Wednesday, 31 May 2017

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Last we looked, our Neighbors to the North© had some serious problems with their national health "care" scheme:

"Euthanasia became legal in Canada in June and by December Quebec bioethicists had already published an article in the Journal of Medical Ethics calling for organ donation after euthanasia."

How lovely. But certainly things have progressed and they're no longer in such a bind, right?

Um:



[Hat Tip: IP4PI‏]

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Insurance Tips and trik auto insurance, auto insurance quotes, auto insurance companies, auto insurance florida, auto insurance quotes online, auto insurance america

Regular readers know that, effective April 1st, the maximum amount of time for which a given short term medical plan may stay in effect is 3 months. This poses a number of challenges to folks who, for whatever reason, are between Open Enrollment periods and find themselves uninsured.

When the gummint, in its infinite wisdom, unceremoniously (and frankly, of dubious legality) announced that no plans could extend past three months, these folks had a problem. Previously, they could have bought a 9 month plan, paid it monthly until they no longer needed it, and been relatively okay: although these plans don't cover pre-existing conditions, if something new cropped up during the term of the plan it'd be covered.

Now, though, they'd have to buy a new plan for month 4, and if something happened during months 1 through 3, they were outta luck.

Which is a quandary, indeed.

Yesterday, though, I got an email from the "General Agent Center" touting a plan offering up to 9 months of short term coverage. Intrigued, I called to see how they could do this. Turns out, they have a very interesting set-up: one buys (up to) four 3-month policies (payable monthly). The first one, of course, covers no pre-existing conditions. At the end of each 3-month term, the deductible and co-insurance "reset," but any health issues arising after issue are covered during successive periods.

So, for example, if one had a heart attack in week three of the first "duration," it wouldn't be considered pre-existing (and thus excluded) in durations 2 or 3 or 4. There *would* be new deductibles to meet, but I'm guessing these are a miniscule fraction of the ICU costs.

Outside-the-bun solution, no?


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Tuesday, 30 May 2017

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Another in a continuing series on the impact of ObamaCare on the lives of ordinary citizens:

Sally and Dave are longtime clients, with a Grandmothered plan boasting a $5,000 per person deductible, then 100% after that for covered expenses. The family max out-of-pocket is $10,000, and the plan is built on the PPO model (which means they have coverage both in and out of network). They're in their late 50's, and in good health.

Their current plan renews in a few months, and will be going up some 15%, from $680 to about $790. As usual, I went out to the 404Care.gov site to do some comparison shopping. The least expensive plan I could find ran a little over $900,with a $6500 deductible, and a max out of pocket of just over $14,000.

So they could spend an additional $1,200 for a plan with 40% higher exposure.

On the other hand, it does cover birth control.

Oh, and they should feel **too** awful about that 15% rate hike. As FoIB Holly R notes:

"Premiums for individual health plans doubled between 2013 and 2017"

Such a deal!


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Another day, another Blue Cross blues story.

Or rather, a couple BX blues stories:

■ Not to run up the score, but about that "if you like your plan, you can keep it" promise?

Well, FoIB Holly R has some sad news:

"Blue Cross and Blue Shield of Kansas City ... just announced that -- everyone, put on your shocked faces --  it's withdrawing from Obamacare."

Of course, if you lose north of $100 million over the previous 3 years, this shouldn't be a surprise.

■ And FoIB Jeff M alerts us that:

"Blue Cross and Blue Shield of North Carolina announced that it has filed for a 22.9 percent rate increase"

Seeing as how they're the only statewide carrier, seems like that may, in fact, be a bargain.

A major factor in the amount of the increase is the cutting off of CSR (cost-sharing reduction); that is, the Feds are shutting off the flow of that sweet, sweet slush fund carrier-subsidy fund. Which, contrary to conventional wisdom (ie The MFM), as always been the plan.

Oh, well.


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Friday, 26 May 2017

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The world is coming to an end! According to CBO (cough, cough) by 2026, 23 million people will lose insurance as Obamacare is "dismantled". This is the headline reverberating through the MSM echo chamber.

The reality is something very different than what is being portrayed. Here are four reasons why the CBO score is flawed.

Baseline Data

Under CBO rules the only way to determine the impact of a new law is to compare it to the data presented under current law. The baseline that was used in calculating the impact of AHCA was from 2016. At that time CBO projected that this year there would be 15 million people enrolled in exchanges. Actual plan election - not paid enrollment - for 2017 was 12.2 million. History shows that 10% never pay a premium giving a conservative true paid enrollment at 11 million.

What this means for the AHCA score is that CBO is assuming 4 million more people starting out with insurance than the actual number.

