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Related Essays on Becket Theme Comparison. 371 words - 2 pages. Waiting for comparison essay Godot is a way for short Beckett to criticize literature. He tries to deconstruct the meaning of words, and contrast essay conclusion image that is created by them. Short. Lucky?s speech does that as well as he makes fun of the formal debate language, and references to literary critics. We also fail to know who or what Godot, and Beckett hints that his neither name nor any other name really matters at all. Comparison. Becket also suggests that those trying to find meaning shouldn?t for there is nothing to pattern be done.
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Prakash Basyal CA. Santosh Kumar Jha CA. Prakriti Tuladhar CA. Bikram Khadka CA. Santosh Ghimire RA. Kedar Nath Paudel Binod Neupane Satyendra Sharma Satyam Superviso. 28370 words - 114 pages. DRAFT ACTIVITY GUIDE BOOK FOR NCSC 2010 -2011 Focal Theme: LAND RESOURCES: USE FOR PROSPERITY, SAVE FOR POSTERITY Sub-Theme: 1. KNOW YOUR LAND 2. FUNCTIONS OF LAND 3. LAND QUALITY 4. ANTHROPOGENIC ACTIVITY ON LAND 5. SUSTAINABLE USE OF LAND RESOURCES 6. COMMUNITY KNOWLEDGE ON LAND USE Coordinators? Note At the outset we thank Dr. R. N Ray and his team of NCSTC Network and Dr. D. K Pandey of RVPSP/DST, GOI for entrusting us with the task of comparison conclusion organizing and conducting the pak china relations brainstorming workshop for contrast the preparation of activity guide NCSC 2010-11 This year a large number of renowned scientists.
2955 words - 12 pages. ?ILLUSORY SUPERIORITY? OR ?CULTURAL DIVISION IN AMERICA? By Sean Flaherty Copyright © 2010 TABLE OF CONTENTS Page 1 - Title Page Page 2 - Table of Contents Pages 3-12 ? Final Project Page 13 - Works Cited and pattern research Images Pages 14-15 - Appendix According to recent Am. 22147 words - 89 pages. Contrast Comparison. ARTICLE IN PRESS Tourism Management 29 (2008) 403?428 www.elsevier.com/locate/tourman Progress in Tourism Management Event tourism: De?nition, evolution, and research Donald GetzA Haskayne School of Business, University of Calgary, 2500 University Ave. N.W., Calgary, Alberta, Canada T2N 1N4 Received 24 April 2007; accepted 31 July 2007 Abstract This article reviews ?event tourism? as both professional practice and a ?eld of academic study. The origins and paper evolution of research on contrast essay event tourism are pinpointed through both chronological and thematic literature reviews. A conceptual.
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How to Write a Conclusion for a Compare & Contrast Essay | The Pen
Writing a web application with Ruby on Rails. Unless you have lived under a rock for the past 5 years or so, you should have already heard of Ruby on contrast Rails. Behavioral? In this article, we’ll write a very simple web application to show its power and speed of conclusion development. We’ll cover the following topics: install Ruby install the rails gem how to start a new rails project directory structure of a rails project how to manage data with a database use already available components to short essay on advantages of internet, handle common tasks add CRUD resources improve the app flawlessy. The following section offers a very quick overview of the tools you need to get started with Ruby on Rails development. If you already have a working rails environment, excluding the default ruby installation that some operating systems have, then feel free to skip the steps. If you run Linux or MacOSX on your computer, you may already have Ruby installed by default, however these kind of installations are out of date (eg: ruby 1.8.x) and essay conclusion, gems are difficult to relations essay urdu, manage. The best way is to install it manually or just use some tool that helps to manage custom Ruby installations, even multiple versions (eg: 1.9.x and 2.0.0 releases). Instead of repeating what others have already said, here are some useful guides:
MacOSX: Ruby on Rails development with Mac OS X Mountain Lion. Follow the steps until you reach Install SQLite3 section, we’ll see here how to install rails. Linux: Setup Ruby On Rails on essay conclusion Ubuntu 13.04. Same as above, follow the steps until you reach Configuring Git . Is Hamlet Crazy? Windows: SQLite3 Ruby 2.0 on Windows and Getting Started with Git and GitHub on Windows. I haven’t too much experience on windows, so keep the finger crossed and/or ask on the same forum thread. The Ruby community is very kind #128578; Now, you should have all the requirements to get started. Bundler is a Ruby gem that helps you to contrast, manage development dependencies in a project. We’ll see how it works later, for now, just install it:
We’re going to behavioral resume, use the upcoming new version of rails. At the time of writing (mid June 2013), it’s the 2nd Release Candidate but, according to its author, it should be stable enough. A Simple Web Application to Manage and contrast conclusion, Share Bookmarks. Someone says that doing it is the best way to learn , so here’s a less common tutorial app: a simple platform to manage or share bookmarks. It’s nothing fancy, but it’s enough to apply some basic concepts. Moreover, aren’t you bored of pattern research todo lists and contrast essay, blog engines over and over? #128578; When you install rails, it comes with a bunch of is hamlet other libraries and/or command line tools. The main one is rails . For now, we’ll use it to generate the initial skeleton:
I’ve also passed some arguments to the command: bookmarks : is the name of our project. -T : skip Test::Unit files. It’s not fundamental for our purpose (but they are in the everyday Ruby and comparison conclusion, Rails development), so I skipped them because testing is an argument apart and I don’t want to overcomplicate this article. -d sqlite3 : we want to use SQLite database. It fits perfectly for our purposes. Please note that, Rails has support for paper, a wide variety of databases, even NoSQL ones. It’s also common to contrast essay, have different database engines based on the environment (eg: SQLite for development, MySQL or PostgreSQL for production, etc…) without code changes. -B : don’t run bundle install , we’ll do it manually later. Once you run the command, you should see a long list of lines that explain what is happening: A new directory called bookmarks (or whatever project name you passed) has been created, along with a set of files and directories inside it. Enter this directory, we’ll see the important contents during the article. A first look at Bundler and Gemfile. We mentioned Bundler as a tool to tree, manage development dependencies in a Ruby app. It works by reading a file called Gemfile that should be present in comparison conclusion the root directory of the app.
You need this to make sure all the required gems are installed, even rails itself. Here’s a brief look at behavioral the Gemfile generated by the rails new command: As you can see, this is the default list of contrast essay conclusion gems you need to start working on a Rails project. Of course, you’ll change it very often to add, remove or upgrade gems. Now you can finally run bundle install (the command we skipped by specifying -B ): If you use git , this is a good moment to initialize the essay repo and proceed with the initial commit. Even if you haven’t yet wrote any line of contrast comparison conclusion code, you can already use the Rails development server. Run the following command: then point your browser to http://localhost:3000 and professionalism essay, you’ll get a standard welcome page.
This time we’ve used rails server , another useful command offered by comparison conclusion, Rails, moreover, it works only when you run it inside a Rails project folder. Essays? We’ll see other useful commands later. A quick introduction to MVC patterns and Rails. Rails is usually defined as an contrast comparison essay MVC framework . Pattern Research? Basically, it means that the essay conclusion app behaviour is defined in this way: Model: manages data between the rest of the application and the database. You can define how a single entity behaves, this includes data validation, before/after save hooks, etc… Controller: this is the glue between the data managed by the Models and the rendered Views. Http requests that come to relations essay, your app, are routed to a controller which usually will interact with one or more models and finally renders the ouput along with an contrast conclusion Http response. View: the crazy essays final output for a request. It’s usually a piece of HTML, but it might also be JSON or XML.
We’ll see this later. This is, of course, an over-simplification, but it should be enough to get a vague idea of how it works. I’ll dive into some details later. The goal of our app is to manage bookmarks, right? So we’ll need to create our Bookmark resource: This time, we’ve used rails generate , one of the most useful commands.
In this case, we’ve generated a scaffold that creates all the necessary files and comparison, code to automatically get a full MVC stack that manages a Bookmark . Pattern Research? In the next few paragraphs, we’ll see in detail what the above command did. We’ve specified that a Bookmark record is contrast essay conclusion made of a title and a url fields, both of type string (255 chars by default). So, the short of internet rails scaffold generator has automatically created a migration script to comparison conclusion, update your database schema: db/migrate/db/migrate/20130614142337_create_bookmarks.rb. Even if it’s almost easy to read, this code basically means: create a bookmarks table on database (note the pluralized form) it has the fields title and relations urdu, url of type string also add timestmps by contrast, default (this is medicine essay automatically translated to created_at and updated_at datetime fields) However, your database still doesn’t know about contrast comparison essay, these changes to behavioral, the schema, you need to comparison conclusion, run the migration task: Rake is another common and useful tool in the Ruby world. It acts like a Makefile in a Ruby fashion. Rails comes with several rake tasks ready to use (you can also create custom ones, if needed): The model representing a bookmark was created in app/models/bookmark.rb , at the moment it’s almost empty in terms of code, but it already knows how to behave with the database.
To demonstrate this, we’ll use another Rails command to resume, open a console : Now, we have a shell to manually issue commands to our rails app. Let’s see if it knows something about our Bookmark : It knows about the bookmarks table, its fields and how to query the database. Ok, create one Bookmark : The BookmarksController and its views. We said that the scaffold generator has created all the parts of the MVC stack, now is the contrast essay conclusion time for the controller in app/controllers/bookmarks_controller.rb . You’ll see a BookmarksController class and a bunch of methods (called actions ). Each action corresponds to an HTTP PATH (eg: /bookmarks ) and an HTTP verb (GET, POST, PUT, DELETE). The autogenerated code is quite clear and, for brevity reasons, I can’t dive too much in to it. The interesting parts are: nowhere in the code is specified how to render views.
There’s a reason for that: HTML views are based on the controller’s actions names. For example, BookmarksController#show will render a template placed in app/views/bookmarks/show.html.erb . Of course, only the behavioral actions that respond to HTTP GET have a template, the contrast essay rest are usually redirects. Check the contents of app/views/bookmarks/ yourself to get an tree idea. Comparison Conclusion? it looks like there’s some automagical JSON support. That’s true, rails supports HTML and JSON request by default, I’ll show you this later. The final component for the MVC stack is about routing the HTTP requests to the proper controller and action. To make this, the Rails generator has updated config/routes.rb file and has added the description line resources :bookmarks that is a shorthand to essay conclusion, say: use REST routes for essay, the the resource bookmark . Contrast Comparison? If you’re wondering what routes are available, you can use the relative rake task : Now, the essay fun part.
Restart your rails server with rails server and go to contrast conclusion, http://localhost:3000/bookmarks. If you followed the above example in paper console, you should already see the Bookmark created earlier, otherwise, you can create a new one by clicking on contrast conclusion New bookmark link. Try http://localhost:3000/bookmarks.json and crazy essays, see what you’ll get. You still haven’t wrote a single line of Ruby, and it already does a lot of things. Essay? Awesome, isn’t it? #128578; Once we have the Bookmark resource, we need Users that own bookmarks and a way to authenticate them. The Ruby and Rails community is very active: whatever the task is, you’ll probably find at least one gem to do it (if you don’t, it might be a good idea to is hamlet essays, write one). Luckily, user authentication is contrast comparison essay conclusion a very common task, and there are several options. The most used is Devise, let’s use it. Open Gemfile and add this line: We also told Bundler to use a version of Devise that should be greater_or_equal than its minor version (eg: 3.0.1 is ok, 3.1.0 isn’t).
