Does the ICD 10 have the Metric Curse?

Headlines on all the health care outlets yesterday (3/27/2014): 

BREAKING NEWS: House approves temporary SGR fix

Bill also delays ICD-10, two-midnight rule and RAC audits

According to the article: “The House of Representatives on Thursday approved a temporary fix to the sustainable growth rate (SGR) for one year in a bill that also delays ICD-10 implementation until at least October 2015 and postpones hospital compliance with the controversial "two-midnight rule" and recovery audits of medically unnecessary claims until March 2015.”

While several items were approved, the excitement was due to yet another delay for the ICD-10. In 1996, the new HIPAA law mandated the acceptance of the ICD 10, and much like the poor metric system, it has been delayed and delayed in its implementation.

Why has it been delayed? Cost and complexity:

There are significant differences between ICD-9, what is used now and ICD-10, what is currently used in 25 countries, which this table demonstrates:

ICD-9	ICD-10
3-5 characters in length	3-7 characters in length
Approximately 13,000 codes	Approximately 68,000 available codes
First digit may be alpha (E or V) or numeric; digits 2-5 are numeric	Digit 1 is alpha; digits 2 and 3 are numeric; digits 4-7 are alpha or numeric
Limited space for adding new codes	Flexible for adding new codes
Lacks detail	Very specific
Lacks laterality	Has laterality (i.e., codes identifying right vs. left)

What has the medical community so upset about adopting the ICD-10: moving from around 13,000 codes to 68,000 codes. Why such an increase? Because in the ICD-10 the code tells a story. Instead of a code that says “Fracture”, the new code says “Fracture, left foot, first incident, middle toe, while a passenger in a car in a car crash”. In fact, the codes are so complex, they are unintentionally funny. Here are a few real codes:

T63.442S Toxic effect of venom of bees, intentional self-harm, sequela

W56.22xA Struck by orca, initial encounter

Z73.4 Inadequate social skills, not elsewhere classified

V91.07xD Burn due to water-skis on fire, subsequent encounter

And then there is the cost. I have already had some webinars on the glory that is ICD-10, and it is recommended to the physicians that they obtain a line of credit to keep their businesses open during the transition, as the new codes will cause delay in payments. In fact, on the CMS Website, a handout for physicians states, “Budget for time and costs related to ICD-10 implementation, including expenses for system changes, resource materials, and training. Assess the costs of any necessary software updates, reprinting of superbills, trainings, and related expenses.” Great, a new unfunded federal mandate, but at least this time they are stating it will be costly to transition.

Needless to say, the medical community is doing cartwheels over a possible delay. (The first question on a CMS ICD-10 webinar I attended at the beginning of March “Is there going to be a delay?” The answer was "no"). Let’s all hope that the Curse of the Metric System continues to plague the ICD-10 or the next time you go to the doctor your code could be “Headache before sex, subsequent occurrence, would rather read “10 Shades of Gray”, or at the least take a long hot bath, sheesh…”

Cavalcade of Risk #205: Call for submissions

Nancy Germond hosts next week's Cav. Entries are due by Monday (the 31st).

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 6 Million Person Question

So there's this:

"More than 6 million Americans have now signed up for private insurance under the [ObamaTax]"

But have they really bought insurance?

Consider that we already know that Ms Shecantbeserious counts plans left unpaid for as "sold." So one is left with the real question:

How many of these (alleged) new policyholders have actually paid for their new coverage?

And here's a couple more:

How many are young and healthy (and preferably male)?

How many are paying full freight, and how many are counting on the generosity of others taxpayers?

Inquiring minds want to know.

Health Wonk Review: March Madness edition

The bad news is that this week's HWR host Chris Fleming missed a total of (sweet) 16 posts by that much.

The good news is that there are plenty of great posts from which to choose, from HWR founder Joe Paduda on ideology and business decisions to David Williams ground-breaking interviews of all 9 candidates for governor of Massachusetts - pretty amazing. And our favorite health care economist, Jason Shafrin, offers some surprising insight into genetic testing and adoptions.

Do check it out.

Deadline? *What* deadline?!

Earlier this morning, Bob noted that the Obamastration itself has acknowledged that it has no "statutory authority to extend the open enrollment period in 2014."

But that was then, and this is now:

"Federal officials confirmed Tuesday evening that all consumers who have begun to apply for coverage on HealthCare.gov, but who do not finish by Monday, will have until about mid-April to ask for an extension."

Now, leaving aside the legal challenge that this poses (as if legalities were of any interest to this regime), one needs ponder a simple question:

Why?

That is, why would they extend the enrollment period, after so vehemently denying that they would do so?

I think a good part of the answer lies here:

"The results were bleak—just two-thirds of the overall respondents knew that they had to get health insurance this month or face a penalty .. Clearly some of those most likely to be affected by the ACA were ill-prepared to navigate the new health insurance environment"

We already know that the vast majority of those who have enrolled are either folks who have lost their previous insurance or who are being shunted to Medicaid.

And we know that the uninsured are staying away from ObamaPlans in droves.

Seems to me, this extension means one thing: the ObamaTax enrollment numbers must be truly, epically dreadful.

Still not convinced?

Then how 'bout this little nugget, buried inside the  WaPo story linked above:

"Under the new rules, people will be able to qualify for an extension by checking a blue box on HealthCare.gov to indicate that they tried to enroll before the deadline."

Seems harmless enough: simply show that you've made a good faith effort to enroll and ... wait ... What's this:

"This method will rely on an honor system; the government will not try to determine whether the person is telling the truth."

What could possibly go wrong?

About that *Other* Big ObamaTax case

Cato's Michael Cannon has been following the Halbig case for quite some time. Last we checked, it looked like a US District judge had shot down this case, which argues that IRS enforcement of the (Evil) Mandate was illegal in 34 of the 58 states.

Reports of the case's death, however, are greatly exaggerated. As Michael reports today:

"[A]ppellate Judge Thomas B. Griffith clarified that an Exchange established by the federal government is not “established by the State.” When the government’s lawyer argued that federally established Exchanges meet that requirement, Judge A. Raymond Randolph cut him off: “That is a leap. That is not statutory interpretation.”

Interesting development.

Shecantbesious vs Hobby Lobby

A simple, factual accounting of tomorrow's SCOTUS hearing on Ms Kathy vs Hobby Lobby:

"Quite simply, if you read a newspaper to find out about the contraception mandate cases, you will read lies. Here are the top six."