Medicaid Expansion Assumption

Another significant figure is the number of people who will lose Medicaid. There are 31 states plus DC who have expanded Medicaid. Without a doubt killing the expansion over the course of a few years will decrease the number of people eligible in these states. With no changes to Medicaid funding prior to 2020 why would any state that has expanded coverage elect to kill the program early? I highly doubt any of them will.

Using the logic that no state will turn away the Federal matching funds for their expansion, the question becomes why does the AHCA have 6 million people dropped from the Medicaid rolls before 2020? The answer is, AHCA's CBO score includes the potential enrollment from the 19 states that "could" expand their Medicaid rules.

Defining Insurance

Under Obamacare the definition of good insurance is set by the government. CBO, in it's infinite wisdom, thinks that they know what good insurance is too. So much so that they have set their own parameters in the scoring. In their estimation "a few million people" would buy policies that don't meet their definition of having "sufficient financial protection". Never mind that it might be what the consumer wants.

While CBO doesn't actually define what constitutes insurance in the score, they insinuate that some states will cut or reduce the number of essential health benefits and cause out-of-pocket limits to rise. Suffice it to say it's amazing that they can't give us this definition yet count a few million people as uninsured because of this definition.

Who Doesn't Want It

Finally, the CBO score doesn't tell us who doesn't want to buy insurance. Without a mandate any number of people might simply say no thanks. These people aren't losing insurance, they simply don't want it.

Does it Matter?

From 4 million to 6 million to a few million and an unknown amount. The CBO model just doesn't add up. The echo chamber will say it does. Fact is, it doesn't matter.

At the end of all the political gamesmanship and shouting matches AHCA will not pass. Not because of a fake 23 million people losing insurance. Not because of pre-existing conditions. Not because of funding cuts. Definitely not because Obamacare is working.

It will fail because just like Obamacare it focuses on the effect and not the cause.



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So, got a call the other day from one of our (numerous) long-term P&C clients asking for some help with a life policy. I'd met with her a few years ago to review it, and now she had some additional questions.

As requested, she brought with her the policy and as much documentation as she could.

In a nutshell:

This is a Variable Universal Life policy (basically a UL with mutual fund-like cash accumulation options). It's for a sizable amount on the life of her ex (I believe as part of the divorce settlement). There had been a pretty significant cash accumulation, but the policy is already looking to go upside-down in a half dozen or so years. Still, there's currently about $60,000 in cash surrender value.

After I explained all this, we discussed her needs and concerns; she's trying to determine whether or not to keep it until it fails or cash it in now. She asked me what I would do, and I of course demurred. But she persisted, and I told her that, based on our discussion, I thought she would do well to consider something called a Single Premium Immediate Annuity.

Briefly: these are plans, sold by insurance companies, that pay out a constant stream of income payable for the rest of her life. There are some tax issues, but in her case they'd be pretty insignificant, and she asked me to get her some numbers.

After receiving and reviewing  quotes from several carriers, I called her to discuss them. She was elated, and asked when we could get together to make this happen.

What's so fun about cases like this is the opportunity to look at different types of plans to find effective solutions based on what our clients need and want. It's a lot of fun, actually, and I'm pleased as punch that we can help her out.


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Thursday, 25 May 2017

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Last we looked, local healthcare behemoth Premier health and health insurance biggie UHC had parted ways:

"As of yesterday (April 30), folks with either individual or group medical plans from UHC are no longer able to receive services at Premier Health facilities at negotiated rates"

This was significant because a lot of folks in this area count on Premier Health doc's and hospitals for health-related services. The stated roadblock was (no surprise) cost-related. Earlier, UHC had claimed that "Premier is one of the most expensive health systems in Southwestern Ohio." On the one hand, that doesn't really say a lot: after all, you (generally) get what you pay for. On the other hand, of course, carriers are always on the lookout for cost-savings opportunities (NTTAWWT).

Anyway, we promised to keep our readers "in the loop," and the other day we received a letter from Premier stating their case. It's addressed to business owners, but the general points are applicable to pretty much all local UHC insureds. Here are some hightlights (full document available for download here):

"We are writing out of concern for recent events that have left Premier Health out-of-network with UnitedHealthcare ... Premier Health has done everything it can on behalf of our patients."

Okay, but if it's "all about the Benjamins," then what's your argument?

Ah:

"Premier Health works to fulfill its nonprofit mission ... We serve more than 60 percent of the region's adult patients who are covered by Medicaid."

Hunh.

Now, I have no inherent objection to charitable care, but I'm already paying for Medicaid through my taxes. I see no reason to further subsidize it by paying more for my own health insurance. After all, Gov Kasich (among others) welcomed Medicaid expansion with open arms, further exacerbating the problem. Premier's argument seems to be heartstring-pulling, not sound financial acumen and planning.

Gonna have to do better, Ms Boosalis.


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