A Plea for Help

Our good friend Chris Van B is helping to raise funds for the Artemis Center for Alternatives to Domestic Violence, a really noble cause, especially with domestic violence apparently on the rise as a result of the lock-downs. The Artemis Center, in Dayton (OH) "empowers survivors of domestic violence to make decisions and choices that will establish and maintain safety for themselves and their children. By working collaboratively with other community services, Artemis Center advocates are able to coordinate needed services."

This is especially necessary in these uncertain times, and one of Chris' vendors is offering to match contributions up to a total of $1,000. But the clock is running out on that offer.

Please click here if you can spare a few dollars for a very worthy cause. Or, you you prefer to send a check, just drop us an email for details.

By the way: Chris notes:  $36 could possibly buy a CASE - 24 (5 oz.) cans of tuna for Artemis. Wow!

Thank you!

HSA News: 2021 edition

Our good friends at FlexBank/Navia sent along this helpful info for 2021 planning (hey, a head start can't hurt):

The IRS just announced the 2021 maximum HSA contribution limits:

Single Coverage  $3,600
Family Coverage  $7,200

By the way, those represent an increase of $50 over 2020 for singles, $100 for families. Not a fortune, to be sure, but something.

As usual, there's a "Catch Up" provision for folks 55 and up: $1,000 per. In case you're wondering, that stayed the same from this year.

Oh! I thought this was interesting:

Special Rule” for Married Individuals

Married individuals (same and/or opposite sex) who are both HSA-eligible individuals may divide their annual HSA contribution limit in any way they want, including allocating nothing to one spouse.

Details here.

Cool beans!

Strange Math: More means Less, ACA-syle

So, another day, another TwitterSpiration©:

"ACA Marketplace Plan Affordability Is Likely To Decrease For Subsidized Enrollees In 2020"

Okay, I'll bite: what gives?

Well, it seems that, across the board, 2020 ObamaPlan premiums have decreased a bit from last year.

Okay, Henry, that seems to be good news for folks stuck with them, why the glum face?

Well, it's because premiums have declined, so insureds are having to pay more.

Hunh?

I know, it's weird, but bear with me here. First, let's take a look at how Exchange-based ObamaPlans are priced:

One goes to the 404Care.gov site, set up an account, and determines subsidy eligibility. It's important to note that there are actually two very different kinds of subsidy: the one everyone know about, which is the Advance Premium Tax Credit (APTC), and the one that seems to always be under everyone's radar: Cost Sharing Reductions (CSR). We're going to focus on the former, because that's where the TwitterSpiraton© comes in.

Once one has determined subsidy-eligibility, the next step is to click through to the quoting engine, which provides a "menu" of various carriers and plans, complete with two prices for each plan: "retail" (no premium credit, so full cost) and "subsidized" (where the APTC is applied and you see how much the plan will cost you each month). There's a bit more to it, but this pretty much sets the stage.

The (online) dictionary defines 'counter-intuitive' as: "counter to what intuition would lead one to expect."

And so?

So the "glitch in the subsidy matrix" is that, contrary to what one might expect, when premiums decrease, the insured's monthly contribution increases.

Say what?

It turns out that "lower premium levels reduced premium spreads for subsidy-eligible individuals. Lower premium spreads mean that subsidy-eligible individuals will face higher premiums."

Yikes.

(If you're interested in the mechanics of how that works, do click on through to the linked article)

Heading further down the rabbit hole, I pondered just how many folks that might actually affect. Our friend Charles Gaba came through for us:

"About 84% of folks with ACA plans receive the Premium Tax Credit (APTC). That's 9.59 million out of 11.41 million nationally"

So more than 8 out of every 10 ObamaPlan enrollees receive premium subsidies. Wow, that's a lot of folks who may well be feeling additional pain this year (at least in terms of premiums).

So here's the $64,000 question:

How will this affect all those folks with plans now receiving premium reductions due to CV-19?