Read the whole thing.

The Morally Bankrupt MVNHS©

[Content warning - this is NOT for the squeamish. To access this post, click on the "Read More" button. But I'm serious, this is a VERY disturbing article. HGS]

Impeach Mitt Romney!

Close your eyes and let yourself go back in time. What if this had been our last few years...

It's November 7th of 2012 and Mitt Romney has just defeated Barack Obama to become the President of the United States. Much has been made of this being a referendum on Obamacare but Mr. Romney has come out and said it is the law of the land.

Even before taking his oath of office Romney takes to numerous talk shows, dances with Ellen, and spends a morning with the ladies at The View. He shares his vision for health insurance and promises everyone that they can keep their current insurance and doctors. Period.

Not even a month into office, and Mitt is already on the offensive in hurting Obamacare. Immediately he hires his "health care advisor" Avik Roy to replace Kathleen Sebelius as Secretary of HHS. Then the decimation of Obamacare begins.

First he delays the Basic Health Program for low to moderate income individuals who don't qualify for Medicaid expansion. Two weeks later he announces that he will give leeway to allow plans that have higher out of pocket maximums than set forth in former President Obama's law. In April he delays the SHOP exchange for a year, too.

As the Romney administration continues to bury headlines by making announcements late on Friday afternoons or around holidays, the biggest shoe to drop from Obamacare hits. On July 2nd, 2013 HHS and the President announce that the employer mandate will be delayed until 2015. This requirement will cost the government $12 billion in revenue and will also mean a higher uninsured population.

As the fall approaches Romney is at it again. This time he is delaying signing final agreements with insurance companies on their plans that will be sold on exchanges. The delay could cause the government to miss its deadlines and gives tight time-frames for people to see what benefits and rates will look like when they go to purchase health insurance at healthcare.gov.

On October 1st healthcare.gov goes live - sort of. Romney and his family go skiing while putting Secretary Avik Roy in front of the cameras to explain the "glitches" in the website. For the next several weeks we see Secretary Roy promise that the site is being fixed and compares it to the roll-out issues Apple had with their iOS7 release. In a blog post at the Washington Post, columnist Ezra Klein calls for Romney to fire Secretary Roy for botching the website roll-out. Democrats unite and hold a rally charging that Romney should be impeached and that HHS Secretary Roy immediately step down from his role. The MSM leads with this coverage for two straight weeks and highlights the problems that Republicans are causing and the abuse of power Mitt Romney is using to unilaterally change Obamacare.

As the website continues to fail, we find out that Mitt Romney's promise that people will be able to keep their current plan was nothing more than a lie of the year. To smooth things over as much as possible, the President issues an executive order that people will be allowed to keep their current plans for another year. Still angered, former Obama deputy director, and now president of Enroll America, Anne Filipic announces that they will no longer associate with HHS Secretary Avik Roy and that they don't want him to help with fundraising efforts any longer as this new administration is Anti-Obamacare.

Heading into 2014 Harry Reid continues to push the Senate to take action against President Romney. He pushes a bill through that is called "The Enforce the Law Act". Before the bill even gets off the ground Romney issues a veto threat. Besides that, Speaker Boehner has already said he won't take up this or any other bill that changes the law. He quotes his predecessor, Nancy Pelosi, by saying: "we had to pass it to find out what is in it." The tweaks that President Romney is making will make it better.

Democrats everywhere are furious. They are making one promise. 2014 elections will have consequences. All of these changes to the health care law that Mitt Romney has made will be the focal point for Dems to take back the House of Representatives.

Now open your eyes. It's March of 2014. Everything above has happened. You simply have to change the names.

Happy Anniversary, Baby: The ObamaTax at 4: - "Success!"

For a certain value of "success."

It seems appropriate to note, four years to the day of its passage, that the over-arching purpose of the ObamaTax - insuring the uninsured - has managed to cover....wait for it...hmmm:

"[J]ust 1.4% of uninsured Americans."

Ta-da!

Ms Kathy Overreaches (Again)

What rational person confuses Critical Illness (CI) coverage with major medical? Well, apparently Ms Shecantbeserious believes it's a pretty substantial demographic, because she's proposing new reg's to significantly decrease the availability of CI plans.

We reached out to the Director of Health Product Sales of one of the most successful CI carriers, who told me that this was a surprise to him and his colleagues, as well. He thinks there may be some push-back from the NAIC (National Association of Insurance Commissioners) as this infringes pretty far on their own autonomy and authority.

In the event, we'll have an in-depth interview with him on the issue in the next week or so. Stay tuned.

Shocker: Ezekiel Emanuel doesn't know anything about employee benefits

It always amuses me when academics and politicians who think themselves so smart really know so little.

"Mr. Emanuel expects the law to produce an unadvertised but fundamental shift in where most working Americans get their health insurance — specifically, a sharp drop in the number of employers who offer coverage to their workers"

 "But now Mr. Emanuel thinks that a number of well-known national companies will break the mold and begin a trend. By his estimation, the proportion of private-sector workers who receive health care from employers will fall below 20 percent by 2025. Currently, just under 60 percent of private-sector workers get health care from employers."

Why do employers offer their employees insurance? In most states they are under no legal obligation to do so. Surely it is a cost to them not to mention a huge time consumer. Because it was a benefit and benefits are part of what attracts employees.

Lets compare ACA Insurance tomorrow to insurance of the past;

• Considerably more expensive
• Requires enrollment through a dysfunctional website
• no assistance in understanding your insurance plan
• no one to turn to for help if your insurance company isn't doing what was expected

By all appearances offering insurance will be an even bigger benefit going forward then it was in the past.

ADDENDUM [FROM HGS]: This is not our first run-in with Mr Zeke. He's been somewhat of a cause celebre for Mike (here and here). And guest-blogger Dr Stuart Fickler was none-too-pleased with Mr Zeke's cavalier attitude towards life itself.

AMA Plays Catch-up

Almost a full year ago, Bob noticed that:

"... exchange participants [have] a 90-day grace period to pay their premiums ... but in the second month, if the patient is still delinquent, all claims can be held as pending. By the third month, if the patient still has not paid, the insurer can terminate him or her."

Thus leaving the provider stuck with the bill.

