Tuesday, October 13, 2015

LTCi in the News

Item the 1st:

Northstar State bureaufolks are contemplating how they'll respond to recent (and often dramatic) Long Term Care insurance rate hikes. The good news?

"Over 99 percent of the policyholders have kept the policies, even with the increases"

On the other hand, venerable insurance wonk Joseph Belth castigated the industry, remarking that "there are many reasons why private insurance cannot be a good solution for handling LTC risk ... the probability of loss is high, knowing whether a covered loss has occurred is open to debate"

Um, not really, Doc: the contracts (and insurance policies are contracts) specifically identify triggers, and there's no evidence of widespread bad-faith claims denial.

Item the 2nd:

Meanwhile, in California, Gov Jerry Brown has signed off on legislation that tweaks how non-forfeiture benefits are handled. LTCi plans allow policyholders faced with rate increases to elect alternate benefits, such as a shorter payout timeline, or lower daily benefit amounts. The new law tightens up insurers' notification obligations.

Item the 3rd:

FoIB Jeff M alerts us to this report on the causes behind many policy lapses:

"Cognitively impaired individuals are more likely to allow a long-term-care insurance policy to lapse even though they're more likely to need long-term care ... less wealthy households allow their LTC policies to lapse more frequently, due in part to inability to continue paying insurance premiums"

As to the first, this is puzzling: all LTCi applications include the name of a 3rd party who would receive notification if a policyholder was behind on premiums. I can't imagine a scenario where that would be left blank (although, I could see where a change might not be communicated to the carrier).

The second is more nuanced: yes, premiums increase. But (as noted above), policyholders are offered various premium reduction options. Still, there's no perfect answer.

Monday, October 12, 2015

Cancer Walk 2015

Time's running out on this year's Making Strides Against Breast Cancer campaign: the walk is  just a few days away, and you can participate without even taking a step:

Just click here to make your donation, secure in the knowledge that you're helping to bring a cure one step closer.

Thank you!

An unCO-OPerative season

When they were first introduced via the ObamaTax, "Consumer Operated and Oriented Plans (CO-OP's) were ... an alternative to private health plans that are being offered to individuals and employer sponsored plans." They were touted as "start up insurance companies funded with taxpayer money that was set aside in the law. Each state was to have at least one or two of these not-for profit operations that would keep "profit mongering" private health insurance companies from paying extreme salaries to executives and huge dividends to wealthy investors."

As with most such initiatives based more on good intentions than sound economics, that hasn't worked out so well in practice. For example, as Patrick mentioned earlier this morning, the Blue Grass State's incarnation of this program has assumed room temperature (no surprise, as it's due to receive less than 12% of the risk corridor funds it was promised).

But it gets worse (depending on one's perspective, I suppose). Co-blogger Bob tips us to this disturbing (but inevitable) news:

"Half of Obamacare co-ops have eroding financial health."

The WashPo folks have even included a handy table to track these oncoming train-wrecks; it's not a pretty sight. If one were a betting person, I'd recommend $20 on Louisiana to go next.

But hey: rousing success.

Another One Bites The Dust (Part 5)

The Kentucky Health Cooperative announced it will be ceasing operations December 31, 2015 leaving 31,000 without their current health insurance plan. The federal government had funded them with approximately $58 million for start up and reserves. How much of that taxpayer money is given back is anyone's guess.

In it's announcement Kentucky Health stated that a big reason why it is closing is due to the fact that under the Risk Corridor program they are only receiving $9.7 million dollars instead of the $77 million they thought they were going to receive.

This theme is beginning to sound like a broken record.

WINhealth Loses

WINhealth, a Wyoming based insurance company announced that it will not be participating in the federal exchange this upcoming year. The decision is directly tied to the federal government's failure to have a timely, effective, and stable risk corridor program. Didn't Hank just mention this?

This shouldn't come as a surprise. When the government can't tell you how much you are owed and when/if you will be paid, even a risk based industry is unable to manage.

Friday, October 09, 2015

Training Day Update 2


Figured I'd update readers who've been following the saga of my 2016 Exchange training travails.

So, received this from the CMS folks:

"Thank you for contacting the Marketplace Learning Management System (MLMS) Helpdesk.

When you enrolled, you were not assigned the curriculum for Navigator – it was not added to your record.  The Navigator curriculum has 14 courses.  You still need courses 011, 012, 013 and 014

Only one problem, which I quickly pointed out to the rocket surgeons at CMS:

"I am NOT a Navigator, I am a licensed insurance agent."

That was Tuesday; I re-sent it an hour or so ago.

And the wait continues....

BREAKING: Mid-sized Groups dodge a bullet

President Obama has signed into law the PACE Act, which allows each state to continue to determine the definition of "small" group. Without it, the definition would become 2-100 lives nationally.

It's expected that Ohio will continue to define "small" as between 2 and 50 employees.

About that 3000% rate decrease: Part 6,549

Bill and Susan have a grandfathered HSA-compliant health insurance plan which covers them and their three children. Because it's Grandfathered, it's immune from some ObamaTax requirements (such as maternity coverage), but it also means that they can't make any changes (such as increasing the deductible to save premium dollars).

Their December renewal landed on my desk the other day, and it's a doozy. Their plan has a $6,000 family maximum out-of-pocket (MOOP), and their rate jumped 30% to just under $1,000 a month. They're not subsidy-eligible, so no help there.

Of course, I suggested that we shop around, but (as usual nowadays) I warned them not to get their hopes up.

Which turned out to be good advice:

Company A offered a plan which doubled their family MOOP to over $12,000, and cost $15 a month more than their renewal, Yippee!!

Company U had a slightly better "deal:" Bill and Susan could shave $20 a month off their premium, and only double their out-of-pocket.

