Tuesday, March 20, 2018

Much ado about ... What, exactly?

Health Agents for America (HAFA) president Ronnell Nolan produces a series of vlogs (basically video blogs) about various issues that we deal with every day. Recently, she posted this one. Please watch (it's only a few minutes long) and then I'll share our discussion about it:

She linked the video on Twitter, with the warning that "one of HAFA's Agents from New Hampshire with a large book of business lost their Anthem contract. Basically, they were told because they could! READ YOUR CONTRACTS!!"

This agency, which had apparently brought a lot of business to Anthem's table, was summarily excused from it. This is not in dispute. Where Ms Nolan and I part ways is in her characterization:

I pointed out that Anthem was well within its rights to execute the contract's cancellation clause, as would be any carrier (and, of course, agents are also free to bail at their discretion). To which Ms Nolan replied:

"Most Agent/Brokers do not know contracts can be cancelled at will. Goes back to the question....whose customer is it. After I bring the company to you....you have a right to discard me?"

Well, yeah.

As I responded, when I request appointment with a carrier I also agree to abide by the terms of their contract (which is supplied to me and which I of course read from cover to cover). And yes, I did bring them my customer/client. Which client, by the way, I am free to move to another carrier in the future, and there's nothing that Anthem (et al) can do about that.

Understandably, Ms Nolan wasn't entirely satisfied with this take, and pointed out that it's "Not wrong by contract you are right. But morally wrong."

Perhaps, although as I just pointed out, it's a two-way street: am I "morally wrong" when I move clients from one carrier to another?

The bottom line is that while I in no way condone Anthem's actions here, I'm not seeing anything illegal or even "wrong" in what they've done. Reprehensible, probably, but not wrong.

Monday, March 19, 2018

From the P&C Files: AirBnB Issues

Several years ago, my daughters traveled to Vancouver (because reasons) and stayed in an AirBnB. What I most recall about the experience was that the hostess insisted upon "meeting" them on Skype and interviewing them to see if they'd be a 'fit.' Having stayed in numerous traditional Bed & Breakfasts myself, this struck me as both odd *and** sensible.

Apparently, not every such host goes that extra mile, and to their detriment. FoIB Tsrblke alerts us:

"An Airbnb host claims that a nightmare guest left $18,000 worth of damage in her home"

After some 300 people trashed their house (invited by her client, no less), the owner admits that there were some "red flags", but it appears that the "green dollars" overcame them.


The corporate folks at AirBnB HQ offer a cool million dollar "guarantee" for hosts, but so far this one's not seen a dime.

So why doesn't she just claim it on her homeowner's policy?

We reached out to our regular Guru of P&C, Bill M, who told us that:

"The use of your home for commercial purposes is typically excluded.  Some companies are coming out with a business endorsement for “air b&b” type exposures.

The biggest thing is to communicate with your agent to discuss challenges and how best to solve them.

And by the way, traditional B&B's can have some of the same issues, especially if the owners/hosts live in the home

As Tsrblke reminds us:

"Nobody in the "sharing economy" is taking basic steps to protect their assets. The company "guarantees" aren't insurance and shouldn't be treated as such."


Friday, March 16, 2018

Willfill Blindness or Simple Fanatacism?

There is no question that insurance companies, primarily as a result of the politics and economics of ObamaCare, contribute less value and drive more out-of-pocket than ever before. And it's also true that Direct Primary Care (DPC) continues to offer a viable alternative method of health care delivery and (to a much lesser extent) health care financing.

But I'm concerned that DPC proponents are, as the saying goes, becoming the abyss:

To which I replied:

And this is becoming a real problem. Regular readers know we have no compunction about calling out Stupid Carrier Tricks, but the fact is, insurance can (and does) play a uniquely vital role in most people's ability to afford catastrophic health care expenses.

Yes, re-introducing true Cat plans would be a tremendous step in the right direction, but we don't have that yet, and aren't likely to any time soon (more's the pity).

But the fanatical DPC Brigade risks losing whatever credibility it's built up by ignoring the actual costs of major claims and presuming that regular folks can bear the brunt of them.


Thursday, March 15, 2018

Ides of March Health Wonk Review

Our good friend David Williams hosts this month's round-up of all things health wonkery.

Do check it out.

Tuesday, March 13, 2018

Another opinion survey

Civis Analytics (CA), a firm started by 2012 Obama campaign veterans, conducted a telephone opinion survey February 28 about American policy priorities.  Powerline reported their results hereand Vox here.

Powerline excerpts two charts from the CA survey.

The first chart shows responses of likely Democratic voters - of whom 45% give top priority to “health care”!  Whut!? Because Obamacare didn't work?  Because this time, they’ll get it right fer shur?  

Reminds me of an old Flip Wilson punch line:  “Hell no, you broke yours off already!” 

The second chart shows responses to the same questions, only this time the sample group is all likely voters – in other words, not just Democrats.  Notice how the percentages change from the first chart to the second.  The second chart reveals far less less support to “health care”.

