Health Insurance: Comparing Blue Cross and Blue Shield Plans with Commercial Insurers : Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives

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U.S. General Accounting Office, 1986 - Health insurance - 53 pages
 

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Page 1 - Nor is an organization operated primarily for the promotion of social welfare if its primary activity is operating a social club for the benefit, pleasure, or recreation of its members, or is carrying on a business with the general public in a manner similar to organizations which are operated for profit.
Page 8 - Code provides for the exemption from federal income tax of civic leagues or organizations not organized for profit but operated exclusively for the promotion of social welfare. Section 1.501(c)(4)-l(a)(2)(i) of the Income Tax Regulations provides that an organization is operated exclusively for the promotion of social welfare if it is primarily engaged in promoting in some way the common good and general welfare of the community.
Page 1 - An organization is operated exclusively for the promotion of social welfare if it is primarily engaged in promoting in some way the common good and general welfare of the people of the community. An organization embraced within this section is one which is operated primarily for the purpose of bringing about civic betterments and social improvements. A "social welfare" organization will qualify for exemption as a charitable organization if it falls within the definition of "charitable...
Page 5 - I should mention that, unlike the Blue Cross and Blue Shield Association, the Health Insurance Association of America...
Page 11 - Association, the Blue Cross and Blue Shield Association, and the Health Insurance Association of America.
Page 52 - Health Insurance Association of America 1025 Connecticut Avenue, NW Washington, DC 20036-3998...
Page 13 - ... payments were shown on the HCFA bill itemization lists for deductions from the HMOs' capitation payments. There is no comparable provision for Blue Shield to pay doctors' bills on behalf of the HMOs. As requested by Representative Smith, we did not obtain comments from HHS or the HMOs on this report. Except as noted above, our work was done in accordance with generally accepted government audit standards. ^An internal control mechanism to advise the paying agents that patients are eligible for...
Page 5 - As agreed with your office, we are sending copies of this report to the Commissioner of the Social Security Administration and the Director of the Office of Management and Budget.
Page 39 - the economic value of insurance policies is determined by the percentage of premiums returned to the insured in the form of benefits.
Page 23 - We cannot accept that the facts presented support the conclusion that there are more similarities than differences between Blue Cross and Blue Shield Plans and commercial insurers.

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