tag:blogger.com,1999:blog-53982780591383473262024-03-12T18:05:07.545-07:00desenhandocomlinhasbygloriaAnonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.comBlogger500125tag:blogger.com,1999:blog-5398278059138347326.post-86780622800934667292012-07-26T08:30:00.000-07:002014-05-04T06:10:41.971-07:00Agent in the Clink: Update<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Last week, we reported on the unfortunate case of <a href="http://insureblog.blogspot.com/2012/07/another-agent-in-clink.html" target="_blank">Aloha State insurance agent Kathleen Kau</a>, who was recently sentenced to 10 years in prison for raiding her clients' insurance policies. We wondered what kind of life insurance policy came with a checkbook (as described in the original article), and reached out to the reporter and to TransAmerica.</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">We were unable to connect with the former, but yesterday got this answer from Cindy Nodorft (she's in Transamerica's Corporate Communications area):</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"<i><span style="font-family: Times,"Times New Roman",serif;">Thanks for your inquiry. I’ve learned that the policy at issue was part of a block of business assumed by Transamerica Life Insurance Company that allowed policyholders to obtain policy loans. This practice was discontinued in about 2005</span></i>."</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">I guess that makes sense, although I'd never heard of carriers issuing checkbooks with loans. It strikes me that this sounds more like a line of credit than a typical loan, but at least we now have an answer.</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">Thanks, Cindy!</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com3tag:blogger.com,1999:blog-5398278059138347326.post-41675719256502228602012-07-26T06:40:00.000-07:002014-05-04T06:10:41.924-07:00From the P&C Files: Iran, Shipping, Insurance and Oil<div class="separator" style="clear: both; text-align: center;"><a href="http://www.cartoonstock.com/lowres/smb080205l.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://www.cartoonstock.com/lowres/smb080205l.jpg" width="165" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Although we primarily concern ourselves with life and health insurance, we're <a href="http://insureblog.blogspot.com/2011/09/come-cropper.html" target="_blank">certainly no strangers to</a> the Property and Casualty side of the biz. This item in the Washington Free <strike>Bacon</strike> Beacon (oops, sorry), piqued my interest:</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">"<a href="http://freebeacon.com/insuring-ahmadinejad/" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">The insurance industry and ... lawmakers are attempting to water down a new Iran sanctions bill that would penalize any company that underwrites Iranian affiliates</span></i></a>"</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Since this is rather outside my bailiwick, I turned (again) to our resident on-call P&C guru, <a href="http://www.inswrks.com/" target="_blank">Bill M</a>, who helped me get my head around it.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Here goes:</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Acme Industries, which ships oil-drilling equipment to Iran, calls AIG (hey, it's called American <b><i>International </i></b>Group for a reason) for a quote. AIG asks all the pertinent questions (including what's being shipped, from where, to where, etc) and generates a quote. Acme likes what it sees, and purchases the policy.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Six months later, Acme is sanctioned for "<i>bolstering the Iranian oil industry</i>."</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Under the bill currently wending its way through the House, AIG would then <i>also</i> be sanctioned.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">The "<i style="font-family: Times,"Times New Roman",serif;">prominent lawmakers</i>" mentioned above would prefer to let AIG (or whomever) off the hook.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">This item raises a number of questions:</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">First, would it have mattered if Acme had <i>already</i> been sanctioned before seeking that AIG quote? Are "sanctions" to this process what speeding tickets are to auto insurance?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Second, what if Acme had bought the policy from a broker in London? After all, it's not unreasonable to presume that a carrier might have offices in other countries in addition to a presence here. </span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">If you have experience in this market, we'd appreciate any thoughts you might have on this.</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-67015356964425550112012-07-25T11:00:00.000-07:002014-05-04T06:10:41.949-07:00ObamaTax: Told ya so<div style="text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbZHmMdU-9rvwFe6d_laE-f3sVbMMCsv2BBXke-T1NKHLAA6I7deOopnGqs__ISJ7THPRcrsToA4ooiR1IknXat_EjYwbF-DVuDGO68L7aHR0ieS8Sn7_wUbR9jO9lCnly9TXXEH6uyWk/s1600/two-cents.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="85" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbZHmMdU-9rvwFe6d_laE-f3sVbMMCsv2BBXke-T1NKHLAA6I7deOopnGqs__ISJ7THPRcrsToA4ooiR1IknXat_EjYwbF-DVuDGO68L7aHR0ieS8Sn7_wUbR9jO9lCnly9TXXEH6uyWk/s200/two-cents.jpg" width="140" /></a><span style="font-family: Arial,Helvetica,sans-serif;">Bob mentioned this last night, but I wanted to toss in my 2¢. Regular IB readers <a href="http://insureblog.blogspot.com/2010/10/2000-and-out.html" target="_blank">won't be surprised</a> that:</span></div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"> "<a href="http://www.insureblog.blogspot.com/2012/07/bye-bye-benefits.html" target="_blank"><i>About one in 10 employers plan to drop health coverage when key provisions of the new health care law kick in</i></a>"</span></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;"></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;"><br /></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;">I think that's lowballing it, and here's why:</div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;"><br /></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;">First, the ridiculously onerous <a href="http://insureblog.blogspot.com/2012/07/how-now-brown-mlr.html" target="_blank">MLR requirements</a>, which add nothing of value but do add lots of extra costs to group plans. Determining who's eligible, calculating employees' shares, and tracking down former employees who might have been covered for only a month sounds like a great reason to bail.</div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;"><br /></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;">Second, those much-touted small business tax credits (subsidies) were a <a href="http://insureblog.blogspot.com/2012/05/small-employer-health-insurance-tax.html" target="_blank">complete bust</a>; how bad is it when you can't even <i>pay</i> employers to offer group health plans?</div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;"><br /></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;">Third, what about all those companies with, say 55 or 60 employees? They're over the <a href="http://insureblog.blogspot.com/2012/06/50th-employee.html" target="_blank">mandate threshold</a>, but not exactly in Fortune 500 territory. Letting go one or two folks might work (to get back below the threshold), but a dozen? Just doesn't sound viable. Smartest alternative? Dump the group and eat the fine.</div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;"><br /></div><div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;">Okay, maybe that's more like a quarter's worth. </div><br /><br />Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-64374014611846415102012-07-25T06:09:00.000-07:002014-05-04T06:10:41.946-07:00Cavalcade of Risk #162: Come and get it!<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><a href="http://www.insuranceregulatorylaw.com/" target="_blank">Van Mayhall</a> hosts <a href="http://www.insuranceregulatorylaw.com/2012/07/cavalcade-of-risk-no-162-on-insurance.html" target="_blank">this week's collection</a> of interesting risk-related posts. Don't miss it.</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-90561493021381302232012-07-24T16:06:00.000-07:002014-05-04T06:10:41.977-07:00Bye Bye Benefits<span style="font-family: Helvetica, Arial, sans-serif; font-size: 14px; line-height: 21px; text-align: justify;">About one in 10 employers plan to drop health coverage when key provisions of the new health care law kick in less than two years from now, according to a survey to be released Tuesday by the consulting company Deloitte.</span><br /><span style="font-family: Helvetica, Arial, sans-serif; font-size: 14px; line-height: 21px; text-align: justify;"><br /></span><br /><span style="font-family: Helvetica, Arial, sans-serif; font-size: 14px; line-height: 21px; text-align: justify;"><i><b><a href="http://www.washingtontimes.com/blog/inside-politics/2012/jul/24/nearly-one-10-employers-drop-health-coverage/" target="_blank">read more . . .