Fast forward a year, and the providers finally get a clue:

"The American Medical Association ... warned the rule could pose a "significant financial risk" for doctors and hospitals"

Just now figuring that out, are ya?

Hunh.

Clearing the ObamaTax Spindle

■ As we recently reported, getting off an ObamaPlan is almost a hard as getting onto one:

"When there is something that needs to be changed on the policy through the marketplace, no one seems to know how to fix it — not people at the marketplace nor their supervisors."

Mr and Mrs Carpenter may have had it easy, though, compared to the plight of Florida resident Melissa Battles:

"When I tried to enroll my entire family... it is very convoluted and it takes a very long time to enroll.”

But enroll she did, and eventually even qualified for a subsidy. Soon after, though, she was fortunate enough to find a new job - complete with benefits, no less - so she "contacted her insurer, Florida Health Care Plans, to terminate her policy. They told her she could not disenroll from her policy with them, instructing her to do it with the marketplace."

Well, we know how well that worked out for the Carpenters, not to mention Larry Basich. After multiple calls, she was finally able to cancel her coverage (maybe), but is stuck paying for at least an extra month's premiums for a plan she doesn't want or need.

What a bargain.

■ "Bill Hobson" (not his real name, for reasons well-explained at the link) has a different sort of problem:

"I've had individual health insurance policies since 1989 ... As with most folks, I saw my premiums go up incrementally over the years as age and health care costs rose, but nothing like what happened in the past year."

So, he made the entirely rational decision to see if he could qualify for a subsidy and thus buy a less expensive plan on the ObamaTax Exchange. According to the calclators he used, he determined that he was, in fact, eligible, and went about applying for a new plan.

Problem was, when he was through inputing all his information, 404Care.gov denied his subsidy. So, he called the toll-free "support line," where he spoke with one of the on-call Navigators. This Navigator asked a few questions, and then honed in on what he (erroneously) believed to be the culprit:

"When he asked whether I had indicated I currently have health insurance, I said I had … because I do have health insurance.

"Ah," he said, "that may be the problem."

Really?

What happened next illustrates an underlying, fundamental problem of the ObamaTax, which is mis- and dis-information. The idea that being previously insured disqualifies one from a subsidy is mis-information; that is, it's a mistake (and/or poor training) on the Navigator's part. But the next exchange qualifies as dis-information:

"But surely, I maintained ... I can't be the only self-employed person who's applying for tax credits who already has insurance. How do other people qualify?

There was a pause on the phone line, then the young man said, "Well, I'm sure that not all people give the, uh, correct answer to all the questions."

Hint, hint.

So why would a Navigator actively encourage an enrollee to lie about being previously insured?

Well, here's a clue:

"A headline in the LA Times this past week answered the question. "Obamacare meeting goal of reducing number of uninsured"

Anyone surprised?

Cavalcade of Risk #204: Bountiful edition

Once again, Van Mayhall presents a cornucopia of risk-related posts, from  frat boys to folks who've fallen and can't get up (hmmm, may be some overlap there).

Do check it out.

Hertz Hurts - How NOT to do Customer Service

According to its Mission Statement, Hertz strives to be the "most customer focused rental company in every market [they] serve." Recently, FoIB Bill M had the opportunity to put this to the test.

Hertz failed. Miserably:

"On March 3, my daughter rented a car from Hertz in Lafayette, IN.  Upon renting she asked about adding me (her father) as a driver.  She was told (in this technology age) that she and I would have to be there at the same time (inconvenient as I live in Ohio).  When she was informed of this, the Hertz rep assured my daughter that we could stop at any Hertz together and they could take care of it.

I then called two different Hertz locations in Dayton and they told me the same thing.  However, when we stopped at the Wayne Ave location in Dayton the rep said she could not access our information.  She was helpful in contacting the Lafayette Hertz and asking them to fax down a form which we signed and she faxed back for us.  They also finally mentioned that there would be an additional $ 13.00 charge per day for me to be able to drive the car (this was the first time we were informed of this).  I attempted to call Hertz customer service to discuss this and bailed on the call after 25 minutes on my cell with no live person yet.

On the 4th day of our trip the Service Engine light came on.  After a 20 minute phone call, we finally spoke to a gentleman at Hertz who told us to stop at any Hertz location (apparently a favorite lie told to customers) and we could trade it in for another model to continue our trip.  Being wiser from the first try we called several locations, and were told that this was not true (surprise!), and that we needed to go to the Airport Location (out of our way and extremely inconvenient).  After a 2 hour good faith attempt to help Hertz, we gave up and decided to drive it back to Lafayette IN (hoping that the vehicle didn't blow up in the meantime).

Needless to say Hertz will not be on our radar to rent from in the future: horrible customer experience. Next time, we'll take our busuiness to a company that actually cares about doing the right thing."

Thanks, Bill, for sharing that - hopefully it will save our readers from a similar fate.

Harry's $407,000 Bind: Liar or Victim

On the one hand, we know that Harry Reid considers all reports of ObamaTax problems to be lies.

On the other, there's this little problem for Harry:

"Basich, 62, bought a plan through the state’s Nevada Health Link insurance exchange in the fall ... Yet the Las Vegan is stranded in a no-man’s-land where no carrier claims him"

Mt B claims that he attempted to sign up for a new ObamaPlan on October 1, but that it took him until mid-November to enroll in a plan that would become effective January 1.

Except: the folks that run the Silver State's Exchange, Xerox, claim his plan was really effective as of March 1. Which wouldn't necessarily be a problem (beyond some premium refunds), except for this small, um, bump in the road:

"[O]n Dec. 31 ... he had a heart attack. His treatment, which included a triple bypass on Jan. 3, resulted in $407,000 in medical bills in January and February that no insurer is covering."

Well, darn!

He's been working closely with his agent, Tamar Burch, and has even called upon his Senator, the aforementioned Mr Reid, for help. For his part, the esteemed Senator has vowed to help (although one might question his commitment, considering he must certainly believe Mr B a liar).

For its part, Xerox seems to be pulling out all the stops:

First, it tried to put him with a different carrier than the one he'd actually selected. When that didn't work, they redoubled their efforts by  promptly calling in the lawyers and clamming up.

Perfectly understandable, don't you think?

As it stands, Mr B is facing almost half a million dollars in unpaid medical bills and uncertainty as to when (or even if) they'll be paid and he'll have coverage.

