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At least 397 records · Page 22Linked to original sources
PubMed2004

Estimating the compensating differential for employer-provided health insurance.

The theory of wage differentials argues that workers must pay for employer-provided group health insurance coverage through lower wages or reductions in other fringe benefits. This paper uses data from the 1988-90 Consumer Expenditure Survey (CEX) to estimate the wage-health insurance trade-off for male workers between the ages of 25 and 55. A fixed-effects model, which takes advantage of the rotating panel design of the CEX, is used to control for unobservable worker characteristics that are positively related with all forms of compensation, including wage earnings and health insurance coverage. I find a compensating differential for health insurance equal to roughly 10 to 11 percent of wages. Some caution is advised here due to the fact that I was unable to control for other fringe benefits, the most important being paid vacation and sick leave.

Adult↗
PubMed2000

[Insufficient legal rights of traffic accident victims. Insurance companies should force more active compensation claims].

According to law, persons injured in road traffic accidents are entitled to compensation. In almost 92% of cases, victims accept a modified solution suggested by the insurance company involved. If an agreement cannot be reached, or the disability is 10% or more, the case is referred to The Road Traffic Injuries Commission (TSN). Insurance companies often claim that the lengthy wait for a final ruling--up to four years or more--is due to the lack of a doctor's certificate of disability.

Accidents, Traffic↗
PubMed1980

[Liability for hepatitis after blood transfusion (author's transl)].

1) Only a very limited amount of all cases of so-called "post-transfusion-hepatitis" (pth) is really due to infectivity of the transfused blood. Regardless of the mostly unknown true source of the infection, the occurrence of "pth" for itself does not qualify the recipient and/or his illness-insurance company for a legitimate action for damages against the blood bank under current West Germany Federal Law. 2) All West German blood banks are obliged by Federal Law to insure themselves against strictly defined damage claims. Their damage-insurance companies are not entitled to pay compensations to the illness-insurance companies of any victim of "pth" without meticulous investigation of the exact circumstances if expenses exceeding the legally defined limitations are included in the premium of damage-insurance charged to the blood banks. 3)Since nearly all inhabitants of West Germany are legally or voluntarily insured against illness, compensations paid by damage-insurance companies to illness-insurance companies are no appropriate means for any cost containment of the latter: The blood banks have no other choice than to calculate the additional premium costs into the costs of the blood units to be debitted to the illness-insurance companies.

Blood Banks↗
PubMed1990

Excess insured health care costs from tobacco-using employees in a large group plan.

Health insurance costs from tobacco have been estimated from tobacco's contribution to annual or lifetime costs for heart disease, emphysema, and selected cancers. Because health plans seldom identify tobacco users, there are few published studies that compare users with nonusers. This study gathered data on paid claims from a large group's indemnity plan (4108 users, 16,723 nonusers) from Jan 1 to Nov 30, 1988. Tobacco users had more admissions per 1000 (124 v 76), days per 1000 (800 v 381), a longer average length of stay (6.47 v 5.03 days), higher average outpatient payments ($122 v $75), and higher average insured payments ($1,145 v $762). Tobacco use is correlated with other high-risk behaviors; thus, cost and utilization differences are not solely due to its effects. Nevertheless, tobacco users add to employer costs for health insurance as well as for absenteeism, workers' compensation, and life insurance. Employers may use these data to reduce costs by not hiring tobacco users, adding surcharges for their health insurance, and strongly encouraging cessation. Issues of equity are discussed in terms of coerciveness and intrusiveness.

Costs and Cost Analysis↗
PubMed2000

Beliefs about and use of occupational medicine practice guidelines by case managers and insurance adjusters.

Workers' compensation case managers and adjusters have increased their use of practice guidelines recently, partly in response to state regulations. However, informally reported rates of use are not as high as desired for the best managed care practices and the greatest reductions in lost work time. Although there are several studies of physicians' use of guidelines, there are few if any studies about case managers' and adjusters' beliefs about, and utilization of, either general medical or occupational medical practice guidelines. Information about attitudes, beliefs about practice guidelines, and actual use should help developers make the guidelines more usable and bring about more effective interaction among case managers, adjusters, treating physicians, and other health professionals. This article reports on pre- and post-training surveys of a cohort of case managers and adjusters who participated in a case-based guideline training course. It then compares their responses to those of the physicians whose cases they might manage.

Case Management↗
PubMed1994

Medicare program; Medicare secondary payment--HCFA. General notice.

This notice provides guidelines for complying with 42 CFR 411.25, which provides that certain third party payers for health services furnished to Medicare beneficiaries must furnish certain information to Medicare intermediaries and carriers when they learn that Medicare made primary payment for services for which the third party payer has made or should have made primary payment. The notice also informs third party payers that they should contact HCFA if they wish to discuss arrangements for exchanging, on a voluntary basis, data about beneficiaries for whom the third party payer has a primary payment obligation under the Medicare Secondary Payer (MSP) provisions of the Medicare law. The third party payers affected by this notice are workers' compensation plans and insurers; all liability and no-fault insurers, including automobile insurers; and group health plans under certain circumstances, including plans which are self-insured and/or self-administered. If the group health plan, or workers' compensation plan is self-insured and self-administered, the employer must provide the notice; otherwise the insurer, underwriter or third party administrator must give the notice. This description of information third party payers must furnish is intended to help ensure that, in accordance with the Medicare law, Medicare pays only secondary to primary coverage of third party payers.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2001

Risk structure compensation in Germany's statutory health insurance.

In 1996 insurees in Germany's statutory health insurance system were given a right to choose their sickness fund. To ensure that all funds had an equal starting position, a risk structure compensation scheme based on income and average expenditure by age and sex was introduced. From an analysis of expenditure and transfers, data on sickness fund membership and a published survey, the following effects can be identified: sickness funds merged, with a reduction in number from 1,221 to 420 between 1993 and 2000; the risk compensation scheme narrowed differences in contribution rates; insurees left the more expensive funds for cheaper ones; and increasing transfer sums indicate further risk segregation. Thus, the compensation mechanism will have to be retained permanently, although modifications are likely.

Choice Behavior↗