/gulp

By the River of Babylon

Note: I really couldn't care less about this, but I have made a strong commitment to break any so-called "embargo" to which I have not previously and explicitly agreed.

So:

"NEWS EMBARGOED UNTIL WEDNESDAY, MAY 27, 6 AM CST

Passing along the embargoed news that Babylon has invested in consumer health engagement company Higi, leading its series B funding. Full press release around the news pasted below."

Any interested folks are free to click through to read the no doubt sordid scintillating details.

[Hat Tip: Kayleigh W]

Silent Spring - 2020

The last 4+ months have provided a fair amount of persuasive evidence that a fully-centralized “universal national health” scheme would be a fiasco in modern America.

That’s because the people running it would be the same kinds of bureaucrats and political functionaries that we’ve witnessed running government agencies like CDC, and leading our large cities and even some of our largest States. 

Unprepared, confused, slow to respond, and ultimately dictatorial.

There is no reason to believe bureaucrats and politicians who run a national health scheme would perform or behave any differently. 

Even the most rabid supporters of national health care must now deal with the implications of  declining public trust in big government.  Certainly the decline is not all because of coronavirus.  And certainly China or The World Health Organization did not help. But China and WHO are political and bureaucratic, after all.   

Regardless, coronavirus required American experts to give timely, correct advice to our government leaders, and required those leaders to make sensible and practical decisions.  Many took too long.  Many went too wrong.  And too many people died.

I expect public trust in big government will not begin to recover until Americans begin to forget the panic and death  over the past 145 days or so. 

Meanwhile, it's a silent spring.

CV-19 Alphabet Soup: Another Update

From our friends at FlexBank/Navia:

"The Internal Revenue Service released Notice 2020-29 and Notice 2020-33 dealing with cafeteria plan elections, grace periods for health flexible spending arrangements (FSAs) and increasing the $500 carryover amount for health FSAs."

It's kind of amazing the ripple effect CV-19 is having on different areas of the insurance business. From Business Interruption on the P&C side, to premium relief on the health side. And of course all the changes already happening on the financial side.

For example, plans (employers) may:

• Prospectively enroll employee or family member in employer sponsored health coverage without an event

• Prospectively change to another health plan option of the same employer without an event

But wait, there's more! They may also:

• Prospectively enroll, increase, decrease, or revoke FSA elections for any reason. Employers may limit decrease/revoke to the reimbursement already provided

Again, these are voluntary; an employer doesn't have to adopt any or them.

Oh, this is pretty nifty:

Temporary Relief from Use-Or-Lose Rule
Claim Grace Periods under Health FSAs and Dependent Care FSAs

Employers may amend their health FSAs and/or Dependent Care FSAs to provide (or extend) a claims grace period during 2020. 

There are some provisos attached, but still, a nice option.

For complete details click here.

At Issue: ACA & HMO

For some time now, ObamaPlans available here in The Buckeye State (and, it seems, pretty much everywhere else) have been built on the HMO chassis:

"One way carriers have found to reduce their costs has been to offer ever-shrinking networks"

And with HMO's if you're out-of-network, you're also out-of-luck.

So recently, one of my ACA clients reached out to me with a problem:

"I've got several acute medical issues, and no nearby providers who can help me. For example, I've got some increasingly problematic thyroid issues, and the only nearby endocrinologist only sees diabetes patients. Plus, my Primary Care doc isn't even in-network. Help?!"

We spoke for quite some time, and agreed that there weren't a lot of options, but that I'd reach out to our carrier rep (I'm anonymizing the carrier here since they've done nothing wrong, this is purely to illustrate the frustration of this model, which the ACA basically drives).

To his credit, I quickly got this reply:

"After some research, it seems that the inured is correct: the closest provider to this zip code is related to the [Diabetes Center]. But I also found this:

[Alternate provider who appears to handle thryoid cases]

While that provider is located a bit farther away, he is the only other endocrinologist appearing in the network.

