Member Month

Medical services and Health insurance are among the most growing areas in the Insurance industry. Individuals and businesses opt to purchase insurance policies to safeguard them for financial losses that they may suffer from the occurrence of a variety of hazards in the future. Insurance companies assume all the risks that are covered in the policies that is why more and more people think it’s wise to invest on something such as obtaining insurance policies that will protect them against any financial burden. Insurance providers offer insurances to the public by individuals or by groups. Surveys and census are conducted to determine the population of the insured and uninsured individuals per state. Insurance companies apparently have records of their members which they also use to determine their competitiveness in the insurance industry as well as to evaluate the number of people who take part of the member month.

What is a member month?
A member month is the overall population of individuals for each month who participate in a health plan as a member. This is a record of membership which insurance providers use to measure their performance in the insurance market and to see if they can meet health plan claims from their consumers. The number of participant health insurers have demonstrates how they effectively carry out their businesses. A member may enroll and withdraw his or her health plan enrollment for some reasons. One of the most important roles that health plan providers play in the industry is to ensure that they provide benefit according to the stipulations in the contract policy and the premiums charged. This way they can keep members insured under their health insurance policy. Insurance plans and premiums are evaluated and implemented from the member month possessed by an insurance provider. The member month, since it depicts the overall members every month allows the insurance providers to calculate or estimate potential health claims which they are by law required to satisfy.

Insurance companies keep their participants included on the member month as long as the coverage is still effective. There are cases or instances when an employee loses the qualification to be covered in the health plan. However, there is a law which protects people from being denied of health insurance coverage after the termination of employment. COBRA is specifically designed to allow employees to stay covered in the health plan even if there are grounds which make them ineligible for the health coverage. COBRA can lengthen an employee’s stay or the dependents, in the health plan to 18 months if the health coverage ineligibility arises from termination of employment or reduction of hours. During one of these months of extension, the member is still part of the total number of participants embraced in the insurance company’s member month. Health insurance providers in this case are expected to provide the benefits to the members whose coverage is extended by the law. The right to keep the health coverage is absolute and the members are entitled to keep the coverage once already insured.