The good news, of course, is that this is obviously a one-off, isolated event.

Wait, what?

Uh-oh:

His agent reports that "of nearly 200 Branch Benefits Consultants client sign ups via Nevada Health Link, only 5 percent have gone through problem-free. More than 20 customers have the same plan-selection issue as Basich." In addition, she reports "widespread enrollment problems, including frequent website error messages; inaccurate federal subsidy calculations; payments missing in the system despite clients’ canceled checks; and wrong effective coverage dates."

And that's just Nevada. What about the other 57 states?

Cliff, Kathy and PCIP

As we've remarked on numerous occasions, the PCIP (Pre-Existing Condition Insurance Plan) was actually a pretty great idea, and one of the very few pieces of the ObamaTax that was well-executed. And it's been scheduled to be executed for some time now: first, at the end of 2013, then the end of March, and now, well:

"Enrollees in the federally-run [PCIP], who have not yet found new health insurance coverage through the Marketplace, can purchase an additional month of PCIP coverage through April 30, 2014, while they continue their search."

That helpful news popped up on their site last Friday (the 14th), to little immediate fanfare. Now, of course, the news is all over the net, but as usual, we're only getting bits and pieces.

Because I have a client who is in the midst of this situation, and because we strive always to keep our readers better informed, I did some digging.

Here's the challenge: it is indeed true that the final day of the initial Open Enrollment "season" is March 31 [ed: unless DC wavers on that, as well]. Which is fine, but under the new rules, one must have one's application submitted at least two weeks prior to one's desired effective date. Since no one wants to work Saturdays, that also meant last Friday (again, the 14th) was the real cut-off date. So if you were on PCIP, and you knew for a fact that your coverage was ending March 31, you'd better have your ObamaApp in by last Friday.

Fortunately for my client, she did. Yes, it was a harrowing afternoon, but we got it done.

Imagine my surprise to walk in yesterday morning to find that - surprise! - the condemned had been given a one month reprieve.

Maybe.

After all, just because Ms Shecantbeserious has decreed it doesn't necessarily make it so (although one would think). So I called our broker rep for the carrier that actually issues (issued) the Ohio PCIPs, Medical Mutual; it was no surprise that they were also caught unaware, and had no idea how to answer any of my questions. I was directed to the Department of Insurance (of course).

So, called the DOI and was quickly routed to Chris, a supervisor who, no surprise, was also unaware of the details. It seems that just because it was decreed in DC, it doesn't mean that the troops in Columbus need to be informed. Since administration of Ohio's PCIP program was handed off to the Feds a while back, I would have to move higher up (or down, as applicable) the food chain, and my next call was to the folks at PCIP.gov, who were also very nice and eager to help.

Once I explained who I was and why I was calling, I asked how this was gong to work. Amanda told me that they would indeed be mailing out "coupons" (premium notices) and information...

By the end of the week.

Here's the thing: that means that at least a few of these will go out in Friday's mail, and will arrive in participants' mailboxes sometime during the last week of March, far too late to find other coverage, and barely enough time to meet the deadline for payment to be received (a very generous April 4th).

Now, they have the option of preemptively mailing in their April payment (which, thankfully, is the same as their March), making sure to note their billing number on their check.

Which may or may not arrive in time, either.

Oh, one more thing from the PCIP site's announcement:

"Enrollees will be notified by mail ... along with details about cost-sharing" [emphasis added]

Hunh? What does "cost sharing" even mean in this context? We use it in Medicare and in certain ACA plans, but PCIP?

Don't feel too bad: it also stumped Amanda. But she offered to find out for me, and I spent a scant few minutes on hold as she consulted a supervisor. The good news is that it's merely a case of someone being a bit too clever with their wording: it refers only to the co-insurance already built into the plan.

Whew!

Now, maybe Cliff can get back to delivering those coupons.

ObamaTax Logic

In 1,000 words:

[Hat Tip: FoIB Jeff M]

Isolated incident? Meaningless anecdote? I wonder.

Yeah, an anecdote is not data, it's just . . . an anecdote.  But anecdotes can make one wonder.

Like this anecdote from New Zealand:

"But at the start of May the couple were told they must leave as Albert’s health was no longer acceptable . . . [Immigration New Zealand's] medical assessors have to consider to what extent there might be indications of future high-cost and high-need demand for health services."

This anecdote suggests New Zealand is deporting people it considers health risks, as a tactic to manage costs within its socialized medical program.   Who knows if INZ uses this tactic a lot? Or for that matter if other countries do the same?

Well, we do know other countries (e.g., U.K., Canada) ration medical services either thru explicit rules, or global budgets, or by queue.  We do know Germany has been using a different creative tactic of its own: "one way Germany has contained its health care delivery costs has been forced labor at under-market rates."   And we do know that European Union countries under the Schengen Convention have “rejected the notion that their citizens areobligated to pay for medical expenses of foreign visitors.”

Even a collection of anecdotes may not be “data” but at some point is there enough to make you wonder?

I think our media have generally done a poor job reporting information - such as the anecdotes above - which illuminates the actual experience in other countries, pro and con, with governmental control of medical delivery and finance.  As a result, the American public was not well-informed during the health care debate and therefore susceptible to smoke-blowers.   So now, sadly, the only practical way for most Americans to anticipate how Obamacare is likely to work is to accept it, so that we can find out what is in it.

Sound familiar?

Bigger better?

This is interesting:

"An unnamed Silicon Valley billionaire has purchased the world's most valuable life insurance policy."

First, Mazel Tov to the anonymous buyer for his foresight, and to Dovi Frances, the agent who put the deal together. The premiums for the $201 million of coverage apparently run into the "low ... millions of dollars," which is actually a pretty good deal: even $5 or $6 million (what most would consider the high end of the low end), represents a very small fraction of the total amount at risk.

I do take exception to the characterization "most valuable," however: perhaps "the biggest" or "the largest face amount," but "the most valuable policy" is the one that's in-force on the day anyone who's bought a policy dies.

A few other factoids from the article struck me as interesting:

As many folks who have bought life insurance can attest, the underwriting process can involve some pretty invasive medical underwriting (exams, blood work, and the like). But what many folks don't know is that there is often financial underwriting, as well; that is, it's not just whether one is healthy enough to buy the plan, but whether one's financial health justifies the face amount. For a plan with hundreds of millions of dollars at risk, one might imagine both of those processes being, well, painfully invasive.