Yet Civis Analytics has this to say:  Democratic voters, and voters in general, seem very clear in their preference that health care come first.”  Vox opines that “the numbers are strikingly similar, with answers more concentrated around health care and guns”.   Really? Voters in general?  Strikingly similar??

I don’t think so.  I say CA and Vox have it wrong.  I say Powerline has it right: “the results skew when all likely voters—not just Democrats—are reported”.  How much does it skew?  Assuming CA surveyed roughly equal numbers of likely Democratic and non-Democratic voters, the results in the two charts imply about 17% support for “health care” among likely non-Democratic voters. Do 45% and 17% seem strikingly similar to you?   Do 45% and 17% mean underlying agreement?   

Of course not.  CA and Vox both err in looking at the average of the combined surveys as though that average reflects unified public opinion. It’s an error because the responses of the two survey populations show a clear and sharp difference of opinion about “health care”.  Therefore it’s false to claim the overall average represents any general preference.   CA’s conclusion is like claiming that, on average, Americans have one testicle and one ovary.  It’s only “true” when you ignore the reality underneath the average. 

Yet despite Civis Analytics’ (and Vox’s) equivocations, I think the CA survey does reveal two important truths – (1) “health care” remains a divisive issue among Americans and (2) the division still appears to have more to do with politics than with the actual substance of “health care”.  

Low Opinion or Xenophobia (or both?)

Well, have to do the (stupid) Anti-Money Laundering course again (don't ask). Each time I do so, I find something else that's ironic and/or humorous (or, more often:  dumb).

[click to embiggen]
So what are they saying here, exactly?

And aren't the folks who actually write and enforce this material in an "elected or appointed government position?"


Monday, March 12, 2018

On Severability

We first noted this issue way back in 2010:

"[A] federal judge in Virginia has ruled the (Evil) Individual Mandate unconstitutional ... Since the judge has ruled that the precept of "severability" does not attach"

Um, Henry, what's your point?

Well, it actually involves The Lone Star State (and 19 of its closest buds), The Constitution, and the law. Severability simply means that if one part of a particular law is deemed unenforceable, the rest of it could still be fine. But its absence would mean that if one part is tossed, then the rest is, too  (baby, bathwater, you understand). Most legislation includes a "severability clause" that essentially says "hey, even if Part 2 is deemed non-enforceable, the rest of this law still stands." It's pretty standard wording.

Unless you're the Party in Power
©, in which case you ram through a hastily written revampling of our entire healthcare financing and delivery system, and decide one's not necessary [ed: we would also accept "You're the Party in Power© and are too stupid to catch its absence"]. And here's where it gets .... interesting:

The theory behind the suit is that, since Justice Roberts (et al) deemed the Mandate 'kosher' as a funding mechanism, and since  the  Tax Cuts and Jobs Act of 2017 explicitly set that funding at $0, the entire platform on which ObamaCare was built is null-and-void.

Whoa there, Henry, went a little fast there, didn't you?

Okay, remember that "severability clause:" we discussed? Well:

"Once the heart of the ACA — the individual mandate — is declared unconstitutional, the remainder of the ACA must also fall."

Of course, the Supremes will do what the Supremes will do, but this seems like at least a viable argument.

Sunday, March 11, 2018

'Nuff said

[Hat Tip: tsrblke]

Friday, March 09, 2018

Breaking: CMS puts kibosh on Gem State ACA plans

Back in January, we reported on Idaho's decision to circumvent the #ACA by allowing carriers "to sell cheap policies that ditch key provisions of the Affordable Care Act."

At the time, we wondered how that would play out from DC's perspective.

Well, now we know:

"CMS Rejects Idaho Proposal for non-Affordable Care Act Plans"


CMS honcho Seema Verma [ed: which would be a great name for a rock band] points out (correctly) that ObamaCare "remains the law, and we have a duty to enforce and uphold [it]."

So that's that.

For now, anyway.

InsureBlog meets Mercatus

Yesterday, I had the distinct privilege of meeting longtime Friend of InsureBlog Bob Graboyes, Senior Research Fellow and Health Care Scholar at the Mercatus Center at George Mason University, and esteemed co-blogger Patrick Paule. Bob was in Columbus for a speaking engagement, and so Patrick and I drove in so that we could all meet, break bread, and shmooze:

[click to embiggen]

It never fails to amaze me that one can develop such strong bonds over these electronic tubes, and what a delight it is to actually meet "in the real world." Our conversation ranged from family, to background, to policy (of course!), and it was just a great opportunity to share ideas and get to know one another on a more personal level.

Thanks, Gents!

Wednesday, March 07, 2018

Triumph of Socialized Health "Care"

For certain values of "triumph," of course.

First up, the caring, compassionate folks at the Much Vaunted National Health Service© seem to really enjoy killing newborns:

"The parents of a seriously ill toddler have lost their appeal against a High Court decision to end his life support."

Alfie Evans, a 21-month old Brit, has been fighting hard for his young life. But the Powers That Be at the MVNHS
© are (literally) pulling his plug, even though his parents have requested to send him abroad for treatment.

And I'm sure that there's no irony ion the fact that the hospital he's being treated at, well, was being treated at, is in Liverpool.

