Health Insurance

Provident American Corp., which is developing an Internet site to sell health insurance, has agreed to sell its traditional agent-based insurance business to an Ohio company for $15 million. Central Reserve Life Insurance Co., an acquisition-minded firm in Strongsville, a suburb of Cleveland, is buying Provident American Life and Health Insurance. The Provident American Corp. subsidiary includes 27,000 agents nationwide and about 60 employees at the head office in Norristown, Peter Nauert, Central Reserve's chief executive, said yesterday.

This is the first of Joel L. Naroff's monthly columns for The Inquirer's Sunday Business section. Obamacare! Nothing gets the blood boiling more than a discussion about this law. Is this a business and health-care system killer, or a medical-sector lifeline? While the political sound bites are strident and conflicting, economic logic makes it clear: A major health-insurance overhaul is needed, and how it is done will have huge implications for the region's economy. Once upon a time, health insurance was a popular, affordable benefit used by firms to attract and retain high-quality employees.

HOW DO WE prevent 1 million heart attacks and strokes in the next five years? The U.S. Department of Health and Human Services launched the Million Hearts initiative in 2012 to answer this question. And it's as simple as the ABC'S: A spirin for risk reduction. B lood-pressure control. C holesterol-lowering. S moking cessation. Since February is Heart Month, this is a great time for Philadelphia to start working on its share of the goal - preventing 5,000 heart attacks and strokes among city residents by 2017.

A state court judge has ruled against Gov. Christie's administration for a second time in a lawsuit over whether the state can increase judges' health insurance and pension contributions. Mercer County Superior Court Judge Linda Feinberg ruled Wednesday that New Jersey cannot increase judges' contributions while the case proceeds. Last week, Feinberg sided with Hudson County Superior Court Judge Paul DePascale, who sued the state over its pension and benefits overhaul. DePascale argued that the increases would diminish his salary.

RICHMOND, Va. - The Obama administration received a generally friendly hearing Tuesday from a panel of three Democratic appointees for its first appeals court defense of the national health-care law. Two of the three judges - Andre Davis and James Wynn Jr. - were Obama appointees, and the third, Judge Diana Motz, was a Clinton appointee. The panels are chosen randomly by computer. Lawyers for Virginia struggled to explain how the state had the legal standing to challenge the health-care mandate on behalf of its citizens.

By Matt Joyce As I slid slowly into Thomas Jefferson University Hospital's glistening, space-age MRI machine recently, preparing for a 40-minute, $1,500 procedure that would yield more than 100 images of my injured wrist, thoughts of American entrepreneurship, preventive care, and the glaring ironies of our health-care system circled through my head. Three years ago, my former college roommate, Tim Ifill, and I started a nonprofit organization called Philly Fellows. Both of us chose to forgo traditional jobs with stable salaries and benefits to build a program that we were passionate about, and that we felt would make a tangible impact on the city of Philadelphia.

TO: GOV. CORBETT Re: Re-election   Look, I know things aren't going all that well. There's your dismal poll numbers. And fallout from that thing you said about the state's unemployed being too high to get jobs. And that sorta dovetailed with that thing you said in 2010 about the unemployed staying unemployed in order to collect benefits. And it reminded everybody about that thing you said in 2012 about women opposed to ultrasounds just having to close their eyes.

State insurance regulators yesterday warned consumers and businesses who have purchased health insurance coverage from Atlantic Healthcare and United Healthcare Benefits Trust that they should find replacement coverage from licensed companies. Both Atlantic and United are unlicensed insurance companies that have operated illegally in the Philadelphia, Reading and Allentown areas, Acting Insurance Commissioner Cynthia M. Maleski said in a statement. The Insurance Department has received complaints that United Healthcare Benefits was not paying claims and had refused to answer customer inquiries.

The cost of health insurance skyrocketed in 2011 after several years of relatively small increases. Prices rose 9 percent for family coverage, with the average family premium reaching $15,073 and employees picking up $4,129 of that cost. Last year, family premium prices rose three percent. "This year's nine percent increase in premiums is especially painful for workers and employers struggling through a weak recovery," said Drew Altman, president of the Henry J. Kaiser Family Foundation in California, in a statement.

When Maria and Vadim Brodsky's then-7-year-old daughter needed an MRI two years ago to examine a tumor in her head, they took her to a hospital in their health plan's network and were dismayed to receive a $4,500 bill. The couple had a $6,000 deductible on their family plan. And even though the bill was reduced to $3,000 - the price the provider and insurer had agreed to by contract - the Brodskys had to cover all of it. The next year, when their daughter needed another MRI, the Huntingdon Valley couple took her to a stand-alone facility and put the procedure on a credit card.

