Thursday, August 26, 2004

Competing health insurer
receives state approval

The state Insurance Commission has approved the group rate plans of Summerlin Life & Health Insurance Co., the newest entrant into Hawaii's medical insurance market.

J.D. Dyer, Summerlin's chairman, said the Las Vegas-based company's products will allow customers "open and direct access to providers and the freedom to go directly to any physician, hospital or health care professional for covered services."

All plans will feature coverage for routine preventive care, specialty care, hospitalization, surgery, diagnostic testing, emergency care and prescription drug coverage. Dental and vision riders will also be offered.

The three plans approved by the state include one in which patients pay 20 percent of all costs up to $2,500 a person or $7,500 a family. A second plan sets a $15 co-pay with a ceiling of $2,500 a person per year, or $6,000 a family.

Its preferred-provider plan requires patients to shoulder 20 percent of health care costs incurred by using doctors and services within the company's preferred-provider network, or pay more for services outside the network.

Bill Donahue, executive director of the Hawaii Independent Physicians Association, said Summerlin's entry in Hawaii's market could help make medical insurance rates more competitive.

"Clearly, any competition is good," he said. But Donahue added that the impact will be muted unless Summerlin shows a willingness to work with physicians to limit "duplicative" testing and other care, which increases administrative costs and, ultimately, health care costs.



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