Or they could choose a plan with only $1,300 additional exposure, and a slight premium increase of only $200 more than their renewal.

Such a deal!

Early Fall Health Wonk Review is up

As usual, Joe Paduda has an outstanding selection of wonky posts, including a fascinating inside look at the role of IT and automation in health care.

Good stuff.

Thursday, October 08, 2015

La Plus ca Change

Hey Mr Peabody!

Wayback (SWIDT?) in 2006, we blogged about Minnesota Blue Cross/Shield's new, bleeding edge health care transparency program:

"So, pick up a box of cereal, a package of pasta, or a can of peas, and you’ll find a handy little chart on the side. This is the Nutrition Facts label ... HealthcareFacts goes one (or three) better, by disclosing not just prices, but quality of care, outcomes, and more."

The idea was to distill critical, relevant health care cost information into as simple (and helpful) a form as possible. And it was indeed genius: who among us haven't at least glanced at the label on, say, that can of beans, or carton of milk? How great would it be to have that kind of detailed, but easily understood, information at one's fingertips when considering various health care options?

Fast forward 9 years, and, as Allison Bell reports, the federal SBC (Summary of Benefits) info required of all health care insurance plans have become bloated and useless:

"Federal regulators eventually decided that "four pages" could mean both sides of four sheets of paper."

Eight pages of fine print? Who reads that?

But it's "the law," so carriers are forced to toe the line.

Now, there's a movement afoot to reform that:

"When text boxes are long and full of complex terms, consumers will avoid reading the information in its entirety," officials say"

No kidding.

The reality is that people, as a rule, don't read their insurance policies any more than they read the EULA they agree to when they download a new app for their phone. Which is a shame: the whole point of the exercise is to produce a more well-informed health care and health insurance consumer, no?

Wednesday, October 07, 2015

Promise: Broken

Not to sound like a broken record, but remember when President Obama swore that "if you like your insurance, you can keep your insurance?"

Just got email from Humana that the following letter is going out to at least one of my clients:
Re:    Policy Number:
Your current Humana plan will no longer be available in your area for 2016
You will need to select a new health plan between November 1 – December 15,2015

Dear :

Unfortunately, your current Humana plan will no longer be available in your area beginning January, 2016; however, it will remain the same as it is today until December 31, 2015, as long as you continue to make your monthly payment. We know how important it is to select the health plan that best fits your needs, so we would like to help you understand your options and what to do next.
The entire letter is available here.

Color me shocked.

Urgent for our NJ readers

New Jersey health officials say nurse reused syringes while giving flu shots; testing urged.

Unintended Consequences #2,584

Back in 2013, we posted on the travails of an Old Line State same-sex couple trying to untangle their health insurance:

"I got a call today from a woman who needed to find new coverage. She had been covered by her same sex partner as a domestic partner, but since Maryland passed gay marriage, she's now been told that she can no longer stay on the policy unless they get married."

Fast forward two years, and the post-Obergefell era is claiming another scalp:

"The Obama administration reversed a policy Monday that had allowed unmarried federal employees and retirees in same-sex domestic partnerships to obtain insurance coverage for children of their partners"

That is, until now, same-sex couples could cover their children on their gummint-issue health insurance even if they weren't married. Back in Aught 14, "the Office of Personnel Management broadened eligibility ... It made children of an employee or retiree’s same-sex domestic partner — although not the partner himself or herself — eligible." That is, they could add their "step-children" (but not their Significant Other) to their health insurance plan.

As a result of the SCOTUS Obergefell ruling, that's no longer the case, and these folks will now have to join us great unwashed in searching for affordable health insurance.

Be careful what you wish for.

[Hat Tip: HotAir]

Tuesday, October 06, 2015

An embarrassment of linkage:

In no particular order:

■ Up to 3 million ObamaTax victims enrollees stand to forfeit their subsidies next year because they're behind on filing their taxes:

"Fully 40% of taxpayers who received ObamaCare subsidies last year haven't filed their taxes yet and are at risk of losing their subsidies for next year"

This, in addition to looming rate increases - Yikes!

■ Fear of going to the dentist is a major issue for a lot of folks; in fact, it affects 75% of us to some extent. But that may become a thing of the past with new Scottish tech (no, not that Scottish tech):

"Remineralization is a natural process ... Reminova's prototype device can speed up this process to the same amount of time it would take to have a filling -- but painlessly, without injections and drilling.'"

Sign me up!

■ LifeHealthPro's Allison Bell alerts us to something that's generally been under the radar:

"[I]nsurers that participated in Gen Re's latest critical illness issuer survey reported a total of $380 million in 2014 critical illness premium revenue, up 15 percent from the 2013 total."

It seems that the Critical Illness (CI) market is exploding, and it's not difficult to understand why: these plans pay actual cash dollars to their insureds who suffer a listed condition (such cancer or stroke).

Something to consider if you have one of the new high out-of-pocket ObamaPlans.

Monday, October 05, 2015

Training Day Update 1

First, the good news: I received email this morning from the training "Help" Desk in reply to my pleas for assistance.

The bad news is what it said:

"After you have completed all registration requirements for the Individual and/or SHOP Marketplace, you may print your completion certificate specific to the Marketplace(s) for which you completed registration.

Note: your certificate will be marked Incomplete if you have completed training but you have not completed identity proofing. After you have completed training and identity proofing, your registration completion certificate will be marked Complete

Here's the problem:

[click to embiggen]

I've obviously completed step 1 and, as noted previously, completed all the training (as confirmed by the site itself).

So I replied that I had, in fact, completed both the identity proofing (?) and the training, but am still unable to print the certificates.

Wait and see, I suppose.