company should have been placed into liquidation a long time ago and that all the Pennsylvania Rehabilitator is doing is wasting the assets of the insurer.

What Is The Approved Rehabilitation Plan

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The Approved Rehabilitation Plan refers to the Plan of Rehabilitation that was approved by the Commonwealth Court in Pennsylvania on August 24, 2021. You can review the Approved Rehabilitation Plan here.

The Rehabilitator is in the process of trying to implement the Plan. If the plan is implemented, SHIP policyholders will have to either pay higher premiums for their current benefits, reduce their benefits to keep their current premiums, or select benefit downgrades to a level determined by the Rehabilitator to avoid future rate increases or benefit reductions. Unless the courts stop the implementation of this plan, SHIP policyholders may receive a form from the Rehabilitator asking them to choose from the previously listed options. If the consumer does not choose, the Rehabilitator will choose for them.

These options may affect you financially and legally. Please secure advice from your financial or legal advisor before selecting an option. You will not be able to change your mind after the election deadline passes.

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What Claim Forms Must Be Completed For Every Claim

The required forms are included within the Claim Information Package. Complete the first two pages of the Policyholder Claim form. Also complete the Authorization For Disclosure of Health-Related Information, if you want to authorize anyone other than the policyholder to speak with us about your claim. Please submit all of these forms to us together. PLEASE ALSO MAKE SURE THAT ITEMIZED INVOICES ARE SUBMITTED TO US. If you are filing a Home Health Care claim, the Caregiver Weekly Timesheets may be used if your provider does not supply them.

Senior Health Insurance Company Of Pennsylvania Claims

For information on submitting claims, whether its your first time or not, click on the Submitting Claims tab of the company website. There, you will find information about who needs to fill out which claim information sheet, and provide corroborating proof, etc.

If you or your loved one has had a claim denied by SHIP and want to contest it, you can submit additional facts and paperwork, and ask for a management review of the claim. This should be sent to Long Term Care Claims, to the attention of the Claims Manager, at the address already given above.

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The Four Choices Policyholders Will Face

The plan offers four initial options for policyholders. At one end of the spectrum, they can pay the rate increases required to keep their full benefits, priced unrealistically decades ago during a time when interest rates were higher and longevity expectations lower. At the other end, they can choose to reduce their benefits and keep their premiums the sameat least at the outset.

An older policyholder could, for example, reduce their maximum coverage period from 10 to five years instead of paying the premium required for a policy with a 10-year period of coverage, Judge Leavitt observed.

“For every policyholder there will always be two competing considerations: the anticipated need for LTC benefits and the cost of maintaining coverage for those benefits,” the plan notes.

For policyholders who cannot afford any rate hikes, option one, maintaining current their rates and reducing their benefits could be the best option for the first phase of the rehabilitation plan. However, those benefits might be insufficient, and the policyholder could still face premium increases and further benefit reductions during the second phase of the rehabilitation.

As an alternative, option two would modify the existing policy to offer a “reasonable” combination of benefits and premiums, while insulating policyholders to some extent from large rate increases and benefit reductions in the second phase of the plan.

SHIP filed an initial application for rehabilitation back in January 2020.

Cease And Desist Order

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On Feb. 8, Maine Insurance Superintendent Eric Cioppa issued a cease and desist order against the SHIP rehab plan. A virtual public hearing is scheduled for Friday at 9 a.m. to determine the state’s next move.

Approximately 350 Maine residents, with an average age of 86 years, are SHIP long-term care insurance policyholders, Cioppa said in a news release.

SHIP’s appointed rehabilitator began taking action under the plan in late January by sending a “Coverage Election Package” to Maine policyholders, requiring them to select modified benefits or premium increases by March 15, 2022, with an effective date as early as April 1, 2022.

Pennsylvania Insurance Commissioner Jessica K. Altman has said that the court-approved plan provides more options for policyholders than they would have if the company was in liquidation. In a November statement to InsuranceNewsNet, she said the plan is equitable across states and across policyholders.

The court thoroughly reviewed the proposed plan and the objections that were filed by a few states, she said. The court issued a well-reasoned opinion addressing the objections and opposition and approving the plan.

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Senior Health Insurance Company Of Pennsylvania Discounts

Although SHIP operates without earnings, it still offers policyholders ways to manage their premiums and options to lower their costs. Currently, premium bills from customers only account for 56% of the payments it makes for customer claims. The other 44% is paid from assets and investment income.

