Friday, March 22, 2019

Happy Anniversary!

For certain values of "Happy:"

Thursday, March 21, 2019

Policy Loans: The Dark Side

One of the benefits of cash value life insurance plans (eg Whole Life, Universal Life, etc) is the ability to "borrow against" it. That is, as the cash value (equity) increases, it's available as a loan, with the death benefit as the collateral.

This can be very handy when sudden, unexpected expenses rear their ugly heads. For example:

"Unable to secure a large enough bank loan, Walt Disney borrowed against the cash value from his life insurance policy to help finance the creation of his new theme park, Disneyland."

Other famous folks with similar stories include James "JC" Penney and Ray Kroc.

Of course, there's a balance here: while these loans can be quite helpful, they have the potential to be very dangerous, as well.

How's that, Henry?

Well, generally speaking, if one borrows from a policy and fails to pay it back, then the company merely subtracts the balance due from the death claim. No harm, no foul, no taxes. But what happens if one borrows from the policy, and it dies before the insured? That is, if it lapses while the insured is still alive?

Well, in that case, the borrower (and potentially his/her heir) are in for a nasty surprise: Form 1099-R.

Such was the case for a recently deceased client:

In January of '18, she let her Whole Life insurance policy lapse with a substantial loan balance. This January, she passed away. Yesterday, I got a call from her widower asking why he had received a tax form from Acme Life. I asked for the policy number to which it referred, and advised him that when the policy lapsed last year it created a taxable event, and that the balance due is being treated as taxable income (which would have also been the case if my client was still with us).

I always advise clients who take loans against their plans to at least keep up with the interest each year, to avoid the loan balance snowballing until the policy is unrecoverable.

Now you know.

Wednesday, March 20, 2019

A Friend Needs Help

My college roomie and Best Man is married to a wonderful, vibrant, caring woman who has been diagnosed with early onset Alzheimer's. She is fading fast.

Deb and Rich recently moved from Connecticut to Florida to see if the change of environment would be beneficial. Unfortunately, her condition has continued to deteriorate, and she is now in a nursing home. Rich would like to bring her back home to Connecticut, but lacks the funds to do so.

He has set up a GoFundMe to try to resolve that. Please consider donating to it.

Wednesday Roundup: International edition

We've written before about the so-called 'Secondary Market' for life insurance:

"And so, as part of HIPAA, a new word entered the popular lexicon: viatical. Basically, one can sell one's plan to a 3rd party with little (or no) tax consequence."

But of course, the good ol' US of A isn't the only place on Earth where this type of sale takes place. Our Neighbors to the North also have this available, but it's getting a little more 'iffy' as to the buyer's benefits. According to FoIB Allison Bell:

"Manulife Financial Corp. and other Canadian life insurers won a legal battle against hedge funds that contended the insurers should be compelled to take unlimited deposits into high-yielding investment policies."

This basically serves to limit the tax-advantaged growth available to certain plans, and re-focuses on the death benefit itself. Will be interesting to see if these restrictions wend their way here.

One of our most enduring memes here is that coverage ≠ care; that is, insurance doesn't guarantee that actual care will be available, either quickly or even at all. And so we look again at CanuckCare© as a warning to those who advocate MedicareForAll:

Be careful what you wish for.

And piling on, we look Across the Pond to Britain's Much Vaunted National Health Service©:

"HIP replacements, cat­aracts, varicose veins and tonsillectomies are among a string of surgical operations that will no longer routinely be carried out on the NHS "

[Hat Tip: Sally Pipes]

Since even (especially?) socialized medical care schemes have proven unsuccessful at reining in the cost of care, the only viable alternative is to ration deny it.


Tuesday, March 19, 2019

Monday, March 18, 2019

MVNHS© Winninng: A Story in Two Parts

Part 1:

This is what happens when a country turns its medical care over to government bureauweenies. As a result of consistent and increasing budget cuts, the Much Vaunted National Health Service© is "push[ing] more patients towards paying for treatment privately."

Wait, what?

