Pension Max: A Primer

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

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

*Summary

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

*Intro

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

*Choices, choices

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

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

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

*When do I choose?

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

*What are my options?

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

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

*So what's "The Third Option"

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

*How does it work?

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

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

*Conclusion

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

*Callout

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

*Really* fast claim

@insureblog best p&c claim ever! https://t.co/pKp1fmHYEf

— CONSUL Ins (@ConSulInsurance) February 3, 2019

Funny because it's true: my eldest is in a Physics PhD program that collaborates with the folks who run the LHC. Heh.

Fraudulent (sub)contractor tricks

But not what you might expect. Thanks to FoIB Jeff M, we get the sad tale of a mid-50's contractor looking to score some additional cash via his customer's pop machine's ice-maker:



ProTip: Camera's are everywhere people!

WCL: An update

Regular readers may recall this past summer's story about the Cincinnati-area family that managed to 'defraud' West Coast Life:

"Mason family who faked life insurance policies, bought Bentley convertible, pleads guilty"

[ed: is it really "fraud" if the carrier's underwriter is asleep at the switch? Isn't there some shared culpability here?]

But that was then, and this is now, and FoIB Holly R tips us that there's been some closure in the case:

"A Mason man was sentenced Thursday to more than three years in prison for conspiring to launder about $3 million in proceeds fraudulently obtained from a life insurance company. 

His wife and daughter were also sentenced on one count of money laundering conspiracy."

The family must now return (what's left of) the money, and give up their newly purchased house.

Seems fair.

Scary Health "Care" Tricks

And for once, it's not about The MVNHS© or CanuckCare©, but in our own Golden State:

"A California woman is accused of posing as a pharmacist and handling out nearly a million prescriptions before she was caught"

Turns out, she'd fraudulently claimed to have graduated from pharmacy school, and then "borrowed" the licenses of two other actual pharmacists with names similar to her own.

Yikes.

And Ms Le isn't the only one in trouble:

"The [California Board of Pharmacy] is looking at revoking Walgreens’s pharmacy license at the stores where Le worked. Walgreens couldn’t tell the Board if they’d requested or reviewed Le’s pharmacist license and couldn’t furnish her employment application during the agency’s investigation."

Ooops.

Seems like maybe they should be working on their employment screening process (although one wonders if there's a bit of a PC angle there, as well).

One wonders how much actual damage she might have done, though: there's no mention in the article of any pending civil litigation from her "patients."

Still my absolute favorite take-away is this:

"During questioning, Le told the Board “me and my son would be very grateful if you could just forget about this.”

I bet.

Finally found that unicorn

I've long held the belief that one can insure anyone for anything, if cost is no object.

Seems like I finally found the exception that proves the rule:

Been working on a life insurance case for a young mother, who had requested the Children's Term Rider be added. Because this was an online application process, I only knew a few basic facts about her children: their names, ages and dates of birth. During the actual paramed exam on mom (due to age and face amount), it was disclosed that her 12 year old son had Type 1 diabetes; further probing revealed that this had been initially diagnosed when he was 5, and that his most recent A1C level (a measure of how much glucose is in one's blood; a "normal" level should be at or below about 5.7 percent).

Billy's was at 10.3 (nearly double).

This rendered him uninsurable (and, as co-blogger Bill notes, "is this kid living on juice boxes and candy?  10.3 is an average glucose level of over 280 and makes him uninsurable.  (90-110 is normal). More importantly, mom needs to get her son's diabetes under control before serious irreversible damage is done." Amen!).

As indicated above, though, I still thought there might be some chance at coverage. Unfortunately, all the Guaranteed Issue life plans I could find start at a much older age. At that point, I reached out to the specialists at Petersen International (whom we've met before), but even they were stumped. The one ray of hope was their suggestion of an accidental death policy (which pays only in the event of, well, you know). A $25,000 plan would run about $20 or so a month. Although it's not perfect, I'm leaning towards recommending this to mom, at least until her son's diabetes is under control for a while.

We'll see how that goes.

