Friday, May 22, 2015

Life Partners back in the news

In 2012, we noted that "Life Partners Holdings, Inc. has been cleared of allegations by Texas state securities officials that it did not register life settlement transactions as securities under state law."

So, bullet dodged, right?

Not so fast there, pardner:

"The bankruptcy trustee for Life Partners Holdings Inc. is seeking to control the proceeds of life insurance policies held by its customers after his own investigation revealed a number of new ways he said the company committed fraud."

Yeah, the ol' shock meter seems busted right now.

And my 5 year old prediction seems pretty much confirmed:

"Artificially shortened life-expectancy figures supplied by the company convinced investors that their returns would be greater ... [LP] charged massive undisclosed fees and misrepresented the company’s business practices."

And the list goes on.

Look for this to get even messier, and we'll keep you posted.

Thursday, May 21, 2015

Health Wonk Review at Julie's Place

HWR co-ordinator Julie Ferguson steps up to host this week's 'Review (your scheduled host, moi, is dealing with end-of-life issues with the canine member of our family).

Please drop by for some great insights.

Unalienable Insurance?

Via co-blogger Bob:

Georgia On My Mind

For the last 5+ years Humana has been my "go to" carrier for individual health insurance. Although I
have scaled back my under 65 health insurance business, I still used them almost exclusively throughout 2014 and 2015.

This will be my last year to write any traditional health insurance. After 40 years in this business, switching from large employer group plans to small group and individual coverage, starting in 2016 and going forward my focus will be exclusively helping those age 65 and older searching for answers to their questions about Medicare.

Humana has been good for my clients, and mostly for me as well, but it is not without hiccups.

Through all of the changes that have occurred in this industry, and internal changes at Humana, they have been rock solid.

But it appears their days are numbered, at least with regard to individual health insurance in Georgia.
Georgia is Humana Inc.’s second-biggest market for insurance policies sold under the health law, and the home of what may be its biggest misstep. The company is now attempting a turnaround as it tries to make its strategy of selling coverage directly to consumers a success. 
If it can’t, it will quit the state. - Bloomberg

This can't be good news for Georgia residents that currently have Obamacare plans through Humana.

Until now, Humana has not only had competitive rates and good value but has also had the broadest access to health care.

While other carriers focused on skinny provider networks, Humana continued to deliver almost unfettered access to a large number of medical providers throughout the state.

Apparently that will end come 2016.

For the last 2 years Humana sold a significant number of policies to individuals that order health insurance from the dollar menu. They wrote a lot of off-exchange business (which is all I do) but also gobbled up more than their share of subsidized policyholders.
Humana, which touts its skills at selling health insurance directly to individuals, ran into trouble in Georgia after charging too little for plans it sold on the state’s new marketplace. Customers came running. 
Unfortunately, more of them were sicker than Humana expected. Flooded with patients, Humana let them see doctors who aren’t in its networks. That’s expensive -- health insurers make deals with doctors and hospitals to add them to their networks, negotiating lower prices in return for business. 
The out-of-network generosity cost the insurer.

Non-par claims are not the only thing that sunk this ship.

Under Obamacare non-par claims are paid at the same rate as par claims. There are no consumer penalties for using providers outside the network.

But when a policyholder does use a non-par provider that provider is allowed to balance bill and the consumer is on the hook for the differential.
 If Humana withdraws from states like Georgia, “then you’ve wasted all your time and effort in building a business that goes away.”

That same argument is not just limited to Humana, this is true for anyone, including agents, that are still hanging on to the hope that change will be good for them.

Some will argue that Obamacare was designed to unravel the current health care financing system and drive agents from the industry.

Looks like it is time to hang a "Mission Accomplished" banner over the White House.

Wednesday, May 20, 2015

Dear HHS, Will You Share My ACA Success Story?