"paying for treatment privately"

It's a not-so-closely guarded secret that even countries with government-run health "care" have huge markets for private insurance. As we reported 7+ years ago:

"Private Medical Insurance ... allows you to have complete reassurance of knowing that, should the need arise you and your family can receive medical treatment privately, without waiting for the NHS to treat you."

We wondered at the time about why this was necessary, given the free and widely available health care that is the MVNHS©. Now we know.

Part B):

One of our most enduring memes here at IB is the fact that health care ≠ health insurance. That is, what good is the coverage if there's no one to provide the care?

Well, our British Cousins are learning this lesson good and hard. From FoIB Rich W:

A lesson to be learned as we rush headlong toward #Medicare4All: Be careful what you wish for.

Friday, March 15, 2019

*True* Junk Plans: A Retrospective

So big news on Capital Hill:

What they really need to be reviewing are the true junk plans:

"Twenty percent of Ohio adults reported that they or a household member go without medical care because of the cost even though more than 90 percent of them have health insurance"

Hint: They're not talking about STM's....

Thursday, March 14, 2019

Blue Cross: Word Salad edition

So this morning, FoIB Jeff M emailed this item about the planned merger of Blue Cross Blue Shield of North Carolina "with Portland, Ore.-based insurer Cambia Health Solutions. The two not-for-profit organizations with combined revenue of $16 billion and more than 6 million customers said the alliance will make health care "simpler, better and more affordable."

Wait a minute: what does "simpler, better" actually mean?

Well, it depends. According to the official email announcement:

It might mean "Each company retains its current assets, such as its reserves and capital, and there is no change to the underlying business in our states."

On the other hand, it could be that "The companies will share services, which will cause some resources to shift."

On the gripping hand, perhaps it notes that "Our long-term goal is to make health care more affordable for the individuals and families we serve ... Our expertise, common management and increased resources will allow us to better address rising costs in the health care system by reinvesting shared savings, enhancing price transparency tool."

Okay, but why does all of that remind me of this?

In the end, one suspects that it means "business as usual," only with a bigger footprint.

And as Jeff notes, a look at their website seems to indicate that "they still think healthcare and health insurance are the same."



[click to embiggen]
So, FoIB Holly R sent us this:

"Just had a doctor's office tell me the doctor couldn't discuss test results over the phone because of HIPAA. This is false, and another reminder that medical facilities constantly use HIPAA as a bogus excuse for being opaque and difficult."

Interesting take, and one I've heard before. But is it true?

I reached out to co-blogger Kelley B, herself a medical office manager, for her reaction. She replied:

"The reality is that the doctor will be paid nothing to tell the patient his test results over the phone. Since this requires medical decision making on the doctor's part, he/she is entitled to be paid and that means that the patient has to come in for an appointment. The patients hate this because it costs them money.

Is it a HIPAA violation. It could be as you cannot confirm that the person on the other end of the phone is the patient. It is in the doctor's best interests not to give out results over the phone and have the patient come in."
That makes sense, although I would point out (before others do) that under the nascent DPC (Direct Care) model, that first point would be moot, since the doc's already been paid.


Wednesday, March 13, 2019

The (New, Improved?) ACA is Working

Regular readers may recall that the current administration loosened a lot of the rules surrounding Short Term Medical (STM) plans, and the ensuing hue and cry from 'the usual suspects' about the world ending (or worse!) as a result.

Well, preliminary results are in, and guess who comes out standing tall (hint: it's not the naysayers):

Turns out, folks who bought these plans are, for the most part, completely satisfied that they worked as promised; in fact, over 80% of buyers who actually had claims were either satisfied or even very satisfied.


And most of the folks who had claims also "said their policies covered what they thought the policies would cover."

Imagine that.

Would that ObamaPlan victims insureds were so satisfied.

Meantime, Colorado becomes the latest state to ban sales of STM plans altogether:

"The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has amended the regulation governing short-term limited duration health benefit plans, requiring these plans to provide many of the same protections afforded by Affordable Care Act (ACA) qualified plans."

In other words, no more short term plans for Centennial Staters.

Wonder why their leaders hate choice.

