Thursday, August 31, 2006

Network News...

Just got this by email:
PHCS to be sold to MultiPlan
Today, Assurant Health, along with Guardian and Trustmark, the majority owners of Private Health Care Systems (PHCS), announced that we have reached an agreement to sell our interests in PHCS to MultiPlan, Inc.
Assurant Health simultaneously entered into a long-term agreement to enable our customers to continue to have access to PHCS PPO Network providers. That means business will continue normally with no interruption or change for our insureds or agents...
PHCS will be owned and managed by MultiPlan, a leading independent network of heathcare providers. We believe the combined strength of MultiPlan and PHCS will lead to stronger and more diverse networks, which will enhance customer access to providers - and that the agreement is in the best interests of all our stakeholders.
It seems to indicate that folks whose health care plans (and "discount" cards) utilize the PHCS network will have access to more providers. It's also possible [NOTE: rampant, baseless speculation follows] that MP will increase their network access fees (to recoup acquisition costs), which could lead to rate increases.
Frankly, though, I'm not really sure what it means.
Stay tuned.

Wednesday, August 30, 2006

Scooped again!

Joe Kristan, blogging at Roth & Co, has news that one large insurer is making it easier (and cheaper) for employers to set up HSA's.

Helpful info.

GoldenCare...

Back in April, Bob alerted us to California's bill SB 840, which would establish a single-payor, "universal" style health care system in the state. Then, earlier this month, he had an update on the bill, and emphasized that "(t)he bill provides nothing. The taxpayers provide the coverage."
Well, the bill has now been passed by the California assembly (it was previously approved by the state senate), and awaits only a few modifications before it heads to The Governator for signature. Or not.
As it stands, the bill would eliminate "regular" insurance plans (group and individual), replacing them with a state-run plan (i.e. expensive, inefficient, tax-gobbling bureaucracy). This will not, of course, affect ERISA plans (which are federally regulated), or (as Bob points out in the comments) public entities. In fact, it may be a boon to the self-funded industry, as employers look for ways to avoid this train wreck.
On the other hand, I'm actually glad to see this effort unfolding in this way. As a 10th amendment supporter, this seems to me the appropriate venue. That is, there is nothing in the Constitution giving the Federal Government the power to commandeer 1/7th of our economy. But "the 10th" reserves such endeavors to the individual states. If it's true that folks vote with their feet (and, of course, their wallets), this new program will be a terrific test of whether or not we're ready for government run health care for all.
How's that ancient Chinese curse go? "May you live in interesting times."
Indeed.

Et Tu, Ken?

Gee, where have we seen this before?
In fairness, it doesn't look as draconian as the Mass plan (for example, those currently covered under an employer-sponsored group plan would keep that coverage). Because state law requires ER's to treat even the uninsured, that's their first (and often last) stop. Emergency care, though, is the most expensive care in the current system, which further drives up the cost of health care delivery.
As one of our astute commenters has noted, however, "the symptom is not the problem. The problem is the high total cost of health care." He concludes "that tinkering with insurance mechanisms does nothing to address the underlying cost of health care." It's not clear that this initiative will do much (if anything) to address that issue.
Of course, funding for this new program is still "nebulous" (from the Latin nebu, meaning "ripped from" and elous meaning "taxpayers wallets"). We'll keep an eye on this, and let our readers know whether or not it gains any traction here in the Buckeye State.

Latest Cavalcade...

Cavalcade of Risk, that is. Fellow Daytonian Kristin McAllister, hostess of Making Cents, hosts this week's edition of the C of R. She's done an outstanding job, not just organizing all the posts into categories, but by including extensive summaries and even snippets of each one. Kudos, Kristin!
If you're using your cell phone on the road (and who isn't), you'll want to read this post from previous C of R host Julie Ferguson. Writing at Workers Comp Insider, she identifies the problem of work-related cell phone use and employer liability. Kinda scary.

Monday, August 28, 2006

A Rainy Money Monday...

