From Reason.com via Instapundit:
Happy Halloween!
Thursday, October 31, 2013
Apropos of nothing much (P&C edition)
Via email, I just learned a new word, "Nutraceutical:"
"Do you have clients involved in the manufacture, distribution, or packaging of vitamin, nutritional or supplement products? ... [We are] pleased to provide our expertise in Primary Product Liability Coverage for the Nutraceutical Industry"
Since this is way outside my wheelhouse, I would normally have just deleted it. But how can one resist that term? Although I must admit, my first thought was of boats.
Thanks, A. J. Renner & Associates!
"Do you have clients involved in the manufacture, distribution, or packaging of vitamin, nutritional or supplement products? ... [We are] pleased to provide our expertise in Primary Product Liability Coverage for the Nutraceutical Industry"
Since this is way outside my wheelhouse, I would normally have just deleted it. But how can one resist that term? Although I must admit, my first thought was of boats.
Thanks, A. J. Renner & Associates!
Because Shut Up, That's Why
The Obamastration has a history of silencing critics of its health care policies. From 2009:
"The government is investigating a major insurance company for allegedly trying to scare seniors with a mailer warning they could lose important benefits under health care legislation in Congress."
This, despite the fact that the carrier, Humana, was absolutely correct. Or perhaps it would be more accurate to say, because they were correct.
La plus ca change:
"What is going on is, behind the scenes attempt by the White House to at least keep insurerers from publicly criticizing what is happening on this [ObamaTax] rollout. Basically, if you speak out, if you are quoted, you're going to get a call from the White House, pressure to be quiet," reports CNN."
Lie down with dogs....
[Hat Tip: Hot Air]
"The government is investigating a major insurance company for allegedly trying to scare seniors with a mailer warning they could lose important benefits under health care legislation in Congress."
This, despite the fact that the carrier, Humana, was absolutely correct. Or perhaps it would be more accurate to say, because they were correct.
La plus ca change:
"What is going on is, behind the scenes attempt by the White House to at least keep insurerers from publicly criticizing what is happening on this [ObamaTax] rollout. Basically, if you speak out, if you are quoted, you're going to get a call from the White House, pressure to be quiet," reports CNN."
Lie down with dogs....
[Hat Tip: Hot Air]
Healthcare.gov is the symptom....
FoIB Bob Graboyes has a wonderful, insightful post up over at Forbes, in which he notes the confluence of Israeli daycare, Blue Grass State healthcare (well, health insurance, to be precise) and the SCOTUS tax-scare:
"[D]ay care centers in Haifa, Israel, had a problem with tardy parents retrieving their children after closing time ... monetary penalties would discourage parents from flouting the no-tardiness mandate"
The problem is that they aimed low, and shot themselves in the foot. How? By imposing only a nominal fine, they ended up reinforcing the behavior.
And then there was Kentucky's ill-fated 1994 attempt at its own version ofRomneyCare the ObamaTax:
"Insurers could neither refuse purchasers nor drop them for health reasons. Insurers could not differentiate premiums on the basis of gender, health status, or claims experience ... Insurers fled the state by the dozens ... By 2000, guaranteed issue was gone"
I remember this debacle well - in fact, I taught a CE class on it, back in the day. I recall how frustrating it was for Kentucky agents, since the only carrier left was Blue Cross. Lots of choice there.
Which brings us to the SCOTUS and liver. To this day, I'm ambivalent about whether CJ Roberts' decision was a gift or a curse. Bob offers his own take, and I can't say that I disagree.
Read the whole thing©.
"[D]ay care centers in Haifa, Israel, had a problem with tardy parents retrieving their children after closing time ... monetary penalties would discourage parents from flouting the no-tardiness mandate"
The problem is that they aimed low, and shot themselves in the foot. How? By imposing only a nominal fine, they ended up reinforcing the behavior.
And then there was Kentucky's ill-fated 1994 attempt at its own version of
"Insurers could neither refuse purchasers nor drop them for health reasons. Insurers could not differentiate premiums on the basis of gender, health status, or claims experience ... Insurers fled the state by the dozens ... By 2000, guaranteed issue was gone"
I remember this debacle well - in fact, I taught a CE class on it, back in the day. I recall how frustrating it was for Kentucky agents, since the only carrier left was Blue Cross. Lots of choice there.
Which brings us to the SCOTUS and liver. To this day, I'm ambivalent about whether CJ Roberts' decision was a gift or a curse. Bob offers his own take, and I can't say that I disagree.
Read the whole thing©.
Top. Men. (Redux)
Back in April, Bob reported on the CGI Group's recruitment as ObamaTax Exchange developers. In case you were wondering, the "C" in CGI apparently stands for "Canadian," since the firm is headquartered there.
And apparently they use igloos as data warehouses, since their last big government contract didn't go so well:
"Their most famous government project was for the Canadian Firearms Registry. The registry was estimated to cost in total $119 million, which would be offset by $117 million in fees. That’s a net cost of $2 million."
Not a bad deal: register 7 million rifles at a net cost of about $4.50 (assuming that's Canadian dollars, that works out to about US$4.38 in 2004 currency values),
Turns out, they underestimated the actual cost a bit: the original $119 million bid ballooned into an impressive $2 billion final price tag; a staggering "thousand times more expensive."
Yikes!
But here's the kicker: "Canada’s auditor general reported to parliament that much of the information was either duplicated or wrong"
Sound familiar?
Oh, the epilogue:
"CGI was hired to create an entirely new CFIS II, which would operate alongside CFIS I until the old system could be scrapped ... $81 million was thrown at it before a new Conservative government scrapped the fiasco in 2007"
Wouldn't it have been less expensive - and certainly more efficient - to just flush a fully-laden Brink's truck down a toilet?
[Hat Tip: Ace of Spades]
And apparently they use igloos as data warehouses, since their last big government contract didn't go so well:
"Their most famous government project was for the Canadian Firearms Registry. The registry was estimated to cost in total $119 million, which would be offset by $117 million in fees. That’s a net cost of $2 million."
Not a bad deal: register 7 million rifles at a net cost of about $4.50 (assuming that's Canadian dollars, that works out to about US$4.38 in 2004 currency values),
Turns out, they underestimated the actual cost a bit: the original $119 million bid ballooned into an impressive $2 billion final price tag; a staggering "thousand times more expensive."
Yikes!
But here's the kicker: "Canada’s auditor general reported to parliament that much of the information was either duplicated or wrong"
Sound familiar?
Oh, the epilogue:
"CGI was hired to create an entirely new CFIS II, which would operate alongside CFIS I until the old system could be scrapped ... $81 million was thrown at it before a new Conservative government scrapped the fiasco in 2007"
Wouldn't it have been less expensive - and certainly more efficient - to just flush a fully-laden Brink's truck down a toilet?
[Hat Tip: Ace of Spades]
Wednesday, October 30, 2013
Halbig is it?
Last week, we noted that Michael Cannon's years-long coverage of the subsidy vs Federally-run Exchange issue had passed another hurdle:
"A federal judge ... refused to dismiss a case that could fatally cripple the Obamacare health insurance law ... 'The IRS cannot rewrite the law that Congress passed'"
This was a substantial blow to proponents of the ObamaTax, and this week, Michael has more details on why this is, in fact, a very big deal. I highly recommend that you click on through.
But I wanted to highlight a few items. Joel L. McElvain is thegovernment's Obamastration lawyer arguing the case on behalf of his masters. Here he attempts verbal jujitsu, with predictable effect:
"Congress is creating a “legal fiction” that each state has established an Exchange. If a state does not establish an Exchange, “the premise stands” that it has. Therefore, when the federal government establishes an Exchange, it is, fictionally but legally, “an Exchange established by the State.”
I told Michael that this gave me a headache, and wondered how Mr McE could say that with a straight face.
A bit later, we run into our old "friend," Timothy Jost. Esteemed co-blogger Patrick recently skewered Mr J here:
"So tell me Tim, as a law professor which quote of yours is correct?"
Definitely read Michael's piece, it's quite enlightening.
"A federal judge ... refused to dismiss a case that could fatally cripple the Obamacare health insurance law ... 'The IRS cannot rewrite the law that Congress passed'"
This was a substantial blow to proponents of the ObamaTax, and this week, Michael has more details on why this is, in fact, a very big deal. I highly recommend that you click on through.
But I wanted to highlight a few items. Joel L. McElvain is the
"Congress is creating a “legal fiction” that each state has established an Exchange. If a state does not establish an Exchange, “the premise stands” that it has. Therefore, when the federal government establishes an Exchange, it is, fictionally but legally, “an Exchange established by the State.”
I told Michael that this gave me a headache, and wondered how Mr McE could say that with a straight face.
A bit later, we run into our old "friend," Timothy Jost. Esteemed co-blogger Patrick recently skewered Mr J here:
"So tell me Tim, as a law professor which quote of yours is correct?"