[Hat Tip: FoIb Lynne]

Tuesday, March 12, 2019

Outstanding Vendor Tricks: Dental edition

Over the years, we've detailed any number of really stupid vendor tricks; the list of terrific ones is, unfortunately, much shorter.

Well, that latter list just grew a little larger today, as Superior Dental Care joins that august group.

And why is that, you ask?

Well, because they are an absolute joy to work with. Case in point:

Recently, I was privileged to write a brand new small group (as in, they'd never had group health insurance before). A month or so later, they asked about adding voluntary dental ("voluntary" in this context means employee paid, no employer contribution). I don't do a lot of dental, but Superior Dental (SDC) is one of my two go-to's for it. Superior especially is a delight, because they just make things so easy. In this case, we were going for a March 1 effective date, and the employer emailed me the forms on February 27.

Except I never received that email. So I presumed that they had decided to either change their minds, or were opting for an April 1 start date. So last week I followed up to see if they were still interested. They replied "of course, we sent you the paperwork last week!"


So I called our SDC rep to see if there was any chance we could still get that March 1 effective date, even though it was already the 7th. And the answer was "of course, just send us the forms right away and we'll get that done for you."

So I called the client and they re-sent the forms, which I dutifully forwarded to SDC.And this morning, I received confirmation that the plan was activated on March 1, and that ID cards would be on the way shortly.

Doesn't get any better than that.

Kudos to Superior Dental Care.

Monday, March 11, 2019

More MVNHS© #Winning

Saturday, March 09, 2019

#Winning: Socialized Health "Care" edition

Friday, March 08, 2019

Friday O'Care Reminder


Thursday, March 07, 2019

A (Timely) Blast from the Past

I had completely forgotten this post from co-blogger Mike, but it is incredibly relevant today. For one thing, it echoes a longstanding principle here that health insurance health care. And it presciently touches on the (Evil) Individual Mandate and the Death Panel that have been ObamaCare hallmarks. Finally, it seems to be an early, distant warning about what lies in store for us if (when?) Medicare4All is actually implemented.

Oh, what's it called?

"Why isn't health care compulsory?"

Here's a taste:

"I’m not talking about health insurance. I’m talking about health care. Health insurance is not the same as health care. Who calls their insurance agent when sick or injured? Who calls an actuary? Don’t real people call their doctor or go to the emergency room?"


And there's this:

"First, all health care professionals become employees of the Federal Government, paid a living wage from public funds. Second, hospitals, clinics, labs and other facilities are nationalized and their staffs also become employees of the Federal Government ... it is illegal to seek or receive health care from anyone except a Federal health care professional."

Yes, yes it is rather scary.

And that's the point.

Read the whole thing here.

Wednesday, March 06, 2019

The More Things Change: 2019 edition

So, FoIB Steve Downey alerted us to this item at CNN:

"A woman received nearly $375,000 from her insurance company over several months for treatment she received at a California rehabilitation facility. A man received more than $130,000 after he sent his fiancée's daughter for substance abuse treatment."

Okay, that's (very) nice for them, but what's that got to do with the price of tea in China, or insurance, well, anywhere?

Well, these folks got these checks as a result of Anthem's (alleged) strong-arm tactics being brought to bear on non-network providers to join up. Generally, carriers pay even out-of-network providers directly (although at less than in-network rates, natch). This has the non-network providers unhappy...

What? So what's the big deal,  you ask?

Well, if you're General Hospital and your patient just got the $375,000 from Anthem, how quickly do you think said patient's going to run it down to your business office to sign it over? Or even bother to do so? And yes, you can sue the patient, but that adds to your own wait time, as well.

Yeah, that's the big deal.

What will be interesting is to see whether the plaintiffs prevail. I doubt it, since Anthem's actions don't seem to be illegal. To the contrary, it could very easily be argued that the carrier has a higher duty to the insured, since there, at least, is a contract (the insurance policy). Not so with the non-network provider.

Oh, and lest one thing that this is some crazy new tactic: well, it's not. As I replied to Steve:

"We blogged on something like this *years* ago (will take a while to dig up), so nothing new under the sun, But *does* point out the lengths to which some carriers will go to get their way."