The bad news is, it's gray, wet and ugly here in southwestern Ohio this morning. The good news is that Frugal at My 1st Million (at 33!) is hosting this week's edition of the Carnival of Personal Finance. He's collected, collated, and organized almost 50 submissions. Great job!
Mapgirl has a helpful post on how to maximize your doctor's visit. Some is just common sense, of course, but since when is that a bad thing? Seriously, a useful post, check it out.
And clocking in with just shy of 40 posts, the Carnival of the Capitalists is now up, over at Business & Technology Reinvention blog. I like how cleanly and simply it's laid out, with brief summaries of each submission. Well done!
Blogger Vihar Sheth has a thought-provoking post at his Green Rising blog. He discusses a survey of cultures, from all over the worls, and how each one looks at individualism, isolation, long term orientation, and other cultural attributes. Interesting.

Sunday, August 27, 2006

Insurance Dispatch

This week's column is up at The Medical Blog Network. We revisit the issue of network discounts (or lack thereof) for non-covered services.

Saturday, August 26, 2006

All or Nothing...

Justin, host of HealthFlux, has a terrific post up about how folks' perception of how health insurance should work is changing (or should be changing). He takes to task those who ask if "they can't have the best without having to pay for the best why settle for anything less?"

Read the whole thing.

Friday, August 25, 2006

Cavalcade #7 - Submissions Due

Submissions for next week's C of R (which will be at Making Cents blog) are due by this coming Monday, Aug 28. You can enter your submissions:
■ via email
or
■ at Ferdy's
Thanks!

For the Children...

Now this is interesting: according to a new study conducted by the Robert Wood Johnson Foundation, a number of state-sponsored initiatives seem to be working. These plans, which offer basic (and sometimes better) health plans to uninsured kids, have had limited success, because (frankly) so few folks take advantage of them.
Apprently, though, that's changing: "State programs that provide health coverage for poor children are working, with the number of uninsured youngsters declining by more than 20 percent between 1997 and 2004," numbers based on the aforementioned RWJF study. The study also determined that there are about 8 million children still without insurance (although I have some problems with this number, I'll stipulate it for the purposes of this post. Of these, some 5.5 million are eligible for one of these state-backed plans.
I'm a bit bothered about one item in particular: the study claims that while there's a 31% increase in the number of 'kinder' enrolled in public programs, there's also a 5% decline in children being insured through private coverage. So parents, who should be paying for this, are foisting off their progeny onto us taxpayers. I'm not all that pleased with this particular development. As it stands, more kids are being covered (which is a good thing), but more of them are being covered on your nickel (which may not be).

Thursday, August 24, 2006

A Wonky Review

This week's Health Wonk Review is up, hosted by The Lucidicus Project. Boasting an even dozen entries, our host has each one with a summary and context. Bravo!
A few weeks ago, our own Bob Vineyard offered an obit on California's PacAdvantage Program. In this week's HWR, Jason Shafrin (writing at the Health Care Economist) picks up the torch.

Wednesday, August 23, 2006

Here's the Beef...

According to a new survey, more than half of the employers who responded have enhanced employee benefits in the past 6 months. Of those, almost 9 out of 10 added some kind (or kinds) of health-related benefits. About 40% increased paid vacation days, and about a third added some kind of flex-hour or job-sharing deal.

Some two-thirds of those surveyed indicated that they had added some kind of financial incentive, such as increased pension matches, as well.

Called "pragmatic benefits," the emphasis is on offering things that are more lifestyle related, not just "show me the money."

Interesting.

Tuesday, August 22, 2006

Grand Rounds...

The 100th edition of Grand Rounds may be found at Dr Charles' blog. This is an especially rich version, with some 55 entries, all categorized and summarized.

Loose Ends...

As in, tying 'em up:
■ First, in What a Tangled Web, we learned that United HealthCare had been a little too vigorous in its compensation to Columbus (OH) insurance agent Kevin Grady. At the time, UHC got a stiff slap on the wrist, and we wondered what might become of Mr G.
Well, now we know. Thanks to alert IB reader Pete D, we learn that:
■ Following up on Part 2 of our Tangled Web series, which again involved those frisky folks at UHC, this time with a fellow named Fritz Neuhart, who allegedly double-dipped his carrier and his clients:
The extra twist here is that the case has widened to include another carrier, Medical Mutual of Ohio. Of course, we're all innocent until proven guilty. We'll continue to monitor both these cases.
■ Finally, in case you've forgotten about our own ground-breaking series on HSA's and network discounts, I received an answer (of sorts) from another carrier yesterday. To their credit, Anthem did get back to me, confirming that it follows industry practice: their network contracts allow providers to determine whether or not to discount non-covered services.