The member is welcome to reach out to Customer Service and request services from a non-network provider, but don't get their hopes up: we had a similar situation in months past and it was not approved."

My client was decidedly not happy:

"Wow… I am not in [that] area.  That is over 20 miles from my house, which I am not comfortable with going that far. They aren’t even close to the hospitals I would need to use if I have a further issue."

As I pointed out, there's nothing in the ACA that requires carriers to make convenience a factor when setting up their networks. It's further exacerbated by the fact that we have competing hospital networks in this market (as in others, of course), and this creates additional issues.

From our rep:

"As for the primary care provider, it's appears that they are independent and not owned and operated by either system. With these plans, [Hospital System] is exclusively the provider network, they provide [us] with the list of providers that are part of their contract. In other words, we don't contract outside of the list of providers that is provided to us by the contracting facility."

The key there is that the carriers' hands are tied. To make matters worse, she's already met her annual deductible for 2020, so moving to another carrier (even if that was an option, which is really isn't) would be another disaster.

#ObamaCrap FTW.

Riddle Me This: Health Insurance Premiums

So, auto insurance companies, recognizing that the shutdown has significantly impacted the number of miles we're driving, have introduced various discount/rebate programs (since we're apparently having fewer accidents, etc):

"In general, insurers that represent four out of five auto insurance policies sold in the United States have offered to refund some portion of driver premiums."

Which is nice, but for many (most?) of us, our auto insurance premiums pale in comparison to what we pay for health insurance. And since we're seeing the doctor less (and he or she's getting paid less), the question arises:

I’ve gotten $100 back from my auto insurance company because of the decrease in traffic. With health care utilization down as much as 70%, where’s my check from my health insurance company?

— Joe Pilot, MD (@JoeSilverman7) May 20, 2020

This is a fair question, and I've been thinking about it, as well.

My initial thought was that it was a matter of logistics; that is, many folks share the cost with either their employer (group plans) or their fellow citizens (subsidized ACA plans). So peeling that back, how does a carrier track this?

As co-blogger Patrick (and reader/commenter 'farmbellpsu') points out, at least one carrier is giving it a go:

"UnitedHealth commits $1.5 billion for premium rebates ... Members will receive a 5% to 20% premium credit on their June billing statements."

This applies to their individual major medical (one presumes this does not include Short Term Medical) and small group plans. As with various other carriers, they're also waiving cost-sharing (deductibles and co-pays) for certain expenses.

There are, of course, some issues with this plan, notably MLR (Minimum Loss Ratio) rebates required under ObamaCare. UHC has indicated that this new endeavor is not related to that requirement.

The primary driving factor here is that "surgical volumes and non-Covid-19 emergency room visits in April down 40% or more from a year ago, which is more than offsetting increased costs on coronavirus care and expenses."

Okay, so if that's true, then what's the problem with carriers offering to refund premiums?

Let's circle back to my reply to Joe's Tweet, which was that it's going to be very difficult for carriers to differentiate who gets what. And as co-blogger Patrick also points out:

"The relief is being questioned as it is similar to MLR rebates. Meaning, if an employer gets funds back they may be required to share in the refund with employees who have had money deducted from payroll."

But there are, in fact, more layers. Our friend, Healthcare Economist Michael Bertaut, had this rejoinder:

Where is healthcare utilization down 70%???
Ours I’d down more like 10-15%. Only 3% of our April claims were COVID related. And no guarantee the avoided elective procedures won’t skyrocket now. Not the same thing.

— Michael Bertaut (@MikeBertaut) May 20, 2020

[Full Disclosure: Michael works for Blue Cross/Shield of Louisiana]

This is also a fair cop, especially that last. Think about all the folks now chomping at the bit for a haircut, and then imagine how many others have had (or chose) to postpone necessary, but not urgent, medical care.

'Tis a poser.