Run bundle install to install the gem: and run the Devise generator: As you can see, it has created two files under config/ directory: config/initializers/devise.rb : here you can change several Devise settings. However, we’ll use defaults because they are enough. Medicine? config/locales/devise.en.yml : this file contains i18n translations for Devise. Comparison Essay Conclusion? Please note that config/locales/ is the default path to put all the locales for is hamlet crazy essays, a Rails app. Devise also told us to check five steps to complete the contrast essay setup: add config.action_mailer.default_url_options = to config/environments/development.rb define a root_url in config/routes.rb . Fow now, we can achieve this by pointing BookmarksController#index to the root of the crazy essays site: add the two pieces of html in contrast essay conclusion app/views/layouts/application.html.erb . Crazy? This file is the main layout your Rails app. skip the contrast conclusion fourth step because we’re running a Rails v4.0.x app, not a 3.1.x one) generate the Devise default views with rails generate devise:views . They contain a basic scaffold to description, get Devise to contrast conclusion, work (eg: login/signup forms, etc…). Short Essay Of Internet? Please note that Devise has several features concerning user authentication and registration, but we’re going to use only a small set of comparison conclusion them, so don’t panic if you see a lot of generated views. Setup for Devise is is hamlet crazy done, but we still haven’t a User model, we need to contrast comparison essay, create one: If you remember the scaffold generator we used to generate a Bookmark , this one is very similar even if just focused on the model, plus the route that tells Devise to handle /users/* paths.
In fact, it created a migration for users and the User class. Edit the relations migration to look like this (remove or comment the essay rest): Also the model needs to reflect the changes made to the migration: The last step, is to run the migration with rake db:migrate. In this way, we have a simple authentication system that lets a user to professionalism medicine essay, register, login and contrast conclusion, logout. Try to run rake routes and you’ll see the new routes for these actions, all referred to users . You can also play in crazy the Rails console to create some users. Now that we have User and Bookmark , we need to contrast conclusion, associate them. In this case, it’s a one to behavioral resume, many relationship.
As a shared convention, foreign keys name are made of the model name suffixed by _id . Contrast Comparison? Of course, we’ll not change the short on advantages of internet already created migrations, instead, we’re going to create a new one: Choosing an contrast essay appropriate, arbitrary name is not mandatory, but it’s a best practice that you should follow. Our generated migration will add a user_id integer column to the bookmarks table. Also, feel free to run the migration now. At the moment, none of our two rails models knows about each other, we’ve only added a field on the database, but it’s meaningless without some additional instruction: add has_many :bookmarks to app/models/user.rb add belongs_to :user to app/models/user.rb. With these changes, a User instance will automatically have a bookmarks method (and many others), referred to all Bookmark records with that specific user id . Require authentication to manage your bookmarks. Looking at the models, it looks like the data part is pak china complete and working.
However, the BookmarksController created by the scaffold command doesn’t apply any authentication check, it needs some fixing. First of all, check user authentication before executing whatever action: This means that, from now on, each request that arrives to the BookmarksController will first check if a user is authenticated ( authenticate_user! is contrast comparison essay conclusion a method provided by Devise), otherwise it will be redirected to the login page. Then, access only bookmarks owned by the authenticated user. To do this, replace Bookmark occurrencies with current_user.bookmarks . Paper? As you may wonder, current_user is an object provided by Devise that represents the authenticated user, while .bookmarks is the method provided by the model association between User and Bookmark models. If you haven’t played with the web interface yet, now is comparison essay a good time to do it.
Here are some hints: At the moment, we have several areas where a wrong user input might damage you application: providing incomplete or malformed data when creating a new Bookmark requesting a bookmark id that doesn’t exist as a record on the database, for example by short on advantages, visiting http://localhost:3000/bookmarks/111, will cause an error in your app, very ugly to see. Let’s see how to solve these issues. If you tried to use a password shorter than 8 chars or a bad formatted email during user registrations, you’d note that Devise has spotted those errors by not saving the record and contrast essay, rendering the user registration form again. In fact, Devise provided some default validations for pattern research paper, users, but our app needs validations on the Bookmark model too. Contrast Conclusion? Change app/models/bookmark.rb to look like this: These validations are self-explanatory, so I’ll not dive into them. Essay? Just keep in mind that there are many others or, in this case, you can create custom ones. The second problem we addressed is about passing a wrong/non-existent identifier for a given resource.
You can handle it in contrast comparison many ways, perhaps the simplest (and laziest) one is to redirect to the index, with a flash message . Short Of Internet? To do this, we only need to contrast, change some line of research code in BookmarksController : The set_bookmark is a method called in a before_action only for actions that need a resource id (show, edit, update, destroy). The new lines will safely check for existence in the database, otherwise the user will be redirected to conclusion, the root path of the site, with a short flash message. Improving the app one step at pak china a time. Our app is almost complete, or at conclusion least, it lacks several little details that make a difference. We’ll try to address some of these. The goal, is to demonstrate how to improve an existing app with small steps. This is a simple task. All we need is a new route, controller and view. This time, we’ll use a generator dedicated to the controller:
I’ve omitted the output because at the moment you should be able to guess what it does. In short, it has created a SiteController with an action called index , plus the related view in app/views/site/index.html.erb and essay, a new route in config/routes.rb . Contrast Essay? However, the route should be changed to reflect our goal: If you try to load http://localhost:3000 you’ll see the empty template of app/views/site/index.html.erb . To render content, we need to change the controller in app/controllers/site_controller.rb : while the view in essays app/views/site/index.html.erb , might contain this basic markup as a starting point: Again, note how the controller processes the contrast comparison conclusion request by retrieving some records from the database through the model Bookmark , then renders its view that contains the proper data to show the bookmarks. Being a programmer, I’m not too skilled in design and layouts, but there are several CSS frameworks that help a lot. Instead of picking the famous Twitter Bootstrap, I chose ZURB Foundation, just to be fancy.
The last step is to fix the contrast conclusion Bookmarks form, it wasn’t updated by the other generators, we’ll do it manually by overwriting its (partial) template in app/views/bookmarks/_form.html.erb with the following content: It would be nice and professional to show a welcome page for non-registered users. Essay Urdu? To keep things simple, I’ll use the comparison essay conclusion same SiteController#index used for the root page. Modify app/views/site/index.html.erb to look like this. Congratulations!
Andrea is also an active member of the essay Italian Ruby community. Behavioral? He helped in the organization for contrast essay conclusion, Ruby Days (2011, 2012) and coached at the first Italian Rails Girls event in Rome. Great Article ! A must for starters and newbies ! Great article – one thing I noticed… add has_many :bookmarks to app/models/user.rb. add belongs_to :user to app/models/user.rb. add has_many :bookmarks to app/models/user.rb. add belongs_to :user to app/models/bookmark.rb. Awesome article.
I was searching a good guide for tree description, Rails4. Great Article.I tried this and got the contrast essay results but when I restart the system I am getting an description essay error called. NoMethodError in Site#index. Showing /Users/sailakshmi/Plackal/Workspaces/plackalwbapp/app/views/site/index.html.erb where line #15 raised: undefined method `username’ for nil:NilClass. Thanks for comparison, writing this. Question about adding the line in the bookmarks_controller `before_action :authenticate_user!`.
How is this visible? You say it is research paper part of Devise, but how is Devise making this method visible? Awesome! Shows the power of essay conclusion rails. Pattern Research Paper? Incredible. It Helped me in my independent study . Thanku:) Beginner’s Tutorials for Developing with Ruby on Rails CSS 3 HTML 5 Links und Infos. […] Ruby on Rails Web Application […]
Nice article. Contrast? short n sweet,, great article for starters. thanks. Fantastic article.Helped a lot.Thanx. Install Ruby on essays Rails on Windows guide | egeek. […] get started developing your first Ruby application, I highly recommend this guide by comparison essay conclusion, Andrea […] You make it sound a lot easier than it actually is I am sure. Essay On Advantages? I hope to use this myself for an app I am working on for finding easy meals to cook online. Thanks for contrast essay, the headsup I will use this myself.
Cheers. very useful for students. Under “Adding users and authentication”, … “Devise also told us to check five steps to complete the setup:…” Step 2 is unintelligible to me as a Rails newb: “define a root_url in config/routes.rb. Fow now, we can achieve this by pointing BookmarksController#index to the root of the site: Bookmarks::Application.routes.draw do # […] root ‘bookmarks#index’ Bookmarks::Application.routes.draw do # […] root ‘bookmarks#index’ in config/routes.rb it errors out. Looking at the checkin, what appears to relations, go in here is contrast comparison essay conclusion simply: Why not just have that in this section instead of essay urdu something which errors out and confuses newbs?
It’s gum on the shoe of an otherwise very good How To. Due to the age of this post, I ended up using rails 4.2.0 and devise 3.4.0 instead of 4.0.0.rc and comparison conclusion, 3.0.0.rc as specified above. Might be good to professionalism essay, update this since there is a bug in devise 3.0.0.rc with ‘merge’. Great article, thanks! Thanks for putting this together. i come from (amongst) the MS ASP.NET MVC and was looking for contrast comparison, a compact demo so i could explore more afterwards myself. mission accomplished! IT Trends Blog Archive Scurtul ghid al unicornului din Ruby on description essay Rails.
[…] Getting started with Rails tutorial.(11) […] Excellent tutorial ! Thanks ! (however I got a final error : ActionView::Template::Error (couldn’t find file ‘foundation’ …) Not easy to solve for a beginnner… I’m amazed, I must say. Contrast Comparison Conclusion? Rarely do I come across a blog that’s both equally educative and amusing, and without a doubt, you have hit the tree description nail on the head.
The issue is comparison essay conclusion something that too few people are speaking intelligently about. Now i’m very happy that I came across this in my hunt for something regarding this. Great article, I was trying to learn Rails for sometime and mind you this is the pattern research only article with no errors when followed step by step. I just got one error with User_id not being reflected…. Contrast Comparison? I can live with that :P. Anyways, Great article. I spent a lot of time debugging a “Could not find devise-3.0.4 in any of the sources” error. Turns out that if I write: in the pak china essay Gemfile instead of: 13 Best Ruby on Rails Tutorials for Beginners | ThePixelBeard.
[…] 7. Writing a Web Application with Ruby on Rails […] undefined method `destroy’ for nil:NilClass. Extracted source (around line #57): respond_to do |format| Application Trace | Framework Trace | Full Trace. dude , i think you have missed. Great work . Love it.
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How to Write a Conclusion for a Compare & Contrast Essay | The Pen
50 Inspiring Resume Designs: And What You Can Learn From Them. Your resume or CV may be one of the most important projects you ever design. Contrast! It can make or break job applications, open doors to new careers, make a great (or dismal) first impression. When you send out your resume, you’re really sending out a piece of yourself. So make sure it’s representing you to your best advantage. Just like how you dress your best for an interview, it’s important to paper give your resume the contrast comparison essay, same treatment — to research paper make sure it’s polished and presentable. The 50 resume designs below span a wide range of styles, from contrast comparison conclusion strictly businesslike to ultra creative — browse through them to get some ideas for updating your own resume.
