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Limitations of Cover Charges
Unfortunately, Blue Cross Health Insurance Texas companies don’t usually make it easy as the equation set for the above. In effort to hold down costs, they often try to put a cap (highest limit) on the amount of the doctors charges that they will pay. This cost containment can in the form of paying only those fees the insurance company considers to be proper – what are called usual, customary, and reasonable charges. Thus, in the scenario of the $2000 medical charge, if the insurance company only allowed $1600 as the usual customary and reasonable fee, the company would pay 80% of $1600, or $1280 (assuming a preventative paid deductible). Their arbitrary determination would increase your copayment accordingly from $400 (20% of $2000) to $720.
Blue Cross Health Insurance Texas
Types of Insurance Companies
People tend to view Blue Cross Health Insurance Texas as a monolithic whole, with no difference among companies, the policies they offer, or the premiums they charge. The truth is quite the opposite. Insurance companies come in a wide variety of types and sizes and, as we shall see, many approach business and sometimes fundamentally different ways.
Stock Companies
Stock companies are just what the name implies: companies that are owned by stockholders. Like other corporations, stock insurance companies are managed by a board of directors. In theory, the board serves at the discretion of the shareholders. In real life, individual shareholders have a minute impact on the company’s management policies or personnel.
Being a for-profit capitalistic concern, Blue Cross Health Insurance Texas will pay dividends to the stockholders when it is profitable. However paying stockholders is one thing and benefiting policyholders is quite another. In fact, the profitability of stock companies usually of little direct consequence to the people who buy insurance from them and who don’t specifically benefit from their success. There may, however, be an indirect benefit to policyholders. For example, a company that is doing well may lower premiums (highly unlikely) or, more commonly, raise them more slowly. When there company’s profitability is poor, on the other hand, policyholders definitely suffer—in increased premiums. In fact, the many industry critics have charged that the horrible premium inflation that Blue Cross Health Insurance Texas consumers have suffered through in recent years got its start when insurance company investments turned sour. A good example of a stock insurance company is Allstate Insurance.
…Continued in Health Insurance Fort Worth TX
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