March 23, 2010 was an historic day for health insurance in America. It was on this day when we all rejoiced knowing that Obamacare was going to reduce the average premiums for a family of four by $2500. It was going to help small businesses find affordable options to offer employees. It was going to eliminate "junk" insurance policies. Employees were told that if they liked their plans they could keep them.
So how has this Obamacare thingy helped my small company:
  • We have seen an overall decrease in benefits since 2010.
  • From November 2010 to our current plan year premiums have increased 58.7%.
  • If we would have been forced to an Obamacare compliant plan the increase would have been 116.7%
Numbers don’t lie. Click on the picture to see the real impact.

Tuesday, May 19, 2015

Blue Grass State HIX Blues

So this happened:

"[T]he Kentucky Health Cooperative, an ObamaCare creation funded initially by federal dollars and then bailed out with tens of millions of dollars more last year, is insolvent."

Ooops. And of course, the bureauweenies behind this massive #fail appear to be circling the wagons. Which is not unexpected, but a shame, nonetheless.

And why is it a shame, you ask?


"The Kentucky Hospital Association outlined its concerns in a report released Friday called “Code Blue,” saying payment cuts to hospitals are expected to reach nearly $7 billion through 2024. “Kentucky hospitals will lose more money under the Affordable Care Act than they gain in revenue from expanded coverage

It's almost as if the system itself is imploding. The bigger question, of course, is whether this is by happenstance or design.

You be the judge.

Another 1,000 Words on O'Care

Courtesy FoIB Jeff M:

Monday, May 18, 2015

(Not So) Shocking O'Care news

Last week, we reported on the latest Volunteer State health insurance premium woes:

"BlueCross BlueShield of Tennessee has filed to increase its health insurance premiums for 2016 individual plans by 36 percent, on top of a 19 percent increase approved last year"

Never fear, though, 5 other states are next in line:

"[E]xchange insurers in six states where 2016 rate requests have already been filed are seeking to raise rates an average 18.6% next year."

That 36% hike in Tennessee was the high water mark this time 'round; Beaver State carriers are seeking a more modest 24% increase. Folks in Connecticut get a break, with average rates increasing just shy of 8%.

Now, there are some that would argue that this is to be expected, and can't be totally the fault of The ObamaTax.

These folks would be wrong, it is 100% attributable to the train-wreck:

It's All Obamacare

Amazing how ignorant the public, and press, are when it comes to ACA Obamacare.

Sen. Ted Cruz (R-Tex.) wants to kill Obamacare, but he admitted that he might have to sign up for it after his wife took a leave from her job and its benefits. 
As it turns out, Cruz never signed up for Obamacare. He purchased his family's health insurance off the open market. -Washington Post

Good grief!

ALL policies issued since 1/1/14 must comply with Obamacare rules so it is ALL Obamacare.

Friday, May 15, 2015

Volunteer Blues

The Volunteer state is also known as Big Orange Country but it is about to turn red because of Blue.
BlueCross BlueShield of Tennessee has filed to increase its health insurance premiums for 2016 individual plans by 36 percent, on top of a 19 percent increase approved last year. - Nashville Post

How did this happen?
When insurers were tasked with pricing a brand new insurance marketplace in 2013, many had to make their best guesses as to both the frequency and severity of claims stemming from newly covered people. 
In Tennessee, BlueCross BlueShield shot too low. Last summer, Vice President of Corporate Communications Roy Vaughn said the insurer could lose "tens of millions of dollars" in its first year of ACA coverage. At that time, the insurer commanded about 88 percent of the federal insurance marketplace in Tennessee.

So how's that Obamacare working for you?

Blindfolded and Hands Tied

How would you like to do your job, whatever it is, blindfolded and hands tied behind your back?

OK, let's say you are not one of the Flying Wallenda's, but just have an ordinary, everyday job.

How well could you perform your duties?

My guess is, not very well.

But that is what Obamacare did to the health insurance carriers.
“The guaranteed-issue aspect of the ACA essentially negates underwriting,” Stark said, referring to Obamacare rules requiring health insurers to allow anyone to enroll, even if they’re already sick. “Health insurance companies have struggled with plan pricing for the past few years because they now must sell to anyone, regardless of preexisting conditions. 
“Additionally, carriers must include all 10 benefit mandates required in the ACA, all of which potentially drive up plan prices,” Stark said. “Unlike automobile or homeowners insurance, health insurance companies have no control over accepting risk and no control over their insurance product.” - Heartland

The government told the carriers, forget what you have learned over the last 50+ years. You can't do that anymore.