Monday, August 21, 2006

It's Money Time!

With over 50 posts, the folks at Carnival of Personal Finance. Done in the style of Dr Suess, it's well-organized AND fun!
I've never understood the value of AD&D (Accidental Death and Dismemberment) plans. So I was pleased to see that I'm not alone: Five Cent Nickel expresses the same doubts.

Sunday, August 20, 2006

Insurance Dispatch

This week's column is up. We discuss how so-called medical discount cards can be a boon, or a big bad bust.
Unfortunately, unscrupulous salesfolk and anxious consumers make for a bad combination.

Saturday, August 19, 2006

Better Late...

I'm baaaack!
And so's the Cavalcade of Risk, graciously hosted by Tim of My Money Forest. Please stop by and check it out.

Monday, August 14, 2006

Your Money Monday

Franky, blogging at the eponymously-named Frank the Financially Savvy Atheist, hosts this week's Carnival of Personal Finance. There are over 20 posts, a half dozen of which he highlighted as stand-outs.

My favorite was this thoughtful item at Tore O's Money Matador. Ever wondered if beggars *can* be choosers?

Barry Moltz hosts this week's Carnival of the Capitalists. With over 30 posts to organize, he's done a great job.

One of my favorite bumper stickers is "The Paperless Office is as likely as the Paperless Bathroom," so I really liked this post from Pocket Change.

Sunday, August 13, 2006

Insurance Dispatch

This week's column is up, over at The Medical Blog Network.

Did you know that you can pay for Long Term Care insurance (LTCi) out of an HSA? It’s true, and it might be a good idea. Read all about it.

Friday, August 11, 2006

(Potentially) Light Blogging Ahead...

The Prof family will be on vacation next week, and I have little hope of Mrs Prof allowing me access to any computers.

My able (and prolific) co-blogger Bob Vineyard is on his own here; please be nice ;-)

Cavalcade of Risk: Reminder

Next week's C of R will be at My Money Forest. Tim's looking for a few good posts, so please consider helping him out.
You can submit your posts (or even someone else's):
■ via email
or
■ at Ferdy's
And don't forget: hosting a Cavalcade is fun and easy, and can be a nice "traffic spike" (the good kind). Interested? Just let us know.

Scooped by a Bean-Counter!

Joe Kristan is all over the Corporate Owned Life Insurance (COLI) topic, with the latest news and helpful tips. A must-read.

Thursday, August 10, 2006

Health Wonk Review

Matthew Holt hosts this week's edition of the Health Wonk Review. Matt's put 16 posts into a useful index.
With Cuba's Fearless Leader in whatever straits he's in, Jared at the Lucidicus Project has a report on that island paradise's health system.

Doing the Laundry...