</a></b></i></span>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-48219528208865250112012-07-24T11:00:00.000-07:002014-05-04T06:10:41.933-07:00And now, the Anti-MVNHS©<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Yesterday, we reported on the sad fate awaiting seniors who trust the Much Vaunted National Health System© to keep them alive. As we noted, many are forced onto a <a href="http://www.insureblog.blogspot.com/2012/07/mvnhs-expediting-health-hare-costs.html" target="_blank">lethal "pathway,"</a> denied fluid and meds.</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">In response to this growing scandal, "<a href="http://www.dailymail.co.uk/health/article-2178116/Terminally-ill-patients-fear-placed-routine-death-pathway-issued-opt-cards-charity.html" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">the anti-euthanasia charity Alert is distributing cards to patients to prevent this happening. The cards simply read: 'Please do not give me the Liverpool Care Pathway treatment without my informed consent or that of a relative</span></i></a>.'"</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">The problem with the Pathway is that it is often "prescribed" without the permission (or knowledge) of the patient or his (or her) advocate. It's an attractive option - for the MVNHS©, natch - because it reduces costs with little or no effort. According to Dr Gillian Craig, a retired geriatrician and former vice-chairman of the Medical Ethics Alliance, "<i><span style="font-family: Times,"Times New Roman",serif;">[i]f you are cynical about it, as I am, you can see it as a cost-cutting measure, if you don't want your beds to be filled with old people.</span></i>"</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">The cards act as garlic to vampires, hopefully fending off over-zealous providers from pulling the plug prematurely. Unfortunately, there doesn't seem to be any way to enforce them; that is, what's the consequence to the provider if that card is ignored? After all, it's the MVNHS© that's footing the bill (hey, it's free health care, right?).</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com1tag:blogger.com,1999:blog-5398278059138347326.post-69673088982184590012012-07-24T06:00:00.000-07:002014-05-04T06:10:41.961-07:00Exchanges, Subsidies and intent<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">[<i style="color: red;"><b>Note: This post was co-written by Henry Stern and Bob Vineyard</b></i>]</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">We've often lamented that it's too bad no one read the ObamaTax bill before they passed it, and with good reason. A fundamental problem is that the </span><a href="http://insureblog.blogspot.com/2012/07/not-exactly-50-shades-of-grey.html" style="font-family: Arial,Helvetica,sans-serif;" target="_blank">2000+ pages of the bill, and the 13,000+ (so far!) pages of reg's</a><span style="font-family: Arial,Helvetica,sans-serif;"> promulgated to enforce it, keep handing up surprises. As we've pointed out, folks in states which opted for Federally-run Exchanges </span><a href="http://insureblog.blogspot.com/2011/11/obamneycare-glitch-ib-ahead-of-curve.html" style="font-family: Arial,Helvetica,sans-serif;" target="_blank">aren't eligible for the ObamaSubsidies</a><span style="font-family: Arial,Helvetica,sans-serif;">, thereby driving <i>their</i> costs even higher.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Or are they?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Cato's Michael Cannon has been, perhaps, the most vocal in pointing out this discrepancy:</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"</span><a href="http://insureblog.blogspot.com/2011/11/obamneycare-glitch-ib-ahead-of-curve.html" style="font-family: Arial,Helvetica,sans-serif;" target="_blank"><i>This was no “drafting error.” During congressional consideration of the bill, its lead author, Sen. Max Baucus (D-MT), acknowledged that he intentionally and purposefully made that bailout conditional on states implementing their own Exchanges ... On May 24, the IRS finalized a regulation that says the law’s $800 billion [subsidy funding] will not be conditional on states creating Exchanges</i></a><span style="font-family: Arial,Helvetica,sans-serif;">"</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">So what's the big deal?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">The following appeared on a </span><span style="font-family: Arial,Helvetica,sans-serif;">forum for insurance professionals in which Bob participates (it's about </span><span style="font-family: Arial,Helvetica,sans-serif;">the ObamaSubsidies noted above):</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"<i>If you are ELIGIBLE to join any employer group plan where your portion of the premium is less than 9.5% of your income, then you won't get a subsidy. Next - drumroll please - this also holds true for dependents ... Due to the fact that the EMPLOYEE portion is less than 9.5% of the FAMILY income, the entire family is disqualified from a subsidy even if the employer pays nothing for dependent coverage</i>."</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">In fact, and this is a real kick in the shins, it doesn't seem to matter whether you actually sign up for the group or not: maybe you found a better deal on the Exchange [<i>ed: hey, it <b>could</b> happen!</i>] and buy it, presuming that the net premium will be less because of the subsidy. Nope.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">And it's no better if you <i>do</i> sign up for the group plan:</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"<i>Actually, the employer doesn't even have to pay a large portion in order for this to kick many families out of the subsidy ... a family of four must pay $729 in premium to equal 9.5% of their income if they make 400% of FPL. That means that any employer group health plan that charged that employee less than $729 for the EMPLOYEE-ONLY coverage would disqualify him and his dependents from receiving a subsidy. Nice</i>."</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">And it only gets <strike>better</strike> worse:</span></div><a name='more'></a><br /><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"<i>If you have an increase in earnings, putting you over the limit, part of your subsidy can be taken from you later</i>."</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Talk about the gift that keeps on giving.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Bob notes that, unfortunately, this "gift" also comes with more questions than answers:</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">■ How much intrusion into our lives will be required to determine if someone is entitled to a subsidy?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">■ Will everyone's return require an audit (which implies an after-the-fact review)? If you get your subsidy and then an audit later determines you were not entitled to it do you owe the money back plus penalty and interest?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">■ Will the IRS be smart enough to run all the calculations?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">■ Will this create an additional burden on employers who will then drop health insurance rather than put up with the red tape? Will this exercise remind employers of what they had to go through for MLR rebates and create a backlash?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">■ Will Dudley be able to save Nelle from being blown up by Snidely?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">And he points out that the only <i>real </i>answer we have is that this latest wrinkle illustrates how impossible this law will be to execute, and how much money will be wasted trying to implement and enforce it.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Our forum participant continues:</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"<i>How many will qualify [for the subsidies]? The government estimated 20 million. I hope they're closer than their estimates for PCIP enrollment. Their estimates for the small business health insurance premium subsidy was as much of a flop</i>."</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">As we've pointed out here, the PCIP program, </span><a href="http://insureblog.blogspot.com/2012/06/pcip-abuse.html" style="font-family: Arial,Helvetica,sans-serif;" target="_blank">while itself laudable</a><span style="font-family: Arial,Helvetica,sans-serif;">, has thus far enjoyed underwhelming success.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">The lynchpin here is whether or not HHS Secretary Shecantbeserious, and her colleagues the Revenooers, can make <i>their</i> <strike>interpretation</strike> rule stick. So far, the law says what HHS (and, of course, Chief Justice Roberts) <b>says</b> it says. </span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Time (and, of course, November 6th) will tell.