Well, I eventually did find that (very) old post, and I was right:

"When Premier's network contract with Anthem expired on Jan. 1, Anthem stopped paying Premier directly ... Anthem sent reimbursement checks of four and five figures to enrollees instead.”

We'll keep you posted on this latest attempt.

Tuesday, March 05, 2019

Anthem/Peach State Update

Whew boy!

So, readers may recall our post from a month ago regarding a class action lawsuit brought by a large Georgia law firm "on behalf of thousands of Georgia healthcare consumers misled by Anthem's “deceptive marketing scheme.” The story is that these insureds were (allegedly) promised that "if you like your doctor, you can keep your doctor" [ed: ISWYDT]. This turned out to be, wait for it .... not the case, which left these poor folks with a lot of out-of-network issues. We promised to update this story as it developed.

There are developments:

It wasn't clear at the time just what relief these clients sought, turns out to be out of left field: instead of (or, perhaps, in addition to) monetary damages the firm "is asking a federal court to allow thousands of consumers victimized by multiple false marketing claims to be granted a “special enrollment period” to switch to a new health insurance company."

If the request is granted, it would be a first, and could set an interesting precedent.

Oh, and it's not just that the providers are out-of-network, but the carrier has also "revers[ed] its marketing promise that consumers would not be required to seek referrals before seeing specialists."

Still, I don't see how Anthem's (alleged) bad faith has anything to do with the ACA, nor that the Feds have the authority to make such an accommodation.

As before, we'll keep you posted.

[Hat Tip: Whitney D]

Monday, March 04, 2019

Monday Morning LinkFest

We've posted fairly often about Health Care Sharing Ministries, most recently here:

"After some online research Mazie, who lives in Miami, found something he thought was a godsend: United Refuah HealthShare, a Jewish alternative to traditional insurance ... He was thrilled by the bargain-priced plans."

This was news because this model of health care financing is typically offered with a Christian slant (NTTAWWT). Regardless, they're gaining in popularity (sort of: there are about 1 million folks on these plans, which makes it a rounding error), and the movement wants a seat at the table as we look for ACA alternatives:

"The health sharing plan movement made itself felt recently at the Inter-Company Marketing Group’s 2019 annual conference."

Good for them!

It's true that we spend a lot of time dissing on Britain's Much Vaunted National Health Service©, and with (very) good reason. For example, FoIB Sally Pipes alerts us to this latest news:

"NICOLA Sturgeon has admitted she is not “surprised” that NHS waiting times are still getting worse despite bringing in a legal guarantee to prompt treatment seven years ago ... [Last] week, official figures showed a record 27.3 per cent of patients waited longer than 12 weeks in the last quarter of 2018, the equivalent of 200 breaches each day."

But hey, it's free!

And on its way here, if the M4A folks have their way.

Even with ObamaCare's actual body count, we're still doing pretty darned well in the health care results metric. From FoIB David Balat:

"The world’s leading medical journals report the U.S. has superior results, including for cancer, heart disease, high blood pressure, diabetes, and high cholesterol."

The Tweet links to an article behind WSJ's paywall, so...

Friday, March 01, 2019

Meanwhile, at the MVNHS© [UPDATED]

[Scroll down for update]

So about that bending the cost curve down by way of nationalized health "care:"

"Friday’s report by the public accounts committee into the cost of clinical negligence in hospital trusts reveals that the bill has quadrupled in 10 years to [~$2 billion] and is expected to double again by 2021."

So why are these expenses climbing so high and so rapidly? Well, there seem to be a couple of factors in play:

"As well as increasing damages for a small and stable number of “high value” ... there is a growth in the number and cost of “low value” claims."

The vast majority of those "high-value" claims, by the way, are maternity-related.

But why the increase in claims themselves?

Apparently, there's a mysterious connection between "steeply rising demand and chronic staff shortages." I mean, who could have foreseen that in a government-run system? And this in turn has led to "endless examples of deteriorating patient safety."


#Unexpected #MedicareForAll

UPDATE: And just when you thought things couldn't get worse under this mess:

"NHS 'backs plans to scrap four-hour A&E maximum waiting target'"

Because it had been working out so well previously. From 2 years ago:

"Nearly a quarter of patients waited longer than four hours at A&E last week with just one hospital hitting its target."