Still, I hate to see a cherished belief go by the wayside.

ADDENDUM: Any suggestions and/or recommendations gratefully accepted. Just drop us a line.

The ACA is #Winning!

WooHoo!

Covered CA announces a 23.7% drop in the number of new sign-ups -- that's huge. Renewals up by 7.5% #ACA

— Ana B. Ibarra (@ab_ibarra) January 30, 2019

Oh.

Regular readers may recall that the Golden State recently "enacted legislation that permanently establishes different enrollment dates within the state, both on and off-exchange. From now on, open enrollment in California will begin on October 15, and end on January 15. So for 2019 coverage, California residents will be able to enroll starting on October 15, 2018, and will have until January 15, 2019 to enroll."

So an extra 2 months to sign up, and they still fell short.

Way short.

Hunh.

Fraudulent Agent Tricks: The Jig is Up edition

We've run into the so-called "Irish Travelers" before:

"[A] secretive and nomadic ethnic group whose members often garner their wealth by doing dubious repair work and executing scams — and by taking out exorbitant life insurance policies on one another."

But that was then, and this is, well, now:

"An insurance agent was sentenced to two years in federal prison Monday for his role in the ghoulish schemes of S.C. Irish Travelers to make up to $33 million off the deaths of elderly or sick people."

Wait, what??

When we wrote that first post on '15, it never really occurred to me that the agent(s?) would have had any direct involvement in the actual fraud. But apparently, there's decent dollars to be made (for a while, anyway), since at least three agents were complicit in the scheme, which went on for at least 4 years.

My favorite part if this, though, is the defense's claim that:

"[O]nly companies were victimized, not individuals. "He is not a person like Bernie Madoff, who was taking peoples' funds."

/sigh

The stupid, it burns.

And it's not as if this was a one-off kind of deal:

"Once he showed them he would violate the law, they started approaching him and kept on approaching him ... Hundreds of these policies violated the law."

So how did it work?

Well, underwriting life insurance policies isn't just about height and weigh, smoker or no. There's also a financial aspect: carriers look askance at agents writing million dollar policies on, say, Walmart greeters. In this case, the agents apparently "inflated the net worth and income of the person being insured."

Which seems to me to suggest that these weren't necessarily outrageously large face amounts, which would typically raise home office flags as well as require (typically) an actual physical exam. But hundreds of $75,000 plans *still* adds up to a pretty big payday, no?

[Hat Tip: co-blogger Bob V]

How 'bout that! LTCi edition

Recently, a long-time long-term client passed away. Many years ago, he and his beloved had purchased a pair of (linked) John Hancock Long Term Care insurance (LTCi) plans. In fact, it was so long ago that I'd forgotten a key feature.

Recently, Jack passed away, and we helped Jill alert the Hancock folks. Over the weekend, she received two premium refund checks, one for Jack's policy (of course) but also one for hers.

This was a problem: we certainly didn't want to lose her coverage, and we couldn't understand why they would have cancelled it and not just Jack's.

As we waited on hold yesterday for the Hancock rep to help us out, I casually mentioned to their son (who is also a client) that I had a vague recollection of a long-ago feature available on those plans that basically said that if one spouse dies, the survivor's plan is automatically paid up for life. but I couldn't recall any details or even if it was, in fact, a Hancock feature or option (although at least one compsny still offers this as an optional benefit).

After a few moments, Melissa came back on the line to let us know that this was, in fact, the case, and that Jill's policy is now completely paid up and in-force. She will never have another premium (or, one presumes, premium increase).

Bravo!

My First look at Bernie's Medicare For All

Today I was puttering about, and for no particular reason decided it was a good day to look at Bernie Sanders website for information about his Medicare For All plan.  You can find Bernie's Medicare For All at berniesanders.com.

