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For A Not-For-Profit, Plenty Of Surplus To Go Around

Home News Tribune / MyCentralJersey.com — Saturday, September 26, 2009

Letters to the Editor

During three separate times in my life I lost my health insurance when I was laid off as a result of company downsizing, at which time I enrolled in an individual Horizon/Blue Cross plan. My premiums grew significantly higher each time I needed insurance, while my benefits became increasingly less. I was therefore surprised when I recently learned that Horizon is a not-for-profit carrier.

I understand that health care costs have risen, but as a policyholder of a non-profit company, I have valid reasons to wonder where the company's surplus goes and why, with such a high surplus, is there a need for an increased rise in premiums that are already too high.

Southshorehealth.net reported that Horizon received a 127 percent increase in surplus from 2000 to 2004 and that the company's CEO alone, received earnings of $3,438,455 in 2004, which included a $2,614,455 bonus that I would think could have better been used to offset premium costs.

While I would hope the CEO and top executives in any company would be fairly compensated, these payouts seem high for a company that is receiving substantial tax deductions for its non-profit claims. Also, it is high for a company claiming that premiums are based only upon rising medical costs. And it's far too much compensation for executives of a non-profit company that has many consumers who are struggling to maintain their monthly payments.

Five years after these reported figures, I am paying $565 a month for a less than substantial policy that includes high copayments and deductibles. And for at least one of my network doctors, my copayment is all he receives, as Horizon pays nothing.

This, plus reports that the CEO donated $23,700 last year to politicians who are not prioritizing health care reform from the consumer's standpoint, gives me further reason to wonder where this company's surplus is going?

As if these figures weren't enough, I also learned that Horizon is considering converting from a not-for-profit to a profit organization. While the state will benefit from additional tax dollars, I fear Horizon executives would be further compensated at the further expense of consumers.

I am naturally concerned with this company's immediate impact on my premiums, as there is an unbalanced correlation between the company's surplus and my rates and benefits. I especially wonder how Horizon has little, if any, restrictions on what it will pay its executives, yet it has severe limits and loopholes attached to what it will pay out to doctors and policyholders.

On the wider scale, I am even more concerned about the need for a public option in the pending health care reform bill. If Horizon is an example of what can qualify as a non-profit carrier, then without a public option to keep these companies honest by holding them to certain criteria, we can only expect more of the same.

If you are also concerned, you can contact your members of Congress (www.visi.com/juan/congress) to ask where they stand in supporting a public option and what requirements would be placed on a non-profit carrier if reform was left to the private sector.

MAUREEN TAGLIAFERRO
Middlesex

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