Hey, at least they're admitting that they can't meet their own (rather modest) goals.

[Hat Tip: FoIB Sally Pipes]

Thursday, February 28, 2019

Hey Scooter!

Well, scooters, to be precise. As in, those now-becoming-ubiquitous motorized units one can rent on the fly. Well, as with much new transportation tech, new insurance issues arise.

The folks at the Insurance Information Institute  alerted us to a story focusing on the question of how or even whether these scooters, and those who rent them, will be covered in the event of an accident:

"An e-scooter company’s insurance policy might not cover a user in the event of an accident. Many e-scooter companies also require users to assume all liability arising out of their e-scooter use."

Okay, that makes sense; after all, Hertz isn't responsible when one of its customers totals someone else's car. But auto insurance generally covers that (as usual, always confirm this with your own agent ahead of time). How does this apply to renting one of these little guys?

I reached out to our guru of P&C, Bill M, asking:

This is about those e-scooter (like rental bikes, but motorized). Specifically, I'm curious about:

"An e-scooter company’s insurance policy might not cover a user in the event of an accident. Many e-scooter companies also require users to assume all liability arising out of their e-scooter use."


"Whether a user’s personal insurance would cover any third-party liability arising out of an accident they caused or contributed to depends on the specific terms and conditions of their policies."

So for example, if I rent a bike (you see these at UD, etc), and hit someone, how would this be any different, liability-wise?


"Personal auto: A standard personal auto policy excludes liability coverage for a vehicle with fewer than four wheels"

So I'm wondering if there's any coverage at all. And not just liability: what if I rent one of these and wreck it? Am I on the hook for replacing it, or will my insurance step in?"

To which Bill graciously replied:

"Spoke with one of my carriers and they said that we would cover this under the auto policy.  This would require each individual to ask their home and auto carrier specifically.

They said they would treat it just like a leased auto in extending coverage.

Just keep in mind it is one company’s opinion

Of course!

This specifically caught my eye:

"...treat it just like a leased auto"

As I told Bill, "Okay, that surprises me: it makes actual sense."

Again, please make sure to check with your own agent before pulling clicking "Yes."

Wednesday, February 27, 2019

Testing, testing, is this thing on?

What thing, you may ask?

Oh, that fitness app on your phone, or the Fitbit on your wrist, or even your shiny new BlueTooth-enabled treadmill.

And by "on," I mean listening intently and passing along what it hears, measures and records.

We've touched on this topic before, most recently here:

"Runner found to be a hitman after GPS Watch ties him to crime scene ... The health-conscious assassin was picked up for another murder, then investigators found his Garmin."

Which may be a win for law enforcement (and society as a whole), but as FoIB Holly R alerts us, it gets a little darker:

"Millions of smartphone users confess their most intimate secrets to apps, including when they want to work on their belly fat or the price of the house they checked out last weekend ... Unbeknown to most people, in many cases that data is being shared with someone else: Facebook Inc."

[ed: link is to 9to5mac due to WSJ paywall]

The question then arises: who else is Facebook selling this information to? The most obvious is marketers, but one presumes that there are potentially lots of other interested parties.

And there's this:

"The social-media giant collects intensely personal information from many popular smartphone apps just seconds after users enter it, even if the user has no connection to Facebook ... Previously unreported is how at least 11 popular apps, totaling tens of millions of downloads, have also been sharing sensitive data entered by users."

Not mentioned: what do we do now that we know?

'Tis a poser.

Tuesday, February 26, 2019

Bullying at the MVNHS©: Feature or Bug?

Hundreds of doctors have been accused of bullying and sexually harassing colleagues in the past five years, prompting concern that a culture of intimidation is thriving in the NHS."

You don't say?

Couldn't have anything to do with the culture of socialized medicine, would it?

Mike points out that:

"The absolute number of reported incidents (585) seems relatively modest, but there are  probably many more incidents that go unreported.

This article contains a link to another article that notes 20% of all NHS physicians have been subject to  "bullying, harassment, or undermining behavior".