</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-2664182536993957822012-07-23T06:06:00.000-07:002014-05-04T06:10:41.901-07:00MVNHS© "Expediting" Health Care Costs<div style="text-align: justify;"><span style="font-family: Arial, Helvetica, sans-serif;">One of the major problems facing nationalized health care systems is that, despite all promises to the contrary, they do very little (if anything) to reduce the cost of delivering care. There are, after all, only so many ways to do so; by far the most efficient (at least for the Much Vaunted National Health System©) is to simply deny it to "undeserving" folks:</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">"<a href="http://www.huffingtonpost.com/2012/07/10/liverpool-care-pathway-uk-hospital-costs_n_1660029.html?ncid=edlinkusaolp00000003" target="_blank"><i><span style="font-family: Times, "Times New Roman", serif;">[S]ix doctors in the U.K. ... claim that the country has gone too far with a publicly funded program aimed at supporting terminally ill patients</span></i></a>."</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">This word, "support" - I dunna think it means what you think it means:</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">"<i><span style="font-family: Times, "Times New Roman", serif;">[T]he Liverpool Care Pathway program is being used to cut costs instead of as simply a more humane mode of care ... allows medical staff to withhold fluid and drugs in a patient’s final days</span></i>"</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">Under the Brits' system, "support" means "death," which is an interesting (if macabre) spin on things. We've discussed 'end of life' care <a href="http://insureblog.blogspot.com/2012/05/end-of-life-care-conundrum.html" target="_blank">here at IB</a>, and determined that there are no easy answers [<i>ed: no kidding</i>]. Although some folks (notably those who advocate it) applaud these "pathways" as both cost-effective and humane, they conveniently ignore the fact that the folks making the decision have a vested interest in the outcome:</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">"<i><span style="font-family: Times, "Times New Roman", serif;">[T]he number of hospital deaths that implemented such end-of-life care measures doubled in the last two years</span></i>."</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">That's a lot of dead grannies.</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-18234273471464702872012-07-21T12:28:00.000-07:002014-05-04T06:10:41.895-07:00Blogroll Update<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">We're pleased as punch to add Jeff Root's interesting and helpful <a href="http://www.rootfin.com/blog" target="_blank">life insurance blog</a> to our blogroll. Jeff's an independent life insurance agent, licensed in all 50 states(!), who specializes in high risk life insurance. He works with consumers and agents alike, helping those with health issues obtain needed coverage at affordable rates. </span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">Jeff performs thorough evaluations of a consumer's risk and submits that to underwriters with whom he's built lasting relationships (as well as other general underwriting desks). He then screens the offers that come back and offers the best one(s). As Jeff says "<i><span style="font-family: Times,"Times New Roman",serif;">it's something I wish most life insurance agents would do instead of taking shots in the dar</span></i>k."</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">Amen to that!</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">What makes his blog so interesting is that he shares these experiences in a consumer-friendly way. He believes that "<i><span style="font-family: Times,"Times New Roman",serif;">there's a lack of helpful information for consumers with health issues on the web</span></i>," and so he tries hard to fill that void. <a href="http://www.rootfin.com/blog" target="_blank">Do click through</a>.</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-9463738452648934412012-07-20T06:19:00.000-07:002014-05-04T06:10:41.980-07:00Cavalcade of Risk #162: Call for submissions<div style="font-family: Arial,Helvetica,sans-serif; text-align: justify;"><a href="http://www.insuranceregulatorylaw.com/">Van Mayhall</a> hosts next week's Cavalcade of Risk - Entries are due by Monday (the 23rd).<br /><br /></div><div class="blogPost" style="font-family: Arial,Helvetica,sans-serif; text-align: justify;">To submit your risk-related post, <a href="mailto:cavrisk@mail.com" style="font-weight: bold;"><span style="color: red; font-style: italic;">just click here to email it</span></a>.<br /><br />You'll need to provide:<br /><br />■ Your post's url and title<br />■ Your blog's url and name<br />■ Your name and email<br />■ A (brief) summary of the post<br /><br />PLEASE remember: <span style="font-style: italic; font-weight: bold;">ONLY</span> posts that relate to risk (not personal finance tips and the like).<br /><br />Thanks!</div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-46010350632559261292012-07-19T12:50:00.000-07:002014-05-04T06:10:41.932-07:00Another Agent in the Clink<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhy-m10GmAoLUtKRTBs4UXtBDC-fVuXToFyUrdUuVWiMS1ka5KpU3uGsEUsZNAw6OhcYGs3_YshaiLEJ_Ko3vcx8dDQQQNLvq1DKhWRH4NE4toIolSpyLj_DiaX3JsoyhmthxeyH484dcs/s400/piggy-bank-bandaids.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="123" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhy-m10GmAoLUtKRTBs4UXtBDC-fVuXToFyUrdUuVWiMS1ka5KpU3uGsEUsZNAw6OhcYGs3_YshaiLEJ_Ko3vcx8dDQQQNLvq1DKhWRH4NE4toIolSpyLj_DiaX3JsoyhmthxeyH484dcs/s200/piggy-bank-bandaids.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Regular readers may recall the <a href="http://insureblog.blogspot.com/2012/04/neasham-chronicles-contrarians-take.html" target="_blank">sad story of Glen Neasham</a>, who sold an annuity and went to jail. A bit further west, insurance agent Kathleen Kau has just been sentenced to 10 years in prison for "<a href="http://insurancenewsnet.com/article.aspx?id=350425&type=topnews" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">stealing more than $360,000 over five years from two longtime clients</span></i></a>."</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">Most definitely <i>not</i> <a href="http://insureblog.blogspot.com/2012/07/someone-who-needs-no-introduction.html" target="_blank">good customer service</a>.</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">I'm a little unclear on how this worked, exactly: "<i><span style="font-family: Times,"Times New Roman",serif;">Kau opened a post office box to receive mail for her victims after falsely informing Transamerica Life Insurance Co. that a fire destroyed [their] home ... Kau also asked the insurance company to mail a checkbook allowing her clients to tap their life insurance account savings because of the home loss</span></i>."</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">I've never heard of a policy that has a checkbook feature as a <b>living</b> benefit. I've reached out to the reporter for clarification, and will update this post if/when I receive that.</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">This case obviously differs greatly from Mr Neasham's: according to the story, the agent clearly set out to defraud her <strike>clients</strike> victims. The prosecutor noted that she stopped doing so only "<i><span style="font-family: Times,"Times New Roman",serif;">because there was no money left in the victims' accounts</span></i>." Although TransAmerica has reimbursed the looted funds, one can only imagine how difficult it will be for the insureds to ever again trust a financial advisor.</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">No winners here.</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-63870390553838210392012-07-19T07:30:00.000-07:002014-05-04T06:10:41.944-07:00Outstanding Carrier Trick [UPDATED]<div class="separator" style="clear: both; text-align: center;"><a href="http://de.easterseals.com/images/content/pagebuilder/1220886.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="139" src="http://de.easterseals.com/images/content/pagebuilder/1220886.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">[<u style="color: red;"><b>UPDATE</b></u>: To participate, <a href="https://www.facebook.com/massmutual/app_379100915483750" target="_blank"><i style="color: red;"><b>click here</b></i></a>, then click "Like"] </span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;"><a href="http://www.massmutual.com/" target="_blank">MassMutual</a> and <a href="http://www.easterseals.com/" target="_blank">Easter Seals</a> are once again teaming up to increase awareness of the important decisions and financial challenges facing families with special needs members. Taking advantage of social media, they've launched a cool FaceBook video giving folks a glimpse into the every day lives of a mother with a special needs child. What's more, MassMutual will donate $5 to Easter Seals for every "Like" the video garners.