Designing your own is easy with our wide collection of beautiful resume templates. Pattern Research Paper! Click the image to see more resume templates. Starting off your resume strong with a bold header, like in this design by Shed Labs for contrast conclusion Loft Resumes, draws attention to your name and makes it more memorable. You can also include a few keywords or descriptors under your name that sum up who you are as a candidate. This chessboard-style layout is certainly striking, giving each category its own distinct space. But Mikha Makhoul’s resume is still somewhat subdued thanks to the simple black-and-white color scheme; it doesn’t sacrifice professionalism for visual interest. Some well-placed shadows can make your resume pop, literally — giving it a 3D appearance and creating the medicine essay, illusion of contrast depth. Errol Veloso explains how he chose the colors of his design purposefully: blue to symbolize his creative side and pattern research red to symbolize his analytic side. Comparison Essay! Try using shapes and frames for tree emphasis.
You can experiment with geometric shapes (circles, squares, rectangles), ribbons, or solid or dashed lines. Here, Michael Long frames his name and his role to help them stand out. Conclusion! A cohesive color scheme of cool blues and pattern research minty hues gives this information-packed, infographic-style resume by Joseph Acena a visual theme and an orderly, coordinated look. Using a horizontal orientation (instead of the traditional vertical format) immediately gives your resume an contrast comparison, edge in terms of pattern attracting attention. Other strong points of contrast comparison conclusion this design by Justin Schueler include a balanced, un-crowded layout and pak china essay plenty of negative space. There seems to be a trend, at least in industries where you can take some risks with your resume, to forget the stuffy business lingo and show that there’s a human behind the piece of paper. Using a more conversational tone, as David Elgena has done with his “Hello, nice to meet you. Here’s a little about me” header at the top of this resume, may help you create rapport with the person who’s reviewing your application before you even meet them.
This resume by Kyle Robertson features a custom crest with Kyle’s name and a catchy tagline. Creating a distinctive personal brand or style for conclusion yourself (such as a personal logo, a color scheme, a nice selection of fonts, etc.) gives your work an extra sheen of professionalism (and an opportunity to show off your abilities). Plus, once you put the work in, this “brand” is pak china something you can use over and over again — on letterhead, business cards, social media profiles, you name it. For a unique take on contrast comparison traditional resume colors, try light text on on advantages a dark background, as Abdullah Al Mamun has done here. Just make sure that your font is weighty enough to be easily readable and not get lost against conclusion, the background. This clean resume by Patrick Rogan uses a bright splash of color and whittles down the information to only the basics (skills and pak china relations urdu past positions). Icons in the skills section provide a visual reference that still complements the simplistic style. Printing your resume on textured paper can give an impression of contrast comparison essay quality, craftsmanship, or luxury.
If a color other than white seems inappropriate for your industry, try a white or cream-colored paper with a slight texture for research an ultra-professional, upscale look. This example by S.N. Carter, printed on a recycled or kraft-style paper, gives the resume a custom, hand-printed feel. When applying for a position where a more creative approach isn’t appropriate, it’s always a safe bet to opt for a simple, text-based resume with clean fonts. Here, Frank Schamhart has embellished his resume slightly with minimal use of an accent color and a small personal portrait.
If you’re after a job in the arts or some other highly visual industry, make your resume a mini portfolio like illustrator Rianti Hidayat has done here. Bradley Brooks keeps his resume businesslike with a classic black-and-white color scheme, but livens things up with a modular layout and a personal logo. Infographic-style resumes have become popular, and they can be effective when done well. But they should be more than a collection of comparison essay pretty pictures; the images should, at a glance, tell something about you and complement or enhance the text, like in this resume design by Rachel Winter. If you’re seeking work in an industry where appearance is medicine important, or the job has asked you to include a portrait, try integrating it into your resume. It doesn’t have to comparison essay conclusion be the center of attention, though — you can make it a bit more subtle by using a small picture or placing it behind a colored screen, like in is hamlet Egotype’s resume template. Mailing out some resumes? Make opening yours up a memorable experience, like Amber Van Mieghem has done with this clever folding resume. Wishing you could infuse a little creativity into essay, your plain, corporate resume? Try a monogram with your initials, like Bill Mawhinney has done for this resume template.
It adds a little style while still keeping the resume, overall presentation very businesslike. You can use the same graphic on comparison your cover letter to professionalism give your application a polished, pulled-together look. Contrast Comparison Essay! If you have some creative leeway in creating your resume, using a non-rectangular shape will be sure to attract attention, like John Mujica’s round resume does here. If you do format your resume in any unusual shape, just make sure all the text is readable. Pak China Essay! You’ve only got one name. Make it memorable. If it’s unique, highlight it. Make it big and bold, like Fredrik Andresen did on his resume. Give the hiring manager something to essay zero in on. Your font choices can change the resume, whole character of your resume.
For instance, the contrast essay conclusion, rounded fonts with soft edges that Louis Omari has used for his resume have a more casual, friendly feel than sharper, serif fonts might have. Need to show your qualifications on on advantages the run? Post your resume online and make it mobile-friendly, like Julien Renvoye has done. You can include your resume on your personal website or even post it to networking platforms like LinkedIn. Use blocks of color and/or lines to separate different sections of your resume, give it structure, and contrast make it easy to navigate visually.
This template from Beautiful Resumes features vibrant colors, but you could just as easily get the same effect with a more subtle color scheme. Pak China Relations Urdu! If you’re going the contrast comparison, infographic route, think of effective ways that you can use different types of graphs to represent your skills, experience, or background, like Martin Suster did here. Organizing your resume with columns, like this three-column layout Anton Yermolov used, keeps the on advantages, information tidy, creates clear divisions between sections, and helps you keep everything sharply aligned. Use a sidebar in your resume to call attention to extra (or extra important) information that you want to comparison essay conclusion highlight. Here, Ola Hamdy used a colored sidebar to separate her personal and essay urdu contact information from her educational and conclusion professional details. Research! Although this resume design is text-heavy, Gershom Charig mixes things up with a two-color scheme and a word cloud to comparison essay creatively represent the breadth of his skills and tree description essay experience.
Similar in function to the word cloud above, various sizes of circles represent Silviu Schiau’s proficiency in various areas, such as management and conclusion design. Essay On Advantages Of Internet! The size of the circles corresponds with his amount of experience — a fresh way to contrast essay illustrate core competencies. Essay Urdu! Give the person looking at your resume an excuse to find out contrast comparison essay conclusion more about you. Including a link to your website or portfolio (or even a QR code, as Krysten Newby has done here) acts as a good prompt. If your job history includes working for big companies with recognizable logos, feature them on your resume. Tamas Leb has included space to do so on this resume template, and it makes an impressive statement, even at is hamlet a glance. For creative resumes, a theme can give you a starting point to build a one-of-a-kind design and think about innovative ways to present your information. Here, Peter Kisteman’s laboratory theme makes a strong visual statement and gives his artistic background a scientific, experimental dimension. Putting your resume in a folder or other kind of holder gives you more space to showcase your experience and accomplishments, plus the extra tactile feature makes it memorable, as with this design from S1M.
The vertical timeline on the outside offers an immediate visual representation of the candidate’s career history. This traditional black, white, and gray design by essay conclusion Brice Seraphin brightens up quite nicely with some turquoise as an accent. This can be done with any color (and you may want to tone it down depending on your industry), but vibrant hues have particular impact. Besides being another nice example of using an accent color, this design by Adam Rozmus keeps things clean and simple, showing that resumes don’t have to be fancy to make a good impression. If competition is stiff, try standing out with a resume package that gives you some space to on advantages of internet demonstrate your abilities, develop a personal brand, and include more information than the limited area of a one-page resume allows for. Here, Sabrae Precure uses a distinct color scheme and custom illustrations to stand out from the crowd. Contrast Conclusion! This resume by Gabriel Valdivia combines a traditional format (the typical positions, dates, and short descriptions) with pictorial elements that provide a more personal touch. As if to say that a normal paper resume just won’t cut it, Alison Root got clever with her resume presentation, which demonstrates that she thinks outside the box. This sample resume from pattern Rahul Chakraborty features bold typography and bright colors for a high-impact look that will make people take notice. There may be times when it’s ok to contrast comparison essay conclusion let your sense of humor shine through in your resume; it makes you more relatable, more likable.
For instance, check out the pronunciation guide Nick Iannuccilli provided for short of internet his difficult last name. Using a border is a good way to add a little bit of color to your resume, as Evelien Callens has done here, without worrying about looking unprofessional. Stylistically, this design is a good compromise between customary and more creative resumes. The two-color, mostly traditional layout uses graphic elements sparingly but purposefully. As a nice touch, Dan Hernandez has branded his cover letter with the same style, which is a smart idea if your job application involves submitting multiple documents. Sometimes you have to do what you can to contrast essay get noticed. For an illustrator like Lucia Paul, hand-drawing her resume is both appropriate for resume her industry and gives her a standout way to contrast comparison conclusion display her skills. Big, bold typography, a high-contrast color scheme, and a well-organized presentation all combine to make sure Joao Andrade’s resume gets looked at. Professionalism! No long-winded explanations of job roles here. Just the essentials — enough to contrast get someone interested in wanting to know more about on advantages, Gianina Santiago and her background.
Clean, sans-serif fonts, relatively little text, and lots of contrast comparison essay white space give Maxat Malbekov’s resume a sleek look that’s easy to achieve if you condense your resume down to essay only the most relevant information. If you have a lot of information you need to fit on one page, take a tip from this design by Halle Rasco and contrast essay conclusion use easy-to-read fonts and clear headings for each section. Need to keep your resume fairly conservative? A two-column layout with a businesslike blue-gray accent color gives this otherwise traditional resume from ResumeBaker some extra interest. Professionalism Medicine Essay! Syril Bobadilla’s illustrations are whimsical and kid-friendly, and her resume reflects that style. Notice how she also created matching business cards for a cohesive personal brand. Even if your industry doesn’t allow as much creative expression as someone in the arts, you can express your personality in more subtle ways, like through font choices or an accent color.
Resumes don’t always have to read from left to comparison essay conclusion right, top to crazy essays bottom. You can play with the layout of your resume to make the best and conclusion most visually interesting use of the space you have available, like Milena Filipova has done here. You can use a grid structure to organize your resume and make it easier to navigate, similarly to relations essay how Orlando Silva designed this template. Comparison Conclusion! If applicable, you might also try including some pieces from essay your portfolio right on the resume (so your abilities are on display at first glance). As you can see from the examples above, there are many approaches you can take to contrast comparison essay conclusion designing your resume.
But no matter what style or format you choose, there are a few things you want to make sure to get right: Readable text Industry-appropriate style (if unsure, play it safe with a conservative design.) Updated and description essay accurate information No spelling/grammar errors. Now it#8217;s your turn. Essay Conclusion! Put these skills into pak china, action! Bring great design to comparison conclusion your entire workplace. On Advantages Of Internet! Janie is contrast essay conclusion a freelance writer and graphic designer and the owner of Design Artistree Creative Studio. Short Essay On Advantages Of Internet! After college, she built on her background in contrast conclusion art to behavioral explore design. and contrast comparison essay loved it. Behavioral Resume! Now, she enjoys finding ways to contrast essay conclusion combine the tree description, craftsmanship of conclusion traditional fine arts with the digital possibilities of graphic design.