Definitely read Michael's piece, it's quite enlightening.
Stupid Chamber Tricks
We have been members (and supporters) of our local Chamber of Commerce (South Metro Regional Chamber of Commerce) for many years, during some of which we've been more active than others. But we have always felt that it was important to support the Chamber's efforts, as they have supported - to a greater or lesser degree - ours.
But no more.
This morning, we received an email that the SMRCOC has decided that rather than support us, they wish to compete with us, by contracting with an out-of-town outfit to sell and administer the Chamber's own private employer health insurance Exchange, in direct competition with us and other member agents.
They've never reached out to us for help or advice on this, or even asked if we'd like to participate as a professional and experienced sales partner.
That's obviously their prerogative, as it is ours to immediately resign.
Here's what's sad: we are not the only agents who've been active and supportive members for many years, and yet the "leadership" has decided that, instead of a mutually beneficial relationship with folks who have donated time, effort and money, they would rather cast their lot with an organization who will never be in a position to financially support (as in patronize) the very businesses that the SMCROC claims to represent and support.
I'd call that pretty shortsighted.
But no more.
This morning, we received an email that the SMRCOC has decided that rather than support us, they wish to compete with us, by contracting with an out-of-town outfit to sell and administer the Chamber's own private employer health insurance Exchange, in direct competition with us and other member agents.
They've never reached out to us for help or advice on this, or even asked if we'd like to participate as a professional and experienced sales partner.
That's obviously their prerogative, as it is ours to immediately resign.
Here's what's sad: we are not the only agents who've been active and supportive members for many years, and yet the "leadership" has decided that, instead of a mutually beneficial relationship with folks who have donated time, effort and money, they would rather cast their lot with an organization who will never be in a position to financially support (as in patronize) the very businesses that the SMCROC claims to represent and support.
I'd call that pretty shortsighted.
Cavalcade of Risk #195: Choose Your Own Adventure edition now up
Jason Hull makes
his CavRisk hosting debut with a true blockbuster of a post. His introduction makes some
terrific points, perhaps the most eloquent of which is that "[o]ne of the
biggest mistakes I see people make is accepting risks they should be insured
against and insuring risks that they should be accepting."
It's also helpful that he gives each featured post helpful context.
Kudos, Jason!!
HOSTING BLEG: We're looking for a few good hosts for late Fall Cav's. Just click here to grab yours!
It's also helpful that he gives each featured post helpful context.
Kudos, Jason!!
HOSTING BLEG: We're looking for a few good hosts for late Fall Cav's. Just click here to grab yours!
Tuesday, October 29, 2013
No, no, no - A thousand times no!
This has been making the rounds:
"The law states that policies in effect as of March 23, 2010 will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered."
Which is true, and puts the lie to the claim that "if you like your insurance, you can keep your insurance."
But some folks, not content to let the truth speak for itself, have added a flourish: that even premium increases will render a plan "ungrandfathered."
No. It. Won't.
Premiums increase all the time. I am looking at one client's grandfathered plan, which has had 3 rate increases since it was written in January 2010, and it is still grandfathered.
Please, people, the ObamaTax is bad and destructive enough on its own; it is in fact counterproductive to mischaracterize additional defects.
So stop it.
"The law states that policies in effect as of March 23, 2010 will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date -- the deductible, co-pay, or benefits, for example -- the policy would not be grandfathered."
Which is true, and puts the lie to the claim that "if you like your insurance, you can keep your insurance."
But some folks, not content to let the truth speak for itself, have added a flourish: that even premium increases will render a plan "ungrandfathered."
No. It. Won't.
Premiums increase all the time. I am looking at one client's grandfathered plan, which has had 3 rate increases since it was written in January 2010, and it is still grandfathered.
Please, people, the ObamaTax is bad and destructive enough on its own; it is in fact counterproductive to mischaracterize additional defects.
So stop it.
ObamaTaxAgeddon Break: CanuckCare
I don't know about you, but I'm getting a bit burned out on the sheer volume of ObamaTax glitches, snafus, cock-ups and crashes. So, for a change of pace, let's look to our Neighbors to the North© for some inspiration.
Oh, wait.
"Canada's Supreme Court has ruled that under the "law of the land" in Ontario, a government board, not the family or doctors, has the ultimate power to pull the plug on a patient."
This reminds me of something, what do you suppose that is?
Oh, wait.
"Canada's Supreme Court has ruled that under the "law of the land" in Ontario, a government board, not the family or doctors, has the ultimate power to pull the plug on a patient."
This reminds me of something, what do you suppose that is?
This Sceptered Isle - Part DLXXIV
“NHS pulls the plug on its £11bn IT system”
Hey, isn’t that good news!??! This means the Fair Kathleen has lots more programming and systems design expertise available to help her fix the federal Exchanges she’s responsible for!
In theory, the UK system was intended "to result in improved quality of care and lower costs. This theory is also widely touted by health care observers in the U.S." As we noted at the time (6 years ago!):
“As with all theory, the true test is whether it works in real life. No better way to tell than to try it out. And - maybe - the best place to try it out is somewhere else not here.”
Now, after lo! these many years and mountains of British taxpayer money, the U.K government has decided that real life is tougher than they thought - and expresses its regret (well, sort of), to wit: “a department spokesman said: "The Government recognises the weaknesses of a top-down, centrally imposed IT system.” Not to mention the cost - 11 billion British pounds sterling is nearly 18 billion US dollars.
Just to clarify, it’s the U.K. Government – not ours - that recognizes its strategic error.
Sadly, our present administration has not learned this lesson. And with each passing day it becomes more obvious that learning this lesson is going to cost American taxpayers a lot more than $18 billion.
Hey, isn’t that good news!??! This means the Fair Kathleen has lots more programming and systems design expertise available to help her fix the federal Exchanges she’s responsible for!
In theory, the UK system was intended "to result in improved quality of care and lower costs. This theory is also widely touted by health care observers in the U.S." As we noted at the time (6 years ago!):
“As with all theory, the true test is whether it works in real life. No better way to tell than to try it out. And - maybe - the best place to try it out is somewhere else not here.”
Now, after lo! these many years and mountains of British taxpayer money, the U.K government has decided that real life is tougher than they thought - and expresses its regret (well, sort of), to wit: “a department spokesman said: "The Government recognises the weaknesses of a top-down, centrally imposed IT system.” Not to mention the cost - 11 billion British pounds sterling is nearly 18 billion US dollars.
Just to clarify, it’s the U.K. Government – not ours - that recognizes its strategic error.
Sadly, our present administration has not learned this lesson. And with each passing day it becomes more obvious that learning this lesson is going to cost American taxpayers a lot more than $18 billion.
Monday, October 28, 2013
You’ve sold it, now what happens…
I have a client, who currently has UHC RPPO, the copay is $0 for
her PCP. I find out today that her Primary care doctor has been charging her a
$35 copay every time she sees her. The doctor is clearly listed as a
"Primary Care Physician" in the directory, and not a specialist, So I
cannot figure out why she would get billed a copay like this. I have not had a
chance to contact the doctor yet to investigate, but when I found this out, I
was outraged, i wanted to go down to her doctor's office and demand they give
her her money back.
While I admire this agent's chivalry, before
he cold-cocks a doctor, maybe we should review the situation, beginning with:
what is a co-payment? A co-payment is an amount of money a patient agrees to
pay a physician for an appointment, as set by the insurance company, which the
physician agrees to accept. These co-payments are to be collected at time of
service, hopefully before the appointment ( but I digress). Some companies determine
the co-payment by the type of provider (eg Family Practice or Specialist) or by appointment type (eg Physical Therapy), or even a single co-payment regardless of
the appointment type or provider. In this situation, the Family Practice Doctor
was charging the higher Specialist co-payment to the patient.
Let’s assume that the doctor is collecting the higher co-payment. When the doctor electronically bills the insurance company for the appointment, the co-payment of $35.00 will be reflected in the bill, so the insurance company will know what the patient paid and the charge by the provider. If the co-payment is incorrect, the doctor will receive an EOB with the $35.00 taken out of his payment and probably a note reflecting that the insurance refunded the patient the $35.00. In the end the doctor still makes the same amount of money, and it will be reflected in the doctor’s practice management system that a co-payment is not due. Insurance companies are very competent in ensuring that doctors are not, in any way, overpaid for the services they render.
To be honest, unless this provider is practicing in the dark ages, without any type of electronic practice management system or EMR, this scenario does not often play out, for two reasons:
Let’s assume that the doctor is collecting the higher co-payment. When the doctor electronically bills the insurance company for the appointment, the co-payment of $35.00 will be reflected in the bill, so the insurance company will know what the patient paid and the charge by the provider. If the co-payment is incorrect, the doctor will receive an EOB with the $35.00 taken out of his payment and probably a note reflecting that the insurance refunded the patient the $35.00. In the end the doctor still makes the same amount of money, and it will be reflected in the doctor’s practice management system that a co-payment is not due. Insurance companies are very competent in ensuring that doctors are not, in any way, overpaid for the services they render.
