Hey Scooter!

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

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

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

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

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

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

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

And

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

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

And:

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

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

To which Bill graciously replied:

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

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

Just keep in mind it is one company’s opinion."

Of course!

This specifically caught my eye:

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

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

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

Testing, testing, is this thing on?

What thing, you may ask?

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

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

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

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

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

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

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

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

And there's this:

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

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

'Tis a poser.

Bullying at the MVNHS©: Feature or Bug?

From co-blogger Mike:

"Bullying and sexual harassment 'endemic' at NHS hospitals.

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

You don't say?

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

Mike points out that:

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

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

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

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

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

But . . . the care is free!!!"

Indeed.

Viva La Difference!

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

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

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

Much more at the link.

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

[H/T FoIB John C]

Friday LinkFest

In no particular order:

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

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

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

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

Still yasher koach ("kudos").

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

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

But hey: Free!

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

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

If you like your plan.....

Attention Gamers! Clock is ticking...

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

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

Amazing!

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

Math is hard

To wit:

New post: "Government report reveals CBO was was scandalously off in Obamacare estimates" https://t.co/wDWP01AGSD

— Philip Klein (@philipaklein) February 21, 2019

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

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

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

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

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

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

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

Nectar of the Gods: Lagniappe

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

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

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

Well, not so fast there Dr. Acula:

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

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

Caveat emptor.

[Hat Tip: FoIB Holly R]

Interesting AutoGraphic

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

[click to embiggen]

Medicare Advantage Plans are Like a Store Credit Card

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

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

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

#MedicareAdvantage #OriginalMedicare #GeorgiaMedicareExpert

It's all so incenstuous: Redux

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

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

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

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

Notice a pattern here?

Well, the other day the industry news reported breathlessly on the objections of the current Keystone State Insurance Commissioner to Short Term Medical (STM) plans:

Pennsylvania's insurance commissioner, Jessica Altman, testified in Congress about short-term health insurance. https://t.co/FSs0UMVZY5

— ThinkAdv Life/Health (@TA_LifeHealth) February 14, 2019

Here's what she had to say:

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

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

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

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

Which is a problem for O'Care proponents.

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

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

Hunh.

A Health Insurance ValDay card

From frequent foil Sarah Kliff:

Roses are red
Violets are blue
We have private health insurance
And the rest of the world does too#healthpolicyvalentineshttps://t.co/ZMmG79Vp9Q

— Sarah Kliff (@sarahkliff) February 13, 2019

The Mask Slips

Yikes!

HOLY S*IT: @AOC’s ‘policy guy’ deletes tweet saying public option won’t pay for ‘hip replacements for octogenarians’ [screenshot] https://t.co/wFEoXwddGu via @twitchyteam

— Rich Weinstein (@phillyrich1) February 13, 2019

Everything Old is New Again: MEWA edition

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

Why's that?

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

And how does that work?

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

And why are you bringing this up now, Henry?

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

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

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

Will be interesting to see how this plays out.

Yanking the teeth from the MVNHS©

Specifically:

Patients resort to DIY dentistry as NHS options disappear via @guardian https://t.co/sjbml151G7 pic.twitter.com/mkYXif3NXl

— Sally Pipes (@sallypipes) February 6, 2019

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

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

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

But hey: Free!

Or maybe not:

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

Yeah, that bites.

Sunshine State Shanda Update

You may recall our item last November about the folks in Florida who were selling bogus health insurance plans:

"Federal authorities have shut down a network of Florida companies that they say used aggressive, deceptive tactics to sell skimpy health insurance products that skirt requirements of the Affordable Care Act and left tens of thousands of people around the country with unpaid medical bills."

Well, shutting them down was only half the battle, and now those authorities are pressing forward with criminal charges, leaving the guy in charge unhappy with where this is heading:

"The CEO of a Hollywood, Fla.-based health insurance agency accused of defrauding tens of thousands of customers might have to say goodbye to his Lamborghini."

Awww.

And especially so since "nearly 37,000 consumers are left in limbo — paying $6.3 million in monthly premiums for insurance plans the FTC says are nearly worthless."

Where do *they* go for relief?

[Hat Tip: FoIB Bill M]

Cycling for Survivors

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

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

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

For those so inclined, the the link is here.

Thank you!

Belated Blogiversary

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

/sigh

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

Here's to the next 14.