If youre a current SHIP policyholder, or family member of a SHIP policyholder looking to help them, you have a few options to lower your premium payments. You can decrease your maximum benefit period, or your maximum benefit amount on a daily or monthly basis. You can also extend the elimination period, which is the waiting period before your benefits begin. Lastly, you can drop some optional coverage off your rider.

Unfortunately, all of these recommendations mean that, in order to pay a decreased premium, you must first decrease your benefits. Unfortunately, because the company isnt taking on any new business, it has a limited pool of income. As the years continue and its policyholders claims grow, the company will have less and less flexibility when it comes to discounts and benefits.

Pennsylvania Commonwealth Court Proceedings

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What Is The If

The Plan defines IF-Knew premium as means the premium that if charged from inception would have produced the greater of the initial target loss ratio or the minimum loss ratio applicable to the policy form. Simply stated, the Rehabilitator is saying: “If we knew then, what we know now, we would have charged you this for your policy. We will charge you that now.”

What Happens To Policies In Phase One

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Policyholders are treated differently depending on whether they live in a state that permits the Rehabilitator to set rates in that state or if they live in a state that wants to set premium rates under the laws of the state and not Pennsylvanias law .

Opt-In States- Phase One

For opt-in states , SHIP policyholders will have to choose among four options in Phase One:

  • Keep your current premium but downgrade your LTC policy benefits to a level determined by the Pennsylvania Rehabilitator.
  • Choose a Basic Policy endorsement. The Pennsylvania Rehabilitator will downgrade your benefits. This selection may mean no future rate increases or benefit changes for some policyholders.
  • Select a Nonforfeiture Option. The selection of this option means you are getting a reduced paid-up policy. The benefits under the policy may be significantly less than the benefits under your current policy.
  • Keep your current benefits but pay the If-New Premium. The Pennsylvania Rehabilitators proposed rate increases range from 0% to 500% depending upon the current premiums being paid.

Policyholders paying at or above the IF-Knew premium rate will not have to make a choice in Phase One. However, these policyholders will have to make a choice in Phase Two they will have to choose an option with a benefit downgrade or pay a self-sustaining premium for their benefits.

Opt-out States-Phase One

These policyholders are also given four options to choose from:

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  • Senior Health Insurance Company of Pennsylvania

Zippia gives an in-depth look into the details of Senior Health Insurance Company of Pennsylvania , including salaries, political affiliations, employee data, and more, in order to inform job seekers about Senior Health Insurance Company of Pennsylvania . The employee data is based on information from people who have self-reported their past or current employments at Senior Health Insurance Company of Pennsylvania . The data on this page is also based on data sources collected from public and open data sources on the Internet and other locations, as well as proprietary data we licensed from other companies. Sources of data may include, but are not limited to, the BLS, company filings, estimates based on those filings, H1B filings, and other public and private datasets. While we have made attempts to ensure that the information displayed are correct, Zippia is not responsible for any errors or omissions or for the results obtained from the use of this information. None of the information on this page has been provided or approved by Senior Health Insurance Company of Pennsylvania . The data presented on this page does not represent the view of Senior Health Insurance Company of Pennsylvania and its employees or that of Zippia.

How Does The Approved Rehabilitation Plan Affect Me

It depends on the following factors: a.) Do you have a paid-up policy or have you selected the nonforfeiture option? b.) Are you paying the IF-Knew premium now? c.) Are you on claim or currently receiving benefits? If you are currently paying premiums, and your premiums are below the IF-Knew level, you will be affected by the Plan in Phase One unless you choose an option that significantly reduces your benefits.

  • Paid-up Policies: Paid-up policies are not affected by the Plan. These policyholders do not have to do anything according to the Plan.
  • Policyholders Currently Paying the If-Knew Premium: Policyholders who are paying premiums are at or above the If-Knew premium rate do not have to make a choice in Phase One. They will have to make a choice in Phase Two.

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Senior Health Insurance Company Of Pennsylvania

A review of Senior Health Insurance Company of Pennsylvania finds an insurance company that has recently undergone ownership changes due to recent problems. Senior Health Insurance Company of Pennsylvania, which is also known as SHIP, was part of Conseco Senior Health Insurance Company before November 2008.

Find health insurance rates from providers in your area by typing your zip code into the box above.

After mid-November of 2008, SHIPs owner became the Senior Health Care Oversight Trust, which was formed by Pennsylvanias Department of Insurance. SHIP is run by a Board of Trustees whose members all have extensive insurance experience. The Board exists to ensure that SHIP continues to meet its obligations to its policyholders.

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