I quickly learned the Medicare Bernie has in mind does not resemble the Medicare seniors have today.  The Medicare seniors have today is very expensive, but its benefits are inadequate. An insurance plan having benefits equal to Medicare benefits would not qualify to be offered on any of the ACA Exchanges.  In fact, Medicare benefits make it necessary for seniors to pay for supplemental plans, to have adequate coverage.  But Bernie's MFA promises significantly better benefits than Medicare.  Except Bernie's description refers only to "workers".  I could not find a statement to indicate seniors qualify for Bernie's MFA.  So does Bernie's Medicare For All really mean "for all"?  I can't tell.  Whatever.  Changed, changed utterly, a terrible beauty is born. 

But wow are Bernie's MFA benefits comprehensive.  Bernie's MFA plan includes "no copays, no deductibles and no fighting with insurance companies when they fail to pay for charges."  The government as single-payer will pay all charges, even for long-term care.  This is way better than ACA!  Just note it's not medical insurance - it's medical welfare.

Bernie says his plan "has been estimated to save the American people and businesses over $6 trillion over the next decade."  Excellent estimate.  Just like the excellent ACA estimate of reducing the average family premium by $2,500 per year.   

Who knows, Bernie's Medicare For All might even make all our children handsome and above average.  

Bernie also summarizes at his website how he thinks this will all be paid for.  I won't bore you with those details, but think "taxes".  No, no, think bigger - much more taxes than that.  Americans must pay much higher taxes because Bernie's MFA will save Americans so much.  But why are you even worrying about how to pay for Bernie's MFA?  The world is coming to an end in 12 years!! 

You'll also notice at Bernie's website he says "We must stop forcing working Americans to choose between bargaining for higher wages or  better health insurance”

Yes.  Bernie's Medicare For All will force working Americans to pay much higher taxes for better health insurance - no choice, period. 

I can scarcely contain my enthusiasm.

Reality Check: MVNHS© vs US

As we dive headlong into our own version (maybe), a few words of caution:

Yay Single Payer!
"The sickest Brits are seven times more likely to die than the sickest Americans, according to research from University College London and Columbia University."https://t.co/wwUf1RsRyD

— Michael Bertaut (@MikeBertaut) January 23, 2019

DC Rocket Surgeons© Bungle Their Marketplace

R'uh r'oh, Shaggy:

Exclusive: D.C. Exchange Site Misled Customers On Individual Mandate

Absent additional action, Washington DC residents may face sizable tax penalties due to a website mess caused entirely by District officials.

via ⁦@chrisjacobsHC⁩
⁦@FDRLST⁩ https://t.co/SGRNnWFgy2

— Tim Gradous (@tgradous) January 25, 2019

Regular readers may recall from late last summer that:

"[T]he District of Columbia City Council approved a requirement for all DC residents to purchase health insurance"

Well, turns out (caution: Spoiler Alert!) that the District's website "failed to inform visitors to its online insurance exchange about the new coverage requirement."

Ooopsies.

Do click through to the actual article to see just how bad this really is.

Getting Fit (Bit)

So last summer's routine physical served as somewhat of a wake-up call, and resulted in some major lifestyle changes, one of which is the FitBit that I now wear on my wrist. It's actually kind of fun, and encourages me hourly to walk another 250 steps.

This morning I got this in email from them:

"Congrats on earning your Serengeti badge!

You may not have seen wildebeasts, giraffes or zebras on this trek, but you have walked 500 miles—the same distance as the Serengeti, one of the 7 Natural Wonders of the World."

So that's pretty cool.

What's not so cool is the subject of this (related?) item sent in by FoIB Holly R:

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

Which reminds me...

Inadvisable Provider Tricks

So saw this the other day:

"Beaumont waives emergency copays and deductibles for federal workers during shutdown"

Beaumont being a hospital in the metro Detroit area. While this seems quote generous, it struck me that it didn't sound ... kosher.

So I reached out to co-blogger (and certified Medical Office Manager) Kelley B, and asked if they could do this.

She replied "Yes they can, but they have to do it for Everyone."

Everyone?

Meaning not just Federal workers affected by the shutdown?

"That is correct. Every person who comes in has to be treated exactly the same. CMS is very specific to that point."