To be honest, unless this provider is practicing in the dark ages, without any type of electronic practice management system or EMR, this scenario does not often play out, for two reasons:
1) The HITECH Act, passed several years ago, outlines 20-plus meaningful uses that each physician’s office must adhere to in order to continue to get their Medicare monies. One of those meaningful uses is to verify insurance and the patient’s financial responsibility. This is then recorded into the software, and when the patient arrives with their insurance card and driver’s license and their paperwork filled out completely, then the patient is charged their co-payment as set by the insurance company.And:
2) Patients do not know much about their health insurance but they, by God, know how much their co-payment is and will REFUSE to pay one penny more than they owe; oftentimes they don’t even want to pay their co-payment, but again I digress.
So, I would not worry too much about the co-payment: the
patient and the insurance will surely keep the doctor in line.
Privacy, Shmivacy
This story has been making the rounds, and it's bad enough. If and/or when one finally does manage to log on to the ObamaTax website, if one looks closely enough, one will find this disclaimer:
"You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this information system"
Now there are actually two things terribly wrong with this picture:
First, the disclaimer is itself hidden inside the Terms & Conditions agreement (to which one must consent before moving forward with the process); it's available only by "using a web browser's "View Source" feature."
Talk about passing it to find out what's in it.
But that's not even the most egregious part: after all, if one is resourceful enough (and aware of its existence) one may find the CYA clause fairly easily.
No, what's truly scary is this:
Not long ago, Isuffered through underwent the training and certification process which allows me to sell new "metal" plans on the Exchange (someday, maybe). Fully 30% of that training was focused exclusively on privacy and security measures that agents must take in order to be compliant.
Section 5 promised that its completion would allow me to:
■ Define PII (Personally Identifiable Information)
■ Identify the extent to which PII may be used and disclosed
■ Identify key privacy responsibilities and restrictions associated with PII under the Marketplaces
Specifically:
"You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this information system"
Now there are actually two things terribly wrong with this picture:
First, the disclaimer is itself hidden inside the Terms & Conditions agreement (to which one must consent before moving forward with the process); it's available only by "using a web browser's "View Source" feature."
Talk about passing it to find out what's in it.
But that's not even the most egregious part: after all, if one is resourceful enough (and aware of its existence) one may find the CYA clause fairly easily.
No, what's truly scary is this:
Not long ago, I
Section 5 promised that its completion would allow me to:
■ Define PII (Personally Identifiable Information)
■ Identify the extent to which PII may be used and disclosed
■ Identify key privacy responsibilities and restrictions associated with PII under the Marketplaces
Specifically:
Two key points to remember about this definition:
1. This definition may be different than definitions provided under other laws. It is important that you are familiar with this federal definition and how it applies to Marketplace information.
2. A key component to the definition is that PII involves information that is linked or linkable to a specific individual. Therefore, if it is possible to link information to an individual, this information would be considered PII, even if it has not yet been linked to that individual.Now compare that with what the Navigators on the phone at the actual government-run web-site have privy to, and yet are completely exempted from, and the web-site itself, which is also exempted from these burdensome requirements.
The purpose of Section 6, we're told, is to enable us to:
■ Define the term "information security"
■ Identify three key elements to protecting information
■ Identify the differences between threats, vulnerabilities, and risks to information
■ Identify certain controls that agents and brokers can take to protect information within the Marketplaces
■ List steps that agents and brokers can take to help promote information security in the Marketplaces
■ Identify types of security incidents
■ List steps for responding to a privacy breach as it relates to information security management
And here's a snippet from that section:
• Information security is achieved through implementing technical, management, and operational measures designed to protect the confidentiality, integrity, and availability of informationBoth "snippets" are culled from the actual on-line coursework, which is available by clicking the highlighted sections. I figure Ms Shecantbeserious is entitled to just as much privacy as the rest of us.
• The goal of an information security program is to understand, manage, and reduce the risk to information under the control of the organization.
• In today’s work environment, many information systems are electronic; however the Department of Health and Human Services (HHS) has a media neutral policy towards information. This means that any data must be protected — whether it is in electronic, paper, or oral format.
Sunday, October 27, 2013
Saturday, October 26, 2013
Friday, October 25, 2013
Cavalcade of Risk #195: Call for submissions
Jason Hull hosts
next week's Cav. Entries are due by Monday (the 28th).
To submit your risk-related post, just click here to email it.
You'll need to provide:
■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post
PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like). And please only submit if you are willing to link back to the carnival if your submission is accepted.
To submit your risk-related post, just click here to email it.
You'll need to provide:
■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post
PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like). And please only submit if you are willing to link back to the carnival if your submission is accepted.
Thursday, October 24, 2013
Health Wonk Review - Ignore at Your Peril edition is up
Jaan Siderov, one of my very favorite wonk-bloggers, presents this week's snarky but effective round-up of posts on health care policy and polity, And it looks like IB's contributed a new catchphrase - but you'll have to read the 'Review to find out what it is.
Kudos, Jaan!
Kudos, Jaan!
Wednesday, October 23, 2013
Let's clear something up
Over at RedState, Moe Lane has a post up detailing a conversation ("online chat") between a potential ObamaTax buyer and one of the helpful help-desk folks. The whole thing's worth a read (it's pretty short), but here's the lede:
"You have until March 2014 to enroll ..."
Wrong!
"... health insurance coverage typically starts on the first day of a given month, and it takes up to 15 days to process applications ... to successfully accomplish that you have to send in your application by the middle of February."
So what else is Dean (et al) getting wrong?
"You have until March 2014 to enroll ..."
Wrong!
"... health insurance coverage typically starts on the first day of a given month, and it takes up to 15 days to process applications ... to successfully accomplish that you have to send in your application by the middle of February."
So what else is Dean (et al) getting wrong?
Breaking: ObamaTax website fixed!
The RH Group has managed the impossible - a working ObamaTax website.
Click here to check it out.
Click here to check it out.
And for those who really want to know, JWF has found the unsecured HHS site with real premiums (unsubsidized). Unfortunately, these aren't a joke.
Cannon-fire scores a hit
A while back, we noted that uber-wonk Michael Cannon claimed that citizens of states with Fed-run Exchanges weren't eligible for ObamaTax subsidies, and that the employer mandate was inoperative in those states. At the time, the story didn't have a lot of "legs;" indeed, the IRS ran rough-shod right over it, announcing far and wide that they were going to ignore that part of the actual, written, passed-by-Congress and sign-by-the-President law.
As one might imagine, this hasn't sat well with various and sundry folks who feel, perhaps nostalgically, that the law-as-written should mean something, and so a group of them filed suit to have it enforced.
The lawsuit has languished for a while, but has now been given new life by a Federal judge who - gasp! - understands that the plaintiffs have a legitimate case:
"A federal judge on Tuesday refused to dismiss a case that could fatally cripple the Obamacare health insurance law ... 'The IRS cannot rewrite the law that Congress passed'"
But of course they can do just that, and so far what's stopping them?
Bueller? Anyone?
As one might imagine, this hasn't sat well with various and sundry folks who feel, perhaps nostalgically, that the law-as-written should mean something, and so a group of them filed suit to have it enforced.
The lawsuit has languished for a while, but has now been given new life by a Federal judge who - gasp! - understands that the plaintiffs have a legitimate case:
"A federal judge on Tuesday refused to dismiss a case that could fatally cripple the Obamacare health insurance law ... 'The IRS cannot rewrite the law that Congress passed'"
But of course they can do just that, and so far what's stopping them?
Bueller? Anyone?
MVNHS© News
It's been a while since we've heard from the Much Vaunted National Health System© (aka that which the ObamaTax seeks to become), which is a shame, since it provides a glimpse into our own future, health-wise.
First up, the Independent reports that "free" health care isn't really, um, free:
"Stagnant health spending combined with ever rising costs and demand mean the NHS is facing "the most challenging period in its 65-year existence," ... In a frank assessment of the dangers faced by the health service, senior officials ... say that the two years following the next general election will be pivotal in deciding whether the NHS can continue to provide free health care for all patients."
I think that we can all surmise what the answer will be. Math is relentless.
Next, the Daily Mail reports that the MVNHS© may well have found its cost-cutting groove:
"GPs have been paid bonuses to put elderly patients on controversial ‘death lists’ in an attempt to save the NHS money by cutting the number of people who die in hospital"
At $81 (£50) a pop, a doc could make a nice living on these one-way tickets to Liverpool (Pathway, that is).
Easy come, easy go.
