Monday, March 30, 2020

CV-19 vs P&C: Grace Period Update

A few days ago, we mentioned that (at least) one of our carriers was offering to "adjust the customer’s current bill and to waive any late fees for any premium payments due between March 16 and April 30."

Well that was then, and this is now, and it's no longer just a nice gesture on the carriers' part. Our friends at the Ohio Insurance Agents association just tipped us:
"This bulletin pertains to all insurers (“Insurers”) providing property and casualty, life, and long term care insurance policies (“policies”) in the State of Ohio. The purpose of this bulletin is to notify Insurers that they must provide their insureds with at least a 60-day grace period to pay insurance premiums or submit information."

As with the similar decree about group insurance (and from the Feds on ObamaPlans), it's critical to keep in mind that this is a deferral, not a waiver: at some point the bill will come due. So think long and hard about your financial status now vs early summer.


Got this from our primary P&C carrier:

"Employers must report COVID-19 illness in workplace."

Which makes sense, but (as I pointed out at that post) seems to contradict HIPAA/privacy requirements, as well as guidance we noted the other day:
"Applicable law limits Anthem’s ability to share an individual’s protected health information with an employer absent an authorization or certain extenuating circumstances. As a result, Anthem is limited by law in its ability to disclose individual’s protected health information to an employer."

So how to square that circle?

Friday, March 27, 2020

Business Interruption vs CV-19: Revisited

This is what I love (and hate) about the insurance biz: to paraphrase a former POTUS, it depends on what the meaning of "covered loss" is.


Well, last week we posted what we thought was the definitive answer to the question of whether one's Business Interruption coverage would be triggered by the current Pandemic:

"In the event of my absence, if anyone for commercial lines calls and asks if there is any business income coverage due to their business shutting down during the Coronavirus outbreak, the answer is "No"."

And that, it seemed (at the time, at least) was that.

But maybe not:

"By way of example, some policies require “direct physical loss of or damage to” property. “Loss” and “damage” are not synonymous and may require separate analysis. Such wording could arguably trigger coverage where there is a loss of the premise’s use (even if the property is not physically damaged)."

That is, maybe BI cover does extend, even absent a "direct, physical loss."

The article notes, for example that if "a property has been contaminated by an infected person, or because COVID-19 is in the airspace or on surfaces, this will likely constitute direct physical damage." I would argue that this alone doesn't seem to reach the threshold, but then, I'm not the judge or the claims adjustor.

And, of course, that particular cite pertained to a New Jersey Appellate Court decision, so its relevance in other jurisdictions is up for grabs.

And there's this:

"Depending on the circumstances, the governing law, and the applicable policy’s language, they may very well be wrong. By way of example, some policies require “direct physical loss of or damage to” property. “Loss” and “damage” are not synonymous and may require separate analysis."

Will be interesting to see how this shakes out.

As always, consult with your own agent about how your policy may (or may not) handle this.

Thursday, March 26, 2020

And now for something completely different (and cute!)

Because we could all use a smile 'bout now:

Breaking: CV-19 & ObamaPlans

That is, premium deferment options similar to what we're seeing in the group market:

The key is that the Feds seem to be allowing such flexibility, not requiring it. And, as we've noted with the group extended grace period offer, these premiums are deferred, not waived; that is, the piper will eventually have to be paid.

Be careful...

Full text of notice here.

Updates as appropriate.

Wednesday, March 25, 2020

LTCi: When to make a claim

Courtesy of co-blogger Mike:

During a visit to my doctor, I asked him, "How do you determine whether or not an older person is ready to make a Long Term Care claim for Assisted Living?"

"Well," he said, "we fill up a bathtub, then we offer a teaspoon, a teacup and a bucket to the person to empty the bathtub."

"Oh, I understand," I said. "A normal person would use the bucket because it is bigger than the spoon or the teacup."

"No" he said. "A normal person would pull the plug. Here’s your claim form."


Tuesday, March 24, 2020

Retiring Age 65 With Younger Spouse - Medicare COBRA Trap

Planning to retire? You are Medicare age but your spouse is not. What are your options?

Age 65 Younger Spouse

You MAY continue to work if that is available.

You can enroll with Medicare, your spouse opts for an #Obamacare plan.

Or you take Medicare and spouse chooses COBRA.

Just don't pick COBRA for BOTH of you. That triggers the Medicare COBRA trap.

#Medicare #YoungerSpouse #COBRA

From the P&C Files: More CV-19 News

I think we've had more P&C-related posts the past week or so than the past year combined. But it is Insureblog, so...

■ From one of our carriers (and, I'm sure, we'll see others following suit):

Policyholders are understandably concerned about their ability to pay premiums as government mandated closures continue to increase. To help, we’re suspending all property casualty cancellations due to nonpayment from March 16 to April 30 – or later if required by an individual state.

While we hope that most policyholders can stick with their current payment arrangements, if you have a standard lines commercial, personal or life policyholder asking about alternative payment arrangements our billing associates are authorized to adjust the customer’s current bill and to waive any late fees for any premium payments due between March 16 and April 30. This is not a waiver of payments during the suspension period, but an extension or grace period for those directly impacted by this pandemic. Please have them contact our billing departments"

■ We've discussed Special Event coverage before:

"World Furniture Mall "promised that if the Bears shut out the Packers in the season opener at Lambeau Field in Green Bay, Labor Day weekend shoppers would get their furniture free."

And of course there's so-called 'Hole-in-one' cover and the like, as well.

Typically, these cover unforeseen issues like weather or the like, but what about the current situation? Well, our friends at the Ohio Insurance Agents association offer this heads' up:

"Read the policy language. Every policy is different. Prepare yourself by reading the policy language and specific exclusions on the Special Event Policies that you have issued. In addition, contact your underwriters for clarification on the exclusions to ensure you have a thorough understanding and will be able to communicate it back to your clients."