DIAM: Speaking of Awareness

Our friend Bernie Flatters has some follow up questions:

"How old is the delivery driver? And what is the chance that she will qualify for SSI? Will her insurance benefits be reduced by SSI benefits? Maybe there should be an insurance product that covers day one until SSI benefits kick in. And maybe it pays for a high power attorney to argue her case."

In the example in that initial post, we posited a 40 year old applicant. The real life example we used in a subsequent post is actually a bit older (not that it's really all that relevant).

I presume that the dearth of zero-day elimination period individual DI plans is cost; that is, carriers can make the numbers work on short term group plans because of the much shorter benefit period (6 months) and lower benefit limits (usually capped at 60%, versus 65% or even 70% for individuals)..

Guessing that the "high power attorney" suggestion was a throwaway line.

So, not a lot there, but his Social Security Security (SSDI) questions are spot on, and I'd like to address those:

The odds of this client qualifying for SSDI would depend, of course, on the nature of her disability:

"The law defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months."

So in our example, we postulated that her most likely cause of disability would be some kind of accidental injury (such as dropping a keg on her foot, or straining her neck or back). It's unlikely that these would result in death, but perhaps might last a year (or more).

Let's assume the latter, and move on:

"Social Security disability applications face an overwhelming 70% denial rate upon initial evaluation."

And it gets better (for values of "better")::

"At the initial stage, a Social Security Disability claim may take an average of just over three months to process. Reconsiderations make take another two months of processing time, while the wait for a hearing date in front of a judge can take more than two years." [emphasis added]

And yes, the plan I quoted is integrated with SSDI, which helps to keep the premium down some. I don't see this as a problem, since it's unlikely that the benefit period would outlast the actual disbursement of SSDI funds.

So, once again, Thank You, BF, for your great questions!

Positive Carrier Tricks

From our friends at OneAmerica Life (one of our go-to Long Term Care insurance vendors):

"Grace period extended through July 1 for premium payments"

Nice!

But wait, there's more:

"We understand that some policyowners may currently be struggling to pay their premiums on time. To meet this immediate need, OneAmerica has again automatically extended the grace period on all individual life insurance coverage through July 1, 2020."

They also address somne other issues that we've also been wondering about:

"If after July 1, the policyowner’s resident state has not lifted the extended grace period, OneAmerica will consider the extended grace period on a state-by-state basis by policyowner’s resident state."

This is important, since we as individuals really don't have much (any?) say in that decision.

As with the auto insurance carriers and their various discount programs, I expect other long term care (and life insurance) carriers to do the same.

Which, of course, begs the question: what about health insurance?

#CanOfWorms

Travel Medical vs CV-19

Regular readers will recall that most health insurance stops at the border, which is why so many folks opt to purchase travel medical plans:

"Travel Medical policies are for folks traveling outside the US ... So for cruises or trips to Europe, or that Cancun get-away, savvy folks purchase plans to help with any medical issues (usually emergencies) which may arise."

Which is a great idea.

But what happens when you're in, say, Barcelona when the Wuhan Flu Pandemic hits, and now you're stuck there [TBF: lots worse places to be]? Well, our friend Peter S at Global Underwriters told me recently that, even though they aren't selling many new plans to folks choosing to travel right now, they're seeing a big upsurge in folks re-upping their coverage since they can't get back home.

And this works both ways: US nationals stuck overseas, and foreign nationals stuck here.

So now you know....

LTCi: The New Normal

According to The Gray Lady, about a third of all CV-19 deaths have occurred in nursing homes:

"While just 11 percent of the country’s cases have occurred in long-term care facilities, deaths related to Covid-19 in these facilities account for more than a third of the country’s pandemic fatalities."

This makes sense, of course; these are pretty much the most vulnerable among us, kept in a relatively small,confined environment.

Heck, even now, politicos know enough to move their own parents out of these places:

"Pennsylvania Health Secretary Rachel Levine’s mother moved out of a personal care home with the health secretary’s help, after Levine ordered all nursing homes and long-term facilities in the state to accept coronavirus patients from hospitals."