[Hat Tip: Ace of Spades]
First up, the Independent reports that "free" health care isn't really, um, free:
"Stagnant health spending combined with ever rising costs and demand mean the NHS is facing "the most challenging period in its 65-year existence," ... In a frank assessment of the dangers faced by the health service, senior officials ... say that the two years following the next general election will be pivotal in deciding whether the NHS can continue to provide free health care for all patients."
I think that we can all surmise what the answer will be. Math is relentless.
Next, the Daily Mail reports that the MVNHS© may well have found its cost-cutting groove:
"GPs have been paid bonuses to put elderly patients on controversial ‘death lists’ in an attempt to save the NHS money by cutting the number of people who die in hospital"
At $81 (£50) a pop, a doc could make a nice living on these one-way tickets to Liverpool (Pathway, that is).
Easy come, easy go.
[Hat Tip: Ace of Spades]
Tuesday, October 22, 2013
Monday, October 21, 2013
NEWS FLASH! Obamacare Program Released On 35 Floppy Disks!
Having problems logging in? Now you can have your very own version of ObamaCare...
Rumor has it that the 6 CD version should be out sometime in 2016.
Rumor has it that the 6 CD version should be out sometime in 2016.
Sunday, October 20, 2013
Are We There Yet?
Remember when you were a kid and you were taking a long trip in the car with your parents? Every ten minutes you would ask "are we there yet?" and your parents would answer "we're getting closer!" even though you had another three hours to go...
The difference is, this time you might not ever get there.
Friday, October 18, 2013
More Healthcare.gov website fun
Yesterday, The Weekly Standard published an interesting article about some of the computer code running on Healthcare.gov. It appears that some sections were plagiarized from a British company. The software in question was published under the GPL license, which means it's free to use, AS LONG AS THE COPYRIGHT NOTICE is left intact. The brainaic programmers behind Healthcare.gov took it out. That's called software piracy in most quarters...
See: http://www.weeklystandard.com/blogs/obamacare-website-violates-licensing-agreement-copyrighted-software_763666.html for more details.
Smooth move guys. Not only doesn't it work, but you stole it to boot....
See: http://www.weeklystandard.com/blogs/obamacare-website-violates-licensing-agreement-copyrighted-software_763666.html for more details.
Smooth move guys. Not only doesn't it work, but you stole it to boot....
Thursday, October 17, 2013
InsureBlog Exclusive: Maryland Exchange rates
Thanks to a generous (and anonymous) benefactor, we've got ObamaTax-compliant rates and plan details for potential Old Line State consumers (assuming they can actually log-in).
Click here for Plan Details
Click here for Plan Rates
Why are these important?
Because these are the actual, non-subsidized rates - what these plans really cost.
Read 'em and weep.
Click here for Plan Details
Click here for Plan Rates
Why are these important?
Because these are the actual, non-subsidized rates - what these plans really cost.
Read 'em and weep.
1 Down, 6,999,999 to go
Huzzah!
"Delaware officials are celebrating the state's first health insurance exchange enrollee."
Here's the bad news:
"59-year-old Janice Baker of Selbyville the first confirmed resident to enroll in the marketplace."
Why is this bad news?
Because the ObamaTax requires more young, healthy Americans to sign up in order to pay for folks like Ms Baker, who's premiums are directly subsidized by substantially higher rates for younger folks. Absent large numbers of the latter, the system's economic assumptions fail. Miserably.
Unfortunately, the Cavalry ain't comin' obver the hill any time soon:
"The number of visitors to the federal government's HealthCare.gov Web site plummeted 88 percent between Oct. 1 and Oct. 13"
Hunh.
"Delaware officials are celebrating the state's first health insurance exchange enrollee."
Here's the bad news:
"59-year-old Janice Baker of Selbyville the first confirmed resident to enroll in the marketplace."
Why is this bad news?
Because the ObamaTax requires more young, healthy Americans to sign up in order to pay for folks like Ms Baker, who's premiums are directly subsidized by substantially higher rates for younger folks. Absent large numbers of the latter, the system's economic assumptions fail. Miserably.
Unfortunately, the Cavalry ain't comin' obver the hill any time soon:
"The number of visitors to the federal government's HealthCare.gov Web site plummeted 88 percent between Oct. 1 and Oct. 13"
Hunh.
Wednesday, October 16, 2013
Adventures On The Marketplace
My journey to “affordable”insurance continues. After giving HHS the benefit of the doubt that these
“glitches” were going to be fixed, I decided to return to www.healthcare.gov and continue the process
of signing up. After getting back into the system (6 failed attempts first) I
clicked on ENROLL and...error message!
So, I called the 800 number and
got a very friendly voice named Mackenzie. Mackenzie was very helpful. She told
me that there are these things called “glitches” that keep happening because
too many people are getting on the site. She said: “2.5 people are on it at a
time and the site keeps having problems.” Of course I asked her what types of
problems to which she promptly replied “It’s not recognizing passwords, email
addresses, usernames, and stuff like that.”
At that point I kindly told her
thanks and asked one last question – How bad do you hate your job right now?
The response sums up the whole marketplace experience.
“Oh, it’s okay. I really wish
we could help somebody. The problem with calling us to
help enroll is that we are looking at the same system you are. When you can’t
log in neither can we. I like that you have been nice. Many callers are angry,
yelling profanity at me.” I said, it’s
not your fault. Did you share with them that people can’t start coverage until
January 1st? Her reply: “No, no, you can start insurance
coverage on November 1st as long as we have your application done by
October 15th. If it is after the 15th then you don’t get
insurance until the following month. You know, December.”
Yep, that's our hard earned tax money giving wrong information again.
Cavalcade of Risk #194: Fantasy edition
Claire
Wilkinson hosts this week's "easy
come, easy go" edition of the Cavalcade. On the one hand, she's got a great
selection of posts, and has done a great job of presenting them.
On the other, now I've got a Queen-induced ear-worm.
Thanks, Claire!
On the other, now I've got a Queen-induced ear-worm.
Thanks, Claire!
Tuesday, October 15, 2013
Sensible Carrier Tricks
Humana has announced that they are discontinuing so-called "HIPAA plans" in Ohio. This follows Anthem's announcement last month that they're pulling their version. One presumes that any other carriers that still have these on the books will soon be following suit.
"HIPAA Plans" came about as a result of, well, the Health Insurance Portability and Accountability Act of 1996. Briefly, the law said that if you were uninsurable in the individual (underwritten) market, you must be offered a standardized guaranteed issue plan. There were two versions, Standard and Basic, both with the same out-of-pocket maximums, but different deductibles and co-insurance levels to get you there. Depending on timing, these plans would also have to cover any pre-existing conditions. The plans were modestly mediocre, and priced on the expensive side (which makes sense, as only folks with substantial health issues were going to need it).
It makes sense, too, that carriers will be deleting these plans: after all, when all health insurance plans must be guaranteed issue, who needs these?
Well, other than the folks who liked their plans and doctors.
"HIPAA Plans" came about as a result of, well, the Health Insurance Portability and Accountability Act of 1996. Briefly, the law said that if you were uninsurable in the individual (underwritten) market, you must be offered a standardized guaranteed issue plan. There were two versions, Standard and Basic, both with the same out-of-pocket maximums, but different deductibles and co-insurance levels to get you there. Depending on timing, these plans would also have to cover any pre-existing conditions. The plans were modestly mediocre, and priced on the expensive side (which makes sense, as only folks with substantial health issues were going to need it).
It makes sense, too, that carriers will be deleting these plans: after all, when all health insurance plans must be guaranteed issue, who needs these?
Well, other than the folks who liked their plans and doctors.
Interesting Carrier Trick
Got this in email this morning (from Anthem):
"We recently changed several UW guidelines which will allow your clients to qualify for more aggressive pricing. Example: We are no longer rating for smoking, smokers will now receive a P1 rating (assuming they have no other ratable conditions). [emphasis in original]
This applies to Ohio, but may also be available in other states.
Anthem, along with various other carriers, is also reaching out to current plan-holders with early renewal offers (such as we've seen in the small group market).
The email also reiterated something they've previously announced:
"List Bills are No Longer available for NEW Business. If you have clients currently on a List bill they will be removed when they MIGRATE to an ACA Plan. GF ["Grandfathered"] members will be able to remain on list bill."
List Bill is (well, was) a mechanism where one could "bundle" several individual plans into a common monthly invoice that would go to one address. Typically, this would have been for small employers who didn't offer a "group" plan but were willing to do the admin necessary for folks to have their premiums withdrawn from their paychecks. It was more a convenience item than anything else. But with new ObamaTax rules this service is going away.
Just another example of how the ObamaTax has negatively impacted our choices.
"We recently changed several UW guidelines which will allow your clients to qualify for more aggressive pricing. Example: We are no longer rating for smoking, smokers will now receive a P1 rating (assuming they have no other ratable conditions). [emphasis in original]
This applies to Ohio, but may also be available in other states.