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;"><a href="http://www.mullen.com/" target="_blank">Courtney Denning</a> offered us the opportunity to interview Joanne Gruskos, director of MassMutual’s SpecialCares program, and we (of course) jumped at the chance:</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">InsureBlog: How did you become interested in/involved with MM and the special needs area?<br /><br /><span style="font-family: Georgia,"Times New Roman",serif;">Joanne Gruskos: Well, I'm a longtime employee of MassMutual, primarily in sales and marketing. After we started the trust company in 2000, we began to grow our relationship with Easter Seals. We had a lot of interest from trust administrators from around the country, which we took as an opportunity to do something new.</span><br style="font-family: Georgia,"Times New Roman",serif;" /><br style="font-family: Georgia,"Times New Roman",serif;" /><span style="font-family: Georgia,"Times New Roman",serif;">This grew into a partnership with the American College, with which we developed an exclusive special needs curriculum and designation. This is slated to go industry-wide in the near future.</span><br /><br />IB: Would you share some of the home history of the MM/ES partnership?<br /><br /><span style="font-family: Georgia,"Times New Roman",serif;">JG: Let's say you're a financial planner. and one of your clients is a family with children developing just fine, and one special needs child. Your task is now complicated by the fact that you have to account for the parents' lifetimes, <i>plus</i> the special needs child's lifetime. This can be quite challenging.</span><br style="font-family: Georgia,"Times New Roman",serif;" /><br style="font-family: Georgia,"Times New Roman",serif;" /><span style="font-family: Georgia,"Times New Roman",serif;">And it gets more difficult: you have to coordinate this with government and other programs, because if you screw up eligibility, you could cost the family a <i>lot</i> of money. Easter Seals is instrumental in helping us thread these needles.</span><br /><br />IB: Is there a central directory/database of folks who've earned the spcial needs consultant designation?<br /><br /><span style="font-family: Georgia,"Times New Roman",serif;">JG: Yes, in fact we have an <a href="http://www.massmutual.com/planningtools/additional-resources/special-needs/special-care" target="_blank">extensive website</a> that's chock full of helpful information, including advisors, FAQ's, all kinds of resources to help navigate all the different programs and opportunities.</span><br /><br />IB: What would be the one thing you'd most like our readers to know about MM/ES and special needs?<br /><br /><span style="font-family: Georgia,"Times New Roman",serif;">JG: We believe that "<i>who matters to you matters to us</i>." In fact, we've distilled this into a short but powerful video that helps people understand more of what we do and why we do it.</span><br style="font-family: Georgia,"Times New Roman",serif;" /><br style="font-family: Georgia,"Times New Roman",serif;" /><span style="font-family: Georgia,"Times New Roman",serif;">We're here to help you when you're ready to start planning. This is such a critical need that we really don't push product, we push education.</span><br /><br />Thanks, Joanne, for your time and insights. For readers who are interested in learning more (and for agents interested in pursuing the special needs designation), there's a wealth of information at the <a href="http://www.massmutual.com/planningtools/additional-resources/special-needs/special-care" target="_blank"><b>MassMutual Special Needs website</b></a>.<br /><br />Oh, and that video Joanne mentioned above? Here you go:<br /><br /><iframe allowfullscreen="" frameborder="0" height="221" src="http://www.youtube.com/embed/AOkduvQYsec" width="392"></iframe></span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-84365578010319592682012-07-19T05:30:00.000-07:002014-05-04T06:10:41.966-07:00Health Insurance Exchanges<div style="font-family: Georgia,"Times New Roman",serif;">Health insurance exchanges. That place on the internet where magic happens. Citizens and business owners can view, compare and purchase government designed and priced health insurance plans . . . all with the click of a mouse.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">But it appears some of the states are lagging behind in establishing this new insurance flea market. According to <b><a href="http://www.ncsl.org/issues-research/health/state-actions-to-implement-the-health-benefit-exch.aspx" target="_blank">NCSL</a></b>, only 12 states have established "The Exchange."</div><blockquote class="tr_bq"><span style="font-family: 'Helvetica Neue',Arial,Helvetica,sans-serif;"><span style="color: #666666; line-height: 17px; text-align: left;"><i>Health Insurance Exchanges are, for most states, new entities that will function as a marketplace for buyers of health insurance, giving them choices for health coverage. They will offer a variety of certified health plans and provide information and educational services to help consumers understand their options. The 2010 Affordable Care Act (ACA) gives states the option to establish one or more state or regional exchanges, partner with the federal government to run the exchange, or to merge with other state exchanges. <b>If a state chooses not to create an exchange, the federal government will set up the exchange(s) in the state. </b></i></span></span></blockquote><div style="font-family: Georgia,"Times New Roman",serif;"><span style="color: #666666; line-height: 17px; text-align: left;"></span></div><div style="color: black; font-family: Georgia,"Times New Roman",serif;"><span style="line-height: 17px; text-align: left;">That last line is the key.</span></div><div style="color: black; font-family: Georgia,"Times New Roman",serif;"><span style="line-height: 17px; text-align: left;"><br /></span></div><div style="color: black; font-family: Georgia,"Times New Roman",serif;"><span style="line-height: 17px; text-align: left;">Why spend state money (that they don't have) if the government will do it for them?</span></div><div style="color: black; font-family: Georgia,"Times New Roman",serif;"><span style="line-height: 17px; text-align: left;"><br /></span></div><div style="color: black;"><span style="line-height: 17px; text-align: left;"><span style="font-family: 'Helvetica Neue',Arial,Helvetica,sans-serif;"><span style="font-family: Georgia,"Times New Roman",serif;">Kind of like owning a business . </span>. .</span></span></div><span style="color: #666666; font-family: Tahoma,Geneva,sans-serif; font-size: 11px; line-height: 17px; text-align: left;"></span><br /><span style="color: #666666; font-family: Tahoma,Geneva,sans-serif; font-size: 11px; line-height: 17px; text-align: left;"><br /></span> <iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/YKjPI6no5ng" width="420"></iframe>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-25474710762007745772012-07-19T05:00:00.000-07:002014-05-04T06:10:41.897-07:00Health Wonk Review: Smokin' hot edition<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><a href="http://www.workerscompinsider.com/" target="_blank">Julie Ferguson</a> presents this week's <a href="http://www.workerscompinsider.com/2012/07/louise-at-color.html" target="_blank">sizzlin' round-up</a> of wonky posts. As usual, there's lots to choose from, so enjoy the A/C and the HWR.</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-63417024958606609082012-07-18T06:21:00.000-07:002014-05-04T06:10:41.942-07:00Mandate, Shmandate?<div style="text-align: justify;"><span style="font-family: Arial, Helvetica, sans-serif;">Regular readers know that, come 2014, it'll be more <a href="http://insureblog.blogspot.com/2012/07/ironically-sensible.html" target="_blank">economically efficient to drop</a> their health insurance than to keep it, since plans will be guaranteed issue with no exclusions for pre-existing conditions. Since the ObamaTax is (at least initially) going to be a lot less than one's premium, why would one purchase insurance before a claim?</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">Now you may be thinking: "<i>But Henry, if I don't buy coverage I'm going to have to pay that tax or I'll be in hot water with the IRS</i>."</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">Um, maybe not so much. Reason's Jacob Sullum makes the case:</span></div><blockquote><span style="font-family: Arial, Helvetica, sans-serif;">"<a href="http://reason.com/archives/2012/07/18/obamacares-uneforceable-linchpin" target="_blank"><i><span style="font-family: Times, "Times New Roman", serif;">Even paying the penalty is effectively optional, because Congress ... barred the Internal Revenue Service from using its most effective tools — liens, forfeiture, and prosecution — to collect it... the IRS, confronted by uninsured taxpayers who refuse to pay the penalty, must instead resort to "scary letters and threats to withhold tax refunds</span></i></a>."