#SomeAreMoreEqualThanOthers, one supposes.
 
So what does this have to do with Long Term Care insurance?

Well as FoIB (and LTCi Guru) Randy G explains, the impact of this is enormous:

Knowing that most (all?) nursing homes have been essentially on lock-down for the past two-plus months, and deaths are still mounting at them, it makes sense that, going forward, even more folks will opt for in-home care. Which is great for places like Visiting Angels and the like, but who pays for this?

If your immediate response was Medicaid, well, think again:

"[B]ecause most individuals would rather be cared for at home and home care is cheaper, all 50 states now have Medicaid programs that offer at least some home care."

The key word here is some, and as states are being saddled with more and more of the Medicaid financial burden, look for those to become even more curtailed. And it's also important to understand just what in-home services are being covered:

"Medicaid home care services are typically provided through home- and community-based services "waiver" programs."

Yikes.

And this is where a properly constructed Long Term Care Insurance plan comes in: one that covers both facility and in-home care (which is pretty much standard now) can offer peace of mind (and choice!). If you've been putting off looking at a plan, there are still a lot of choices available (and yes, that includes you folks over 65).

Oh, and if you think we're exaggerating about the impact of this situation on the future of nursing homes, Randy G also sent along this:

"Someday, most of us will return to life before COVID-19. Nursing homes will not ... Operators are being crushed by higher costs and shrinking revenues."

But wait, there's more:

"Even before COVID-19, the mixed business model of nursing homes was extremely challenging for all but the most efficient providers ... Some of those short-term challenges may fade over time. But some will not."
 
#SomethingToConsider

This Doesn't Look Like Kansas, Toto

Welcome to the world of COVID-19 where up is down and right is wrong.

A world where tattoo's are essential but elective medical and dental procedures are not.

And restaurants are allowed to serve food but only for take-out. Your prepaid meal is in a plastic bag delivered by a person in a mask and gloves who places it in your trunk.

No checking until you get home where your hamburger and fries miraculously transformed into a fish sandwich with onion rings.

My wife and I do not eat out that often. That choice preceded COVID-19. But one of our favorite restaurants was always a choice for romantic dining on special occasions.

That was then. This is now.

Restaurant patrons are not allowed to enter until they have been scanned to see if they have a temperature.  At this point they are using an infrared scanner vs the more reliable rectal probe. As long as they are above room temp but below 100.4 they are allowed to advance to the next station. 

Hand sanitizing is in order, but no foot washing.

Guests are greeted by a staff member wearing a surgical mask and medical exam gloves. The menu is disposable, one time use only.

Tables are now separated by non-bulletproof Plexiglass. Eating utensils are wrapped in paper. At least for now they are stainless, not plastic.

Seating is reduced and for now can only operate at 25% of max capacity.

Sounds like a real mood killer. The only thing worse would be Hannibal Lecter explaining the menu.

Restaurants that CHOOSE to open have a list of 39 rules that must be followed.

In Georgia it is easier to get a tattoo than to enjoy a meal at a nice restaurant.

Oh. What. Fun.

Chow!

Another DIAM Post

In the  comments on a recent Disability Insurance Awareness Month post, FoIB Bernie Flatters made a most cromulent point:

"I have looked at disability insurance and it "feels" very expensive compared to the value. I wish I could get over this. When I think of the benefits of this type of insurance, I think about not being able to work and having to stay home for days, weeks, months while I recuperate."

And indeed, DI poses quite the conundrum: on the one hand, unlike life insurance, there's no guarantee that one will ever actually become disabled. And, as we pointed out the other day, these plans "are one of the two most complicated insurance products in our portfolio."

So here's how I often help folks get over that hump, and I'll use Monday's example to illustrate:

To review, we have a delivery truck driver in good health (other than tobacco use, which impacts her rate substantially). The plan we quoted would provide $3,400 a month (or just shy of $41,000 a year, tax-free), for up to two years. Her annual salary is $60,00.