Anthem, along with various other carriers, is also reaching out to current plan-holders with early renewal offers (such as we've seen in the small group market).
The email also reiterated something they've previously announced:
"List Bills are No Longer available for NEW Business. If you have clients currently on a List bill they will be removed when they MIGRATE to an ACA Plan. GF ["Grandfathered"] members will be able to remain on list bill."
List Bill is (well, was) a mechanism where one could "bundle" several individual plans into a common monthly invoice that would go to one address. Typically, this would have been for small employers who didn't offer a "group" plan but were willing to do the admin necessary for folks to have their premiums withdrawn from their paychecks. It was more a convenience item than anything else. But with new ObamaTax rules this service is going away.
Just another example of how the ObamaTax has negatively impacted our choices.
New Sponsor
Proving once again that this is truly the world wide web, our newest benefactor comes to us from the home of sherry, the original Valencia and the Prado.
Op de Beek & Worth is an insurance brokerage headquartered in Marbella, and in business for over 40 years. Feel free to click the link in the sidebar for more information on the firm.
Welcome aboard!
Op de Beek & Worth is an insurance brokerage headquartered in Marbella, and in business for over 40 years. Feel free to click the link in the sidebar for more information on the firm.
Welcome aboard!
RomneyCare --> ObamaTax
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One presumes that this is a rhetorical question:
"Why is it so hard to find a doctor? Half of primary care physicians in [Massachusettes] are not accepting new patients."
The author posits that it's a function of age; that is, many patients are Baby Boomers, and so are their doc's. As the former group ages and needs more care, those in the latter are ready to retire.
One supposes that there is a grain of truth in this, but the real reason comes in a bit of belated self-awareness:
"Meanwhile, when the state reformed health care in 2006, it expanded insurance coverage, increasing access to care without boosting the supply of doctors."
Gee, ya think?
"Why is it so hard to find a doctor? Half of primary care physicians in [Massachusettes] are not accepting new patients."
The author posits that it's a function of age; that is, many patients are Baby Boomers, and so are their doc's. As the former group ages and needs more care, those in the latter are ready to retire.
One supposes that there is a grain of truth in this, but the real reason comes in a bit of belated self-awareness:
"Meanwhile, when the state reformed health care in 2006, it expanded insurance coverage, increasing access to care without boosting the supply of doctors."
Gee, ya think?
Monday, October 14, 2013
Avik cuts to the chase
If you're not regularly reading Avik Roy's "The Apothecary" (and you should be - it's in the sidebar), you're missing out on some of the most accurate, cutting-edge analysis of health care policy and polity available. Here, Avik explains with cystal clarity exactly why the ObamaTax Exchanges are a colossal failure:
"Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping ... HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away." [emphasis added]
The key concept here is "no wrong door." Simply put, the entire process begins (and, for most, ends) at the front gate. The "no wrong door" philosophy is that, once one gets through the initial portal (and some do), the very first thing that happens is that one is directed to a widget that determines what, if any, subsidy one may be entitled to, and then applies that subsidy when one begins "shopping" for plans.
And there's a very simple, elegant reason for this: the actual premiums would cause a normal person to seek immediate medical help, and we can't have that. Only after the subsidy (and whether one is truly eligible has become a matter of debate, as well) has been applied are theproles "customers" allowed to see the prices.
This is brilliant.
Evil, but brilliant:
The most important demographic, from the ObamaTax POV, is the "young invincibles;" those people, in their twenties and early thirties, who have very little in the way of health care costs (save for, perhaps, maternity) but who are counted on to provide outsized premiums to subsidize their healthcare-consuming elders. After all, someone has to pay the piper, neh?
And remember, the ObamaTax mandates that there can only be a threefold difference in prices between the young invincibles and seasoned citizens. If the former are scared off early - as they most assuredly would be if they knew the true price of their "free" healthcare insurance - then the system grinds to a halt.
If one were a cynic, one might consider that a feature, not a bug.
"Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping ... HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away." [emphasis added]
The key concept here is "no wrong door." Simply put, the entire process begins (and, for most, ends) at the front gate. The "no wrong door" philosophy is that, once one gets through the initial portal (and some do), the very first thing that happens is that one is directed to a widget that determines what, if any, subsidy one may be entitled to, and then applies that subsidy when one begins "shopping" for plans.
And there's a very simple, elegant reason for this: the actual premiums would cause a normal person to seek immediate medical help, and we can't have that. Only after the subsidy (and whether one is truly eligible has become a matter of debate, as well) has been applied are the
This is brilliant.
Evil, but brilliant:
The most important demographic, from the ObamaTax POV, is the "young invincibles;" those people, in their twenties and early thirties, who have very little in the way of health care costs (save for, perhaps, maternity) but who are counted on to provide outsized premiums to subsidize their healthcare-consuming elders. After all, someone has to pay the piper, neh?
And remember, the ObamaTax mandates that there can only be a threefold difference in prices between the young invincibles and seasoned citizens. If the former are scared off early - as they most assuredly would be if they knew the true price of their "free" health
If one were a cynic, one might consider that a feature, not a bug.
Gary's Story
In September of 2009 a new client called me with news you never wish upon an enemy let alone a friend. His wife had been diagnosed with breast cancer. Not more than six months prior to that we had met to write their health insurance.
They had gone uninsured for a few months after the employer plan available to Gary had become unaffordable for them. Financial times were tough and he was now on a new path as a self employed consultant.
With a limited budget, I suggested that he buy a high deductible plan that was on the lower end of his price range but would provide major medical benefits and allow him to use pre tax dollars to pay his expenses. The initial plan was a $2500 CDHP with embedded deductible. It carried a monthly premium of $480 per month.
When Gary called that day his first question was about pre-existing conditions. He was worried that since the policy hadn't been in force for very long that the insurance company was going to look back and cancel the policy. He was also worried that the insurance company was going to increase his rates to a point he couldn't afford it.
All of this coincided with the time when President Obama was pushing his new health care reform proposals. Gary's nervousness was a direct correlation to the false propaganda being pushed by the mainstream media and Democrats in congress. They were screaming about medical bankruptcy, people being dropped from insurance, and profit mongering insurance companies who would rather see you die than pay your claims.
I assured him that in Ohio there were laws in place that protected him from these things as long as he paid his premiums on time and wasn't fraudulent on the application. While this put him at ease his second question was very simple: we want Pam to see the very best doctors. Will my plan cover that? I assured him that it was and that the plan we had chosen was from one of the best and easiest to work with insurers. From this point forward Gary was at ease.
Fast forward to October 10, 2013. Pam has been cancer free for three years. Their oldest daughter is in grad school and their boys are busy playing high school sports. Gary's business is thriving and he employs a part time administrative assistant. Life is good.
Their insurance program now is a $5000 CDHP with embedded deductible and it carries a monthly premium of $648 per month. They understand that health care costs continue to rise and are concerned with how they will pay for insurance in the future. What prompted the discussion this time is Obamacare. Last week we began the process of sending out notices to clients about renewing early to avoid some of the unintended consequences of the law. Their policy renews April 1st so we wanted to take advantage of an opportunity to lock them in at a lower rate. It was also possible that they might qualify for a subsidy and that they could get a new plan through the Exchange although that wasn't very likely. In either event it is my professional responsibility to give clients all of their options and make recommendations based on their circumstances.
This is what we found. To early renew their current plan early will increase their premiums to $683 per month. Gary and Pam's household income is too high for them to qualify for a subsidy in the exchange but we ran rates with a January effective date for them to compare. The results were astounding. A plan with the same deductible that included coinsurance with a higher out of pocket maximum is going to cost $1180 per month!
Renewing early is a great strategy, but is essentially like putting a Band-Aid on a severed jugular. It successfully helps Gary and Pam's situation in the short term. Come next December when they are forced to play in the Obamacare sandbox who knows what will happen.
They had gone uninsured for a few months after the employer plan available to Gary had become unaffordable for them. Financial times were tough and he was now on a new path as a self employed consultant.
With a limited budget, I suggested that he buy a high deductible plan that was on the lower end of his price range but would provide major medical benefits and allow him to use pre tax dollars to pay his expenses. The initial plan was a $2500 CDHP with embedded deductible. It carried a monthly premium of $480 per month.
When Gary called that day his first question was about pre-existing conditions. He was worried that since the policy hadn't been in force for very long that the insurance company was going to look back and cancel the policy. He was also worried that the insurance company was going to increase his rates to a point he couldn't afford it.
All of this coincided with the time when President Obama was pushing his new health care reform proposals. Gary's nervousness was a direct correlation to the false propaganda being pushed by the mainstream media and Democrats in congress. They were screaming about medical bankruptcy, people being dropped from insurance, and profit mongering insurance companies who would rather see you die than pay your claims.