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Comparison and Contrast Essay: Block Method
CO-OP health plans: patients’ interests first. By Louise Norris healthinsurance.org contributor August 27, 2017. It’s been a rough few years for the ACA’s Consumer Operated and Oriented Plans. There were 23 CO-OPs when the first open enrollment period got underway in the fall of 2013, but by contrast essay conclusion, the beginning of 2016, only 11 of them were still operational. By July 2016, four additional CO-OPs – in research paper Ohio, Connecticut, Oregon, and Illinois – had failed. And in contrast comparison essay September, Health Republic Insurance of New Jersey stopped offering new plans and announced that their existing plans would terminate at the end of behavioral 2016 (unlike the comparison essay conclusion other CO-OPs that have failed, state regulators in New Jersey were initially saying that it might be possible for Health Republic to be rehabilitated enough to is hamlet crazy essays, return to the market in 2018, but that ultimately was not the case, and an order of liquidation was filed in February 2017). In December 2016, more than a month after open enrollment began for 2017 coverage, Maryland regulators announced that Evergreen Health CO-OP would not renew or issue individual market plans for 2017, leaving just five CO-OPs offering coverage in 2017 (Maryland regulators made an administrative order in conclusion July 2017 that is expected to lead to receivership for pattern research Evergreen Health). In June 2017, Minuteman Health announced that they would no longer offer coverage as a CO-OP after the end of contrast comparison 2017.
Their intent at that point was to reopen in 2018 as Minuteman Insurance Company (and to have plans available for sale during open enrollment in the fall of tree description essay 2017 under that name), which was to have been a for-profit insurer rather than a CO-OP. But by mid-August, they had failed to raise enough capital by the deadline to secure a license to sell coverage for 2018, and contrast essay, would not be able to re-open as Minuteman Insurance Company in 2018. Behavioral Resume! Minuteman Health has been placed in receivership by contrast, the Massachusetts Division of professionalism medicine essay Insurance, and their plans will terminate at the end of comparison essay 2017. After all the closures, there are just four CO-OPs slated to offer coverage in 2018, in five states: Maine, Montana, Idaho, New Mexico, and Wisconsin. The CO-OP failures have been due in professionalism medicine large part to a combination of comparison conclusion premiums that were too low, benefits that were too generous, enrollees who were sicker than anticipated, competition from bigger carriers with larger reserves, the risk corridor shortfall that was announced in the fall of 2015, and the risk adjustment payment announcements that were made in June 2016 (see below for a timeline of the closures). The Trump Administration’s approach to essay of internet, health care reform, and GOP lawmakers’ efforts to essay conclusion, repeal and short essay on advantages of internet, replace the ACA (via bills written in secret that bypass the normal bipartisan committee process), have further increased the uncertainty that insurers are facing, making the situation even more precarious for small insurers like the remaining CO-OPs. 2018: 4 CO-OPs selling plans in 5 states.
There are four CO-OPs that are expected to offer plans in five states in 2018. Although the vast majority of the original CO-OPs have failed, these four are showing signs of overall stability. It’s important to contrast comparison, note, however, that if the Trump Administration continues to cause uncertainty and instability in the insurance markets (including Trump’s recent threats to pattern research, cut off federal funding for cost-sharing reductions), the remaining CO-OPs will be among the most vulnerable. Community Health Options (CHO) This was originally called Maine Community Health Options, but the name was changed to reflect the carrier’s expansion outside of comparison essay Maine. 44,000 people enrolled in coverage through the exchange in 2014, and 83 percent of them selected Community Health Options, making the professionalism medicine CO-OP’s first year an amazing success. CHO expanded into New Hampshire for 2015, fueled by their initial success in 2014 and by a new loan from comparison essay CMS. During the crazy second open enrollment period, CHO once again dominated the Maine market, securing about 80 percent of the exchange market share. They also enrolled about comparison 5,000 people in New Hampshire. However, CHO reported significant losses in the third quarter of 2015, and decided to limit enrollment in individual plans for 2016. Enrollment directly through Community Health Options ceased December 15, 2015; enrollment in Community Health Options plans through Healthcare.gov ceased December 26. CHO ended 2015 with $74 million in losses – a far cry from the profitable year they had in 2014.
In early 2016, Maine’s Insurance Superintendent proposed putting the CO-OP in receivership and essay, canceling a portion of its plans (about 20,000 members would have been transitioned to comparison, other coverage). But CMS didn’t allow that, saying that the pak china relations essay urdu plan cancellations would run afoul of the ACA’s guaranteed-renewable provision. Contrast Comparison Essay Conclusion! The CO-OP is under increased oversight from the essay Maine Bureau of Insurance, which puts out monthly reports that detail how the CO-OP is faring relative to its business plan. According to contrast comparison essay conclusion, the July 2017 report from the Bureau of Insurance, CHO’s net income in is hamlet essays May 2017 was considerably lower than projected, but year-to-date claims were running just about as-projected. CHO is the comparison essay only remaining CO-OP that received money—as opposed to essay, having to pay out money—under the risk adjustment program for 2015 and again for 2016. Contrast Comparison Conclusion! For 2017, Community Health Options had an average rate increase of 25.5 percent in Maine, where bulk of their members live. They exited New Hampshire entirely at research paper, the end of contrast essay 2016, and tree description essay, reverted to operating solely in Maine, as they did in 2014. They have proposed roughly a 20 percent average rate increase for 2018 in the individual market, where they have about three-quarters of their membership. Their total membership was 67,539 at the end of 2016, and had dropped to 44,015 by the first quarter of 2017 (all in Maine, since they’re no longer offering plans in contrast conclusion New Hampshire). Mountain Health Cooperative Montana Health CO-OP started in Montana, and expanded to Idaho in 2015.
The CO-OP seems to be on relatively solid financial ground. CEO Jerry Dworak noted that the is hamlet crazy essays CO-OP didn’t expand too quickly, and comparison essay, maintained substantial reserves; they were not relying as heavily as other CO-OPs on risk corridor payments to resume, shore up their financial position. Average rates for Mountain Health CO-OP in Idaho increased by 26 percent for 2016. For 2017, Mountain Health CO-OP’s average rate increase is 29 percent in Idaho, and 31 percent in Montana. As of December 22, 2016, the CO-OP ceased enrollments in Montana due to the “large number of contrast comparison essay conclusion new members for 2017.” The enrollment freeze was lifted in medicine July 2017 for off-exchange enrollments; on-exchange enrollments in Montana were expected to become available in the summer of contrast essay conclusion 2017 as well. In both cases, this was ahead of schedule, as the CO-OP had originally expected the lift the relations enrollment freeze as of November 1, at the start of open enrollment. In another indication of the CO-OP’s increasing viability, their average proposed rate increase for 2018 is only 4 percent in Montana. Comparison! This demonstrates that the 31 percent average rate increase for 2017 may have been enough to stabilize the CO-OP and “right-size” the is hamlet crazy essays premiums. New Mexico Health Connections The CO-OP had net earnings of $420,000 in the first quarter of 2016, as opposed to conclusion, a loss of $2.3 million in the first quarter of 2015. By the end of the 2016 open enrollment period, New Mexico Health Connections had more than 50,000 members, and the CO-OP had added several big-name employers, including Goodwill Industries of resume New Mexico, Youth Development Inc., and Heritage Hotels Resorts.
NM Health Connections has said that they weren’t counting on significant payments from the risk corridor program in 2015, so the essay conclusion shortage didn’t hurt them as much as it hurt other carriers. New Mexico Health Connections dropped their PPO plans for 2016 in order to focus on plan designs that allow them to better control costs. Several big-name carriers around the country took a similar approach in 2016, and PPOs are less common than they once were in the individual market. For 2017, New Mexico Health Connections had an description average rate increase of 33 percent, before any exchange subsidies are applied. They have filed an average rate increase of 30.1 percent for comparison 2018 (much lower than the 84 percent average rate increase they initially filed; the lower rate filing came about once it became clear that other insurers would not be exiting New Mexico’s market and the CO-OP did not have to description, insulate themselves against a flood of new enrollees). But their average rate increase could be even lower still, and the CEO noted in July that the CO-OP’s proposed rate increases were in the 20 to 25 percent range.
Common Ground Healthcare Cooperative – The CO-OP offers coverage in 19 eastern Wisconsin counties. The approved weighted average rate increase for Common Ground for 2016 was 18 percent. The CO-OP had 23,629 enrollees in Wisconsin in contrast comparison 2015. For 2017, the pattern research CO-OP had an comparison essay average rate increase of 12.6 percent. And after losing money from 2014 through 2017, Common Ground Healthcare posted a positive net income of $2.7 million in the first quarter of 2017. 2015 risk adjustment: 9 of crazy 10 CO-OPs owed payments.
Under the ACA’s risk adjustment program, health insurers with lower-risk enrollees end up paying money to health insurers with higher-risk enrollees. Contrast! The idea is to prevent insurers from designing plans that appeal only to tree description essay, healthy enrollees, and to ensure that premiums reflect benefit levels, rather than the overall health of comparison a plan’s enrollees. On June 30, 2016, HHS released data on risk adjustment numbers for 2015. Of the essay urdu 10 CO-OPs that were still operational at that point, nine had to pay into the risk adjustment program for 2015; only contrast comparison essay, one remaining CO-OP – Community Health Options in relations urdu Maine and New Hampshire – received a risk adjustment payment. Comparison Conclusion! Community Health Options received about $710,000 in tree description risk adjustment funds. Some of the contrast comparison essay conclusion remaining CO-OPs had begun to be profitable in pattern paper early 2016 (details below), but all of the CO-OPs’ financial situations now have to be considered in conjunction with the fact that the CO-OPs will have to pay out the following amounts in risk adjustment payments, making their financial futures even more uncertain (of the nine CO-OPs that owed money in 2016 for the risk adjustment program, six have closed or are facing impending closure; only the CO-OPs listed in contrast comparison essay conclusion bold continue to professionalism medicine essay, be fully operational) Mountain Health CO-OP/Montana Health CO-OP (Idaho and comparison conclusion, Montana): $481,000 Oregon Health CO-OP (Community Care of short on advantages of internet Oregon): $914,000 ( closed; plans ended July 31, 2016 ) Common Ground CO-OP (Wisconsin): $1.9 million Minuteman (operates in Massachusetts and contrast, New Hampshire, but risk adjustment outlay was for NH; MA operates its own risk adjustment program): $11 million (Minuteman has filed a lawsuit against CMS in an effort to “invalidate the illegal Risk Adjustment methodology and institute necessary changes immediately.” Minuteman Health is in on advantages receivership, and will stop offering coverage at the end of 2017 ) New Mexico Health Connections : $14.6 million. NM Health Connections filed a lawsuit against HHS in August 2016 over the risk adjustment program, requesting that the comparison essay conclusion program be halted until improvements could be made. Healthy CT: $13.4 million ( closed; plans ended December 31, 2017 ) Evergreen Health CO-OP (Maryland): $24.2 million (Evergreen filed a lawsuit to block the collection of the risk adjustment payments; a district judge denied the CO-OP’s request on July 21, and the CO-OP immediately appealed the decision; Between $2 million and $3 million of the risk adjustment payment was to be withheld by CMS in mid-July from funds owed to the CO-OP for premium subsidies and cost-sharing reductions, and the remainder of the payment had to be remitted by Evergreen by August 15). Evergreen notes that they would have profited between $2 million and $3 million in 2016 if it weren’t for the $24 million they had to pay into behavioral resume, the risk adjustment program. As a result of the losses, they began the process of being acquired by private investors and comparison conclusion, converting to a for-profit entity (this process ultimately didn’t happen fast enough for Evergreen to be able to sell or renew individual plans for 2017; in essay on advantages July 2017 the investors terminated the acquisition, and Maryland regulators began the process that’s expected to lead to receivership for essay conclusion Evergreen Health ). Tree Description Essay! Land of comparison Lincoln (Illinois): $31.8 million (the state ordered Land of Lincoln to withhold payment until if and when the CO-OP receives the behavioral money they were supposed to get in 2015 for the 2014 risk corridors program.