Always good advice.

What could go wrong?

Let's say that you deliberately skipped Open Enrollment (because, hey, why not?). And let's say that you now regret that decision.

No problem, mi amigo:

"Eleven States Now Letting Uninsured Sign Up for Obamacare"

Never let a crisis go to waste.


[Hat Tip: FoIB Holly R]

Monday, March 23, 2020

Anthem Update

Just off conference call with Anthem execs, lots of interesting info, and will try to put together a more complete post, but some highlights:

Extraordinary focus on "Virtual Care" - what we've been calling 'telehealth' or 'telemedicine' and which has been mostly under the radar, until now. This is as much about capacity as it is social distancing, and the government is requiring carriers (like Anthem) to offer these services with no cost-sharing.

Relaxed rules on early refills for maintenance meds - this makes sense, again to minimize travel and maximize social distancing.

Group Plan Special Enrollment - This was a surprise to me: employees who initially waived group coverage can actually enroll between now and April 3rd, with full coverage.

There's more, and I'll try to update as quickly as possible. Stay tuned.

And speaking of Group Insurance

Last Friday, we posted a breaking news item pertaining to group health insurance plans and grace periods:

"Employers can defer their premium payments for health insurance for up to 2 months."

Now, we have more details:

"Insurers must permit employers to continue covering employees under group policies even if the employee would become ineligible due to a decrease in hours worked ... Employees who lose coverage are eligible for a special enrollment period to enroll in new [individual] coverage."

More at this link.

One presumes other states will also roll out similar decrees.


We also got some interesting info from Anthem, courtesy of FoIB Beth D:

Q: Can Anthem provide my company with information regarding COVID-19 cases within our member population?

A: Applicable law limits Anthem’s ability to share an individual’s protected health information with an employer absent an authorization or certain extenuating circumstances. As a result, Anthem is limited by law in its ability to disclose individual’s protected health information to an employer.

Q: Can an employer receive information on the number of claims — but not specific names — for COVID-19 tests and related services?

A: No. Currently, it may be possible to identify someone specifically even if, for example, their name is not shared. We recommend checking in with local health authorities to understand the total number of cases in any given area.

Hadn't even considered the HIPAA/Privacy angles here. Thanks, Anthem (and Beth)!

And one more thing (because I'd been wondering about how this will affect self-insured plans, as well):

Self-insured plans no longer have the option not to waive out-of-pocket member expenses for the diagnostic test and the visit associated with the test, as laid out in the federal mandate.

So there ya go.

Underwriting, Selling, and CV-19 [UPDATED]

We've been discussing some of the insurance issues which agents, companies and clients are facing while the Pandemic continues. Obviously, people still need insurance, and of course a lot of policies are negotiated at the proverbial kitchen table. But what happens when the kitchen table meets 'social distancing?'

Well, our friends at Mutual of Omaha have some suggestions:

"We encourage you to also do your part to slow the spread of the coronavirus. You're likely rethinking how you can keep yourself and others safe in a business that's built on relationships with people and, most often, face-to-face interactions ... We strongly encourage you not to conduct in-person client meetings and we should all be prudent to exercise an abundance of caution."

And they go on to list some reasonable alternatives:

o Opt for video meetings or phone calls when possible.
o Avoid in-person meetings if either you or another participant is at risk.

They also suggest contacting folks in advance, and avoid meetings where any of the participants aren't feeling well. And they also suggest - and I think this is particularly helpful - that if one does "proceed with an in-person meeting, please document the client's agreement to meet ... This will be key if there are any questions later regarding meetings or participants."

Or, as our friends at Issue Insurance call it, 'Professional Distancing.'

I like it.

All of these strictures apply, of course, to any insurance sales opportunity, from a simple auto policy renewal to complex Long Term Care insurance reviews.

And remember Sgt Esterhaus' admonition.

 Of course, Professional Distancing just got a lot easier for us folks in the Buckeye State.

UPDATE: We've also just learned that we're actually considered an Essential Service:

In this order, the business of insurance falls under EssentialBusinesses and Operations. This means that you can continue to operate but mustdo so under the Director of Health’s operating requirements.

How nice for us.

Friday, March 20, 2020

Breaking (Group Health Insurance) News: Buckeye State edition

Co-blogger Patrick just sent me this:

This is relevant to our post the other day wondering about the short term future of group health plans, and is welcome news indeed.

More from P&C World: CV-19 update

While we've been focused primarily on the health insurance aspect of the pandemic, we've also blogged petty extensively about Business Interruption coverage in commercial lines packages, and even noted how the P&C side of the biz is likely sheltered from catastrophic losses.

But something I hadn't seen addressed, at least until now, is the Worker's Comp issue:

That is, as more workers succumb to the Chinese Coronavirus while on the job. I can see this; for example:

Had to meet a relative at the ER yesterday, and while she was squadded in, I had to walk to the ER from the parking lot. I was immediately stopped by a very polite yong nurse tech(?) who took and reported my temp and asked a few health questions. Her PPE consisted of a blanket (it was a bit chilly, and the door was propped open) and a pair of latex gloves. And yet, here I waltz in, breathing (and maybe coughing?) and I'm thinking that that blanket and those gloves are no match for CV-19.


Good news, bad news: CV-19 style

The good news is that, through government action and insurance company efforts, (initial) CV-19 testing is "free" (scare quotes because, well, we all know why).

The bad news, as FoIB Sheron Sidbury notes, is less obvious:

And it gets worse: pretty much all individual plans, and not a few group ones, are built on an HMO-chassis, which means that if the only (or closest) treatment facility is out-of-network, you're outta luck.