This also caught my eye:

"The firm has represented the billionaire since he responded to a direct mail solicitation in 2010."

Musta been one heckuva mailer.

Finally, the unnamed policyholder acknowledges purchasing the plan to cover any estate tax liabilities. This is an often overlooked use of life insurance, and further underscores its value: paying a few dollars (or even millions of dollars) for a life insurance policy to cover a large estate tax exposure is also a great tax planning tool.

So, thanks to Mr Frances and his anonymous client for some terrific lessons, whether our own life insurance needs run into the hundreds or millions of dollars (or somewhere in between).

March Madness

Down by at least a few million late in the 4th quarter and HHS is looking for a miracle. So they go to LeBron. They were shooting for a slam dunk. Instead it is a full court heave that will come up way short.

 

Cavalcade of Risk #204: Call for submissions

Van Mayhall hosts next week's Cav. Entries are due by Monday (the 17th - Happy St Patrick's Day!).

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.

ACA fun...

My week so far...

■ One client called. Her daughter has cystic fibrosis.  In 2013, two of her meds had a 30% copay, with a $200 cap per Rx.  In 2014, the cap was eliminated and the price went to $3600 when she went to fill it.  She can't afford them and her daughter hasn't had her meds since early January.  Appeals to Blue Shield for reclassification of her meds outside of Tier 4 had been declined.  I (finally) found out that the Genentech and Novartis discount programs weren't being applied correctly.

■ Four hours were spent on-hold at Anthem; three at Blue Shield.  CoveredCA has a "we're too busy right now, try using the web site" message...followed by hanging-up. That happened six times.

■ Several clients called because their doctors are no longer in-network for their  individual policies...the worst case had all five of her doctors disappear.  Even more fun, if you search by name, they show up as in-network because they take some, but not all, of the carrier's plans.  I caution anyone I talk to to check, but there are a lot of people that don't bother.  It'll be fun once March 31 rolls around and people are really stuck.

■ Three small business clients discontinued their group policies.

■ One small business client wants a refund for a years worth of premiums for duplicate dental coverage.  Unbeknownst to me, he'd checked the "Delta Dental" box on a form he sent into Kaiser at his last renewal...he already had a direct Delta Dental policy.  Kaiser promptly also signed him up with Delta.  Since Kaiser invoices don't list lines of business separately, he didn't notice until he received this year's renewal.

You know, there was a time that I really liked this business...

On Carriers and Service

Believe it or not, I don't really expect perfection from carriers. I do expect a level of service commensurate with their overall reputation; that is, I generally expect a carrier with an excellent reputation to provide excellent service. And, for the most part, this has been my experience.

Sometimes, though, even the best carriers fail to live up to that lofty goal, as was recently the case with John Hancock, specifically their Long Term Care insurance arm:

Some 20 years ago, I sold a policy to a very nice gentleman who eventually moved to another state, and who has been on claim for several years. The plan had two "buckets:" one for facility care, and one for home care. He has exhausted his facility care benefits and his children are attempting to determine if there's a way to access the home care benefits.

Seems simple enough, no?

When I originally reached out to JH in early February, I was looking for specific info on a 20 year old policy. The service rep with whom I spoke told me that she had to "research the archives" to find the answers to my questions, and would email them to me in the next day or so. I did hear from her two days later, with the message that she was "still gathering necessary documents and information needed for this policy." It would be another week or so before I heard from her again, and the information she shared did not fully answer my questions.

In the meantime, I had called the service number again, and got another rep who had no trouble pulling up the information I needed.

All of that was just for questions related to the policy. When I started asking claims-specific questions, I was transferred to the claims department. On the one hand, this is common: most carriers have separate departments for policy service and claims. What became increasingly frustrating was that, each time I called back, I got a different rep, and different answers. It was only when I was finally connected to the supervisor that I began to get consistent answers each time.

One can imagine how quickly this became old.

And there's this: I asked this supervisor for written confirmation of her answers (either by mail, email or fax), and was told that she couldn't do that.

It was at this point that I reached out to the company's media relations folks, and asked them if they'd like to respond to these issues before I posted about them. I have found this to be a very fair, very effective way to encourage carriers to engage in a little reflection, and ultimately provide a better experience to their customers, my clients.

I soon heard from Seth Kilgore, Director of LTC Claim Operations. He indicated that he would indeed appreciate the opportunity to address these issues, and we spoke at length later that day, and I followed up with some additional documentation.

We spoke again a few days later, and it was clear that Mr Kilgore took these issues seriously. He told me that he has begun asking his managers to actually listen to the recorded calls, and to provide written confirmation of answers when requested to do so. He told me that, while this is an unusual request, it is not an unreasonable one.

He's also going to treat this experience as a learning and training opportunity, to try to avoid the "different reps, different answers" problem.

As regards the specific manager with whom I spoke, Mr Kilgore told me that, once I started asking more detailed questions and asking for written confirmation, she should have escalated  to her leader or manager. Again, he saw this as a reasonable request, and a learning opportunity for the supervisor.

As regards the specific claims situation which prompted this whole ordeal, he is helping me to shepherd that through, as well.

So, once again the incredibly valuable megaphone that is InsureBlog enabled me to connect with the person best suited to address some major concerns, and the folks at John Hancock restored my faith in their reputation.

Health Wonk Review: A Cold & Muddy Spring is up

Brad Wright presents this week's eclectic collection of health policy posts. Come for the pics, stay for the interesting links.

More Lies About O'Care

The Honorable Harry Reid (D-NV) says "There's plenty of horror stories being told. All of them are untrue. But in those tales turned out to be just that. Tales. Stories made up from whole cloth. Lies distorted by Republicans to grab headlines or make political advertisements."

What, then, to make of this whopper from The Big Apple's Annette Frey:

"At the heart of her maze of problems is the fact that the plan she signed up for on the New York exchange listed doctors she needed as "in network" -- she later found out they were not"

No, no, no. The President promised that "if you like your doctor, you can keep your doctor." And we know that he never lies.

The Shameless Hussy continues her tall tale:

"Frey has made close to 200 calls looking for services she says were promised when she signed up through the New York state exchange."

Has this woman no shame?