Long time, First time

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

And so...?

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

As in this case.

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

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

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

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

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

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

Pretty powerful incentive, that.

Not So Peachy Anthem/BX News

Via email from a reader:

"DOSS LAW FIRM FILES CLASS ACTION LAWSUIT ON BEHALF OF THOUSANDS OF GEORGIA HEALTHCARE CONSUMERS MISLED BY ANTHEM “DECEPTIVE MARKETING SCHEME”

Well bless their hearts.

Do go on:

"Thousands of Georgia consumers were misled during the 2018 open enrollment period by “misrepresentations and omissions” from Anthem, Inc./Blue Cross and Blue Shield of Georgia, Inc. (Anthem) when they were told they would continue to have access to the doctors and specialists of Georgia’s largest health care provider."

That's according to a class action lawsuit filed yesterday by what appears to be a fairly large Peach State law firm. At issue is what appears to have been a serious case of bait-and-switch, where, at renewal time, Anthem assured folks that certain providers would indeed remain in-network, allegedly knowing this to have been, er, incorrect.

I can certainly see where folks would feel blindsided, especially if they'd been shopping for coverage based substantively on keeping their docs.

Be interesting to watch this play out.

[Hat Tip: Whitney D]

Pension Max: A Primer

Been working with a client on how best to handle her upcoming retirement income options, and realized that the most comprehensive post I ever did on this was actually at my old Answers.com gig.

So, since that's been memory-holed by TBTB, here's a reprise:

*Summary

One of the challenges when planning for one's retirement is balancing benefits with the risk of death. Pension Maximization is a useful tool for solving this dilemma.

*Intro

In planning for retirement, we often have choices about how we'd like to receive our post-employment income. Typically, these pension plans will offer various dollar amount levels based on how long we expect to live, and how long we'd like to receive that income. The challenge is that we don't know for sure how long that might be.

*Choices, choices

So your retirement plan offers you, for example, two choices. Under Plan A, you receive $1,000 per month for as long as you live. At your demise, though, the payments stop.

Or perhaps you'd like to make sure your spouse continued to receive some income after you're gone. In that case, perhaps you'd like Plan B, in which you receive only $500 a month, hut your widow or widower would continue to receive a benefit after you're gone.

But what if there was a way to have the best of both options, high income in a perpetual stream? There is, and it's called Pension Maximization, or Pension Max.

*When do I choose?

The first challenge is that Pension Max requires some advance planning and forethought. It wouldn't do to wait until one actually retires, because at that point all the choices have been made. Ideally, one would start considering options years beforehand. 

*What are my options?

This will vary from plan to plan, company to company, but generally fall into one of two broad categories. The first is called the Single Life option. Under this scenario, you'd receive the highest monthly income because the plan is paying only you, and you've agreed to have payments stop at your death. This might make sense if one is single, or if one's spouse has sufficient income to make up for any shortfall.

The other category is called the Joint and Survivor option and, as its name implies, covers both your own life as well as your spouse's (or other designated beneficiary). The benefit to this method is that at least a portion of the retirement income continues on after your death, although at a reduced level. The major drawback is that the cost of doing so is a significantly smaller retirement income than the Single Life method.

*So what's "The Third Option"

Under the Pension Max method, one chooses the Single Life retirement income option, and then buys a life insurance policy to guarantee that the surviving spouse continues to receive the income that will be cut off at one's death. It's not a terribly complicated arrangement, but does require a certain amount of math.

*How does it work?

Let's assume that your Single Life option income amount would be $4,000 a month, or $48,000 a year. Let’s further assume that the plan administrators use 75% as their survivor’s benefit cost. That is, if you elect the Survivor Benefit option, you'd only receive $3,000 a month, or $36,000 a year. That's a cost of $12,000 a year. Over the course of even 20 years, that's a net reduction of almost a quarter of a million dollars.

Under the Pension Max option, you'd take a fraction of that lost income and use it to purchase a life insurance policy sufficient to produce an income stream equal to the Single Life option even after you've died.

*Conclusion

Making informed and economically rational choices in planning for retirement income can be challenging. Using Pension Maximization to insure the greatest possible retirement income stream for both you and your surviving spouse can make it easier.

*Callout

According to the Employee Benefit Research Institute, two-thirds of American workers expect to have to work during retirement.