Sometimes, when I just can’t help it, I sell life insurance. My clientele generally runs to the middle class, although I do count as clients one state representative, a Public Utilities commissioner, and an engineer.
But, because I am in the “financial services” industry, I am apparently subject to new rules put in place by the Financial Crimes Enforcement Network (FinCEN, not to be confused with CENTCOM).
HIPAA, Sarbanes-Oxley, and FinCen; insurance carriers are now required to set up “anti-money laundering” processes, and to file “Suspicious Activity Reports.” Thankfully, we peons (literally: insurance agents) are absolved from actually establishing and maintaining our own such programs.
Still, we are required to be familiar with our carriers’ plans, and to undergo special training to learn about them, and to be aware of the scope of “the problem.” Although I’m not really convinced that Abdul is going to walk in with a cool 10 G’s, looking for a “hot life policy,” I’m subject to this requirement, and recently spent part of an afternoon fulfilling it.
I find CBT (Computer Based Training) to be both a pain in the, um, PC and pretty cool. I miss the interactivity of classroom learning, but it’s also fun to go at my own pace, and make snarky comments while absorbing the material. The purpose of this online program was to raise my awareness of “anti-money laundering rules” [ed: shouldn’t that be anti “money-laundering?”], in order to be more adept at spotting such activities.
Actually, I had never thought about how the life insurance business could be used for this sort of thing. Since cash value policies (e.g. Whole or Universal life, annuities, etc) all have onerous cash surrender penalties in the early years, it seemed to me that they would be poor choices for quickly moving large sums of cash.
Turns out, though, that I just wasn’t devious enough in my thinking: one of the consumer-friendly features of such policies is the “free look” provision, which is “where the action is.” In this scenario, a prospective customer comes in, and plunks down $10,000 for a single premium annuity. I submit that, along with the completed application, to the insurer. The policy is issued, and the client says “um, y’know what, never mind, I really don’t want this after all.” I send the policy back to the carrier, and a few weeks later, a refund check drawn on the carrier’s account comes back to the “prospect.” He’s just laundered the loot.
Granted, I probably would have had some questions of my own in this case, but it illustrates how even innocuous vehicles like annuities can be used for illicit purposes. And the course gave numerous other examples, as well, which also surprised me. For my part, I’m now more aware of clues and tell-tale signs, and cognizant of the potential for abuse.
All in all, I’d have to say: 45 minutes well-spent.

Tuesday, August 08, 2006

Small Business Storm Warning

According to SurePayroll, a lot of small employers may drop their group health plans in the next year or so:
According to a survey commissioned by the online payroll service provider, a little over half of the nation's small businesses currently offer some kind of group health benefit, and a little over half of those pay the lion's share of the premiums (okay, they really don't, but that's another post.
One quibble: they don't define a "small business;" could be 2 people, could be 100.
Something else that showed up: of those small employers who don't currently offer a plan, more than half indicate that they may offer one next year.

Monday, August 07, 2006

Where There’s a Will...

When working with life insurance clients, I usually (although not always, to my shame) ask if they have a valid, current will. Such an instrument is important for a number of reasons, not the least of which is to ensure that one’s final wishes are known, and (hopefully) carried out.
Wills generally cover the disposition of property, caring for any children, and charitable bequests. But what about one’s legacy?
Hunh?
We’ve all heard about “living wills,” but what about “ethical wills?” One of my absolute favorite books is “Ender’s Game,” by Orson Scott Card. In it, he introduces a person called a “Speaker for the Dead.” It is this person’s job to forthrightly report on the life of the dearly beloved, warts and all.
Absent such a person (it is science fiction, after all), an ethical will is a means for one to sit down with one’s estate planner and talk about life experiences, what one’s learned (and what one wishes had been learned), family history, personal stories (funny and sad), and the like. And, of course, how one wishes assets to be “divvied up.”
In a recent Harris Interactive poll of 1,200 Americans aged 40 to 59, 77% of those surveyed said that knowing exactly their parent’s values was very important, while only 10% said it was important that they inherited financial assets from their parents. ” (ibid)
Hopefully, we’ve learned what our parents lived, and have, in turn, helped our own children adopt an appropriate value system. But I found this idea to be quite interesting: to not just assume that they know, but to ensure it.
Food for thought.

Monday Money...

With almost 40 posts, this week's Carnival of Personal Finance is a blockbuster. Compiled by host J.D. at Get Rich Slowly, each post has its own headline and recap.
My better half hates it when I don't leave 20% as a tip, even if the service doesn't warrant it. Plus, I always tip on the balance before tax, which also drives her nuts. Which is why I appreciated this post from David at The Good Human blog.
And a big Tip o'the Hat to David Hunter, proprietior of The Business of America, for filling in (at the last minute!) as host of this week's Carnival of the Capitalists. David aggregated over 40 posts, and even had time to include a brief description with each one. Kudos!
And if you're in the mood for something exotic to wash down your meal, check out this suggestion from AvantNews. Yummy!