And she's not done with her deceitfulness:

“Trying to make an informed choice with this insurance was virtually impossible”

Enough! President Obama promised that "if you like your plan, you can keep your plan," and we will stand for no more of these shameless, hateful canards that prove otherwise.

Wait, what?

A Tale of Two Clients

On the one hand, the plural of "anecdote" is not "data;" on the other, I believe that these two clients' recent experiences with the ObamaTax Exchange may be illustrative of a broader set of problems:

Client Number 1 recently lost his employer-based health insurance (the employer made the perfectly sensible decision to cancel the increasingly expensive group plan altogether), leaving himself and his family to fend for themselves on the Exchange.

After fiddling with the Subsidy Calculator, they determined that they were eligible for about $200 a month in subsidies ("premium discount"). That's a lot of cash to leave on the table, so they headed to the Exchange.

Over the course of the past week or so, we've spoken most every day, as he finally decided which plan he wanted. I had quoted this plan both on and off the Exchange; the off Exchange plan allowed him to add a reasonably-priced dental option that included ACA-compliant Pediatric Dental; the on Exchange version required digging through dozens of dental plan options to find one that fit.

We determined that their best bet would be to buy the medical plan on Exchange, and the dental plan as a separate, stand-alone policy. And so, I thought, we're finally ready to go on this one.

Ah, not so fast there, buddy:

This morning, Client 1 called and asked "hey, if I end up the year and it turns out I wasn't really eligible for the subsidy after all (I ended up making too much), do I have to pay it back?"

Well, yeah.

There was a pause, and he replied, "in that case, let's go back and do the off Exchange version - I'd rather forego the subsidy than worry all year about having to pay it back."

Client Number 2 is in no such danger: he definitely qualifies for a subsidy. After shopping on the Exchange, he also picked a plan that fit his needs and budget (well, close enough for gummint work). So he logged on, started the enrollment process, and then promptly stopped and called me: "hey, Henry, do I  have to answer all these Medicaid-related questions?" I replied, "only if you want the subsidy."

Some background on Client 2: he chose not to go the early renewal route, and his current plan expires on April 1st, at which time his carrier will transition him onto (what they deem) an appropriate, comparable ACA plan. Or, he can shop the Exchange for one better suited, taking advantage of the anticipated $300 per month subsidy, as well.

Again a pause, and then, "y'know what? I'm going to just stick with the plan that [his insurance company] has me moving to; I'd rather pass on the subsidy than get cauight up in the Medicaid stuff."

So here are two families that selected a plan, only to leave it twisting in the wind in their Exchange "cart." One wonders how many others whom Ms Shecantbeserious counts as "enrolled" did likewise?

And what does it say about the ObamaTax itself that folks are willing to walk away from significant piles of cash to avoid it?

VERY Stupid Agent Tricks

On the one hand, having an agent help you "navigate" (heh)  the 404care.gov site is essential. Having one who actually knows what he/she is talking about is equally so.

Witness the power of this fully operational StupidStar:

"Yes, you can still get health insurance after Obamacare open enrollment ends."

In a glaring - and unprofessional - attempt to correct herself, "The Goddess" has completely revamped her original post, without leaving the original post intact, as if actual professionals didn't already save her egregious misrepresentations.

Here's what her post originally said:

“Yes, you can still get health insurance after Obamacare open enrollment ends.

Obamacare has NO bearing when health insurance is available for purchase. It’s available year-round- like it’s always been."

And she actually doubled down on The Stupid in her comments section:

"I stand by my statement, but perhaps my explanation in the post was unclear. Here's another try: Health insurance is available year-round- but in two different ways- inside the Marketplace and outside the Marketplace"

The fact is that, without an officially sanctioned "Qualifying Event," one may not purchase a new plan "year 'round," on or "off" the Exchange.

Rather than acknowledging and then correcting her mistake, "The Goddess" simply dumped her original post "down the memory hole" and attempted to shift the blame for her stupidity onto some nameless carrier.

The fact of the matter is that, if she truly underwent (and understood) the FFM training, then she would have known that what she posted was wrong. And if this is the quality of her "advice," then Heaven help her poor clients.

Now you may be thinking "hey Henry, why the attitude? She owned up, 'fessed up and apologized. What's the big deal?"

Except:

Except she didn't, really. What she did is throw the original post "down the memory hole" and (attempt to) blame some anonymous carrier rep. Even if this rep had claimed that Open Enrollment applied only to On-Exchange plans (about which there is some dispute), "The Goddess' - alone - was responsible for vetting this information before posting it. And it was easy to do, as anyone who had taken (and passed) the FFM certification course could attest.

Again, we all make mistakes, but responsible folks acknowledge and correct them, and responsible bloggers make sure to keep the original post intact (or, perhaps grayed out, to indicate something's amiss) so that others could see the error and understand the correction.

"The Goddess" did neither.

And that's the reason for "the attitude."

Smoke 'em if you got 'em

The ObamaTax has evicerated the concept of underwriting, at least so far as medical insurance is concerned. About the only thing for which carriers can levy a surcharge is tobacco use. In fact, the law allows them to charge up to 50% for tobacco users.

Two questions spring immediately to mind: first, what's the definition of "tobacco use" and second, what if you lie about misrepresent your tobacco use when applying for coverage?

The first seems simple enough. According to HHS (as included on ACA plan applications):

"Tobacco Smoker definition – the legal use (other than religious or ceremonial) of any tobacco product on average four or more times per week within no longer than the last six months."

So let's dig a little deeper: what, exactly, constitutes a "tobacco product?" Well, a Marlboro or a Cohiba would suffice, as would a nice briar or meerschaum, or even a "pinch of chaw."

But what about e-cigarettes (e-cigs)?

About a year ago, we looked at how life insurance companies were underwriting e-cig users ("vaping"). Turns out, some of the same issues will now confront those looking to buy a new ObamaPlan. That's because, as noted above, tobacco use can result in a substantial premium hike. But is "vaping" truly "smoking" (in that context)? To determine that, we really have to discover the source of the nicotine:

"Nicotine is a[n] ... alkaloid ... found in the nightshade family of plants ... The main source of nicotine is the tobacco plant."

Although it can also be found in much lower quantities in, for example, eggplants and tomatoes, e-cig "juice" gets its jolt via extraction of nicotine from tobacco leaves. So it seems pretty obvious that, insofar as the ObamaTax is concerned, vaping is tobacco use.