In Scenario 1 (no insurance), she nets about $45,000 a year while working, and $0 per year if she's disabled and unable to work.

In Scenario 2, she spends about 6% of her take-home pay ($231/month) in premiums. So, in this case, she clears about $42,000 a year while working, or about $41,000 a year if she's disabled.

That help?

First TeleMed, Now TeleEd

Insurance agents must take a set number of Continuing Education courses, generally over a multi-year period. Mostly this is in-person, but web-based learning has really taken off the past few years. I've so far resisted, because I enjoy the interaction and personal touch. My hands down favorite instructor (and this includes myself, as well) is Becky E, who runs a local remediation company. This may sound counter-intuitive, since I'm a life/health guy, but I really enjoy learning about other sides of the business, and Becky is such a natural-born and enthusiastic teacher.

I had been signed up for a couple of her classes this Spring, but the Wuhan Flu caused her to re-imagine them as Zoom meetings. As a rule, I don't Zoom, but this sounded like an interesting experience, so I signed up for her ID Theft course, which I took last week.

The content, as usual, was terrific (I always learn something new in her classes), and she did a great job of teaching it (of course). But just as with my recent teledoc appointment, I was underwhelmed with the whole experience. For one thing, even with the chat feature (which allowed for at least some interaction), there was just something missing. Also, and this may well be long-established, the state has made this form of education delivery unnecessarily burdensome:

For example, in-person classes require only that one show up and stay for the class; there is no requirement that one actually pay attention (now, it would be rude not to, but there's no rule requiring that). Also, one signs in and out of the class only at the beginning and end; there is no requirement to sign in and out at each 10 minute break.

How does this differ under the TeleCE model?

Well, each hour one is required to respond to 3 polling questions (and these have nothing to do with the course, only to prove that you're still there). And one must sign out at each break, and then back in when class resumes. Yes, these are little things, but one gets the sense that the state, in its infinite wisdom, has decided to be as petty as possible in permitting us proles to use this advanced, almost magical technology.

Anyway, Becky and Co did their usual terrific job, especially impressive given the circumstances. As for moi, pretty sure I've now participated in both my first, and my last, TeleEd course.

Interesting DI Option

Since May is DIAM (Disability Insurance Awareness Month), it seems like a good idea to post about a case I'm currently working on. This happens to be a young lady who drives a food service delivery truck (like the ones that supply Speedways or 7-11's, for example). She's in her mid-40's and makes a decent wage, but has no employer-sponsored disability insurance, so she reached out to me to see if we could help.

Individual Disability Insurance (DI) plans are one of the two most complicated insurance products in our portfolio (the other being its cousin, Long Term Care insurance). Plans and pricing are based on a number of factors: age and sex, tobacco use (she smokes), occupation and salary, and a few others. The occupation part can limit what plans and options are available. In this case, her Occupation Class is 1A, so she's eligible for a maximum benefit period of 2 years (which is far better than the 0 years she currently has). One other factor is the Elimination Period; that is, how long she's willing to wait from the date she's disabled until she begins receiving checks. This can range from a month to several years; the longer the wait (ie "deductible") the lower the premium.

My experience has long been that the EP "sweet spot" is generally 90 days (3 months). Much shorter than this is usually "spendy," while there's increasingly diminishing returns on going longer. Of course, there's also the fact that you're going without a paycheck for 3 months...

One of my go-to carriers for these plans is Assurity Life, and I usually just call them up and give them the case particulars (I always do a pre-screen with the client beforehand), and ask them for recommendations. We discuss those and put together an individualized plan.

In this case, my client doesn't have a lot of extra options from which to choose, but one is something I hadn't been aware of: the 'retro injury rider.' And just what is this magical beast?

