As Globe Gallops Into Vaccine Trials, Insurers Remain Unfazed | Top News

By Noor Zainab Hussain, Carolyn Cohn and Ludwig Burger

LONDON/FRANKFURT (Reuters) – The world is racing towards a vaccine in record time, stirring public concerns about safety to the extent that nine leading developers have felt compelled to issue a pledge to uphold scientific standards and testing rigour.

Yet, while more than 40 experimental COVID-19 vaccines are being tested on humans, the insurance companies with decades of experience in assessing the risks of clinical trials don’t see anything to be unduly concerned about.

Executives at insurer Allianz and brokers Gallagher and Marsh, among the leading players in clinical trials insurance, told Reuters that premiums had only marginally increased so far in the current pandemic.

They argued there was little structural difference to trials carried out in the past, despite drugmakers around the world competing to shatter the fastest time in history for developing a vaccine, which stands at around four years.

“Rates have been relatively stable. Even this year we have so far seen only moderate price increases on average, with higher price jumps for particularly exposed COVID-19 trials,” said Mark Piazzi, senior underwriter liability at Allianz Global Corporate & Specialty (AGCS).

This was echoed by David Briggs, managing director, life sciences practice at Gallagher, who said every trial was rated on its methods and the kinds of patients involved.

Gallagher said premiums in Britain, for example, started at about 5,000 pounds ($6,500) per trial.

Total claims limits in policies were typically set at roughly $6-12 million, depending on the country’s rules, according to several insurance companies interviewed by Reuters.

In Britain, for instance, claim limits were usually set at no lower than 5 million pounds, while in Germany the figure was around 10 million euros ($11.8 million).

‘LOSS EXPERIENCE NOT DRAMATIC’

However part of the reason why premiums have not risen as sharply as some people might have expected is that claims from trial are generally uncommon, according to executives. This is because patients have often signed so-called informed consent agreements, they said.

Jim Walters, managing director of Life Sciences & Chemical Group at broker Aon, said such agreements outlined the risks that patients were taking by participating in the trial.

“So, you know, everything from you could have a sore spot on your arm. To you could potentially die. And you know, they would literally go that far in some of these protocols,” he added.

“Those generally tend to hold up in courts and in legal systems around the world. That means that the loss experience coming out of clinical trials is not very dramatic.”

Claims are often limited to circumstances linked to the improper conduct of trials or any wrongdoing, rather than side-effects of the treatment, executives said.

Such have been the worries about the vaccine race among some members of the public, who fear safety standards could slip, that nine developers issued a joint pledge last month to “uphold the integrity of the scientific process”.

ASTRAZENECA TRIAL SUSPENSION

AstraZeneca and Oxford University’s suspension of global Phase

Health Insurers Lay Groundwork For Biden And ‘Medicare Advantage At 60’

Health insurance companies are expanding Medicare Advantage health plan offerings to seniors in hundreds of new counties for 2021 as new regulations allow for new benefits and the program becomes more popular.

But these health plans could also be establishing a beachhead for perhaps an even bigger draw of seniors if a Joe Biden White House successfully convinces Congress to lower the eligibility of Medicare to 60.

As the presidential campaign heats up in its final month, Biden is stepping up talk about his healthcare proposal that includes allowing Americans between the ages of 60 and 64 the option of buying into Medicare, the federal health insurance program for the elderly. The proposal is considered less costly than earlier versions proposed by Democrats in the U.S. Senate to lower Medicare eligibility to as young as 55 or even 50 and is expected to allow private insurers to offer Medicare Advantage at a younger age just as they do now for existing eligible Medicare beneficiaries.

Meanwhile, the Trump administration supports Medicare Advantage but doesn’t have a plan to lower the age of eligibility. Health insurers aren’t weighing in on a general election presidential endorsement, but advocates and lobbies to expand Medicare Advantage see potential to expand if eligibility widens to more Americans.

“With Medicare Advantage’s steady growth in enrollment and the increasing evidence of its value through better costs and better outcomes for beneficiaries, it would be our expectation that any proposal to extend Medicare to more beneficiaries would include a strong role for Medicare Advantage,” says Allyson Y. Schwartz, who is president and CEO of the Better Medicare Alliance, which includes an array of business, community, health groups and insurers like Humana, CVS Health, parent of Aetna, and UnitedHealth Group.

Insurers began last week announcing their expansions in new regions ahead of the annual open enrollment period when seniors eligible for Medicare can choose new benefits or stay with their existing plans. Such changes can be made during Medicare’s open enrollment, which runs Oct. 15 through Dec. 7.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs.

Every state in the U.S. offers Medicare Advantage and choices of plans are soaring with practically every major plan offering options that include “$0 Medicare Advantage 2021 premiums.” 

Among those that have already announced their Medicare Advantage expansions include Cigna, Humana, UnitedHealth Group and newer companies like Alignment Healthcare, which said last week it is offering 36 Medicare Advantage options

Some Insurers Stop Waiving Fees or Deductibles for Telemedicine

Some people will have to start paying more out of their own pockets for telemedicine appointments, if their virtual visits with doctors are unrelated to Covid-19 and are needed to monitor conditions like diabetes or to check out sudden knee pain.

Two of the largest health insurers, Anthem and UnitedHealthcare, are no longer waiving co-payments and deductibles for some customers beginning on Oct. 1. People who have been relying on telehealth to steer clear of the emergency room or a doctor’s office during the coronavirus pandemic will need to check with their insurers to see how much they will now owe for a virtual visit.

Just how much people who paid nothing before will now have to pay will vary widely, depending on the type of visit and the details of their insurance policy. But you might have the same $25 co-payment to see your doctor over video as you do when you go to the office, and you could even be on the hook for the cost of the entire visit if you have not yet met your deductible.

While a virtual visit is likely to be much cheaper than going to an emergency room, you could end up paying anywhere from $55 to $92, the average cost of a lengthy telemedicine visit within your plan’s network, according to an analysis of insurance claims by FAIR Health, a nonprofit group.

The changes in insurance policy were first reported by STAT news.

In the early months of the coronavirus crisis, the federal Medicare program and private health insurance companies wanted to encourage people to use alternatives to in-person care by talking with a doctor over video or by telephone. They relaxed many of the rules for seeking virtual care, and many waived the co-payments that would normally be charged for those appointments.

But some of the largest insurers, like Anthem and UnitedHealth Group, were reluctant to commit to extending the waivers beyond the fall, despite the caseloads across the country that still amount to nearly 45,000 a day. And people are still wary of in-person care. Many continue to shy away from a hospital’s emergency room and rely on other options, including telemedicine, according to a recent analysis by TransUnion Healthcare. In areas where Covid cases surged, as they did this summer in Arizona, Florida and Texas, people turned to telemedicine, according to a study by Harvard researchers published last month.

“There are still individuals who are vulnerable under any definition that should not be navigating the health system, for their own safety,” said Shawn Martin, the chief executive of the American Academy of Family Physicians, describing the timing of the decision to stop the waivers as “inopportune.”

“The downward economic pressures on families are only building,” he said, noting that there are indications that people are already forgoing needed care during the pandemic. While the co-pay might be only $35, people will be tempted to put off contacting a doctor, he said.

The nation’s major insurers have drawn stiff