Which brings us to our next little conundrum: what happens if one simply answers "no," even if one does, in fact, partake of that Marlboro, Cohiba, briar or e-cig? What's the worst that could happen?

Turns out, not much:

There are really only two possible outcomes should one be caught lying about one's tobacco use: rescission or reimbursement. Rescission is when a carrier cancels your policy as if it was never actually in-force. That particular option is much less applicable under the ObamaTax. In fact, I tried very hard to find a definitive answer as to what it would take for a carrier to legitimately rescind a policy; turns out, it's very difficult to pin that down.

But thanks to FoIB and fellow insurance blogger Louise Norris, we learn that:

"If an enrollee is found to have reported false or incorrect information about their tobacco use, the issuer may retroactively apply the appropriate tobacco use rating factor to the enrollee's premium as if the correct information had been accurately reported from the beginning of the plan year. However, an issuer must not rescind the coverage on this basis. "

And, what, pray tell, happens if (when) said miscreant ignores the collection plate? Nothing, apparently, since they can't rescind the policy. Can they refuse to pay claims until premiums are caught up? Maybe, maybe not.

I'm just not seeing a downside to lying about this.

Wow.

[Hat Tip to FoIB Brian D!]

Fox Butterfield, indeed

We've discussed the Fox Butterfield Effect before ("the prisons are full, despite a decreasing crime rate"), but I wonder if two seemingly unconnected news items don't provide a powerful demonstration of it.

Co-blogger Mike Feehan sends us this little worthy:

"...more than 37 significant changes already have been made to ObamaCare: at least 20 that President Obama has made unilaterally, 15 that Congress has passed and the president has signed, and 2 by the Supreme Court"

That's from the Galen Institute, and goes on to observe that more changes are on the way. While it's quite an exhaustive list, and well worth keeping handy, I was struck by the fact that I received it almost immediately after FoIB Holly R sent me this little tidbit:

"Only one in 10 uninsured people who qualify for private plans through the new marketplaces enrolled as of last month ... The findings emerge as the Obama administration has been revising a series of rules that define how the 2010 law works in practice"

Here's what I'm wondering: is it coincidence that the very people on whose behalf we destroyed a functioning, if imperfect, health care financing and delivery system are turning up their noses at the "solution?" It seems to me that a lot of the uninsured are taking a wait-and-see attitude because all these changes are taking place.

Time will tell, of course, but as long as HHS Secretary Shecantbeserious and her Boss keep "tweaking" the "settled" law, a lot of folks will keep sitting on the sidelines.

Patrick hits the Big Time (Again)

Our own Pat Paule has written a guest article at The Federalist about the upcoming slaughter of impact of the ACA on small group plans. It's a great post (no surprise).

An excerpt:

"The big elephant in the room for small business owners is high costs to insure people. The promise of every family saving $2500 wasn’t something employers ever believed would happen. But they also didn’t anticipate the significant increase in premiums they are about to see due to community rating and narrow age bands."

Please go Read The Whole Thing.

Julie Boonstra goes Boom on The ObamaTax

A few weeks ago, Michigan's Julie Boonstra, a leukemia victim, cut a video critical of her CongressCritter's support of the ObamaTax. This wife and mother soon found herself on the receiving end of the Oh-So-Tolerant-Left, who threatened to sue any media that ran the ad.

But Wolverine Mama Grizzlies are no pushovers:



[Hat Tip: Powerline Blog]

A Principal of Underwriting

Buying life insurance can be a daunting experience. First of all, who wants to think about being dead? Then, one has to consider all the financial considerations and problems facing one's family when one passes on, and make some determination about how much coverage to buy. Finally, one has to then decide what type of plan is appropriate (term, whole life, etc).

And then, one most likely has to "face the needle:" undergo a paramed exam including blood and urine samples.

But what if there was a way to avoid that last step?

The Principal Financial Group has introduced their "accelerated underwriting" process that could dramatically reduce both the intrusiveness and the timeline of the process. I recently had the opportunity to speak with Neal Halder, The Principal's assistant vice president and chief underwriter of individual life insurance, who filled me in on the finer points.

Let's start with the fact that it can often take a month (or longer) for a typical plan to make its way through underwriting. There's the application, of course, then (usually) an exam and maybe a Medical Information Bureau (MIB) report, and then the underwriter has to wait for all those results and inquiries to come in before a decision can be made. In the meantime, the applicant may or may not actually have coverage, and may in fact be having second thoughts about the whole ordeal.

That's where the "Principal Accelerated Underwriting" program comes into play. As Mr Halder explained, "our studies found almost 50 percent of eligible individuals tend to have a high number of favorable health factors so the need for lengthy exams and blood work are simply not necessary." He told me that the program was developed and is owned by Principal Financial Group.

Insurance agents are often loathe to cede control of a case to some other entity, and the "tele-app" process is a great example of that tension. Tele-apps are essentially telephone interviews between the home office and the applicant, and in Principal's accelerated underwriting program they’re used to help move things along. The process is actually pretty simple:

Once the agent and client have settled on a face amount and plan design, the agent consults a one-page checklist [ed: although this isn't a requirement, it's a pretty good idea] that helps cull out those that probably won't qualify. As long as the applicant is 18 to 60 years old and applying for one of their standard life insurance policies (including term, universal and variable life plans) of up to a $1 million of coverage, they might qualify for Principal Accelerated Underwriting. As an aside, a $1 million policy without a blood draw is almost unheard of these days.

Once the completed application hits the home office, Principal checks the MIB, motor vehicle reports and prescription records. At that point, the tele-app folks in Des Moines reach out to the applicant and ask a series of questions (part of the application). Those answers are then forwarded to the underwriter who, based on the MIB and other info and the answers to the tele-app questions, can approve the application with no further input (such as blood or urine) from the client.

It's also worth noting that the rates are the same regardless of the process; that is, one doesn't pay a higher premium by sidestepping the paramed exam.

All in all, a very interesting program. It's always great to find carriers thinking "outside the bun," looking for innovative ways to make it easier for people to buy the coverage they need.

Kudos to Principal, and Many Thanks to Neal Halder!

[Hat Tips to Erica J and Julia M]

Cavalcade of Risk #203: Done and Up

Bob Wilson presents a truly remarkable edition of the Cavalcade of Risk, with almost a dozen interesting entries. From ID Theft to the perils of Physical Interactivity, he's got you covered.