</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial, Helvetica, sans-serif;">Hmm, scary letters? I can handle that. As I think most people could.</span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">The problem here is that Mr Sullum's just not thinking this through. If millions (or tens of millions) of Americans "opt out" and also refuse to pay the <strike>penalty</strike> tax, what's left of the system falls apart. For the Obamastration, this is a <i>feature</i>, not a bug, because it paves the way for what they <a href="http://insureblog.blogspot.com/2012/06/single-payer-train.html" target="_blank"><i><b>really</b></i> want</a>.</span><br /><br /><span style="font-size: x-small;"><i style="color: red;"><b><span style="font-family: Arial, Helvetica, sans-serif;">[Hat Tip: FoIB <a href="http://themoderatevoice.com/author/holly" target="_blank">Holly R</a>]</span></b></i></span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-28013414544061429662012-07-17T13:35:00.000-07:002014-05-04T06:10:41.902-07:00Even More MLR Fun<div style="font-family: Georgia,"Times New Roman",serif;">Got this from a forum used by insurance agents all over the country. It shows the insanity of the MLR debacle.</div><blockquote class="tr_bq"><span style="font-family: 'Helvetica Neue',Arial,Helvetica,sans-serif;"><i><span style="text-align: left;">United Healthcare just informed me that I can look online and see what rebate amounts my group clients received. A group with 44 enrolled employees in 2011 and an annual premium of $132,211.45 for 2011 will receive a rebate of $124.97 representing .001%. What a mess.</span></i></span></blockquote><blockquote class="tr_bq"><span style="font-family: 'Helvetica Neue',Arial,Helvetica,sans-serif;"><i></i></span><span style="font-family: 'Helvetica Neue',Arial,Helvetica,sans-serif;"><i><span style="text-align: left;">Humana didn't list the rebate amounts for my clients, but I just received an e-mail from a client who has 5 enrolled employees on one of Humana's lowest cost plans ($5,000 deductible 70% plan), and they received a $1018 rebate.</span></i><span style="text-align: left;"> </span></span></blockquote><div style="font-family: Georgia,"Times New Roman",serif;"><span style="text-align: left;">Thank you HHS for this wonderful gift.</span></div><div style="font-family: Georgia,"Times New Roman",serif;"><span style="text-align: left;"><br /></span></div><div style="font-family: Georgia,"Times New Roman",serif;"><span style="text-align: left;">As we now know, if you own a business you didn't build it by yourself. You had help from the government.</span></div><span style="text-align: left;"><span style="font-family: 'Helvetica Neue',Arial,Helvetica,sans-serif;"><br /></span></span><br /><br /><iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/YKjPI6no5ng" width="420"></iframe>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-678846545190853052012-07-17T11:32:00.000-07:002014-05-04T06:10:41.957-07:0010 Things You Probably Didn't Know<div style="font-family: Georgia,"Times New Roman",serif;">but were afraid to ask about Obamacare.</div><div style="font-family: arial, helvetica, sans-serif; font-size: 13px; line-height: 18px; margin-bottom: 14px; margin-top: 1em; padding: 0px;"><i>So you think the Supreme Court upheld a <a href="http://www.healthcare.gov/law/full/index.html" style="color: #2262cc; text-decoration: none;" target="_blank">law</a> that requires most people to buy health insurance? That's only part of it. The measure's hundreds of pages touch on a variety of issues and initiatives that have, for the most part, remained under the public's radar. Here's a sampling: </i></div><table border="0" cellspacing="14" style="color: black; font-family: arial, helvetica, sans-serif; font-size: 13px;"><tbody><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%201.png" style="border: none;" width="90" /></td><td><b>Postpartum Depression</b> (Sec. 2952)<br />Urges the National Institute of Mental Health to conduct a multi-year study into the causes and effects of postpartum depression. It authorized $3 million in 2010 and such sums as necessary in 2011 and 2012 to provide services to women at risk of postpartum depression.</td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%202.png" style="border: none;" width="90" /></td><td><b>Abstinence Education</b> (Sec. 2954)<br />Reauthorizes funding through 2014 for states to provide abstinence-only sex education programs that teach students abstinence is "the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems." Federal funding for these programs expired in 2003.</td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%203.png" style="border: none;" width="90" /></td><td><b>Power-Driven Wheelchairs</b> (Sec. 3136)<br />Revises Medicare payment levels for power-driven wheelchairs and makes it so that only "complex" and "rehabilitative" wheelchairs can be purchased; all others must be rented.</td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%204.png" style="border: none;" width="90" /></td><td><b>Oral Health Care</b> (Sec. 4102)<br />Instructs the Centers for Disease Control and Prevention to embark on a five-year national public education campaign to promote oral health care measures such as "community water fluoridation and dental sealants."</td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%205.png" style="border: none;" width="90" /></td><td><b>Privacy Breaks for Nursing Mothers</b> (Sec. 4207)<br />Requires employers with 50 or more employees to provide a private location at their worksites where nursing mothers "can express breast milk." Employers must also provide employees with "a reasonable break time" to do this, though employers are not required to pay their employees during these nursing breaks.</td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%206.png" style="border: none;" width="90" /></td><td><b>Transparency on Drug Samples</b> (Sec. 6004)<br />Requires pharmaceutical manufacturers that provide doctors or hospitals with samples of their drugs to submit to the Department of Health and Human Services the names and addresses of the providers that requested the samples, as well as the amount of drugs they received. </td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%207.png" style="border: none;" width="90" /></td><td><b>Face-to-Face Encounters</b> (Sec. 6407)<br />Changes eligibility for home health services and durable medical equipment, requiring Medicare beneficiaries to have a "face-to-face" encounter with their physician or a similarly qualified individual within six months of when the health professional writes the order for such services or equipment.</td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%208.png" style="border: none;" width="90" /></td><td><b>Diabetes & Death Certificates</b> (Sec. 10407)<br />Directs the CDC and the HHS Secretary to encourage states to adopt new standards for issuing death certificates that include information about whether the deceased had diabetes.</td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%209.png" style="border: none;" width="90" /></td><td><b>Breast Cancer Awareness</b> (Sec. 10413)<br />Instructs the CDC to conduct an education campaign to raise young women's awareness regarding "the occurrence of breast cancer and the general and specific risk factors in women who may be at high risk for breast cancer based on familial, racial, ethnic, and cultural backgrounds such as Ashkenazi Jewish populations."</td></tr><tr><td><img alt="" height="80" src="http://www.kaiserhealthnews.org/%7E/media/Images/KHN%20Features/2012/July/9%2013/numbers/no%2010.png" style="border: none;" width="90" /></td><td><b>Assisted Suicide</b> (Sec. 1553)<br />Forbids the federal government or anyone receiving federal health funds from discriminating against any health care entity that won't provide an "item or service furnished for the purpose of causing … the death of any individual, such as by assisted suicide, euthanasia, or mercy killing."<br /><a href="http://www.blogger.com/goog_1620586258"><br /></a><br /><span style="font-size: small;"><i><b><a href="http://www.kaiserhealthnews.org/Stories/2012/July/13/10-little-known-health-law-provisions.aspx" style="color: red;" target="_blank">Source: Kaiser Health News</a></b></i></span></td></tr></tbody></table>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-39949685719205751192012-07-17T06:27:00.000-07:002014-05-04T06:10:41.917-07:00How Now Brown MLR?<div style="font-family: Georgia,"Times New Roman",serif;">MLR is confusing. It shouldn't be, but it is. Perhaps it is confusing because it was a rule created by those who did not have to implement it, or deal with the associated problems, particularly for employers.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Employers.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Those that actually CREATE jobs vs. just talking about <i>saving or creating jobs</i>.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div class="separator" style="clear: both; font-family: Georgia,"Times New Roman",serif; text-align: center;"><a href="http://www.brainlesstales.com/images/2007/Jun/sleeping-pill.