That tactic didn’t work however, and on July 12, Illinois regulators began the process of closing Land of Lincoln Health, and the CO-OP was placed in liquidation as of October 1, 2016 ). Comparison Conclusion! Freelancer’s CO-OP (Health Republic Insurance of New Jersey): $46.3 million ( in September 2016, regulators placed Health Republic in rehabilitation, and the CO-OP stopped selling new plans ; the risk adjustment payment — which was much more than they had previously been advised it would be — was cited as a primary reason for the CO-OP’s financial instability). HHS has proposed changes to the risk adjustment program for 2018, to make it more equitable and less burdensome for new, smaller carriers. Pak China Relations! They’ve also indicated that states can make regulatory changes before 2018 to ensure a more functional risk adjustment program. 2016 risk adjustment: 4 out of 5 remaining CO-OPs once again owe money. On June 30, 2017, HHS published the risk adjustment report for 2016. Maine Community Health Options was once again the only remaining CO-OP that will receive funding under the conclusion risk adjustment program; they’ll get $9.1 million. The report also details the amount that insurers owe or will receive for 2016 under the ACA’s temporary reinsurance program (2016 was the crazy last year for the reinsurance program). All five of the remaining CO-OPs will receive money from the 2016 reinsurance program, but in most cases, it’s not as much as they’ll have to pay out contrast comparison, under the risk adjustment program. Maine Community Health Options — the only remaining CO-OP receiving funding under the risk adjustment program — will also receive $21 million under the 2016 reinsurance program, which is far more than any of the other CO-OPs will receive. Common Ground CO-OP has to pay $3.7 million in risk adjustment (but will receive $10.5 million in reinsurance) Mountain Health CO-OP/Montana Health CO-OP has to essay, pay $8.3 million in risk adjustment (but will receive $2.9 million in reinsurance) New Mexico Health Connections has to pay $8.9 million in risk adjustment (but will receive $3 million in reinsurance) NM Health Connections sued the federal government in 2016 over the risk adjustment program, but so far, the system is still set up in a way that ultimately ends up taking money from smaller, newer insurers and giving it to larger, more established insurers. Minuteman, which is closing at the end of 2017, has to pay $25.4 million in risk adjustment for 2016 (but will receive $3 million in reinsurance).
Notably, they owed far more in essay conclusion 2016 risk adjustment than any of the other remaining CO-OPs. They explained in short essay of internet June, in contrast comparison essay conclusion conjunction with their announcement that they would no longer be a CO-OP after 2017 (at that point, they hoped to relations urdu, re-open as a for-profit insurer, but that plan was scrapped when they were unable to raise enough capital to secure a license for 2018), that the amount they had been forced to pay into contrast comparison, the risk adjustment program amounted to about a third of the premiums they had collected. In May 2016, after extensive input from relations urdu stakeholders, HHS issued new regulations in an effort to help the remaining CO-OPs become financially viable. Due to the urgency of the situation, the regulations took effect almost immediately, on May 11. The new regulations make a variety of changes that make it easier for CO-OPs to seek outside investments and expand their coverage offerings beyond the individual and small group markets: In the contrast comparison past, there were relatively strict rules governing the make-up of CO-OP boards. CO-OP board members could not be representatives or employees of any federal, state, or local government entity, and they could also not be representatives or employees of any health insurance carrier that was operational as of July 2009. These rules were established to professionalism, prevent conflicts of interest among CO-OP board members (for example, an contrast comparison essay employee of a competing insurance company might have a conflict of research paper interest and might not make decisions solely based on the best interests of the CO-OP).
The new regulations relax these rules, as HHS has discovered that the contrast essay rules were too strict, and were preventing well-qualified experts from behavioral joining CO-OP boards. The new regulations allow government employees and representatives to be on CO-OP boards as long as they’re not in contrast essay senior or high-level positions in the government. And employees or representatives from already-established insurers can be on CO-OP boards as long as they’re affiliated with insurance carriers that don’t compete in the individual and small group markets where CO-OPs operate. The old rules also required all of a CO-OP’s board of directors to be elected by CO-OP members, and also required all members of the board of directors to also be members of the CO-OP. The new regulations allow for some leeway here too. Professionalism Medicine! Only a majority of the board members must be elected by CO-OP members, and board members are no longer required to be members of the essay CO-OP. Pattern Paper! This allows outside entities that are providing loans, investments, and services to the CO-OP to essay, have representatives on the board of directors, and is hamlet crazy essays, will – in essay theory – make it easier for CO-OPs to attract new investments . HHS notes that including investor representatives on boards of directors is short essay on advantages of internet, a common practice in the private sector. The old rules made it difficult for CO-OPs to find willing and qualified individuals to serve on their boards of directors, and the old rules allow them to seek outside experts to provide assistance via being on the board of directors. The CO-OPs will still be member-driven though, as the majority of board members must still be elected by CO-OP members. New Mexico Health Connections announced in 2016 that they planned to work with Raymond James, a New York based investment firm, to essay, raise “a substantial amount” of funding for New Mexico Health Connections.
Maryland’s CO-OP, Evergreen Health , was working to raise $15 million by August 2016, and by July, the CO-OP had come to agreements with eight guarantors to front more than half of that $15 million. But Evergreen Health later opted for the ultimate private investor arrangement, with plans for private investors to acquire the CO-OP in 2017. Is Hamlet Crazy Essays! If that had worked out, the insurer would still have been called Evergreen Health, but would have been a for-profit entity and no longer a CO-OP. Ultimately, the new arrangement didn’t receive federal approval in time to continue to offer coverage for 2017, and Maryland’s Insurance Commissioner announced on contrast, December 8 that Evergreen would not sell or renew any individual plans for 2017. Essay! They had planned to contrast comparison essay, return to the individual market in 2018, but the private investors terminated the pattern paper acquisition in July 2017, and Maryland regulators imposed an essay administrative order that is expected to pak china essay, lead to the CO-OP entering receivership. Contrast Comparison Essay! The ACA requires that at least two-thirds of a CO-OP’s policies must be issued in the individual and pak china, small group markets in contrast essay conclusion the state where the CO-OP is licensed. Originally, the rule was that CO-OPs that ran afoul of that provision would have to repay their federal loans immediately.
The new regulations allow for more leeway: CO-OPs that aren’t meeting the two-thirds rule don’t necessarily have to repay their loans immediately, but they do have to demonstrate a plan for behavioral getting into compliance with the two-thirds rule, and be acting in conclusion good faith to achieve that standard (most CO-OPs only resume, operate in the individual and essay conclusion, small group markets thus far, but HealthyCT in research paper Connecticut is an exception – they offer large group plans in addition to individual and small group plans). The new flexibility allows CO-OPs to enter into other markets – including large group, Medicare, Medicaid, and ancillary products such as dental and vision, without having to comparison essay conclusion, be overly concerned with running afoul of the two-thirds rule and triggering an immediate payback requirement for federal loans. Under prior rules, CO-OPs weren’t allowed to sell their policies to another insurer. So when 12 CO-OPs failed by behavioral resume, the end of 2015, the only option was to send their members back to the general market – on or off-exchange – to seek new coverage. The new HHS regulations allow insolvent CO-OPs to sell their policies to another insurer, although the transaction would have to contrast essay conclusion, be approved by CMS. The idea here is to professionalism medicine, preserve coverage for existing members if additional CO-OPs fail. Membership surpassed a million enrollees by 2015, but has declined sharply with CO-OP closures. During the 2014 open enrollment period, just over 400,000 people enrolled in CO-OPs nationwide.
That climbed to over a million by the end of the 2015 open enrollment period – despite the fact that CoOpportunity (Iowa and Nebraska) stopped selling policies in December 2014, and essay, their once-robust enrollment (120,000 members) had dropped to about 2,000 people by professionalism medicine, mid-February 2015. While enrollment in private plans through the exchanges increased by 46 percent in 2015 (from 8 million people in the first open enrollment period, to 11.7 million in the second open enrollment period), enrollment in CO-OPs increased by 150 percent. At the end of 2015, however, more than 500,000 of those enrollees had to essay, switch to professionalism medicine essay, a different plan, as 11 of the contrast essay 22 remaining CO-OPs closed at the end of 2015. Is Hamlet Essays! In May 2016, Ohio regulators announced that InHealth Mutual would be liquidated, leaving just ten remaining CO-OPs nationwide. And only three of them are not currently subject to enhanced federal oversight: New Mexico Health Connections, Mountain Health Cooperative (Montana and Idaho), and contrast comparison essay conclusion, Minuteman Health, Inc (Massachusetts and New Hampshire). The other eight CO-OPs still in operation are all under “corrective action plans” from the federal government.
Seven of the eleven CO-OPs that were still operational at the end of essay on advantages 2015 had at least 25,000 enrollees as of mid-2015, which is the minimum number that CMS says is necessary for financial solvency. The other four had not yet achieved that benchmark by comparison essay, early 2016, and two of them—in Oregon and description, Ohio—were among the four CO-OPs that had failed by July 2016. Of the remaining six CO-OPs, five had membership in excess of contrast essay conclusion 25,000 people as of mid-2015. CMS recognized that, in a competitive marketplace, CO-OPs would face challenges. The agency acknowledged that more than one-third of the CO-OPs would likely fail in the first 15 years. CMS projected a 40 percent default rate for the planning loans and a 35 percent default rate for pak china the solvency loans. Contrast Comparison Essay! But with only five of tree 23 CO-OPs slated to still be in business by the end of 2017, the failure rate is comparison, 78 percent, after three and a half years of operations. In terms of recent enrollment totals for the remaining CO-OPs: Common Ground CO-OP had 19,300 members in 2016 Mountain Health CO-OP/Montana Health CO-OP had roughly 15,000 members in Montana in 2016, and added 10,000 new members for 2017. Behavioral! They also have members in Idaho. Contrast Essay Conclusion! New Mexico Health Connections membership had grown to 50,000 by 2016 Community Health Options: 44,015 members as of the first quarter of 2017.
In addition, Minuteman Health (which will no longer exist as a CO-OP after the crazy essays end of 2017) has 37,000 members in Massachusetts and New Hampshire in 2017, and Evergreen Health (which is under an comparison essay administrative order that is expected to lead to receivership) has 25,000 members in essay on advantages of internet Maryland. A look at the CO-OPs that are facing impending closure. In addition to contrast, the four CO-OPs described above that intend to continue to offer coverage in pak china relations essay 2018, two other CO-OPs are still operational in 2017, but will no longer exist as CO-OPs in 2018: MASSACHUSETTS and NEW HAMPSHIRE Minuteman Health Inc. ( will close at the end of 2017 ) Enrollment exceeded 22,500 in the first quarter of 2016, and the CO-OP ceased its advertising campaign in contrast essay an effort to avoid enrolling too many members. The CO-OP had a profitable first quarter of 2016, as opposed to the $3.8 million loss they suffered in the first quarter of pattern research paper 2015. By April 2016, Minuteman’s enrollment had reached about 26,000 people, which was an 85 percent increase over contrast conclusion, 2015 enrollment. Is Hamlet Crazy! More than 21,000 of Minuteman’s QHP enrollees are in New Hampshire, and the state also has more than 3,400 Premium Assistance Program (privatized Medicaid) members with Minuteman coverage. All Minuteman Health enrollees in New Hampshire and comparison, Massachusetts will need to secure new coverage for 2018, as the essay CO-OP is closing at the end of 2017. MARYLAND Evergreen Health Cooperative Inc. (group coverage only in 2017; (no longer allowed to sell or renew any policies under an administrative order that is “a preliminary step to an anticipated receivership”) Enrollment was under 30,000 at the end of 2015, and had grown to 40,000 by March 2016. Evergreen had its first-ever profitable quarter in the beginning of 2016, with a net income of $547,000. Comparison! That’s compared with a loss of professionalism $2.3 million in the first quarter of 2015.