Ooops, looks like someone's in a heap o'trouble (or about to be).

Much Vaunted National Health Service© & Your Health

"9-in-10 NHS trusts run hospitals that have the carcinogen asbestos, according to a BBC investigation released in December."https://t.co/89LVCXIirX

— Michael Bertaut (@MikeBertaut) January 23, 2019

Sure, sure, but Michael's missing the point: It's free!

If I Had A Billion Dollars

CMS released the proposed 2020 Notice of Benefit and Payment Parameters this past week. As part of the proposal the Trump Administration is proposing to reduce the exchange user fee from 3.5% to 3%. The user fee is paid for by insurers (cough, cough) who participate on the individual and SHOP exchanges.

So what, this appears to be good news that will reduce costs right? Well, yes - technically it should reduce premiums.

Except when you look at a total cost perspective.

In 2014 the average premium was $346 per month. 3.5% of the monthly premium is $12.11 or $145.32 per enrollment per year. With enrollment of 6.3 million the total amount insurers "paid" to help with exchange operations was $915,516,000.

In 2018 the average premium was $595 per month. 3.5% of the monthly premium is $20.82 or $249.84 per enrollment per year. With enrollment of 9.8 million - a conservative estimate since final effectuated enrollment hasn't been released - the total amount insurers gave to fund exchanges was $2,448,432,000.

In four years the cost of the exchange has increased by $1,532,916,000. Even when factoring in the additional people the cost increase is $1,024,296,000.

And that is what we consider "government efficiency".

Canuckcare© Follow-up: She got better

Nothing really earth-shattering here, just a news item from this morning that caught my eye:

"Former Magna International Chief Executive Officer Belinda Stronach is rejecting claims of mismanagement made by her father Frank ... Belinda Stronach, a former Canadian lawmaker, is seeking about C$33 million ($25 million) from her father."

Reason that piqued my interest was because I was pretty sure that was a familiar-sounding name. And it was.

From Aught Seven:

"[Canadian] Liberal MP Belinda Stronach, who is battling breast cancer, travelled to California last June for an operation that was recommended as part of her treatment."

From politics to the boardroom.

At least the American healthcare system worked for her.

ObamaCare news: Market Rules edition

Over at ThinkAdvisor, FoIB Allison Bell has a round-up of proposed ObamaCare Market rules for '20, including restrictions on web brokers:

"CMS officials say they want to make it easier for web brokers to enroll consumers directly in HealthCare.gov plans, without sending the consumers to HealthCare.gov.

But they have also indicated that they want to set some limits on how HealthCare.gov brokers operate."

This would include weighting quotes by how much comp the broker receives from a particular carrier.

There's also a proposal to add a new Special Open Enrollment Period trigger based on income/subsidy eligibility changes.

And the 2020 "annual cost sharing" (ie out-of-pocket) will increase about 4%, from $7,900 per person to $8,200 (and $16,400 per family).

"Affordable."

More at the link (in case your blood pressure's too low).

The MVNHS© vs The ER

That's not how this is supposed to work:

In UK, patient waits 45 hours in emergency rooms via @BBCNews https://t.co/VIX7Mw1JOh pic.twitter.com/9iJhUrUk80

— Sally Pipes (@sallypipes) January 17, 2019

Then again, this is the Much Vaunted National Health System©, so maybe it is.

Heads' up: The weather and your home's pipes

Timely reminder from our friends at the Cincinnati Insurance Company:


Prevent frozen pipes in your home from The Cincinnati Insurance Company on Vimeo.

For whom the bell tolls: The Venerable Health Wonk Review

From email from our dear friends Joe Paduda and Julie Ferguson, co-founders of the long-running, highly respected Health Wonk Review:

"Hello, Health Wonker friends –

First, wishing you all a happy New year and extending thanks for your ongoing participation in Health Wonk Review.