Well, it's pretty darned cool:

If my client is injured, she still has to wait the 90 days for benefits to kick in, but this rider then generates a lump sum check for the 3 months of benefits she forewent. So, nice lump sum and monthly benefit checks. And in her case, the rider costs less than $10 a month (for a $3,400/month benefit).

Sweet!

So: helping out a client, and learning something new.

Doesn't get much better than that.

Misleading "Research"

Our friend Rick B tipped us to this bit of propaganda:

"Four in 10 residents in states that have not expanded Medicaid may be uncovered by health insurance because of COVID-related unemployment."

Do tell. Are they somehow no longer eligible for COBRA, or Special Open Enrollment?

Oh:

"Those affected by loss of coverage would be forced to enroll in Medicaid, purchase coverage through the Marketplace or become uninsured."

Right, because there are no other options.

"[O]nly about 33% of the newly unemployed will enroll in Medicaid, which means the uninsured rate in those states will increase to almost 40%."

Spoiler Alert: All those folks on Medicaid are still uninsured. Nice try, though.

"The research brief highlights several policy options"

None of which is about allowing true cat plans, or even (in those states that currently outlaw them), STM plans.

Gee, Henry, what do you mean?

"Sale of Short Term Medcial plans is disallowed in "In New York, New Jersey, Maine, Massachusetts, Rhode Island, Vermont, California, Colorado, Hawaii, Connecticut, and New Mexico."

These plans offer more (and usually less expensive) options, and most are PPO-based instead of HMO (as ObamaPlans now tend to be). Wonder what the insured rates in those states would be if they allowed STM plans.

Hint: To ask is to answer.

And there are other options, as well, including Direct Primary Care, Sharing Ministries, and (of course) "Daves' Plan."

But hey, #NarrativeUberAlles.

Hubris: DC, BI and CV-19

Via email from FoIB Sean K:

"DC City Council Withdraws Business Interruption Coverage Proposal"

Okay, interesting, but so what?

Oh:

"I wanted to flag today’s District of Columbia’s City Council proceedings, where they withdrew draft legislative language that would have forced insurers to pay pandemic-related claims."

Heh.

So let's unpack this, shall we?

First - and really, the only thing that matters - is under what sense of delusion did a city council decide it could arrogate unto itself the power to force insurance companies to cover anything? Regardless of its status as our nation's capital, DC is, after all, a city: not a county or state or country.

What I find even more amazing (and arrogant) are quotes from some council members which completely miss this point. For example:

"As an attorney, I feel we are stepping into uncharted territory in a way that I would not advise us to do. I don’t see why we would insert ourselves in this situation when there are already court cases out there trying to work this through."

He then expresses concern that this action may actually undercut federal efforts.

No, sir, they won't, for the simple reason that your council's actions (or lack thereof) are 100% irrelevant: you do not matter.

On the other hand, this is a good take:

"It's going to perhaps send a false sense of hope and promise to a community of folks who need action and relief now."

Precisely, and for the exact same reason as the first quote: what the DC council says has no legal weight, but the "hurry up and do something" nature of this effort could cause folks who are in desperate financial straits to falsely believe that help is on the way.

No, it's not. And we should actually be grateful for this. First, because we already know that "[f]orcing insurers to foot the bill for losses not covered by policies “would do great damage. It would bankrupt the industry."

Beyond that, forcing carriers to automatically include such coverage going forward would mean that only large commercial accounts will be able to afford coverage of any kind, forcing the permanent closure of countless small businesses.

Sheesh.

More CV-19 Alphabet Soup

From our good friends at FlexBank/Navia, two new items:

First up, 'Claims Run-out Deadline Extended for COVID-19 FSAs & HRAs.' At the end of last month, The Feds (Departments of Labor, Revenue, and Treasury) issued guidelines relaxing the benefit extensions for "certain group health plans" during this meshugas. These include disregarding the "Outbreak Period," that is, The Feds "recognized that participants may find it difficult to comply with certain pre-established timeframes."