Sunday, August 06, 2006

Insurance Dispatch

The new column is up, and available at The Medical Blog Network.

This week, we look at how quickly and accurately health insurance carriers pay claims. There's even an interactive online tool to help out.

Saturday, August 05, 2006

WeekEnd LinkFest

If you haven't checked out some of the other great sites on our blogroll, here's a sampler of what you're missing:

Joe Kristan at Roth & Co makes sense of the whole Estate Tax controversy (now that's an accomplishment!).

Over at the Health Business Blog, Eric Zimmerman has a great piece on how health care "consumerism" and internet-based information come together.

Jon Coppelman, co-host of Workers Comp Insider (which, BTW, plays host to the current Cavalcade of Risk), shows us that Mom was right when she told us to "stop that before someone gets hurt!"

And Bob Coffield at the Health Care Law Blog fills us in on the new Health Information Technology Promotion Act (now there's a mouthful).

Friday, August 04, 2006

OT: Technical Question

Okay, so I'm not the uber-geek I thought I was. We've had a number of requests recently from folks who'd like to be automatically notified when we post new items. I'm pretty sure that they're talking about RSS feeds, and I did add the RSS "chiclet" to the side-bar.
Is that all I have to do, or am I missing something?
Any and all helpful suggestions are welcome.
Have a great weekend!

Thursday, August 03, 2006

Sneakin’ a Peek...

With all the talk about “transparency,” it’s easy to forget that it’s still about our health care, including why it costs so much.
Here’s a clue:

According to MedSolutions, which deals with quality management of medical imaging services, radiology seems to be the next big cost battleground between health plans and physicians. HealthLeaders-InterStudy, which conducted the study, found that radiology costs have risen to nearly 10 percent of each healthcare dollar, and are anticipated to grow at a rate of 18 to 20 percent per year.
And here you thought it was all Big Pharma and insurance carriers.

Wednesday, August 02, 2006

Cavalcade of Risk (#5)

The good folks at Workers Comp Insider host the biggest Cavalcade yet: with 20 posts, Julie has done a tremendous job. Plus, each entry has a little blurb explaining what it's about - I like that.
Wenchypoo (dont'cha LOVE that handle?) at Frugal Wisdom has a chilling, cautionary tale about how secure (or insecure) your IT info really is. Eye-opening.

And Another Thing...

If you’re sick of the whole discount/non-discount brouhaha, please feel free to skip this one: I have a mini-rant coming on.
In a nutshell, folks with network-driven plans, who see par providers for non-covered expenses, don’t get the insurance companies’ discounts for those services. Nowhere in the sales literature or training, nor in the policies themselves, is this made clear.
So, an agent who is not aware of this situation has no obligation to inform his client – or potential clients – of this salient fact.
But what about those of us who do?
I’ve already mentioned how I felt compelled to explain this to a potential client. Today, I had an even more worrisome experience:
One of my clients is a locksmith, who has a (very) small business. About 5 years or so ago, I sold him (or he bought from me, you pick) an MSA (subsequently converted to an HSA). He came by today, because we needed some locks re-keyed. I hadn’t spoken with him in a while, so we spent some time catching up on “mom and them,” and (naturally) the conversation turned to his insurance. He positively gushed about how happy he’s been with the HSA; in fact, he has almost $10,000 socked away in the loss fund, money that (in his words) would have been in the insurance company’s pockets, not his.
So why am I ticked?
Because I had to decide whether or not to ask him about his experiences (if any) with non-covered expenses. I literally argued with myself for several minutes about this. In the end, he excused himself to go about his work, so I was (at least for the nonce) relieved from engaging him in this subject. But I know that I will – I must – bring it up with him at some point, most likely sooner than later.
Ah, ignorance is bliss. (Or would be, I suppose)

Tuesday, August 01, 2006

Grand Rounds...

Dr Lisa Marcucci hosts this week's edition of Grand Rounds. I really appreciate the way she's organized it, so that several similarly-themed are grouped together in paragraphs. Very cool.
One of my favorite med-bloggers, Dr John Ford, reminisces about a theory espoused by one of his medical school professors. Let's just say that life works in cycles.