Interesting Pathway, nyet?

But we really shouldn't be that surprised, since we see similar results here in our own version of government-run healthcare:

"Obamacare Medicaid expansion is causing more disabled people to die on waitlists."

Shades of the VA, no?

Again, what good is having "insurance" if you can't actually access care?

Inquiring minds....

[Hat Tip for Baby Alfie storyNDH]

Monday, March 05, 2018

Latest #ACA Winners and Losers

Last time we checked, Blue Cross/Shield of North Carolina had just "filed for a 22.9 percent rate increase."

So how'd that work out?

Well, FoIB Jeff M alerts us that the carrier - the largest in The Tar Heel State - appears to have done okay for itself, as it:

"[H]as reported a higher than anticipated net income margin in 2017 at 7.8 cents for every dollar of revenue."

I bet.

Over on The Twitter, Dr Ari Friedman warns us about the dangers of ObamaCare's Medicaid expansion:

"Declining Medicaid Fees and Primary Care Appointment Availability for New Medicaid Patients"

To be fair: someone has to pay the piper.

Finally, longtime FoIB Holly R tips us to this bit of non-helpful rhetoric from the anti-ACA side:

"Sen. Orrin Hatch calls Obamacare supporters 'stupidest, dumbass people'

The Senator may not be wrong, but this kind of inartful, divisive and insulting characterization does not help out the good guys. In fact, it cheapens and denigrates the anti-ObamaCare argument.

Respectfully: Zip it, sir.

Friday, March 02, 2018

More Great News from the MVNHS©

Free health care rocks!

Wait, what?

The Much Vaunted National Health System© strikes again:

Not So Open Enrollment

I've been working with a referral over the past few days. This young man works for a regional retail store, and thought he'd enrolled for the group health insurance during their most recent Open Enrollment period (he was a relatively new hire at the time), but found out unexpectedly (at the provider, natch) that he had not, and was currently uninsured.

So he went to HR to try to get back on-board, but his appeal was denied. Ken was told that he'd have to find another health insurance plan, "any plan," in fact, and then cancel it to be eligible (yeah, didn't track for me, either, but there it was).

Over the course of several emails and phone calls, Ken shared with me this little tidbit that seemed to confirm what he was being told:

[click to embiggen]

Eagle-eyed readers will note the two rather glaring problems here. First, does no one use spell-check any longer? Second - even more egregiously - as I pointed out to Ken, "Credible" coverage would mean any ID card I successfully PhotoShopped together. And it's not like "Creditable" coverage is a new term, it's been around for at least 20 years.

In the event, we still had to get him something for a month, but with ObamaCare's Open Enrollment in the rear-view, and no Special Open Enrollment triggers available, what to do?

Of course, this is a perfect use of Short Term Medical (I mean, how much shorter of a term could there be?), so we got Ken signed up for March, and we'll cancel it at the end of the month so he can qualify for group coverage.

What's that? "Playing chicken, you say?"


My concern is that we'll get to the end of the month, cancel the STM, and then find out that it wasn't "Credible" coverage, after all. All we could do then, of course, would be to look at another STM, or perhaps explore other options for the balance of the year.

I'm not happy about this, but at least we've bought him some time.

Thursday, March 01, 2018

"Duty of Care"

Our friend Peter Shulteis at Global Underwriters wants folks to be aware of some critical issues related to working in distant lands:

"The number of people driving and flying for business purposes each year is astounding. The Global Business Travel Association counts over 488 million trips taken annually. Each year business travelers take an average of 12 trips, typically lasting at least 5 days. An estimated 1.3 million business trips occur daily in the U.S. alone. These figures are expected to grow another 7% this year.

Even with video conferencing, webinars, and daily conference calls business travel continues to increases and is vital to the success of your clients company. Hectic schedules, missed flights, transportation issues, and hotel problems are the least of employees' worries. Many employees are citing concerns related to personal security, terrorism, political unrest and infectious disease epidemics.

It's crucial that companies and organizations embrace Duty of Care obligations [ed: about which we've previously posted] and take the necessary steps to reduce potential dangers or problems that could occur while employees travel. Employers need to have a well communicated plan in place and part of this plan is providing Business Travel Accident (BTA) insurance for their employees. BTA insurance is an inexpensive benefit that supplements any employee benefit program. This World Class Protection is designed to offset the risk and potential loss of a key employee(s) and to compensate families of employees for their loss of income due to accidental death or permanent disability of a loved one

So, what is Business Travel Accident (BTA) insurance? Basically, it "provides protection for employees who travel on business domestically and / or internationally."

By the way, this is available both for American companies sending folks abroad, and for business travelers coming to our fair shores.

Peter goes on to note:

"Most companies and organizations are innocently unaware of potential hazards that exist for employees that travel on behalf of the company or organization. Employers need to know how a Business Travel Accident (BTA) policy can mitigate risk for both the company and employee(s). Serious consequences can be levied against companies or organizations that neglect to properly insure or protect their employees when they travel."

Thanks, Peter!

And readers interested in more detailed info on BTA should click here.