For 2015, Evergreen Health CO-OP lost money, as did all of the CO-OPs. But their loss was the smallest of the 11 remaining CO-OPs, at $10.8 million. In 2016, Evergreen would have been profitable for the full year, except for the $24 million they had to pay into the risk corridor program for comparison conclusion 2015. For 2017, Evergreen had proposed an average rate increase of just 8 percent, but regulators ultimately approved an average rate increase of more than 20 percent. Evergreen owed CMS $24.2 million in risk adjustment funds for 2015, which is more than a quarter of the pattern carrier’s total revenue. Conclusion! They had worked out an arrangement under which they would be acquired by private investors and converted to a for-profit (ie, not a CO-OP) insurance company, but the investors terminated the acquisition in research July 2017, leading state regulators to determine that the CO-OP was no longer financially viable. The following CO-OPs had already closed by essay, 2017: ARIZONA CLOSED Meritus Health Partners In a deviation from the norm, Meritus offered year-round enrollment outside the exchange until late summer 2015; tax credits were only available inside the exchange, and regular open enrollment dates applied to plans purchased in the exchange. Meritus was among the worst-performing CO-OPs in terms of 2014 actual enrollment as a percentage of projected enrollment. The HHS report showed just 869 people enrolled through Meritus as of the urdu end of 2014, out of a projected 24,000. Meritus claims that the actual enrollment total at the end of 2014 was higher (3,500) but still well short of the target number.
By August 2015, enrollment in Meritus plans had skyrocketed to contrast, almost 56,000 people. But just two days prior to the start of the 2016 open enrollment period, the Arizona Department of Insurance announced that Meritus could no longer sell or renew policies, and that existing plans would terminate at the end of 2015. Tree Description Essay! COLORADO CLOSED Colorado HealthOP – The CO-OP got roughly 13 percent of the exchange market share in 2014 (the second highest of any carrier in contrast comparison conclusion the exchange), but they lowered their prices considerably for 2015, and garnered nearly 40 percent of the exchange’s enrollees during the second open enrollment period. For 2015, they had the essay lowest prices in eight of Colorado’s nine rating areas. Colorado Health OP was also facing a shortfall from the risk corridors program, and contrast comparison conclusion, immediately began working hard to overcome it. But their efforts were not sufficient, and the Colorado Division of Insurance decertified them from the essay exchange on October 16, 2015.
CONNECTICUT CLOSED HealthyCT – The CO-OP had 15.6 percent of the market share in 2015, but dropped to just under 12 percent for essay 2016. The CO-OP raised their premiums by an average of 7.2 percent for 2016. Unlike many other CO-OPs, HealthyCT wasn’t counting on the risk corridors payout that they were owed for 2014, so the shortfall wasn’t as significant for HealthyCT as it was for behavioral resume some of the other CO-OPs. Unlike most CO-OPs, HealthyCT also sold coverage in the large group market, so they had a stronger off-exchange presence than carriers that only offer individual and small group plans. HealthyCT also built its own provider network, instead of having to rent an contrast comparison already-established network from another carrier, as many CO-OPs did. But ultimately, the CO-OP succumbed to the $13.4 million bill that they received for the 2015 risk adjustment program. In July 2016, state regulators ordered HealthyCT to stop writing new policies or renewing existing policies. The CO-OP’s 13,000 individual market insureds (most of whom had coverage through the state’s exchange) were insured through December 31, 2016, but needed to pick a new plan during open enrollment. The CO-OP’s 27,000 employer-sponsored group enrollees continued to have coverage through the CO-OP until their renewal date in 2017 if their 2016 renewal date was July or earlier. Groups that renewed in August or later had to switch to a different carrier as of their 2016 renewal date. ILLINOIS CLOSED Land of Lincoln Health The CO-OP in Illinois weathered the initial risk corridor storm, as they weren’t counting on a full payment from medicine essay CMS.
But they limited small group enrollments for the last two months of 2015, and they also capping 2016 enrollment at about 65,000 to 70,000 people (roughly a 30 percent increase over their 2015 membership) in comparison order to sustainably manage their growth. Enrollment for medicine the year had ceased by contrast, early January, as the pattern research paper CO-OP had met their membership target. During the first quarter of comparison conclusion 2016, Land of Lincoln lost $7.1 million, up from the short on advantages of internet $5.3 million they lost in the first quarter of 2015. An AP analysis of contrast essay conclusion ten of the remaining 11 CO-OPs found that all of them lost money in 2015, but Land of Lincoln Health lost the most, at $90.8 million. Nevertheless, the CO-OP is on the hook for research a $31.8 million payment for 2015 risk adjustment. In late June, state regulators ordered Land of comparison Lincoln to withhold payment until if and when the CO-OP receives the $73 million they were supposed to get in 2015 for the 2014 risk corridors program.
This move was made in an effort to keep the CO-OP solvent, but it was unsuccessful. On July 12, regulators in Illinois announced that they were beginning the process of essay on advantages of internet shutting down Land of Lincoln Health; the CO-OP will close on September 30, 2016. Comparison Essay Conclusion! A special enrollment period will allow the CO-OP’s 49,000 enrollees to pick a new plan. Essay On Advantages Of Internet! If a plan selection is made between August 2 and September 30, coverage under the contrast conclusion new plan will take effect October 1, with no gap in pak china urdu coverage. If a plan selection is made between October 1 and November 29, normal effective date rules will apply and there will be a gap in contrast comparison essay coverage. IOWA and NEBRASKA CLOSED CoOportunity Health (Iowa and Nebraska) – EDIT, 1/5/15, and 7/30/2015 : CoOportunity Health was taken over by Iowa state regulators in research late December 2014. Once federal funding ran out, it became clear that the carrier didn’t have enough money to remain viable, as reserves had dropped to about $17 million by December. At the time, HHS said that the other 22 CO-OPs appeared to still be financially viable early in 2015. CoOportunity had raised their rates considerably for 2015, although they covered about 120,000 members in Iowa and Nebraska.
Most existing policy holders transitioned to other carriers by February 15, but there were still about 2,000 members as of contrast comparison mid-February. Early in 2015, there was some hope that regulators would be able to successfully rehabilitate the carrier. But by essay on advantages, February 18, the Insurance Division announced that they would begin the process of liquidating the carrier before the end of the month, and the remaining insureds had to transition to other carriers by comparison, March 1. KENTUCKY CLOSED Kentucky Health Care Cooperative Near the resume end of the 2014 open enrollment period, Kentucky Health Cooperative had garnered 75 percent of the exchange enrollments in Kentucky . Essay Conclusion! By the end of on advantages 2014, Kentucky Health Cooperative was covering 55,852 people in the state. Conclusion! The CO-OP had planned to expand into West Virginia for 2015, but backed out just a week before open enrollment over worries that their infrastructure wasn’t ready for the new influx of members. They had planned to move forward with their expansion to West Virginia in 2016, but the West Virginia Insurance Commissioner’s office confirmed in early September 2015 that the Kentucky CO-OP no longer had plans to expand into West Virginia. As of short essay June 2015, Kentucky Health Cooperative still had more than 55,000 members, despite the fact that their premiums increased by an average of 15 percent in 2015. But Kentucky Health Cooperative also had the distinction of being the CO-OP with the most red ink in comparison essay 2014, losing $50.4 million by the end of tree 2014 (although losses had diminished considerably in 2015; by the end of the first half of the year, losses totaled just $4 million). The losses from 2014 would have been offset by contrast comparison, the risk corridors payment if it had been paid as owed ($77 million).
Instead, the of internet CO-OP was going to receive less than $10 million from the risk corridors program, and that simply wasn’t enough to sustain them. Kentucky Health CO-OP announced in early October that they would cease operations at the end of 2015. Contrast Comparison Essay! LOUISIANA CLOSED Louisiana Health Cooperative Inc. Relations! – EDIT, 7/30/2015: On July 24, the comparison essay conclusion Louisiana Department of Insurance announced that the CO-OP would be winding down its operations this year, and would not participate in the upcoming open enrollment for 2016. The existing 17,000 enrollees can remain with the carrier for the rest of 2015, and there are still enough cash reserves to cover claims for the rest of the year. Paper! MICHIGAN CLOSED Consumers Mutual Insurance of Michigan Nearly 80 percent of the CO-OP’s enrollees in 2015 were off-exchange. Contrast Essay! Michigan’s CO-OP was the last to announce failure in 2015, doing so on November 2, the day after open enrollment began for 2016 coverage. NEVADA CLOSED Nevada Health Cooperative – In late August 2015, officials at Nevada Health CO-OP announced – amid mounting financial losses and behavioral resume, “challenging market conditions” – that the carrier would be ceasing operations by the end of the year.
The CO-OP had about a third of the contrast conclusion individual enrollments in the Nevada exchange for 2015, but they had to pak china essay, switch to another carrier for 2016. NEW JERSEY CLOSED Health Republic Insurance of New Jersey (Freelancer’s CO-OP) – The CO-OP ended 2014 with 4,254 members. Contrast Conclusion! By July 2015, the CO-OP’s enrollment had exceeded 60,000 people, thanks to medicine, new plan designs and lower premiums. Rate increases for 2016 ranged from 9 percent to 18 percent. For 2017, Health Republic of NJ proposed an average rate increase of just 8.5 percent, but ultimately the carrier was placed in rehabilitation in conclusion mid-September, and had to stop offering new plans at that point. State regulators initially said that it was possible the CO-OP could return to the market in 2018, but that ultimately was not the tree description case, and comparison essay conclusion, an order of pak china urdu liquidation was filed in February 2017). All existing Health Republic plans in New Jersey terminated on December 31, 2016. Contrast Essay! NEW YORK CLOSED Health Republic Insurance of New York – The CO-OP enrolled 19 percent of the people who purchased plans through NY State of professionalism Health (the state-run exchange) during the 2014 open enrollment period. Their membership had grown to 112,000 by April 2014, and 155,000 by the end of 2014 – far surpassing their initial 2014 goal of essay 30,000 members. Behavioral! In 2015, they again garnered 19 percent of NY State of Health’s private plan enrollees, and had total enrollment of about 200,000 people by the time regulators announced in contrast essay conclusion September 2015 that the CO-OP would be closing. There were 16 carriers offering plans through NY State of Health, and only one had slightly higher market share than the CO-OP.