I assured him that in Ohio there were laws in place that protected him from these things as long as he paid his premiums on time and wasn't fraudulent on the application. While this put him at ease his second question was very simple: we want Pam to see the very best doctors. Will my plan cover that? I assured him that it was and that the plan we had chosen was from one of the best and easiest to work with insurers. From this point forward Gary was at ease.
Fast forward to October 10, 2013. Pam has been cancer free for three years. Their oldest daughter is in grad school and their boys are busy playing high school sports. Gary's business is thriving and he employs a part time administrative assistant. Life is good.
Their insurance program now is a $5000 CDHP with embedded deductible and it carries a monthly premium of $648 per month. They understand that health care costs continue to rise and are concerned with how they will pay for insurance in the future. What prompted the discussion this time is Obamacare. Last week we began the process of sending out notices to clients about renewing early to avoid some of the unintended consequences of the law. Their policy renews April 1st so we wanted to take advantage of an opportunity to lock them in at a lower rate. It was also possible that they might qualify for a subsidy and that they could get a new plan through the Exchange although that wasn't very likely. In either event it is my professional responsibility to give clients all of their options and make recommendations based on their circumstances.
This is what we found. To early renew their current plan early will increase their premiums to $683 per month. Gary and Pam's household income is too high for them to qualify for a subsidy in the exchange but we ran rates with a January effective date for them to compare. The results were astounding. A plan with the same deductible that included coinsurance with a higher out of pocket maximum is going to cost $1180 per month!
Renewing early is a great strategy, but is essentially like putting a Band-Aid on a severed jugular. It successfully helps Gary and Pam's situation in the short term. Come next December when they are forced to play in the Obamacare sandbox who knows what will happen.
Sunday, October 13, 2013
Saturday, October 12, 2013
Told ya so
We've been banging this gong for a while; here's another real-life examplar of why we object to the conflation of health care with health insurance:
"A recent survey covering more than 1,000 physician practices confirms what many experts had feared—many doctors will not participate in Obamacare’s exchanges ... Fewer than three in 10 practices (29.2 percent) definitely plan to “participate with any new health insurance product(s) sold” on an exchange"
Thus putting the lie to those who say "Obamacare is great, I'll finally get health care."
No, you probably won't - what you'll get (perhaps) is health insurance, but good luck using it.
And it gets worse:
"UnitedHealthCare has sent thousands of pink slips to Connecticut doctors ... letters were sent out to doctors caring for 'Medicare Advantage' patients ... A mix of primary care and specialty doctors are affected by it."
So even folks who are currently insured don't get to keep their doc's.
Welcome aboard!
"A recent survey covering more than 1,000 physician practices confirms what many experts had feared—many doctors will not participate in Obamacare’s exchanges ... Fewer than three in 10 practices (29.2 percent) definitely plan to “participate with any new health insurance product(s) sold” on an exchange"
Thus putting the lie to those who say "Obamacare is great, I'll finally get health care."
No, you probably won't - what you'll get (perhaps) is health insurance, but good luck using it.
And it gets worse:
"UnitedHealthCare has sent thousands of pink slips to Connecticut doctors ... letters were sent out to doctors caring for 'Medicare Advantage' patients ... A mix of primary care and specialty doctors are affected by it."
So even folks who are currently insured don't get to keep their doc's.
Welcome aboard!
Friday, October 11, 2013
Meet Patrick (Yes, it is me)
As a broker it is extremely important that I understand all aspects of PPACA. This includes a need to set up an account at the healthcare.gov site so that I can aid clients in the purchase of subsidized insurance. We've all seen the "glitches" of the system, and if you haven't then I strongly encourage you to wait until they are "fixed".
On Tuesday I decided that I'd give it another try. After getting kicked out of the system time and time again I decided I would click on the chat feature. Here is my conversation:
[3:17:26 pm]: Thanks for contacting Health Insurance Marketplace Live Chat. Please wait while we connect you to someone who can help.
[3:17:31 pm]: Please be patient while we're helping other people.
[3:19:02 pm]: Please be patient while we're helping other people.
[3:19:57 pm]: Welcome! You're now connected to Health Insurance Marketplace Live Chat.
Thanks for contacting us. My name is Shaunda. To protect your privacy, please don't provide any personal information, like Social Security Number, or any other sensitive medical or personal information.
[3:20:09 pm]: Shaunda
Hello, before we get started, are you looking for information about health insurance in the state you live in, or a different state?
[3:20:09 pm]: Patrick
My screen is blank and not showing my applications.
[3:20:44 pm]: Shaunda
I'm required to inform you of specific details regarding your state. This is essential information for your future reference. After I give you this information, I will address your initial question. Thank you for your patience.
[3:21:20 pm]: Patrick
Ohio. Why can't I get into the "My Applications & Coverage" section?
[3:22:02 pm]: Shaunda
I can answer your questions about the Marketplace and how you can enroll. You can also use HealthCare.gov to find this information and what programs you may qualify for, as well as find and apply for coverage, compare plans, and enroll in a health insurance plan. You can apply now through the end of open enrollment. Open enrollment for health coverage in 2014 closes on March 31, 2014.
[3:22:13 pm]: Shaunda
Thanks for your interest in the Health Insurance Marketplace. We have a lot of visitors trying to use our website right now. That is causing some glitches for some people trying to create accounts or log in. Keep trying and thanks for your patience. You might have better success during off-peak hours, like later at night or early in the morning. We’ll continue working to improve the site so you can get covered!
[3:22:55 pm]: Patrick
I feel like I am typing with Peggy from the Discover Card commercials. Can you confirm you are not Peggy?
[3:23:42 pm]: Shaunda
Do you have any other questions that I can help you with?
[3:24:21 pm]: Patrick
Will I ever be able to log in and actually see coverage options? If yes will it be before December 15th?
[3:24:39 pm]: Shaunda
Currently it’s not known when it will be resolved, I suggest you keep trying. I'm sorry.
[3:25:40 pm]: Patrick
What is causing the "glitch"? Overload of people or poor site creators?
[3:28:27 pm]: Shaunda
The heavy traffic.
[3:28:34 pm]: Shaunda
Do you have any other questions that I can help you with?
[3:28:43 pm]: Patrick
Are you sure you are not Peggy?
[3:29:25 pm]: Shaunda
My name is Shaunda. Do you have any other marketplace questions I can help you with?
[3:30:06 pm]: Patrick
If it's heavy traffic then why am I able to get to my account then getting kicked off the system? I can click on my profile and all of that information pops up.
[3:31:03 pm]: Shaunda
Glitches in the sytsem.Currently it’s not known when it will be resolved, I suggest you keep trying. I'm sorry.
[3:31:49 pm]: Patrick
Why should I keep trying when you are telling me that you have no idea when the system issues will be resolved?
[3:32:09 pm]: Shaunda
Do you have any other questions that I can help you with?
[3:33:12 pm]: Shaunda
Thank you for contacting Health Insurance Marketplace Live Chat. We are here to help you 24 hours a day, 7 days a week.
[3:33:22 pm]: 'Shaunda' has left the chat session.
[3:33:25 pm]: Your chat session is over. Thanks for contacting us, and we hope we've answered your questions. Have a great day.
[3:33:25 pm]: 10/8/2013
As I was typing another question my session unexpectedly ended. Maybe another glitch? Did Shaunda fall victim to the government shutdown? Who knows, but maybe I'll have better luck tomorrow.
On Tuesday I decided that I'd give it another try. After getting kicked out of the system time and time again I decided I would click on the chat feature. Here is my conversation:
[3:17:26 pm]: Thanks for contacting Health Insurance Marketplace Live Chat. Please wait while we connect you to someone who can help.
[3:17:31 pm]: Please be patient while we're helping other people.
[3:19:02 pm]: Please be patient while we're helping other people.
[3:19:57 pm]: Welcome! You're now connected to Health Insurance Marketplace Live Chat.
Thanks for contacting us. My name is Shaunda. To protect your privacy, please don't provide any personal information, like Social Security Number, or any other sensitive medical or personal information.
[3:20:09 pm]: Shaunda
Hello, before we get started, are you looking for information about health insurance in the state you live in, or a different state?
[3:20:09 pm]: Patrick
My screen is blank and not showing my applications.
[3:20:44 pm]: Shaunda
I'm required to inform you of specific details regarding your state. This is essential information for your future reference. After I give you this information, I will address your initial question. Thank you for your patience.
[3:21:20 pm]: Patrick
Ohio. Why can't I get into the "My Applications & Coverage" section?
[3:22:02 pm]: Shaunda
I can answer your questions about the Marketplace and how you can enroll. You can also use HealthCare.gov to find this information and what programs you may qualify for, as well as find and apply for coverage, compare plans, and enroll in a health insurance plan. You can apply now through the end of open enrollment. Open enrollment for health coverage in 2014 closes on March 31, 2014.