After a baker’s dozen years  and more than 280 issues, we’ve decided to call it a day.  It’s become a bit more of a heavy lift to get varied hosts. We moved to a monthly issue to address that, but it’s still been slow going. Submissions are down too as more people abandon blogs in favor of social channels like Twitter and LinkedIn. Readership and cross posting appears to have waned, too.  Going forward, we may host an ad hoc issue occasionally under the HWR banner and invite your participation when health policy issues rise to the surface, but the regular issues will cease.

We can’t thank all of you enough – we’ve discovered new blogs, learned new things, shared some laughs and made good friends that we hope will continue into the future.

We’ll be preserving the archives and will send you a link to the new location.

Be well, and keep doing what you do so very well!"

We'll miss the HWR, and can't say enough about how much effort Joe and Julie poured into it all these years. We are proud to have been with them from the beginning, and know that their efforts have been appreciated.

Nectar of the Gods?

Merriam-Webster defines ambrosia as "the food of the Greek and Roman gods." If that's still the case today,  we have questions.

Why's that, Henry?

Well, because of this (apparently legit) item sent in by FoIB Holly R:

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

Ummmm.

The company was started about 3 years now, and is now up and, er, beating well, as they now boast a wait-list. And since its process is considered an off-label use of established medical procedure, it's apparently 'kosher' as far as the FDA is concerned.

How effective is it? Well,there's scant scientific proof of its efficacy (and by "scant" we mean "next to none"); on the other hand, what's the harm?

Tune in again in 2075 for an update.

Oh, and definitely go for the brand name, not the generic,and no word yet on whether or no it's HSA-eligible, but one doubts it's insurable (after all, what carrier actually has a heart?).

ObamaCare Open Enrollment v6.0: Anecdata version

We know that anecdotes ≠ data, but this item (to which we were alerted by co-blogger Bob V)  provides some helpful, personal perspective:

"Last week, we asked you to send in details of the insurance plans you purchased on the Affordable Care Act exchanges. We received more than 70 messages, mostly all with the same theme: This sh*t is too expensive, and it sucks."

Well, we've been saying that for years now, but welcome to the party!

There are a bunch of interesting example, none of which were surprising to longtime O'Care observers.

Feel free to share your own experiences in our comments section.

CanuckCare© Continues Swirling

But hey,it's free:

60 hour wait in ED for a hospital bed.

Even 90th percentile waits (which are bad) still miss waiting at the extremes. #CanadaWaits #cdnhealth #onhealth https://t.co/7BPKcDXQ0N

— Shawn D. Whatley (@shawn_whatley) January 9, 2019

[Hat Tip: Dr Michael B]

#FakeHealthNews: Burying the Lede

Our friend Holly R tips us to this story currently making the rounds at FB:

[click to embiggen]

"Kentucky Sen. Rand Paul, one of the fiercest political critics of socialized medicine, will travel to Canada later this month to get hernia surgery"

Now why would he do that?

After all, we have many fine surgical centers here in the states, why would he choose a government-run one Up North?

Well, turns out that the opening sentence is rendered completely moot by the third:

"He is scheduled to have the outpatient operation at the privately adminstered Shouldice Hernia Hospital in Thornhill, Ontario"

/Busted

Transparency gone terribly wrong

We've been covering (and advocating for) transparency in health care pricing for a very long time:

"Gov. Rod R. Blagojevich today signed the Illinois Health Care Consumer’s Right-to-Know bill, which makes health care price and performance information for outpatient procedures available to all Illinois consumers."

That was over 13 years ago, and we can see how well that's worked out. Recently, co-blogger Bob V sent me a link to a story that not only indicates that we have a long way to go, but also implicitly explains why we likely will never really see true transparency:

"Her insurer’s price tool estimated less than $1,375 for a breast MRI. Then she got a bill for $3,200."

Ms Smith apparently did everything right: she researched MRI facilities and prices using UHC's online cost estimator [ed: and by the way, this is not an indictment of UHC in particular; I'm confident that that same would hold true with other carriers, as well], and still got socked with a larger-than-expected bill.

But why is that? Why is something so seemingly simple so difficult to obtain? After all, when I order a Big Mac and fries, I know exactly what I;'m going to shell out. Likewise a gallon of gas or an oil change. Why is medical care immune?