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="186" src="http://www.brainlesstales.com/images/2007/Jun/sleeping-pill.jpg" width="200" /></a></div><div style="font-family: Georgia,"Times New Roman",serif;">MLR seems to be simple. </div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Carriers are assigned loss ratio's based on line of coverage. If your loss ratio fails to meet the guideline you are required to issue a policyholder refund. If your loss ratio exceeds the mandate, you suck it up.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">How difficult is that?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Complicated enough for carriers. How about employers?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Well . . .</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Fortunately the DOL has issued this handy dandy technical release on how to allocate and distribute those wonderful MLR rebates.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">If you have insomnia, this is highly recommended. It is effective and non-habit forming</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif; text-align: center;"><b><a href="http://www.dol.gov/ebsa/newsroom/tr11-04.html" target="_blank">Click here for sleep therapy.</a></b></div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">So how do employers allocate and distribute the refund?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Funny you should ask.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">First you need to remind yourself that those who wrote the law, issued the regs and then wrote the DOL technical release are not employers. They have never walked a mile in your shoes. They have no clue how to run a business.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">They are government <b><i>employees.</i></b></div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Not private sector <b><i>employers</i></b>.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Got it?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">However they did provide a "hotline" you can call if you have questions.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif; text-align: center;"><b>(202) 693-8510</b></div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Burn that number into your mind. Put it on speed dial.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">You will need it.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">So how does an employer allocate the refunds?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">You start by counting all covered participants during the PLAN YEAR that generated a refund. Not the calendar year (unless your plan follows a calendar year schedule), the plan year.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Include current employees that were covered as well as former employees. Don't forget those that may have only been covered for a few months. Include any employees that went on COBRA during the plan year.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">If you had more than one plan from more than one issuing carrier during 2011 you will need to repeat this process for each carrier.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Of course you may have only received a rebate from one carrier, not both.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">That is a good thing.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">If you had COBRA participants from carrier A for the first 6 months of the year and you changed carriers, you need to calculate the refund separately for carrier A vs. carrier B.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">This calculation also applies to active <b><i>and</i></b> former employees covered by two different carriers during the year.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Segregate those employees that only had single coverage from those that had dependents.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Calculate the rebate based on the percent of premium you (the employer paid) vs. the premium paid by the employee.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Now total up the MLR rebate from carrier A and allocate accordingly. Repeat this process for carrier B.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Issue refund checks (from each carrier) to active employees.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Now do the same for former employees.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Don't have a forwarding address for former employees? Issued a refund check and it came back addressee unknown?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Call (202) 693-8510.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Oh, did you have a Section 125 plan?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Let's just say the refund calculation is more complicated.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Besides, you have probably already dozed off . . . </div><br /><br />Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-8551958984988813132012-07-17T05:30:00.000-07:002014-05-04T06:10:41.968-07:00MVNHS© circling...<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN9Bamnx_4GrAppBqolhCcOLs8BoF-tNG19cRf1UrmxDW-qhzO28UnjrG0UQjT3o_jWnTrkT9R9gdf5Zh8UvkSL66fB28xaeck47WjmG2vB7exR39RQmaZNmSZWc_G4QmER_jBSGjV-tI/s400/flush.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="140" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN9Bamnx_4GrAppBqolhCcOLs8BoF-tNG19cRf1UrmxDW-qhzO28UnjrG0UQjT3o_jWnTrkT9R9gdf5Zh8UvkSL66fB28xaeck47WjmG2vB7exR39RQmaZNmSZWc_G4QmER_jBSGjV-tI/s200/flush.jpg" width="118" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Ah, the Much Vaunted National Health Service©:</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">"<a href="http://www.dailymail.co.uk/health/article-2172879/Thousands-75s-denied-statins-GPs-prevent-heart-attacks-strokes.html" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">Thousands of over-75s 'are being denied statins by GPs' that could prevent heart attacks and strokes ... <b>Researchers believe</b> that GPs are reluctant to prescribe such medication for the elderly as they are worried about the possible side-effects</span></i></a>." [emphasis added]</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;"><i>Researchers</i> speculate? Who cares?! What do the doc's <b>themselves</b> offer by way of explanation? Well, it may soon become illegal for British physicians to refuse treatment to elderly folks, which is nice.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">In <i>theory</i>.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">The reality is a bit different, though:</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">"<a href="http://www.express.co.uk/posts/view/332923/Would-you-get-early-surgery-for-lung-cancer-" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">A map produced by The Roy Castle Lung Cancer Foundation, using the latest NHS data, shows that in some areas patients are twice as likely to be offered surgery</span></i></a>."</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">This in response to claims that Brits with lung cancer face an uphill battle to receive treatment. In point of fact, MVNHS© results in this area are abysmal, revealing that "<i><span style="font-family: Times,"Times New Roman",serif;">only a third of hospital trusts met its 80 per cent target of referrals ... The map shows big variations in two affluent areas of southern England</span></i>."</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">But, but, but ... national health care schemes are the most fair, offering equal treatment to all. Yes, but some demographics are more equal than others, wink wink, nudge nudge.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Don't just take <i>our</i> word for it, though; here's an actual <strike>victim</strike> patient:</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">"<a href="http://www.dailymail.co.uk/news/article-2170267/My-17-hours-hell-hospital-patient-died-thirst-Left-unattended-agony-writers-account-ordeal-NHS-centre-excellence.html" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">I had no idea then that a patient had died from thirst. My fear of the place was born from my own bitter experiences ... Almost everyone I know locally has a story to tell about its services falling short ... After a four-hour wait, a female doctor looked at my weeping skin and said: ‘Dermatology is not an emergency at weekends</span></i></a>.’</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Luckily for Ms Kite, the "free" system isn't the only game in town. Those with <strike>dollars</strike> pounds to spare can opt for "<i><span style="font-family: Times,"Times New Roman",serif;">a private hospital where, for £100, a doctor diagnosed a nasty form of eczema and put me on steroids</span></i>."