20% - so not likely that Doc Martin can be responsible for it.  At least, not all of it.

But with 41,000 nursing vacancies in England alone, this situation isn't helping effort to increase staffing or, for that matter, isn't presenting an attractive career choice for students.

Notice it's mentioned that bullying is thought to be a common tactic to coerce longer hours or more shifts from junior staff,  to make up for staff shortages.

But . . . the care is free!!!


Monday, February 25, 2019

Viva La Difference!

We've written about both the Concierge Medicine and Direct Primary Care (DPC) health care practice models. And, we've interviewed one of the pioneers of the latter, FoIB Dr Rob Lamberts.

But how cool is it that Dr Rob has written this very helpful explication of their similarities and differences:

"While there are many similarities between the two models, the differences are not only basic, but, in my opinion, they turn DPC from a curiosity or sideshow to a potentially huge player in the American healthcare marketplace. This article will compare and contrast the two practice models and conclude with a few thoughts on how DPC may have a much larger role in changing our entire system than many yet grasp."

Much more at the link.

One thing I think Dr Rob missed is that only the DPC model is specifically ObamaCare-compliant (which may be relevant if/when the mandate is reinstated).

[H/T FoIB John C]

Friday, February 22, 2019

Friday LinkFest

In no particular order:

We've discussed Health Care Sharing Ministries many times here at IB; one thing they all tend to have in common is that "ministry" part, which at least implies a Christian slant (NTTAWWT). I get the sense that many (most?) aren't particularly heavy-handed about it, but still, as a Member of the Tribe, it gives me a brief pause.

Now, thanks to FoIB Dutch R, we learn about a "kibbutz of healthcare:"

"After some online research Mazie, who lives in Miami, found something he thought was a godsend: United Refuah HealthShare, a Jewish alternative to traditional insurance. (“Refuah” is Hebrew for healing.) He was thrilled by the bargain-priced plans."

As with its gentile counterparts, Refuah (which one presumes refers to "r'fuah shleima," a blessing for healing) satisfies the (currently defunct) mandate, and a way to pool resources to help others pay for health care. And, as with those other ministries, there are additional risks that come with being uninsured.

Still yasher koach ("kudos").

For fans of Medicare4All, a warning about what one wishes for:

"THE number of patients who die while languishing on NHS waiting lists has rocketed, new figures suggest. At least 10,000 extra people every year never receive the treatment they have been waiting for compared with five years ago."

But hey: Free!

And speaking of M4A, despite all the positive press it's currently garnering, a funny thing happened on the way to the potential implementation:

"A new poll finds that about only one in 10 registered voters want the equivalent of Medicare for all if it means abolishing private health insurance plans."

If you like your plan.....

Thursday, February 21, 2019

Attention Gamers! Clock is ticking...

Our friends at Fat Dragon Games have launched their newest Kickstarter, and there's less than a week left to get in on it:

"Printable Miniatures is a collection of fantasy miniatures designed to 3D print without slicer supports."


Even if you're just considering the world of 3D printing [ed: BTW, a fantastic printer runs about $230], would be a great idea to get in on this for when you do pull that trigger.

Math is hard

To wit:
And by "scandalously" Mr K means "by an order of magnitude:"

"The fact that the CBO assumed 14 million could lose coverage mainly due to the elimination of mandate penalties helped kill the effort to repeal and replace Obamacare."

Uh, no: that falls 100% on the feckless GOP "majority."

Still, it's worth noting that the reality turned out to be a lot less of a big deal than the projections, and doubtless played at least some role in the mid-terms.

But that's not even the best part (for certain vales of "best"). No, the best part is this:

"... actuaries for the [CMMS] ... estimated that the elimination of the individual mandate would have a significantly smaller impact than the CBO has long estimated. Specifically, the CMS report revealed that 2.5 million more people would go without insurance in 2019 due to the repeal of the individual mandate's penalties, and the impact would be "smaller" thereafter."

In marked contrast  to the 13 or 14 thousand folks the CBO "guesstimated." Close enough for government work!