TO: GOV. CORBETT Re: Re-election   Look, I know things aren't going all that well. There's your dismal poll numbers. And fallout from that thing you said about the state's unemployed being too high to get jobs. And that sorta dovetailed with that thing you said in 2010 about the unemployed staying unemployed in order to collect benefits. And it reminded everybody about that thing you said in 2012 about women opposed to ultrasounds just having to close their eyes.

TRENTON - Spending on prescription medicines in the United States fell for the first time in decades last year, slipping as cash-strapped consumers continued to cut back on use of health-care services. Patients also benefited from a surge of new, inexpensive generic versions of widely used drugs for chronic conditions such as high cholesterol, according to a new report. Total spending on medications dipped 1 percent, to $325.8 billion last year from $329.2 billion in 2011. Likewise, average spending per person on medicines fell by $33, to $898 last year, according to the report from the IMS Institute for Healthcare Informatics.

The biggest changes in health insurance in a generation are set to take effect this year and next. Robert I. Field, a law and public health professor at Drexel University, answers questions about the changes stemming from the health law. Insurance exchanges are coming. What are they? An exchange is a marketplace where you can buy health insurance for you and your family. Most people will access them online, but there will be offices for those who prefer human contact.

Philadelphia City Council passed a pioneering equal-rights bill Thursday offering tax incentives to businesses that expand health coverage for lesbian, gay, bisexual, and transgender employees - a measure hailed as the first of its kind in the nation. The bill extends rights to "life partners" throughout the city code in a wide range of matters, such as medical decision-making; provides gender neutrality on certain city forms; and requires health insurance offered to city employees to cover the needs of transgender individuals, including sex-change surgeries.

This story has been updated. IN A MOVE that the LGBT community called "historic," City Council approved a bill yesterday that would require the city's health plan to pay for transgender city workers to complete "gender-confirmation surgery. " The bill also would require newly constructed or renovated city-owned buildings to have gender-neutral bathrooms. "We're continuing on the American road to full equality and civil rights for all of our citizens," said Councilman Jim Kenney, who sponsored the bill at the request of the LGBT community.

IN THIS ERA of sky-high health-care costs and overbooked doctors, you don't need health insurance and you don't need an appointment at Temple ReadyCare on Roosevelt Boulevard, just south of Byberry Road. It's next door to Chickie's & Pete's, and it's just as walk-in friendly, which explains why more than 2,100 Northeast Philadelphia patients have walked into the nonemergency urgent-care facility since its New Year's Day opening. "We opened up just as flu season hit," said Dr. Steve Matta, who came from the Temple ReadyCare in Port Richmond to man the Northeast office.

'YOU DON'T TALK to 'em . . . You plant 'em!" Larry "The Rock" Zeidel is standing over me now, fists clenched, his mammoth knuckles inches from my face. Four months ago, he was lying pale-faced in the intensive-care ward of Bryn Mawr Hospital, his legs swollen and blackened from a congestive heart condition worsened over the years by a lack of medical insurance. But there is little hint of that man now. Now it is easy to understand why he has ignored those health problems, why he has in the past refused or flatly not sought health insurance provided by the Social Security he collects in his advanced age. At 85, more than 4 decades removed from his last days as a stick-wielding hockey enforcer, Larry Zeidel lives most of his waking hours still inside that character, rambling on in no apparent chronological order about a modest heyday that he surrendered so much of his life to obtain.

SEVERAL years ago, I wrote about health care in Japan, where the government had begun charging corporations for their overweight employees. The Japanese tackle diabetes, high blood pressure, cancer and heart disease with a tape measure first: A waist circumference greater than 33.5 inches for women and 35.5 inches for men is enough to trigger a fine for an employer. My readers scoffed at this strategy, reacting with laughter and a lot of eye-rolling. Fast-forward to today. With health-care costs soaring in the United States, many companies have started to penalize overweight employees.

Chris Christie called Mike Rice, so gifted at hurling basketballs and homophobic epithets at his players, an "animal. " No, Rice is merely a former Division I coach, a product of the system. Division I sports is about winning and money, while tolerating behavior that would be unacceptable anywhere else on campus. Had Rice been an economics professor and engaged in similar actions, he would have been gone within the week. Rice's actions weren't initially extreme to Rutgers officials, who initially chose to suspend and fine him. The only reason Rice is now the former coach is because he was caught on a videotape that went viral, produced by an angry staffer whose contract was not renewed in a possible extortion being investigated by the FBI. So, really, there is something for everyone.