[3:22:13 pm]: Shaunda
Thanks for your interest in the Health Insurance Marketplace. We have a lot of visitors trying to use our website right now. That is causing some glitches for some people trying to create accounts or log in. Keep trying and thanks for your patience. You might have better success during off-peak hours, like later at night or early in the morning. We’ll continue working to improve the site so you can get covered!
[3:22:55 pm]: Patrick
I feel like I am typing with Peggy from the Discover Card commercials. Can you confirm you are not Peggy?
[3:23:42 pm]: Shaunda
Do you have any other questions that I can help you with?
[3:24:21 pm]: Patrick
Will I ever be able to log in and actually see coverage options? If yes will it be before December 15th?
[3:24:39 pm]: Shaunda
Currently it’s not known when it will be resolved, I suggest you keep trying. I'm sorry.
[3:25:40 pm]: Patrick
What is causing the "glitch"? Overload of people or poor site creators?
[3:28:27 pm]: Shaunda
The heavy traffic.
[3:28:34 pm]: Shaunda
Do you have any other questions that I can help you with?
[3:28:43 pm]: Patrick
Are you sure you are not Peggy?
[3:29:25 pm]: Shaunda
My name is Shaunda. Do you have any other marketplace questions I can help you with?
[3:30:06 pm]: Patrick
If it's heavy traffic then why am I able to get to my account then getting kicked off the system? I can click on my profile and all of that information pops up.
[3:31:03 pm]: Shaunda
Glitches in the sytsem.Currently it’s not known when it will be resolved, I suggest you keep trying. I'm sorry.
[3:31:49 pm]: Patrick
Why should I keep trying when you are telling me that you have no idea when the system issues will be resolved?
[3:32:09 pm]: Shaunda
Do you have any other questions that I can help you with?
[3:33:12 pm]: Shaunda
Thank you for contacting Health Insurance Marketplace Live Chat. We are here to help you 24 hours a day, 7 days a week.
[3:33:22 pm]: 'Shaunda' has left the chat session.
[3:33:25 pm]: Your chat session is over. Thanks for contacting us, and we hope we've answered your questions. Have a great day.
[3:33:25 pm]: 10/8/2013
As I was typing another question my session unexpectedly ended. Maybe another glitch? Did Shaunda fall victim to the government shutdown? Who knows, but maybe I'll have better luck tomorrow.
Cavalcade of Risk #194: Call for submissions
Claire
Wilkinson hosts next week's Cav. Entries are due by Monday (the
14th).
To submit your risk-related post, just click here to email it.
You'll need to provide:
■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post
PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like). And please only submit if you are willing to link back to the carnival if your submission is accepted.
To submit your risk-related post, just click here to email it.
You'll need to provide:
■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post
PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like). And please only submit if you are willing to link back to the carnival if your submission is accepted.
The Doctor will speak with you now
In light of the effect that the ObamaTax is having (and has already had) on physician availability, I've been taking a look at some interesting sales opportunities being pitched at agents (and others).
The buzzword seems to be "telemedicine" or "telehealth," and the idea is that you buy a subscription to a service that promises you near-instant access to a doctor (or, perhaps, some other health care professional) that can help you determine the cause of the problem, and even issue a prescription if needed.
I've seen two of these so far (and I'm sure there are others); one offered a webinar, and our own Kelley Beloff has graciously consented tofall on her sword participate in one for us. I expect that we'll see her post on this soon. In the meantime, I thought readers might be interested in some broad descriptions of this product:
■ One fee per family per month. At least one of these products charges a single fee, regardless of how many people are "covered" [ed: the "scare quotes" are there because this isn't really "insurance"].
■ No co-pays. This is sort of a virtual "boutique" type model, where one fee covers all services. The benefit, of course, would be that one avoids being nickel-and-dimed for repeat calls.
■ The Doc is always in. This seems sort of obvious: what added value is there in this type of plan if the doc is available only during "business hours?" Come to think of it, this may be a good supplement for folks stuck with a new ObamaTax-compliant plan's "skinny" network.
Of course, it'd be nice to know how much these things cost. While these will vary from vendor to vendor, the price points seem to be $10, $15 and $25 per month, depending on the different services offered. That could add up to $300 a year to your health care costs, but if it guarantees access to actual care, perhaps that's a worthwhile expense.
Something to consider.
The buzzword seems to be "telemedicine" or "telehealth," and the idea is that you buy a subscription to a service that promises you near-instant access to a doctor (or, perhaps, some other health care professional) that can help you determine the cause of the problem, and even issue a prescription if needed.
I've seen two of these so far (and I'm sure there are others); one offered a webinar, and our own Kelley Beloff has graciously consented to
■ One fee per family per month. At least one of these products charges a single fee, regardless of how many people are "covered" [ed: the "scare quotes" are there because this isn't really "insurance"].
■ No co-pays. This is sort of a virtual "boutique" type model, where one fee covers all services. The benefit, of course, would be that one avoids being nickel-and-dimed for repeat calls.
■ The Doc is always in. This seems sort of obvious: what added value is there in this type of plan if the doc is available only during "business hours?" Come to think of it, this may be a good supplement for folks stuck with a new ObamaTax-compliant plan's "skinny" network.
Of course, it'd be nice to know how much these things cost. While these will vary from vendor to vendor, the price points seem to be $10, $15 and $25 per month, depending on the different services offered. That could add up to $300 a year to your health care costs, but if it guarantees access to actual care, perhaps that's a worthwhile expense.
Something to consider.
Thursday, October 10, 2013
Val Day cut-off vs Exchange SNAFU [UPDATED & BUMPED]
In theory, one has until the end of next March to sign up for coverage, or face a penalty fine tax for being uninsured.
In theory.
The reality is that, according to Ms Shecantbeserious, that may well be a day (or rather, 6 weeks) late and (more than a) dollar short:
"... health insurance coverage typically starts on the first day of a given month, and it takes up to 15 days to process applications ... to successfully accomplish that you have to send in your application by the middle of February."
My first question, of course, is why it would take a month-and-a-half to "process" an application, seeing as how a) everything's now Guaranteed Issue (no underwriting) and b) that shiny new Data Hub is supposed to coordinate all the various agencies (plus pinging your credit report) fast and effortless.
Here's the bigger issue, though: we're 10 days into the Exchange train-wreck, with no end in sight. Does that mean that The Fair Kathleen and her minions will extend the deadline out to February 24th?
Fat. Chance.
UPDATE: And good luck signing up in time:
In theory.
The reality is that, according to Ms Shecantbeserious, that may well be a day (or rather, 6 weeks) late and (more than a) dollar short:
"... health insurance coverage typically starts on the first day of a given month, and it takes up to 15 days to process applications ... to successfully accomplish that you have to send in your application by the middle of February."
My first question, of course, is why it would take a month-and-a-half to "process" an application, seeing as how a) everything's now Guaranteed Issue (no underwriting) and b) that shiny new Data Hub is supposed to coordinate all the various agencies (plus pinging your credit report) fast and effortless.
Here's the bigger issue, though: we're 10 days into the Exchange train-wreck, with no end in sight. Does that mean that The Fair Kathleen and her minions will extend the deadline out to February 24th?
Fat. Chance.
UPDATE: And good luck signing up in time:
UPDATE II [From Bob V]: Speaking of hula skirts and other oxymorons:
"Hawaii’s health insurance marketplace is hoping to turn around a stalled start by providing plans and pricing to consumers by Oct. 15 — but there are no guarantees ... The insurance exchange ... hasn’t been able to sell any insurance in Hawaii"
Looks like it was the Exchange, not the pig, that got roasted.
"Hawaii’s health insurance marketplace is hoping to turn around a stalled start by providing plans and pricing to consumers by Oct. 15 — but there are no guarantees ... The insurance exchange ... hasn’t been able to sell any insurance in Hawaii"
Looks like it was the Exchange, not the pig, that got roasted.
Some harsh words from Our Future
In the midst of the disastrous roll out of the ObamaTax, it's heartening to see that there may, indeed, be a light at the end of the tunnel:
"A University of Michigan graduate penned an open letter ... as she described how President Barack Obama’s signature health care law hurts the working poor, and has “raped” her future."
The 26-year-old, Ashley Dionne, is a 2009 University of Michigan graduate, who's had trouble finding jobs ("she was told she was “too educated and wouldn’t stay” at low-paying jobs"), and suffers from several serious health problems, including "ulcers, and mild cerebral palsy."
Given all that, you'd think she'd be a poster child for the train wreck. But that's not how she sees it:
"Obamacare takes my monthly rate from $75 a month for full coverage on my “Young Adult Plan,” to $319 a month. After $6,000 in deductibles, of course"
She must be lying, though: the President himself promised us that rates would go down 3000 percent.
"A University of Michigan graduate penned an open letter ... as she described how President Barack Obama’s signature health care law hurts the working poor, and has “raped” her future."