But Health Republic of crazy essays NY lost $35 million in 2014, and $52.7 million in the first half of 2015; their high enrollment was not a financial panacea – they enrolled far more people than expected, but that ultimately translated into losses that far exceeded projections. Contrast Comparison Essay! On September 25, state and federal regulators, along with NY’s state-run exchange, announced that they had ordered Health Republic to stop issuing new policies and prepare to terminate existing individual plans at the end of 2015. It was subsequently determined that the CO-OP was simply losing too much money to continue as a viable insurer, and coverage was terminated on description, November 30. OHIO InHealth Mutual CLOSED InHealth Mutual enrolled just 11 percent of their target membership for 2014. But that was partly because the contrast essay conclusion carrier got licensed too late in 2013 to be sold on Healthcare.gov. So instead, InHealth Mutual mainly sold off-exchange small group plans in 2014. But for the 2015 open enrollment period, InHealth Mutual was available through the exchange, and enrollment had more than doubled to professionalism medicine essay, 16,000 by mid-January. However, during the first six months of 2015, InHealth reported $9.1 million in net losses. Ultimately, state regulators announced in late May 2016 that the CO-OP would be liquidated, and that the current 21,800 enrollees would have a 60 day special enrollment period during which they would be able to switch to a different carrier. Enrollees who remained with InHealth Mutual had coverage through the end of 2016, but it was through the state guaranty fund, which means it had a cap of contrast comparison conclusion $500,000 and would subject the enrollees to the ACA’s penalty for not having minimum essential coverage.
OREGON CLOSED Health Republic Insurance of Oregon Health Republic’s failure was blamed in large part on the risk corridor shortfall, as was the case with many of the CO-OPs that failed in late 2015. Medicine Essay! In February 2016, Health Republic of Oregon announced that they were suing the federal government over the risk corridor shortfall. Their hope is to make the suit a class action case so that other insurers who were shorted by the risk corridor program can join in comparison essay the lawsuit. OREGON CLOSED Oregon’s Health CO-OP Oregon Health CO-OP is officially called “Community Care of Oregon”. It had just 1,582 members at the end of 2014.
By January 2015, their membership had grown to description essay, 10,000 people, and by April 2015, they said they were on track to hit 20,000 by contrast comparison essay, the end of the pattern research paper year, and essay, had “healthy financial reserves.” But they were expecting to receive $5 million via the 2015 risk adjustment program, and ended up owing $900,000 instead. That pushed the CO-OP into insolvent territory, and the state announced on July 8 that they were placing the CO-OP in receivership. Professionalism Essay! All Oregon Health CO-OP plans terminated on July 31, 2016. The CO-OP had 20,600 members—11,800 in the individual market, and 8,800 in the small group market. Individuals had a special enrollment period beginning July 11 to enroll in essay a new plan, with coverage effective August 1. To get an August 1 effective date, members had to pick a new plan by July 31.
Small groups worked with brokers or carriers to secure a new plan with an August 1 effective date. The state also worked out an short essay on advantages of internet arrangement to ensure that CO-OP members get credit for their out-of-pocket spending during the first seven months of 2019, even after transferring to a new carrier starting in August. SOUTH CAROLINA CLOSED Consumer’s Choice Health Insurance Company Consumers Choice had the same CEO as neighboring Tennessee’s Community Health Alliance Mutual Insurance Company, which also closed at the end of 2015. Consumer’s Choice had 67,000 members in 2015. TENNESSEE CLOSED Community Health Alliance Mutual Insurance Company (Tennessee) – Community Health Alliance had just 2,287 members at the end of 2014 – out of a projected 25,000 – and contrast comparison essay, experienced a loss of $22 million in 2014. But they lowered their premiums for 2015 and experienced a surge in enrollment (35,761 members as of May 2015). Enrollment grew so quickly during the 2015 open enrollment period that Community Health Alliance suspended enrollment in their plans as of January 15, noting that they had already met their enrollment goal for behavioral the year. They proposed a 32.6 percent rate increase for 2016, although regulators ultimately increased it to 44.7 percent in contrast essay conclusion order to preserve the CO-OP’s viability.
The CO-OP had planned to resume selling coverage during the 2016 open enrollment period, but regulators announced in mid-October 2015 that the carrier would instead be closing at the end of the year, and all members would need to transition to another carrier for 2016. UTAH CLOSED Arches Mutual Insurance Company Arches insured roughly a quarter of Utah’s exchange enrollees in 2015. The CO-OP’s on-exchange enrollment was about 32,000 people, all of crazy whom had to find alternate plans for 2016. In July 2015, HHS released financial and enrollment data for comparison essay conclusion the 23 CO-OPs, as of December 2014. The outlook based on the report was not particularly great: all but one of the CO-OPs operated at a loss in 2014, and 13 of the CO-OPs fell far short of their enrollment goals for resume 2014. Contrast Comparison! The audit called into question the CO-OPs’ ability to essay, repay the contrast loans that they received from the federal government under Obamacare. The risk corridor shortfall has been directly implicated in the failure of CO-OPs in Kentucky, Tennessee, Colorado, Oregon, South Carolina, Utah, Arizona, and Michigan. There is no way around the fact that such a significant financial blow is hard to overcome, particularly for professionalism carriers that were new to the market in contrast conclusion 2014. Eight CO-OPs failed in the weeks following the description risk corridor shortfall announcement.
Those eight CO-OPs were in serious financial jeopardy as a result of the risk corridor shortfall and comparison conclusion, other factors, and tree description, state Insurance Commissioners made the difficult decision to shut them down prior to the start of contrast comparison essay conclusion open enrollment, or shortly thereafter. It’s much less complicated to wind down operations in pak china an orderly fashion in the last couple months of a year than it is to essay, have a carrier become financially insolvent mid-year. That, coupled with the late announcement regarding the risk corridors shortfall, explains the rash of CO-OP failures announced in pattern research paper late 2015 (It should be noted that it’s not just CO-OPs feeling the pain from the risk corridor shortfall; in Wisconsin, Anthem exited the exchange market in three counties and scaled back operations in 34 other counties, partially as a result of the risk corridor shortfall. Contrast Comparison Essay Conclusion! And in Wyoming, WINhealth has exited the individual market because of the risk corridor shortfall; in Alaska and essay, Oregon, Moda nearly exited the market, due in large part to the risk corridor shortfall.) But with 12 out of 23 CO-OPs going under in 2015, it wasn’t surprising that the contrast comparison essay conclusion mood in late 2015 was relatively pessimistic regarding the behavioral CO-OP model. In his press release about the demise of Arches Health Plan, Utah Insurance Commissioner Todd E. Contrast Comparison! Kiser noted that “ It is regrettable that the co-op model has not worked across the country .” That didn’t bode well for the remaining 11 CO-OPs, and ultimately only four of resume them intend to offer coverage for 2018.
All 11 of the remaining CO-OPs suffered losses in 2015, amounting to a total of about $400 million (Evergreen lost the least, at $10.8 million; Land of Lincoln lost the most, at $90.8 million). The bulk of the losses were in the fourth quarter, indicating that consumers are trying to get as much value as possible from contrast comparison their coverage before the end of the plan year. So although a few of the remaining CO-OPs are in the black so far in behavioral 2016, their profits are very modest, and it’s unclear how the rest of the year might go. The fact that lawmakers decided at the end of 2014 to retroactively require the risk corridors program to essay, be budget-neutral was a significant blow to the CO-OPs. The CO-OPs – along with the rest of the carriers – had set their premiums for 2014 (and by that time, for 2015 as well) with the expectation that risk corridors payments would mitigate losses if they experienced higher-than-expected claims. Clearly, that has not panned out, and it certainly put the CO-OPs in a tough spot. To clarify, HHS said in 2013 that the risk corridor program would NOT be budget-neutral, and that federal funds would be used to make up any short-falls; carriers set their rates for 2014 based on that. But then in 2014, HHS announced in behavioral resume 2014 that they had made several adjustments to the risk corridor program, and that they projected “that these changes, in combination with the comparison conclusion changes to behavioral resume, the reinsurance program finalized in this rule, will result in net payments that are budget neutral in comparison essay 2014. Resume! We intend to comparison conclusion, implement this program in a budget neutral manner, and may make future adjustments, either upward or downward to this program (for example, as discussed below, we may modify the ceiling on allowable administrative costs) to the extent necessary to achieve this goal.” But this was after rates for essay on advantages 2014 were long-since locked in, and enrollment nearly complete. At the end of 2014, congress passed the Cromnibus Bill, requiring risk corridors to be budget neutral, with no wiggle room for HHS.
We do have to comparison essay conclusion, keep in mind, however, that CMS knew from the get-go that some CO-OPs would fail. They expected at least a third of them to fail in description essay the first 15 years, and that was long before the contrast comparison risk corridors program was retroactively changed to be budget neutral. What are CO-OPs and how are they different? Consumer Operated and Oriented Plans (CO-OPs) were created under a provision of the Affordable Care Act. CO-OP plans were proposed by Senator Kent Conrad (D-ND) when the original public plan option was jettisoned during the health care reform debate. Essays! Lawmakers added the CO-OP provision to the Affordable Care Act to placate Democrats who had pushed for a government-run, Medicare-for-all type of health insurance program.
At the time, progressives who preferred a public option derided CO-OPs as a poor alternative because they can’t utilize the efficiencies of scale that would come with Medicare For All, nor do they have the market clout that a single payer system would have when negotiating reimbursement rates with providers. But supporters noted that because CO-OPs are neither government agencies nor commercial insurers, they can put patients first, without having to focus on investors or Congressional politics. Instead of contrast comparison conclusion paying shareholders, CO-OP profits are reinvested in the plan to is hamlet crazy essays, lower premiums or improve benefits (in 2014, only one CO-OP, Maine Community Health Options, had revenue that exceeded claims and contrast comparison essay conclusion, administrative expenses – but the reinvestment of profits is the plan for all CO-OPs, once they become profitable). Professionalism! And customers’ health insurance needs and contrast essay, concerns become a top priority because the CO-OP’s customers/members elect their own board of directors. And a majority of these directors must themselves be members of the research CO-OP. CO-OPs are private, nonprofit, state-licensed health insurance carriers. Their plans can be sold both inside and outside the health insurance exchanges, depending on contrast comparison conclusion, the state, and can offer individual, small group, and medicine, large group plans. But they’re are limited to having no more than a third of their policies in the large group market (a more lucrative market than individual or small group). Lawmakers had originally planned to provide $10 billion in grants to get the CO-OPs up and running in contrast comparison every state. But insurance industry lobbyists and fiscal conservatives in Congress succeeded in reducing the total to $6 billion, and turning it into loans – with relatively short repayment schedules – instead of grants (and CO-OPs are not permitted to essay urdu, use federal loan money for conclusion marketing purposes). Then, during budget negotiations in professionalism essay 2011, those loans were cut by contrast comparison essay, another $2.2 billion.
And in 2012, during the of internet fiscal cliff negotiations, CO-OP funding was reduced even further – and applications from 40 prospective CO-OPs were rejected. To be approved to comparison, establish a CO-OP, applicants underwent background checks that included public records searches at the local, state, and national level as well as searches of federal debarment databases. Loan recipients are subject to pak china relations urdu, strict monitoring, audits, and reporting requirements for the length of the loan repayment period plus 10 years. Ultimately, the Centers for Medicare and Medicaid (CMS) awarded about $2.4 billion in loans to 23 CO-OPs across the essay conclusion country (there were 24 CO-OPs, but Vermont Health CO-OP never became operational. CMS retracted their loan in tree September 2013 – before the exchanges opened for the first open enrollment – because there were doubts that the program could be viable with Vermont’s impending switch to single-payer healthcare in 2017; ironically, Vermont pulled the plug on their single payer vision in late 2014). Focus on cost savings and reinvested profits. How do CO-OPs increase cost efficiencies?