Wednesday, February 20, 2019

Nectar of the Gods: Lagniappe

Almost exactly a month ago, we notified readers of a (ghoulish?) new anti-aging technique:

"A controversial startup that charges $8,000 to fill your veins with young blood to 'defeat aging' now claims to be up and running in 5 cities across the US"

At the time, we also noted that there was scant (ie "zero") scientific evidence backing up that rather extravagant claim. But: no harm, no foul, right?

Well, not so fast there Dr. Acula:

"The Food and Drug Administration (FDA) is warning against buying young people’s blood in an attempt to fight aging and other diseases."

Now notice they're not saying that this is potentially harmful (and, of course, they're not saying it's not, either), but the Feds are concerned that folks may be sweet-talked into spending thousands of dollars on junk science.

Caveat emptor.

[Hat Tip: FoIB Holly R]

Tuesday, February 19, 2019

Interesting AutoGraphic

Our friends at the Insurance Information Institute have provided us with this handy (and helpful) visual guide to how your car insurance rates are determined:

[click to embiggen]

Monday, February 18, 2019

Medicare Advantage Plans are Like a Store Credit Card

Why are Medicare Advantage plans like a department store credit card? Before BankAmericard and Master Charge department stores like Sears, J C Penney, Macy's, etc had their own store credit cards. You could get what you want at Sears with your Sears card but don't try to use it at J C Penney's.

Original Medicare is accepted almost everywhere, but not so for your Advantage plan insurance card.

Georgia Medicare Expert explains Advantage plans like you have never heard before.

#MedicareAdvantage #OriginalMedicare #GeorgiaMedicareExpert

Friday, February 15, 2019

It's all so incenstuous: Redux

Just over 3 years ago, we noted the revolving door between the government and the insurance business:

"As regular readers know, AHIP (the health insurance industry's lobbying organization) has been on-board Team O'Care since Day One. What folks may not know is just how deep the ties run between the administration, major labor unions and the insurance industry."

We mentioned several folks specifically, including one who went from the AFL-CIO to AHIP, and then on to running EmblemHealth in New York.

We also pointed to "the lovely and talented Marilyn Tavenner, who came to AHIP directly from her previous gig as Administrator of the Centers for Medicare and Medicaid Services."

Notice a pattern here?

Well, the other day the industry news reported breathlessly on the objections of the current Keystone State Insurance Commissioner to Short Term Medical (STM) plans:
Here's what she had to say:

"One big problem with expanding consumer use of short-term health insurance is that consumers may have no good way to know what a policy will really cover."

Well for one thing, this is true of every insurance policy of every type: who actually reads them? And whatever happened to personal responsibility? It's true that STM's are underwritten, and don't over pre-existing conditions, maternity or routine physicals.

On the other hand, they offer a much less expensive alternative to ObamaPlans, and generally have significantly lower out-of-pocket maximums, to boot.

On the gripping hand: they appear to be a threat to ObmaCare, since lots of folks have figured out that they are an efficient, lower cost alternative.

Which is a problem for O'Care proponents.

Which brings us back to Ms Altman, who, it turns out, has a vested interest in curtailing the flight of folks from ACA to the short term market. As I pointed out on Twitter, "Ms. Altman worked at the U.S. Department of [HHS] for Consumer Information and Insurance Oversight, where she developed policy and facilitated implementation of the Affordable Care Act. No vested interest here."

And then co-blogger Patrick chimed in with even more helpful information: turns out, she's also the daughter of current Kaiser Family Foundation President Drew Altman (KFF has been a consistent and vocal ACA supporter).


Thursday, February 14, 2019

A Health Insurance ValDay card

From frequent foil Sarah Kliff:

Wednesday, February 13, 2019

The Mask Slips


Everything Old is New Again: MEWA edition

It's been a while since we discussed MEWAs (Multiple Employer Welfare Arrangement), but this type of plan (along with AHPs and self-funding arrangements) have become hot (again).

Why's that?

Well, primarily because they offer smaller employers the ability to (potentially) save a lot of money on their group health insurance plans.

And how does that work?

Mostly because, unlike ACA group plans, they're medically underwritten, so relatively healthy groups can benefit from rates that reflect the actual risk, instead of Community Rating, which basically dictates ACA plan rates, which subsidizes unhealthy groups at the expense of healthier ones.