Paging Captain Obvious.

To that end, the "date within which participants must file a claim under your tax-free FSA or HRA plan's claims procedures has been extended to 60 days after the end of the Outbreak Period." Note that folks still have to incur eligible expanses in order to be reimbursed, just that there's now some flexibility in the timing of those reimbursements.

Click here for more details on that.

Next up, 'COBRA Timeframe Extensions During COVID'. So in addition to FSA/HRA extensions, COBRA gains some flexibility, too:

"The goal of the benefit extensions is to minimize the possibility of individuals losing benefits because of a failure to comply with an applicable timeframe."

Typically, one has a 60 day "window" in which to elect COBRA once one loses eligible group coverage. Obviously, this will prove .... challenging for a lot of Americans, so the The Feds' new guidance "requires benefit plans to disregard the period from March 1, 2020 until sixty (60) days after the announced end of the National Emergency, or such other date announced by the Agencies in a future notice (the "Outbreak Period")."

Which is also helpful.

For more on the COBRA aspects, click here.

As always, consult with your own benefits admin folks for specific details on your situation.

Carrier Kudos

A few weeks ago, we posted on efforts being made by various insurance carriers to ease the premium burden during the pandemic:

"Amica: 20% credit on April and May premiums

The Hartford: 15% refund on April and May premiums (but only for policies in effect as of April 1)"

And others. But FoIB Bill M alerts us to a unique effort being made by Erie Insurance to help promote local businesses, and particularly restaurants, during the lockdown:

"Want to buy a restaurant or store gift card but fear being stuck if the business never reopens after the coronavirus pandemic?In a generous move in these uncertain times, Erie Insurance will add gift card and gift certificate reimbursement coverage to its 2.2 million homeowners’ policies at no cost."

Well first, who doesn't like free? And  more important, what a generous and useful gesture: the plan covers up to $500 in gift cards - that's a lot of take-out (and coffee, and knick-knacks).

Nice job, Erie!

May = DIAM

That is, May is Disability Insurance Awareness Month, and of course it's quite timely this year. As the Council on Disability Awareness informs us:

"Two months ago, few Americans understood the impact this novel coronavirus and COVID-19 would have on our business and personal lives. The good news is that after about six weeks of operating with new precautions governing many of our daily activities, we know more about this virus as well as how people are responding to and behaving during a pandemic."

There are still plenty of good, strong carriers and plan choices available, and we've seen no increase in rates as a result of the pandemic (yet).

Another thing that the CDA notes is this:

"Peter Sandman, a well-respected risk communication consultant, developed a framework for how to discuss risk. He coined an equation long ago that summarizes how people assess risk:

Risk = Hazard + Outrage"

Where Hazard is how much harm the risk is likely to cause, and Outrage is how upset folks are likely to be as a result.

So what does this mean to you? Well, take a look at your own financial and employment position, and decide if maybe now's the time to consider insuring at least a part of your income.

Before it's too late.

CV-19: Benefits, Furloughs, and Layoffs, Oh My!

Our friends at FlexBank (now FlexBank/Navia) have posted a very informative FAQ-type explication of the differences between furloughs and layoffs, and what those differences may mean towards your (and/or your employees') health insurance.

For instance:

"Furloughs are meant to be temporary periods of leave for a defined and finite period. With furloughs, your employees will remain as employed during their time away. Unlike a furlough, layoffs are permanent with no expectation for the employee to return."

Okay, good to know, but what does that have to do with my benefits?

Well:

"With a furlough, employees remain with the company and generally stay on any benefit programs they were already enrolled in. With a situation like the coronavirus pandemic, the furlough timeframe is largely unknown. This makes it very difficult for companies to predict how long they can afford to offer benefits to individuals that have been furloughed."

Okay, that makes sense.

There are also some interesting, under-the-radar issues like 'Pre-payment' and 'Catch-up on return' that folks might find helpful.

Click here for the whole thing.