The 26-year-old, Ashley Dionne, is a 2009 University of Michigan graduate, who's had trouble finding jobs ("she was told she was “too educated and wouldn’t stay” at low-paying jobs"), and suffers from several serious health problems, including "ulcers, and mild cerebral palsy."
Given all that, you'd think she'd be a poster child for the train wreck. But that's not how she sees it:
"Obamacare takes my monthly rate from $75 a month for full coverage on my “Young Adult Plan,” to $319 a month. After $6,000 in deductibles, of course"
She must be lying, though: the President himself promised us that rates would go down 3000 percent.
No Doc for You!
Speaking of "skinny" networks for Exchange-based health insurance plans, good luck finding a doc if you're in The Old Line State:
"... doctors and other providers are not yet available in Maryland Health Connection; therefore, if you choose to search for them on the website, you will receive a message that “no doctors are found” message"
And Minnesota may have 10,000 lakes, but they don't seem to have any docs interested in participating in the Exchange:
"A reader from Minnesota points out that MNsure, the Minnesota exchange, has not yet activated a provider search feature either"
But I'm sure they'll get right on that.
"... doctors and other providers are not yet available in Maryland Health Connection; therefore, if you choose to search for them on the website, you will receive a message that “no doctors are found” message"
And Minnesota may have 10,000 lakes, but they don't seem to have any docs interested in participating in the Exchange:
"A reader from Minnesota points out that MNsure, the Minnesota exchange, has not yet activated a provider search feature either"
But I'm sure they'll get right on that.
Justice served (Finally)
Regular readers may remember the frustrating story of Glenn Neasham, an insurance agent from California, who went to jail for selling an annuity. When last we discussed him, Mr Neasham was sitting in jail, hoping for exoneration.
Today, there's good news:
"An Appellate Court in California has overturned Glenn Neasham’s 2011 conviction ... there was no evidence that defendant [Neasham] appropriated the elder’s funds to his own use or to the benefit of anyone other than the elder herself, nor was there evidence that the defendant made any misrepresentations or used any artifice in connection with the sale.”
In short, there was never any "there, there." In fact, the Appellate Court made it clear that the original jurors were given incorrect instructions on which to base their decision, all but guaranteeing the case's final outcome.
Now, Mr Neasham is hoping to get his life back on track, and re-secure his license to sell insurance. There's a slight chance that the case will be re-tried, but it's unlikely because the "money was returned ... in full with interest in 2012; therefore, there was no theft ... [the "victim"] is now deceased."
Godspeed, Mr Neasham, Godspeed.
Today, there's good news:
"An Appellate Court in California has overturned Glenn Neasham’s 2011 conviction ... there was no evidence that defendant [Neasham] appropriated the elder’s funds to his own use or to the benefit of anyone other than the elder herself, nor was there evidence that the defendant made any misrepresentations or used any artifice in connection with the sale.”
In short, there was never any "there, there." In fact, the Appellate Court made it clear that the original jurors were given incorrect instructions on which to base their decision, all but guaranteeing the case's final outcome.
Now, Mr Neasham is hoping to get his life back on track, and re-secure his license to sell insurance. There's a slight chance that the case will be re-tried, but it's unlikely because the "money was returned ... in full with interest in 2012; therefore, there was no theft ... [the "victim"] is now deceased."
Godspeed, Mr Neasham, Godspeed.
Health Wonk Review: Depth of Understanding edition
The estimable (and amiable) Joe Paduda hosts this week's round-up of posts at once wonky and insightful, with emphasis on the Exchange roll-out (such as it is), the ObamaTax itself, and the defund/delay debate.
Lots of red meat here, whatever your particular viewpoint.
Lots of red meat here, whatever your particular viewpoint.
Wednesday, October 09, 2013
The Con and the Vet
The Con:
"The Eighth Amendment guarantees adequate medical care for prisoners ... That's one of the reasons why you're seeing a lot of Republican governors support the Medicaid expansion because for them, it's a fiscal windfall," said [FoIB] Avik Roy."
At issue here is the plan, anticipated to be adopted by at least a few of the 58 states, todump shift prisoners onto the ObamaTax Exchanges, sending tax dollars from states that opted out of Medicaid expansion to those that opted in. Some call this "fairness," a more accurate description is "redistribution."
And if you think that story shows the ObamaTax going to the dogs, well, FoIB Holly R tips us that:
"...some veterinarians are unhappy that they, their practices and their patients’ families could end up paying a tax designed to help pay for Obamacare."
InsureBlog readers knew of this seven years ago (in dog years, of course).
Woof, woof!
"The Eighth Amendment guarantees adequate medical care for prisoners ... That's one of the reasons why you're seeing a lot of Republican governors support the Medicaid expansion because for them, it's a fiscal windfall," said [FoIB] Avik Roy."
At issue here is the plan, anticipated to be adopted by at least a few of the 58 states, to
And if you think that story shows the ObamaTax going to the dogs, well, FoIB Holly R tips us that:
"...some veterinarians are unhappy that they, their practices and their patients’ families could end up paying a tax designed to help pay for Obamacare."
InsureBlog readers knew of this seven years ago (in dog years, of course).
Woof, woof!
Tuesday, October 08, 2013
Top. Men.
I showed the following headline to my certified professional IT infrastructure Project Manager better half, and she Laughed. Out. Loud:
Obamacare Site Resets All User Passwords In An Attempt To Fix Massive Login Problems
Because nothing says "competent" like this massive fustercluck.
The good news is that these, ahem, "professionals" will be in charge of your health care.
Sleep tight.
Obamacare Site Resets All User Passwords In An Attempt To Fix Massive Login Problems
Because nothing says "competent" like this massive fustercluck.
The good news is that these, ahem, "professionals" will be in charge of your health care.
Sleep tight.
Garbage in, Garbage out
What with all the ObamaTax Exchange "glitches," it's hardly surprising that we'd see this:
"Insurers are getting faulty and incomplete data from the new U.S.-run health exchange, which may mean some Americans won’t be covered even after they sign up for an insurance plan."
That may not be as big a deal as you'd think, since it appears that very few people have actually been able to purchase a plan in the first place. The bigger problem is going to be that, once they (theoretically) fix all the problems, how likely is it that those who are successful in signing up will have actual coverage on place on January 1?
Yeah, that's pretty much what I thought, too.
[Hat Tip: FoIB Holly R]
UPDATE: Quelle surprise:
"The healthcare.gov website was taken down over the weekend for scheduled maintenance and more improvements. Today, the problems are the same, a web site that doesn't work."
No kidding.
"Insurers are getting faulty and incomplete data from the new U.S.-run health exchange, which may mean some Americans won’t be covered even after they sign up for an insurance plan."
That may not be as big a deal as you'd think, since it appears that very few people have actually been able to purchase a plan in the first place. The bigger problem is going to be that, once they (theoretically) fix all the problems, how likely is it that those who are successful in signing up will have actual coverage on place on January 1?
Yeah, that's pretty much what I thought, too.
[Hat Tip: FoIB Holly R]
UPDATE: Quelle surprise:
"The healthcare.gov website was taken down over the weekend for scheduled maintenance and more improvements. Today, the problems are the same, a web site that doesn't work."
No kidding.
Monday, October 07, 2013
Exchange "waiting rooms"
This is just to funny to be true;
"Jay Carney says that engineers adding a "gate" on Obamacare website, creating a "waiting room" to restrict access to manageable levels"
I won't go so far as to call it a death panel, but rationing the ability to buy insurance seems sorta third world. Get in line and wait? How long so you can access a website?
How long till you can buy someone's place in line on Craig's list?
"Jay Carney says that engineers adding a "gate" on Obamacare website, creating a "waiting room" to restrict access to manageable levels"
I won't go so far as to call it a death panel, but rationing the ability to buy insurance seems sorta third world. Get in line and wait? How long so you can access a website?
How long till you can buy someone's place in line on Craig's list?
I stand corrected: ObamaTax HSA edition
It had been my understanding that HSA's would be phased out under the ObamaTax:
"As we've previously noted, the survivability of Health Savings Accounts (HSA's) and High Deductible Health Plans (HDHPs) under the ObamaTax has been questionable."
Turns out, I was wrong.
I was finally able to access real-time, real-number rates for new ACA-compliant plans with a January 1, 2014 effective date. So, I put in some basic demographic info, and one of the choices jumped out at me:
"As we've previously noted, the survivability of Health Savings Accounts (HSA's) and High Deductible Health Plans (HDHPs) under the ObamaTax has been questionable."
Turns out, I was wrong.
I was finally able to access real-time, real-number rates for new ACA-compliant plans with a January 1, 2014 effective date. So, I put in some basic demographic info, and one of the choices jumped out at me:
[Click image to embiggen]
It appears that several "metal" plans will have HSA options. What's not making much sense yet is that the HSA plan (with $1,000 higher deductible and no co-pays) is actually a bit more expensive than the non-HSA version.
Curious, that.
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