What could *possibly* go wrong?

"Hospital records are being used by private firms advising companies how to target their marketing"

No, this isn't a result of The ObamaTax (yet), but it's clearly where we're heading.

Now, if this was "aggregated" information (that is, information on groups or demographics) then perhaps this could be a good thing: if, for example, it turned out that 40-year-old diabetics were routinely misdiagnosed or treated, then that could help the MVNHS© hone in on specific providers and, perhaps, resolve that problem.

In this case, however, it appears that the (heretofore private) health information of specific patients is being divulged (sold?). On the one hand, "marketing firm Beacon Dodsworth said it had not been able to access raw data, but analysis of the hospital trends, integrated with other information;" on the other, "documents suggest the sensitive data would be used to target people on social media websites such as Facebook."

Fortunately, we have HIPAA and other privacy regulations in place, so that could never happen here.

Right?

That train(wreck) has left the station [UPDATED: Clarification]

Unbelievable:

"...the White House will announce a new directive allowing insurers to continue offering health plans that do not meet ObamaCare’s minimum coverage requirements."

Really?

Here's a news flash:

"...even if carriers wanted to sell these plans, they still have to price and file them with the 58 states' departments of insurance, and then feed these rates into their quoting engines"

That's right: the only non-ACA-compliant plans that are left are those that have been grandfathered. And adding insult to injury, grandfathered plans cannot be changed; that is, no deductible changes, no adding or dropping benefits, period. I just looked again, and there are no non-ACA-compliant plans available on or off the Exchange.

Now, some might point to "mini-med" and short term plans as examples of non-ACA-compliant polices, but these were never considered true major medical plans in the first place.

Smoke and mirrors.

UPDATE/Clarification: In re-reading this story (as well as a few others), it appears that this applies to those who went the "early renewal" route in order to stave off the cancellation of their pre-ACA plans for a year. The "relief" is that, under this new regime, those who had in fact renewed early may be able to keep their pre-ACA plans an additional year.

No word yet on whether or not any changes to these policies will be allowed (as they are disallowed on grandfathered plans).

Oh, and let;s not forget that, just a few short months ago, these plans were all characterized as "sub-standard."

Wait, wait!

So, MVNHS© victims patients continue receiving free healthcare.

Eventually:

"Millions of patients wait as long as three weeks to see their GP"

The problem, of course, is quite simple: high demand ("free" healthcare) with low supply (healthcare).

Here, of course, it's a completely different matter: we can't even get the "free" part right. Just ask Jacki Manley:

"...a stay-at-home mom in the western Maryland town of Keedysville, who has been trying since mid-December to enroll in a health plan through that state's health exchange."

Just wait 'til she's signed up, and gets the same great "service" as our Cousins Across The Pond.

The good news is that our Betters-in-DC© don't have to worry about these little hiccups:

"This year, members of Congress and thousands of their staffers are finally signing up for health insurance provided by an ObamaCare exchange ... unlike those millions of Americans, members and staff have a way to opt out of ObamaCare — retirement"

That's right, they actually make enough to get to retire, at which point they can hop back on the incredibly benefit-rich Federal Employees Health Benefits Program (FEHBP).

Two legs good, four legs better?

Some thoughts on my Answers.com experience

As I mentioned the other day, my final long-form Answers.com article went up last Thursday (February 27th). Although I'll continue in my role as the Insurance Content Expert Writer (CEW) at Answers, that role has significantly changed.

I think that's a good thing.

When I was first approached to apply for the position, the folks at Answers were very clear as to what they expected from me (10-20 articles per month, each article had to clock in at between 400 and 600 words, specific format choices), and that they could modify that agreement at any time going forward. That seemed (and seems) fair, and I applied for the position knowing full well what that meant.

Or so I thought.

No, they did not mislead me in any way; rather, I misled myself. I had determined that writing 3 articles a week would get me to 12 or so a month, which seemed eminently doable. And heck, this is insurance, after all - how hard could it be to come up with a virtually endless supply of topics?

Aye, there's the rub:

As it turns out, writing "evergreen" articles (that is, non-"topical" pieces that would remain accurate for some indefinite period of time) is a lot harder than I'd anticipated: while insurance policies change all the time, insurance principles generally don't. Plus, I'd determined to go outside my own comfort zone of Life and Health, and try to write about Property and Casualty plans, as well. My knowledge of that side of "the biz" is, hmm, limited, but I have quite a few P&C friends with whom to consult (and to whom I am eternally grateful). Still, I found myself brainstorming topic ideas, in an effort to stockpile as many potential posts as possible.

This became a losing battle.

Fortunately for me, about two months in they lowered my minimum "quota" to 5 posts per month. Surely, I thought, that can't be difficult. Again, I was fooling myself as I quickly ran through my "stash" of topics.

Finally, in early February, I received a very nice email from the folks at Answers.com, informing me that they had revisited the whole CEW program, and decided that the numbers just weren't working. I get that: as far as I can tell, they had dozens of CEWs in various categories  churning out hundreds of articles every month. That's a lot of cash going out and, although I really don't know how much they took in (none of my business, of course), I have to think this became a losing proposition for them.

I was pleasantly surprised at my own reaction: rather than profound disappointment or even anger, I felt relief. After all, I still have my real job, plus IB, and, most important, my family, with whom I would like to spend at least some time.

And then there's that whole sleep thing...

So, beginning this month, I'll be tasked with answering just six insurance-related questions per year, which they'll feed to me every so often, and to which I must craft a 100 or so word response. Of course, this dramatically reduces the amount they're paying me, but I can live with that. The long-form compensation was very nice, but I think we'll survive without it (after all, we survived without it before I accepted the position).

All in all, I must say that this has been a very positive experience, and my "body of work" will remain online at Answers.com (and I'll continue to be their Insurance CEW).

So: Thank You, Answers.com, for the opportunity and the experience!

My (last) new article is up....

At Answers.com:

"A professional insurance agent can provide timely, expert advice on both the types and amounts of coverage you may need, and you don't have to pay extra to access or benefit from it."

This is actually my last long-form article: they've changed the role of CEWs. I'm actually grateful for that, as well as the opportunity to "stretch" my writer's muscles.

Cavalcade of Risk #203: Call for submissions

Bob Wilson hosts next week's Cav. Entries are due by Monday (the 3rd).

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.