And why are you bringing this up now, Henry?

Well, because I recently underwent training to be able to actually sell these plans. The session I attended was for Anthem's version, and took about an hour. The plans themselves are pretty much "off the shelf," with a variety of options and plan designs, including HSAs. From the employer side, there's a bit more paperwork, including something called a Form 5500, "an important compliance, research, and disclosure tool for the Department of Labor, a disclosure document for plan participants and beneficiaries, and a source of information and data for use by other Federal agencies."

From the employee side, it looks just like any other group health plan: you get an ID card and a website "portal" that lets you track expenses, find providers, all the same bells and whistles as ACA plans, but at (potentially) substantial savings.

Of course, there's also the possibility that the rate could could come back higher than an ACA plan (a group can't be declined for health reasons, but it can be rated up), but in that case they're no worse off than before, it just means they're "stuck" with their current plan for a while.

Will be interesting to see how this plays out.

Tuesday, February 12, 2019

Yanking the teeth from the MVNHS©


Seems that the Medicare4All folks could be taking a lesson from our Cousins Across the Pond:

"... news was breaking on the other side of England of the desperation of David Woodhouse ... who claimed he had resorted to extracting one of his own teeth with pliers after a fruitless search of up to 100 miles to find an NHS dentist."

This is a lesson in what happens when the government runs health "care."

But hey: Free!

Or maybe not:

"There is a growing sense that NHS dentistry is at ... a tipping point ... the “high street” dental sector as a whole remains robust, with forecast annual growth of 2%-2.5% over the next three years, this is down to expanding private care."

Yeah, that bites.

Monday, February 11, 2019

Saturday, February 09, 2019

Cycling for Survivors

Cancer survivors, that is. FoIB Meredith L is asking for our help:

"Rare cancer research is underfunded, leaving people fighting these cancers with few options — sometimes none. But I’m working to change this by riding with Cycle for Survival.

I’m hoping to surpass my fundraising goal and with your help we can make a difference in the lives of rare cancer patients everywhere. 100% of the money raised through my ride directly funds rare cancer research led by Memorial Sloan Kettering within six months of the events.
Every donation counts! Please consider making a tax-deductible gift online today."

For those so inclined, the the link is here.

Thank you!

Friday, February 08, 2019

Belated Blogiversary

And once again, I let our blogiversary - #14, this time - slip by without notice. The actual date was January 31st.


A HUGE Thank You to our readers and commenters, and especially to my fantastic co-bloggers.

Here's to the next 14.

Long time, First time

I've been in this business for almost 4 decades, and pretty sure just sold my first Juvenile SPWL plan.

And so...?

Well, SPWL stands for Single Premium Whole Life, and it's a way to (inexpensively) pre-pay a life insurance plan. Now, it's not for everyone (no product is), but in the right circumstances, it can be most useful.

As in this case.

I recall (vaguely) from Insurance 101 that parents buying their grandkids life insurance is a great idea (again often, not always) and I've had a few clients do that. But they were (as far as I can recall), of the "pay-as-you-go" variety. In this case, Gramps paid a little less than $1,900 and his new grandbaby is insured for $25,000 for the rest of his life. And, as FoIB Jeff M points out, who knows, this may turn put to be the only plan the little guy will ever be able to buy.

So, what's the advantage of a Single Pay plan? Well for starters, Junior there will never have to pay any premiums. Plus, it's at his age 0, meaning rates go up from here. And, of course, what a loving gift from his Grandfather.

Now the downside is that these plans are by definition "Modified Endowment Contracts" (MEC's), which means that the cash value that will begin to accrue won't have all of the tax advantages of a "regular" plan. But since that's not a goal here, no harm or foul.

Oh, why does one buy life insurance on a child?

Well, for a variety of reasons., For one, as noted above, it guarantees that they'll always have at least some life insurance protection, no matter what life eventually throws at them.

And, as co-blogger Bob is fond of noting, it's really more about buying time; that is, time for the parents to mourn without having to worry about losing dollars from missing work.

Pretty powerful incentive, that.