CMS has laid out guidelines for CO-OPs to use “private purchasing councils” through which CO-OP carriers can use collective purchasing power to obtain lower costs on comparison essay, a variety of items and services, including claims administration, accounting, health IT, or reinsurance. But private purchasing councils are allowed to on advantages, use their collective purchasing power to negotiate rates or network arrangements with providers and health care facilities, as antitrust issues could otherwise arise. But the Kaiser Family Foundation notes that CO-OPs can emphasize Patient Centered Medical Home models to contrast comparison, keep costs down. (the PCMH model allows physicians to use health information technology and care managers to pak china urdu, provide a full spectrum of care that’s coordinated among each patient’s various providers. Essay Conclusion! The goal is to keep patients healthy – and out of the hospital – by using best practices and essay, evidence based medicine. If PCMH doctors are successful, they qualify for bonuses). CO-OPs generally emphasize preventive care in an effort to keep their members healthy. A challenge for CO-OPs has been developing their provider networks.
At least 15 CO-OPs are renting networks from other insurers, which adds to essay, their administrative expenses. In Maine, Community Health Options (the one profitable CO-OP in 2014) built its own provider network from the ground up, a move that CEO Kevin Lewis notes as one of the reasons CHO has been successful. CO-OPs also have the option to hire doctors directly, rather than contract with them through provider networks (the upside for the doctors is that the CO-OP then handles the administrative details, and is hamlet crazy essays, the doctor can focus on healthcare instead). Will the contrast comparison conclusion few remaining CO-OPs survive? It’s too soon to tell. Is Hamlet Crazy Essays! In many states, the CO-OPs started out in a David and Goliath situation, competing with carriers that have dominated the comparison conclusion health insurance landscape for years. Short Essay Of Internet! There are some promising signs from some CO-OPs that may ultimately survive long-term. And even among the contrast comparison conclusion CO-OPs that struggled early on, long-term sustainability is possible. Premiums that carriers – including CO-OPs – set for 2014 and 2015 were little more than educated guesses from actuaries, since there was very little in the way of actual claims data on which to rely (there was no data at all when the 2014 rates were being set, and only a couple months of early data available when 2015 rates were being set).
Once the CO-OPs had more than a year of claims history in the books, they were able to be more accurate in pricing their policies for pak china relations essay 2016, and contrast comparison, that will again be the case for 2017. CO-OP supporters had hoped that the new carriers would disrupt existing markets, driving down premiums and shaking up the market share among commercial insurers. Although CO-OPs struggled financially in essays their first year, average premiums market-wide were lower in both 2014 and 2015 in contrast comparison conclusion states that have CO-OPs than in states without CO-OPs. Crazy Essays! A GAO report found that average CO-OP premiums in 2014 and 2015 in most states tended to contrast essay conclusion, be lower than the average premiums across all carriers in those states. And enrollment in CO-OPs increased at a much faster pace than overall enrollment growth (across all carriers) from 2014 to essays, 2015. CMS acknowledged from the start that not all of the CO-OPs would be likely to essay, succeed – just as a crop of new for-profit health insurance carriers wouldn’t all be expected to succeed. But over the next few years, the remaining CO-OPs will have an opportunity to refine their business models, reinvest any profits they make, and pattern paper, grow their enrollment – especially as grandmothered plans cease to exist by the end of 2018, increasing the number of people who need to contrast comparison essay conclusion, purchase ACA-compliant plans. The retention of grandmothered plans has benefited health plans that were already in place prior to 2014, since enrollees on grandmothered plans had to professionalism essay, go through underwriting to obtain their coverage; on the other hand, new insurers like CO-OPs have had to contrast essay, contend with a population that’s less healthy than expected, partly because people with grandmothered plans have not yet all transitioned to research paper, ACA-compliant plans. In short, it’s too soon to contrast comparison essay, know how the CO-OPs will fare. With only four remaining as we head into the open enrollment period for 2018 coverage, the odds certainly haven’t seemed to be in their favor. But some of professionalism them may experience long-term success and become integral parts of the health insurance landscape.
In July 2015, Louisiana Health Cooperative announced that it would cease operations as of the end of 2015. LHC was the second CO-OP to comparison essay conclusion, fail; CoOpportunity, which served Nebraska and Iowa, received liquidation orders from state regulators in February. At the end of is hamlet crazy August, the Nevada Health CO-OP announced they would also close at the end of 2015. And in September, New York officials announced that Health Republic of New York, the nation’s largest CO-OP, would begin winding down operations immediately, and that individual Health Republic of NY policies would terminate at the end of 2015. On October 1, 2015 the federal government notified health insurance carriers across the country that risk corridors payments from 2014 would only amount to 12.6 percent of the comparison conclusion total owed to the carriers.
The program is budget neutral as a result of the 2015 benefit and payment parameters released by HHS in March 2014. And the pak china essay “Cromnibus bill” that was passed at essay, the end of 2014 eliminated the essay urdu possibility of the risk corridors program being anything but budget neutral, despite the fact that HHS had said they would adjust the program as necessary going forward. But very few carriers had lower-than-expected claims in comparison 2014. So the payments into the risk corridors program were far less than the amount owed to carriers – and the result is that the carriers essentially get an IOU for a total of relations urdu $2.5 billion that may or may not be recouped with 2015 and 2016 risk corridors funding (risk corridors still have to be budget neutral in 2015 and 2016, so if there’s a shortfall again, carriers would fall even further into the red). Many health insurance carriers – particularly smaller, newer companies – are facing financial difficulties as a result of the risk corridors shortfall. CO-OPs are particularly vulnerable because they’re all start-ups and tend to be relatively small. All of the contrast comparison conclusion CO-OPs that have announced closures since October 1 have attributed their failure to the risk corridor payment shortfall. On October 9, Kentucky Health CO-OP announced that their risk corridors shortfall was simply too significant to pak china, overcome. (The CO-OP was supposed to receive $77 million, but was only contrast essay, going to get $9.7 million as a result of the shortfall.) The CO-OP will not offer plans for tree description 2016, and their 2015 policies will terminate at contrast comparison, the end of the year. This means about 51,000 people in Kentucky will have to shop for new coverage for short 2016, as they will not be able to essay conclusion, keep their Kentucky Health CO-OP plans.
And then on October 14, Tennessee regulators announced that Community Health Alliance would also close at the end of the year. CHA stopped enrolling new members in January 2015, but it had planned to sell policies during the pak china essay 2016 open enrollment period, albeit with a 44.7 percent rate increase. Ultimately, the risk of the CO-OP’s failure in 2016 was too great, and it will wind down operations by the end of the year instead. Two days later, on contrast essay conclusion, October 16, Colorado Health OP was decertified from the exchange by the Colorado Division of Insurance, resulting in the CO-OP’s demise; Colorado Health OP’s 80,000 individual members will all need to transition to new carriers for 2016. Almost immediately after that, Oregon’s Health Republic Insurance, also a CO-OP, announced that it would not offer 2016 plans, and pattern research, would wind down its operations by the end of 2015. Health Republic currently has 15,000 members. On October 22, The South Carolina Department of Insurance announced that Consumers Choice would voluntarily wind down its operations by year-end, and contrast essay, would not sell plans for 2016. Consumers Choice was run by is hamlet essays, the same CEO – Jerry Burgess – as Community Health Alliance in Tennessee. 67,000 Consumers Choice members will need to comparison conclusion, switch to a new carrier for 2016. Professionalism! The South Carolina Department of Insurance has put together a series of FAQs for impacted plan members. On October 27, the Utah Insurance Department announced that they are placing Arches Health Plan in receivership, and the carrier will wind down operations by the end of the year.
Arches Health Plan garnered roughly a quarter of comparison essay conclusion Utah’s exchange market share in 2015, but those enrollees will need to description essay, switch to a new carrier for 2016. On October 30, just two days before the start of the 2016 open enrollment period, the Arizona Department of essay Insurance announced that Meritus would cease selling and renewing coverage, and crazy essays, existing plans would terminate at the end of essay 2015. Healthcare.gov removed Meritus plans from the exchange website, and current enrollees – who comprise roughly a third of the private plan enrollees in essay the Arizona exchange – will need to contrast, obtain new coverage for 2016. Meritus was unique in that they allowed people to enroll off exchange year-round up until late-summer 2015. Relations Urdu! They were also among very few CO-OPs that had requested a rate increase of contrast comparison conclusion less than ten percent for 2016. Open enrollment began on November 1, and coverage was still available at that point from the remaining 12 CO-OPs. But on November 2, it became clear that Consumers Mutual of Michigan was in financial trouble. The carrier announced that they would not offer plans in the exchange in 2016, although at that point, there was still a possibility that they would continue to research paper, offer plans outside the exchange. But on November 4, they announced that they would wind down their operations by the end of the year, and all 28,000 members would need to find new coverage for comparison conclusion 2016. In May 2016, state regulators in Ohio announced that InHealth Mutual would shut down and that members would have a 60 day special enrollment period to select a new plan. In July 2016, state regulators in short essay Connecticut announced that HealthyCT would shut down at the end of 2016 (employer groups were able to keep their coverage through the renewal date in 2017, as long as the contrast comparison plan’s renewal date in 2016 was July or earlier).
In July 2016, state regulators in Oregon announced that Oregon Health CO-OP would shut down at the end of July 2016. In July 2016, state regulators in essay of internet Illinois announced that they were beginning the process of taking over Land of Lincoln Health and winding down the CO-OP’s operations. A special enrollment period was created for contrast the CO-OP’s 49,000 enrollees. In September 2016, state regulators in New Jersey placed Health Republic Insurance of tree description essay New Jersey into contrast comparison essay, rehabilitation, and the CO-OP ceased selling new plans. Description! Health Republic’s existing plans terminated at the end of 2016. In June 2017, Minuteman Health announced that they would no longer offer coverage as a CO-OP after the end of 2017. At that point, they intended to transition to a for-profit insurance company (Minuteman Insurance Company). However, they were unable to raise enough capital by the August 2017 deadline for securing a license for 2018, and will thus not re-open as a for-profit insurer.
Minuteman Health is in receivership, and enrollees will need to obtain new coverage during open enrollment in the fall of 2017. In July 2017, Maryland regulators issued an administrative order blocking Evergreen Health from selling or renewing any plans (they only conclusion, had group plans in force at research, that point, having terminated individual market plans at the end of 2016). The order notes that it’s expected that the process will culminate in receivership. Louise Norris has been writing about health insurance and conclusion, healthcare reform Read more. RT @LouiseNorris: 1. On Advantages! Avg rate increase in Nevada 31.6%, but for the only contrast comparison, returning carrier in the exchange, it's 36.8% https://t.co/AYXmXMK… After subsidy, Minnesota health exchange insurance rates largely stable or dropping for 2018 | from pak china essay urdu @kpottermn… https://t.co/DabHX4CtIk. RT @LouiseNorris: If initiative is approved, they have until April to contrast comparison, get enough signatures to essay, get it on the ballot. Spread the word! https… Copyright ©1994-2017, healthinsurance.org llc, 5353 Wayzata Boulevard, Suite 300, St. Louis Park, MN 55416. For quote requests or help in purchasing insurance, call toll-free 1-855-367-0132. Essay! or use our quote form.
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