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Health Insurer Prevails During Early Stage of Insured s Denial of Benefits Class Action

Health your username 5 days ago On Monday, defendant-administrator Health Care Service Corp. (HCSC) secured the dismissal of a lawsuit brought by the beneficiary of an employer-sponsored health insurance plan. The Northern District of Illinois class-action was filed after HCSC denied coverage for residential treatment that the plaintiff’s daughter received for behavioral health conditions in 2018. The court explained that pursuant to the plaintiff’s second amended complaint, HCSC’s denial was the consequence of “improperly narrow residential treatment guidelines that HCSC continues to employ in making benefits determinations,” in violation of the Employment Retirement Income Security Act of 1974 (ERISA). The plaintiff seeks to certify a class consisting of “any member of a health plan governed by ERISA whose request for coverage of residential treatment services for a behavioral health disorder was denied by HCSC,” wholly or partly, and based on

Mark Farrah Associates Assessed Profit Margins for Leading Blue Cross Blue Shield Plans

Press release content from Business Wire. The AP news staff was not involved in its creation. Mark Farrah Associates Assessed Profit Margins for Leading Blue Cross Blue Shield Plans February 2, 2021 GMT MCMURRAY, Pa. (BUSINESS WIRE) Feb 2, 2021 Mark Farrah Associates (MFA), www.markfarrah.com, analyzed profit margins of Blue Cross Blue Shield (BCBS) plans, comparing year-over-year performance for third quarter 2020. The Blues brand controls over 40% of total U.S. commercial health enrollment, nationwide. The top seven BCBS affiliated insurers with over $10 billion in revenue include Anthem, Health Care Service Corp. (HCSC), Blue Shield of CA, BCBS of Michigan Group, Guidewell Mutual Holding Group, Independence Blue Cross (IBX), and Highmark.

Aetna Agrees to Expand Coverage for Gender-Affirming Surgeries

Aetna Agrees to Expand Coverage for Gender-Affirming Surgeries
nytimes.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from nytimes.com Daily Mail and Mail on Sunday newspapers.

Trans women persuade Aetna to expand insurance coverage

Trans women persuade Aetna to expand insurance coverage
chicagotribune.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from chicagotribune.com Daily Mail and Mail on Sunday newspapers.

Aetna to Expand Coverage for Gender-Affirming Surgeries

Aetna Agrees to Expand Coverage for Gender-Affirming Surgeries One of the nation’s largest health insurers is agreeing to pay for breast augmentation for some trans women. Two years ago, Cora Brna, a health care worker in Pittsburgh, was devastated to learn that her insurance would not cover the breast augmentation she had planned to have along with a genital reassignment surgery.Credit.Sarah Huny Young for The New York Times Jan. 26, 2021 Allison Escolastico, a 30-year-old transgender woman, has wanted breast augmentation surgery for a decade. By 2019, she finally thought her insurance company, Aetna, would pay for it, only to find that it considered the procedure cosmetic, not medically necessary, and refused to cover it.

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