<br /><br />Meanwhile, "regular" folks can look forward to sharing the fate of Kane Gorny, a 22 year who had just successfully fought brain cancer. Unfortunately, he "<i><span style="font-family: Times,"Times New Roman",serif;">needed drugs to regulate his hormone levels ... during a hospital stay nurses forgot to give him his medication</span></i>" and he promptly became the <i><b>late</b></i> Kane Gorny. </span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Once again underscoring the truly insidious nature of nationalized health care (aka ObamaTax).</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-6818498758019384982012-07-16T12:21:00.000-07:002014-05-04T06:10:41.959-07:00Domino's Part Deux<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsG5iHAAoAMV2OLrAISZ_m3T08zGZkHfOOvRLH_OTnn7vPO2z1RnNOVkia2Ls9e1uE4NZljewTC10PosFF-CVl98F-qVOpEC_ELRWXRREkCmM5qabpCXEM2Q0EMObIV9sriVjYDoyf1nE/s1600/dominos.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsG5iHAAoAMV2OLrAISZ_m3T08zGZkHfOOvRLH_OTnn7vPO2z1RnNOVkia2Ls9e1uE4NZljewTC10PosFF-CVl98F-qVOpEC_ELRWXRREkCmM5qabpCXEM2Q0EMObIV9sriVjYDoyf1nE/s200/dominos.jpg" width="158" /></a></div><div style="font-family: Georgia,"Times New Roman",serif;">And speaking of Domino's . . . </div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">What happens to all those hundreds of thousand of people covered by risk pools and PCIP?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Come 2014 these money-losing plans are no longer needed. You can say goodbye to COBRA as well, at least for those who lose their employer coverage after January.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">With 10,000 baby boomers turning 65 every day there will be more than 5,000,000 new beneficiaries on Medicare when the calendar turns over to January 1, 2014.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">And then there are 15,000,000+ who will become eligible for Medicaid on that date.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">It takes about 10 years to produce a new doctor. Will we have enough medical personnel to handle all these people? </div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Will the federal government have the funds, and personnel to administer health insurance for 20,000,000 more people in January, 2014?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">With 43 million on Medicare now, and 54 million on Medicaid, where will the money and staff come from to handle another 20 million new "policyholders"?</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div><div style="font-family: Georgia, 'Times New Roman', serif;">Did anyone in Washington bother to think this through?</div><div style="font-family: Georgia, 'Times New Roman', serif;"><br /></div><div style="font-family: Georgia, 'Times New Roman', serif;">And this just in, courtesy of Holly Robinson . . .</div><div style="font-family: Georgia, 'Times New Roman', serif;"><br /></div><blockquote><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><i>(Ohio) <span style="background-color: transparent; color: #333333; line-height: 21px;">Gov. John Kasich says he doesn’t know if the state can afford adding more poor, uninsured Ohioans to Medicaid rolls as called for in President Barack Obama’s health-care law.</span></i></span></blockquote><blockquote><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><i>Even if Ohio opts out of expanding <b><a href="http://www.dispatch.com/content/stories/local/2012/07/15/medicaid-estimate-grows-by-365m.html" target="_blank">Medicaid</a></b>, as the U.S. Supreme Court ruled last month states could do, the Kasich administration projects nearly 400,000 Ohioans already eligible will sign up, costing taxpayers $940 million in 2014 and 2015.</i></span></blockquote><blockquote><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><i>That price tag cited by Kasich, a staunch opponent of Obama’s health-care law, is 63 percent ($365 million) higher than projections his administration produced a little more than a year ago.</i></span></blockquote></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-43400997496362604952012-07-16T06:22:00.000-07:002014-05-04T06:10:41.930-07:00Domino's<div class="separator" style="clear: both; text-align: center;"><a href="http://groomsadvice.com/wp-content/uploads/2009/11/dominos.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="http://groomsadvice.com/wp-content/uploads/2009/11/dominos.jpg" width="200" /></a></div><span style="font-family: Georgia, "Times New Roman", serif;">The tiles, not the pizza. Stack them up, give them a little push, watch them fall. </span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">Years ago Pete Seeger penned a song titled "Where have all the flowers gone?". Recorded and made famous by the Kingston Trio and Peter, Paul and Mary in the 60's, the song, with some lyric modifications might now be re-titled "Where have all the carriers gone?".</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">Much has been discussed and cussed about Obamacare but very little has been said about the impact on the economy once Obamacare unfolds in 2014 and beyond.</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">Many carriers will simply withdraw from the market rather than put up with the frustration. The ones that remain will scale back their operations. Support staff, including home office service reps, claims adjudicators and premium accounting staffers will go. Regional offices will close.</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">Sales reps that promote individual major med and small group insurance plans will be the first to go, starting about a year from now in the summer of 2013. Underwriters will depart in early 2014.</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">How many thousands of people will lose jobs, how many offices will go dark?</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">Hard to calculate at this point.</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">How much will this impact a failing economy?</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">And what will happen when the carriers finally leave the market entirely? <strong><em>When</em></strong>, not <em>if</em>, because they <strong>will</strong> eventually withdraw and we will have Medicare for everyone.</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">States will lose a major tax base as the health insurance business shifts from the private sector to government (taxpayer) funded plans. Premium taxes rank in the top 3 revenue sources for every state. Those lost revenues will have to be made up somewhere else and there will be further reductions in state provided services.</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">The hits just keep on coming.</span><br /><span style="font-family: Georgia, "Times New Roman", serif;"><br /></span><br /><span style="font-family: Georgia, "Times New Roman", serif;">How is this working for you?</span>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-50163433320770856612012-07-16T06:16:00.000-07:002014-05-04T06:10:41.937-07:00Stormy Weather: Buckeye style<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Got this in email:</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">"<i><span style="font-family: Times,"Times New Roman",serif;">Due to the severe weather throughout Ohio on June 29, 2012, the Ohio Department of Insurance has issued a notice requesting that insurance companies give affected subscribers additional time to pay their insurance premiums.</span></i>"</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-family: Arial,Helvetica,sans-serif;">We had some rip-roaring weather hear the end of last month; lots of folks lost power for days, even weeks. The "request" is really a bit more than "<i>pretty please</i>," though:</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"<i><a href="http://www.insurance.ohio.gov/Newsroom/Pages/07052012.aspx" style="font-family: Times,"Times New Roman",serif;" target="_blank">The bulletin, 2012-02, states that insurance companies are to give those who have been directly impacted by the storms 60 days from the date the premium was due to pay their premiums, interest free ... This request to insurers derives from the Federal Emergency Declaration for the state</a></i>"</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Still, it's nice that those seriously affected by the storms and subsequent power loss get a little breathing room.</span><br style="font-family: Arial,Helvetica,sans-serif;" /><br style="font-family: Arial,Helvetica,sans-serif;" /><span style="font-size: x-small;"><i style="color: red;"><b><span style="font-family: Arial,Helvetica,sans-serif;">[Hat Tip: <a href="http://www.medmutual.com/" target="_blank">MMO</a>]</span></b></i></span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-8937552331828344272012-07-14T05:36:00.000-07:002014-05-04T06:10:41.973-07:00Company Check Up<div class="separator" style="clear: both; text-align: center;"><a href="http://s1.goodsalt.com/view/uncle-sam-running-with-barrel-of-money-GoodSalt-kibas0072.