Makes as much sense as the government telling the banks they must issue a mortgage loan to anyone who can fog a mirror.

Wait, we tried that already.

Makes you wonder what DC's next project is, doesn't it?

Thursday, May 14, 2015

Obama Made Me Go Blind

A South Carolina man is going blind and blaming Obama for his predicament.

49 year old Luis Lang is a self employed handyman. He has never had health insurance and always paid his own medical bills.

Lang is a smoker with a history of uncontrolled diabetes
Luis Lang learned in late February that he had suffered a series of mini-strokes that left him with bleeding in his eyes and a partially detached retina caused by diabetes 
His vision has worsened so much that he hasn’t worked since December, which could put the couple’s $300,000 Fort Hill home in jeopardy along with his health. 
“He will lose his eyesight if he doesn’t get care — he will go blind,” said Dr. Malcolm Edwards, an ophthalmologist who has given Lang injections at a discounted rate to control the bleeding. - Raw Story

Lang shunned Obamacare and the exchange, gambling he could always get help in an emergency.

He was wrong.
“(My husband) should be at the front of the line because he doesn’t work and because he has medical issues,” said his wife, Mary Lang. “We call it the Not Fair Health Care Act.” 
Lang found he was a month too late to enroll for 2015, and he now earns too little to get a federal subsidy to buy a private policy. 
Lang and his wife blame President Barack Obama and congressional Democrats for passing a flawed law – although not even private insurers allow people to forgo payments when they’re healthy and cash in benefits after they’re sick.

Speech. Less.

Gender Bender Preventive Care

So, the kind folks at Ballard Spahr (a well-known benefits law firm) passed along info on the efforts by Our Betters in DC© to more stringently enforce the so-called Preventive Care requirements in ObamaPlans. There's the usual litany of "free" (cf: TAANSTAFL) items, and then this particular turn of phrase caught my eye:

"In applying preventive service recommendations that are sex-specific to particular individuals (for example, a transgender individual)"

Regular readers know that the exhaustive list of preventive care requirements contain exactly ZERO male-specific benefits. So here's a conundrum: folks undergoing female-to-male "transitioning" will be giving up valuable coverage, with no corresponding decrease in premium.

Is this fair?

When can we expect to see the first lawsuit?

Will there be popcorn?

Cover Cali sputtering

As Bob pointed out last month, The Golden State's health exchange (Covered California) continues to burn through tax-payer dollars at an alarming rate. That wouldn't necessarily be a bad thing if, say, they had something - anything, really - to show for it.

But alas:

"After using most of $1 billion in federal start-up money, California's Obamacare exchange is preparing to go on a diet"

And why is that?

Well, it's actually pretty simple:

"[A] reduced forecast calling for 2016 enrollment of fewer than 1.5 million people."

You'll recall, of course, that the primary purpose of The ObamaTax was to increase the roles of the insured. Adding insult to injury, that pesky first 'A' in PPACA continues to remain out of reach, even with subsidies:

"[H]ealth policy experts said that some uninsured folks still find health insurance unaffordable"

The problem, of course, is that folks who qualify for subsidies still find it difficult to come up with the scratch to cover mega out-of-pocket maximums, and that's when they're successful even finding a provider who takes ObamaPlans.

So, the state is tightening its metaphorical belt:
• Spend $58 million less compared with the current fiscal year, a 15% reduction.

• Devote the largest portion, $121.5 million, to outreach, sales and marketing. That's down 33% from the current year.

• Maintain the monthly $13.95 fee for each individual policyholder, which would raise $233.2 million in revenue.
I find #2 to be the most ludicrous: sell all you want, if folks can't afford what you're selling, well...

So, who's next?