Well, there's the obvious challenge that the doc can't be sure that a particular surgery will go exactly as planned, and I get that. But simple things like non-emergency MRI's should be basic, off-the-shelf, easily priced items.

Or so one would think.

But here's the dirty little not-so-secret:

"Health-care costs are difficult to pin down because prices vary widely and are part of confidential agreements between insurers and providers." [emphasis added]

Now, I actually "get" that: UHC doesn't necessarily want Humana to know the specifics of its agreement with Dr Smith. And, of course, coverage will often change depending on one's plan's design. I just don't see how to square the circle.

On the other hand, we have newer models like Direct Primary Care and facilities like the Surgery Center of Oklahoma, which operate on a strictly cash basis, no insurance needed (or, in fact, accepted). So we know that cutting out the middleman (ie insurance and/or the heavy hand of government) is a way around the conundrum.But of course, both of these have their own problems and challenges, not the least of which is the ability of one to come up with the scratch to pay for it.

/sigh

ObamaCare #Winning!

More "ObamaCare is Working" News:

ObamaCare to Cost Large Employers Added $4,800 to $5,900 Per Employee Per Yearhttp://t.co/qnGr4w2zfw

— JointheNRA NOW! 🇺🇸 (@CarmineZozzora) July 10, 2014

Sad news: A client story

Over the weekend, a long-time agency client took his own life. Dan was a retired (and much beloved) pediatrician who had been (recently?) diagnosed with both dementia and Parkinson's. One supposes that, as a physician, he knew what lay ahead, and decided to forego that.

Something that often comes up in these tragedies is the issue of whether or not a life insurance policy would "pay off." As with so much insurance-related "conventional wisdom," it's not actually all that simple.As we wrote back in Aught Nine:

"Until just after the Great Depression, suicide was excluded by life insurance policies. There was, it was thought, a very good reason for this: it would be against the public interest to encourage folks to kill themselves to enrich those left behind. And there's some validity to this: we don't want to make such an outcome attractive to people to leave an inheritance at the cost of one's own life.

But a lot of people who lost everything in the Depression killed themselves anyway; not for the insurance (there wouldn't be any) but out of desperation and despondence. And this left behind a lot of widows and children who lost a parent and a spouse along with their life's savings. This was also against the public interest.

So, how to reconcile these two seemingly irreconcilable principles?

New laws were enacted that required life insurance policies to cover suicide after a "reasonable" period ("reasonable" in this case meaning no more than two years). The premise is that no sane person is going to buy a policy with the intent of waiting two years to jump out a window; that a person would do this was ample demonstration of mental illness, and that would be a covered exposure. This protects the interests of innocent family members, while still discouraging a casual view of suicide."

Our condolences to Dr C's family.

Not so great HIX news: SEP edition

So by now, most folks understand that it's quite the challenge to buy ObamaPlans outside the regular Open Enrollment season; that one requires a Special Enrollment Period trigger (losing group coverage, getting married or having a baby, etc) to do so. Well, the process just got a bit more onerous.

From email from our Betters in DC©:

"Special enrollment periods (SEPs) provide an opportunity to consumers who experience certain qualifying events to enroll in or change their health coverage outside of the annual Open Enrollment period.

Beginning in early 2019, Marketplace consumers may need to choose a plan in the same metal tier category (instead of from all available categories) during their SEP window. [emphasis in original]

 This impacts consumers when they:

•Currently have a Marketplace plan,
•Experience most SEP-qualifying life events, and
•Want to change from their current plan.You can help consumers understand that their plan choices after Open Enrollment will likely be limited later in the year, even if they qualify for an SEP and want to change plans. You can encourage them to choose a plan that will meet their needs and their family’s needs until the next Open Enrollment period."

Oh goody.

Did I mention that I'm aware of precisely zero carriers paying commissions on plans outside of the regularly scheduled Open Enrollment? How come no one seems to care (since they don't reduce the premiums to reflect that fact)?