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://s1.goodsalt.com/view/uncle-sam-running-with-barrel-of-money-GoodSalt-kibas0072.jpg" width="183" /></a></div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><span style="font-family: Georgia, 'Times New Roman', serif;">How well is your health insurance company doing under the Obamacare regime and MLR? The mandated Medical Loss Ratio was intended to keep premiums down and penalize carriers that were viewed as greedy.</span> </span><br /><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="font-family: Georgia,"Times New Roman",serif;">As we have stated before, regulating premiums AND "profit" margins is nonsensical in a competitive market place but try telling that to the folks in Washington who have never held a real job.</div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="font-family: Georgia,"Times New Roman",serif;">None the less, if you want to know how carriers in your state have done, the architects of the final solution to eliminate free choice with regard to health insurance are providing data at <b><a href="http://companyprofiles.healthcare.gov/" target="_blank">HealthCare</a></b>.</div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="font-family: Georgia,"Times New Roman",serif;">We decided to look at some Georgia health insurance companies and see how they fared under Obamacare MLR.</div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="font-family: Georgia,"Times New Roman",serif;">What follows is a summation by carrier name, individual MLR, rebate, small group MLR, small group rebate.</div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="text-align: center;"><br /><table class="me57447ecxalign" style="border-spacing: 0px; border: 0px; color: black; font-family: 'helvetica neue', arial, sans-serif; font-size: 12px; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed;"><tbody style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; unicode-bidi: embed;"><tr style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; unicode-bidi: embed;"><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">Company</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;"> Individual MLR</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;"> Rebate</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;"> Group MLR</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;"> Rebate</span></td></tr><tr style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; unicode-bidi: embed;"><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;"> </span></td></tr><tr style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; unicode-bidi: embed;"><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">Blue Cross</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">83.3%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">0</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">82.6%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">$0</span></td></tr><tr style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; unicode-bidi: embed;"><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">Coventry</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">68.4%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">$44</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">80.3%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">0</span></td></tr><tr style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; unicode-bidi: embed;"><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">Kaiser</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">126.7%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">0</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">90.5%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">0</span></td></tr><tr style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; unicode-bidi: embed;"><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">Humana</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">113.5%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">0</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">81.5%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">0</span></td></tr><tr style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; unicode-bidi: embed;"><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">United Healthcare</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">NA </span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">0</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">84.0%</span></td><td style="background-color: transparent; border: 0px; color: inherit; margin: 0px; outline: 0px; padding: 0px; text-align: center; unicode-bidi: embed; vertical-align: middle;"><span style="font-size: small;">0</span></td></tr></tbody></table><br /><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><br /></div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">Missing from the report are Assurant, Aetna, Celtic and Cigna. If a carrier has fewer than 1000 policyholders for that particular line of coverage they are not subject to MLR rules.</div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="font-family: Georgia,"Times New Roman",serif;">United has fewer than 1000 individual major medical policyholders and are not subject to MLR for that line, but are subject to MLR for small group.</div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="font-family: Georgia,"Times New Roman",serif;">If you were covered by an individual major medical or small group plan from any of the above carriers only those with a Coventry individual plan got a rebate.</div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="font-family: Georgia,"Times New Roman",serif;">Don't spend your $44 in one place.</div><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></span><br /><div style="font-family: Georgia,"Times New Roman",serif;">Obamacare is supposed to bring down the cost of health insurance.</div><div style="font-family: Georgia,"Times New Roman",serif;"><br /></div><div style="font-family: Georgia,"Times New Roman",serif;">How is this working for you?</div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-67766298920205121422012-07-13T08:39:00.000-07:002014-05-04T06:10:41.953-07:00Trendy Diabetics<div class="separator" style="clear: both; text-align: center;"><a href="http://cloudintegration.files.wordpress.com/2009/09/wilford-brimley1.gif" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="140" src="http://cloudintegration.files.wordpress.com/2009/09/wilford-brimley1.gif" width="92" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">So, received an interesting piece of mail yesterday from my primary life company: <i><span style="font-family: Times,"Times New Roman",serif;">Current Trends in Diabetes and Underwriting Diabetic Applicants</span></i>.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">(And yes, I am geeky enough that I find this stuff fascinating)</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Turns out, a lot of the hype we see and hear on TV and the radio isn't really <i>hype</i>, after all, The mailing quoted CDC studies which revealed that:</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">■ The number of Americans diagnosed with diabetes more than tripled from 1980 to 2010</span></blockquote><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">■ </span><span style="font-family: Arial,Helvetica,sans-serif;">In 2010, more than 200,000 Americans under age 20 had diabetes</span></blockquote><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">■ </span><span style="font-family: Arial,Helvetica,sans-serif;">Almost 80 million Americans are considered "pre-diabetic."</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">In a follow-up conversation with my underwriter, I was told that this carrier alone (hardly one of the biggest names) receives over 300 apps a year on folks who didn't even <i>know</i> they were diabetic.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Yikes!</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0tag:blogger.com,1999:blog-5398278059138347326.post-11714287481182637712012-07-13T05:56:00.000-07:002014-05-04T06:10:41.887-07:00Ironically Sensible<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Political Calculation's "Ironman" has a VERY interesting question regarding the <strike>mandate</strike> ObamaTax and whether (come 2014) one should buy coverage or roll the dice:</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"<a href="http://politicalcalculations.blogspot.com/2012/07/should-you-drop-your-personal-health.html" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">Does it make more financial sense for you to pay for health insurance or to pay the ObamaCare mandate tax instead?</span></i></a>"</span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">The premise is that, at least initially, the tax is going to be much less than the premium for most people, so why bother buying insurance until one actually <i>needs</i> it?</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">What makes this such an outstanding post is that he <b>quantifies</b> the problem, and offers readers a tool to calculate their decision.</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Very cool.</span></div>Anonymoushttp://www.blogger.com/profile/09216747433748773226noreply@blogger.com0