Tuesday, 31 May 2016

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And now for something completely different.

According to the NY Times, the details of Obamacare
were revealed to the IRS in a "by special invitation only" meeting. Here are the bullet points.


  • IRS doubted the Obama administration had legal authority to spend the projected $3.9 billion on health insurance premium subsidies
  • Attendees were given an OMB memo outlining the salient points of the proposed spending
  • Attendees could read and discuss the memo, but could not take notes or copies
  • Then Attorney General Eric Holder signed off on the legality of government subsidies
  • The Obama administration failed to get Congress to sign off on spending $3.9 billion but they went ahead and spent over $7 billion anyway
  • Obamacare premium subsidies are not authorized by  IRS code

For those that want the details, here is the link "In a Secret Meeting ...."

You can file this away in your Obama administration transparency filing cabinet.



#ObamacareFail #TheMostTransparentAdministrationInHistory




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From UHC via email:

"Next year UnitedHealthcare will offer individual plans through the Exchange in a limited number of states. This change in market footprint reflects our longstanding goal to offer products that are both affordable for consumers and financially sustainable for our company."

Which is surprising enough (given the on-Exchange losses), but then there's also this:

"After a detailed review ... we have determined that we will not offer individual Off-Exchange plans in 2017 except in the state of Utah. These changes reflect our longstanding goal to offer consumers products that are both affordable and financially sustainable."

Frankly, this surprises me: I would have thought that it would be the other way around.

Regardless, here's the money quote:

"If you have clients with 2016 Off-Exchange comprehensive medical plans, they will remain covered until Dec. 31, 2016."

How's that go again?

Oh, yeah.


[Hat Tip: Cornerstone]


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I've always believed that the best way to do business is to look for ways to do business; that is, throw up as few roadblocks as possible (with zero being optimum). Glitches do happen, of course, but a good attitude and a smile go a long way towards smoothing things out.

And then there are the incompetents at ExamOne.

I just wrote a combination case for one of my clients: life insurance with Company A, and disability coverage with Company B (long story, not really relevant here). I double-checked with each to confirm that we could do one exam (so poor Betty only gets stuck once); no worries, they were both fine with that as long as I noted it on the applications.

I've used ExamOne pretty much exclusively for many years, solely from inertia. Never had any real problems (until now). On the other hand, I've never really challenged them before.

So, this morning, I called to place the order. I explained to the gentleman what I needed done, and he asked to put me on hold to see if that the carriers would agree to "share" the information (since we were looking to get by with one needle-stick). Since I'd already pre-cleared this, I knew the answer, but I did understand that he couldn't just take my word for it. So he asked me for the carrier names and then put me on hold while he checked it out.

After a few minutes, he came back to confirm that he had the right name for the DI carrier (hint: it's not exactly obscure). After confirming it with him, he again put me on hold to see if he could ascertain whether or not they would be able to accomplish this very simple task.

After a while, he came back and told me that "I can't find a definitive answer, so I'll just go with no."

Really?

Making up our own rules as we go along, are we?

This is absolutely unacceptable.

I thanked him for his time and hung up, seething.

Recently, I'd received an email from our new ExamOne rep (who even knew we had an ExamOne rep?), so I reached out to her to tell her about this experience, and that they had just lost a customer (there were also other issues with the original call that aren't relevant here). She promised to "look into it," and I promised to find another vendor.

Which I almost immediately did: I called both the life and disability carriers for suggestions, and they both recommended APPS - Para Medical Services. Well, I called, spoke with a rep right away, and had everything locked down in under 5 minutes. They understood exactly what I needed and knew which insurance carrier was which, no problem.

So, out with the old and incompetent vendor, in with the helpful new one.

Happy ending.


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Sunday, 29 May 2016

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Friday, 27 May 2016

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So I reached out (via email) to my InHealth clients today:

"Yesterday afternoon, the Ohio Department of Insurance placed InHealth into receivership. This was not completely unexpected: almost all the Co-Ops nationally have failed; we were hoping that IH would be an exception.

The good news is that the DOI will handle taking care of outstanding bills, etc, and this is a trigger for a Special Open Enrollment period so that you can obtain coverage elsewhere.


I'll be in touch early next week to let you know how we can help with this transition. Meantime, have a GREAT (and safe!) Memorial Day Weekend."

I sent this to all my IH clients, and almost immediately received this reply from one:

"Does this mean that I will be required to meet my deductible again this year with the new company?  I've already met my deductible with IH for this year and have more expected medical expenses scheduled in the next few months (MRI for GI and more testing for the neurosurgeon).  Hopefully they take these sorts of things into consideration. 

Hope you have an enjoyable weekend as well!

Keep me posted..."

Good question.

Here's my reply:

"That will depend on the carriers, but my guess would be that yes, everything would reset to zero. I’ll know more as they roll out what options will be available: it’s possible (no idea how likely) that the DOI could make some provision for this. But just don’t know yet."

To which he responded:

"Ugghhhh.....not the answer I was hoping for; however, the one I had expected.  Guess they feel like the working middle class is made of unlimited amounts of money.




Rant over.  Lol!"

I can certainly empathize. I'm sure that the coming weeks will bring some clarification, both as to how the transition will be handled by the DOI, and my own choices viz fees.

A dear friend has reminded me that things change, and I do need to be more open to other practice choices (less medical, more life, etc). I know that he's right, and I've been wrestling with this for a while (as regular readers have likely gathered). I do love what I do (mostly), so one supposes that it's natural to sound off on having to adjust course.

But time and tide....


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Thursday, 26 May 2016

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[From email just now]

"COLUMBUS - Lt. Gov. Mary Taylor was appointed receiver for Coordinated Health Mutual, Inc. today following the Ohio Department of Insurance (ODI) request to liquidate the company which provides health insurance to nearly 22,000 Ohioans under its InHealth Mutual brand.  The action allows ODI to assure that claims of policy holders, providers and vendors are provided for in an orderly manner while it winds down company operations."

More as this develops.

Really disappointed, had hoped that they'd make it. Take-away? Co-Op model = wishcasting.


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