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Wednesday, 31 October 2018

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In case you were under any illusion that The DC Rocket Surgeons© have gained a single clue lo these past 6 years, well let's just disabuse ourselves of that notion.

Readers may recall that I did my annual Marketplace re-certification a few weeks ago, at which time I received a certificate (suitable for framing!) so attesting. You may imagine my surprise - my dismay - to then receive this in email this morning:

"Our records show you have not completed Marketplace registration and training for plan year 2019. To avoid losing your Marketplace access for Open Enrollment beginning on November 1, you must complete plan year 2019 registration by October 31."

What???

After a frantic phone call to the Exchange folks, including a 30+ minute time on hold, I was assured that this was an error on their part, and the nice man could only confirm that a blast-email with this misinformation was generated last evening.

Thankfully, I received this helpful update a few minutes ago:

"You may have recently received a message entitled “One Day Left Before You Lose Your Marketplace Access,” which stated that you had not completed Marketplace registration and training for plan year 2019. This message was sent in error." [emphasis in original]
One wonders, though, how many senior agents are still recovering from heart attacks caused by the message "sent in error."

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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

Heads' up, courtesy of the CMS in email this morning:

"If your clients do not update their Marketplace application and enroll in a plan November 1-December 15, they may be automatically enrolled in a 2019 plan."

If you're okay with that, then no need to take action. On the other hand, if you'd like to see what's "new and improved" out on the market [Spoiler Alert: pretty much zilch], then starting tomorrow you can get a quote for a new plan, preferably through the services of a local, professional, independent agent.

Oh, and if you don't, and you'd like to keep your plan as-is? Well, that may not be possible:

"Individuals currently enrolled in plans through issuers that will not be participating in the Marketplace for 2019. These consumers will be matched with an alternate plan from a different issuer."

Seems like there was some kind of explicit promise made, back in the day.

Oh, yeah.

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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

Wow:

A Utah insurer is offering plane tickets to San Diego, transportation to Tijuana, and a $500 cash payout to patients who need certain pricey drugs for multiple sclerosis, cancer, and autoimmune disorders. https://t.co/oAZtKWsYtX
— Rebecca Robbins (@RebeccaDRobbins) October 29, 2018

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Tuesday, 30 October 2018

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Medicare states with special rules.

Most states follow CMS guidelines about when one can enroll in a Medicare supplement (Medigap) plan and whether or not you can be medically underwritten.

But a few states follow their own rules.

Birthday rules.

Anniversary rules.

Rule rules.

Here is a sampling of what you can expect.

In New York and Connecticut, Medigap plans are guaranteed issue year-round.

California and Oregon both have “birthday rules” that allow Medigap enrollees a 30 day window following their birthday each year when they can switch, without medical underwriting, to another Medigap plan with the same or lesser benefits.

In Maine, Medigap enrollees can switch to a different Medigap plan with the same or lesser benefits at any time during the year, and all carriers must designate one month each year when Medigap Plan A is available on a guaranteed issue basis to all enrollees.

Missouri has an Anniversary Guaranteed Issue Period; anyone with a Medigap plan has a 60-day window around their plan anniversary each year during which they can switch to the same plan from any other carrier, guaranteed issue. - Medicare Resources

While most states allow the current 10 standardized Medigap plans, if you live in MA, MN or WI you will be offered plans that differ from the standardized plans in other states.

And in case you are wondering, Obamacare prohibitions on underwriting pre-existing conditions does not apply to Medicare plans.

You have questions, we have answers.

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Monday, 29 October 2018

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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

Surprise!

This woman spent 47 hours waiting for surgery in the Sunnybrook ER, with shattered wrists, a broken elbow, cracked ribs and internal bleeding. An investigation into the overcrowding of Toronto ERs..https://t.co/by2dxBLjLO pic.twitter.com/5m0oyaDELC
— Dutch Rojas (@DutchRojas) October 28, 2018

Money quote:

"There was a curtain, but no switch to turn off the lights at night. That location would be Yerxa’s home for the next 19 hours—and her predicament would get worse from there."

But hey: Free!

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Last Friday, we posted on a new product being rolled out by Blue Cross/Blue Shield of North Carolina (BX):

"MyChoice is a less expensive option for families and small businesses who may not be able to afford other, higher-priced ACA plans"

The product's "hook" is that, instead of paying negotiated rates (as in PPO and HMO models), the plan reimburses "up to" 140% of what Medicare would pay. So, for example, if the doctor charges $100, and Medicare would have paid $60, MyChoice would reimburse $84 (leaving $16 as a potential balance to be billed). Now it's possible, given the "up to" wording, that the carrier may, in fact, send a check for (substantially?) less than this.

But it gets even more interesting: I had at first taken this to be a plan for small employers, but BX is also offering it on the individual market for 2019. Note, though, that even though it's ACA-compliant, it's not going to be offered on the Exchange, and therefore it's not subsidy-eligible (which makes sense, given it's already bare-bones pricing). On the other hand, it does include ACA-required EHB's and no exclusions for pre-existing conditions. And, of course, no extra charge for folks with those conditions.

So Henry, you may ask, how can they offer ObamaPlans with premiums discounted by up to 30%?

Well therein lies a rather interesting tale: while pretty much all carriers are now moving to narrower networks and abandoning PPO-style plans, MyChoice eschews the network model altogether, and, in fact tosses out UCR (usual, customary and reasonable), as well. Instead, you go to any doc you choose, and the plan will pay up to that pre-arranged number. And this is the case with both the individual and group models.

Patrick and I have some questions about this, and have reached out to the carrier for clarification (which we'll share in a future post providing they reply). But in the meantime here's my takeaway:

On those individual plans, the anti-choicers went ballistic over the new, expended Short Term Medical plan rules; one can only imagine the paroxysms they'll have on these.

And what about employers: will they be able to explain the potential balance billing nightmares to their employees? The carrier provides at least a partial answer:

"Blue Cross NC encourages myChoice customers to talk with their provider before any appointment or procedure to make sure they will accept the benefit payments that are provided, or find providers who will."

Now again, this touches on the Holy Grail of transparency, but as I alluded to in the previous post, who shops for the cheapest brain surgeon?

Patrick was concerned about how prescriptions would be handled in these plans, and now we know:

"The plan has a contracted network of pharmacies with agreed-to prices. There is no balance billing if a member goes to an in-network pharmacy."

And they're also HSA-compliant, which may help mitigate some of the balance billing concerns (or no).

Patrick also noted that these plans aren't available state-wide:

"BCBSNC is only offering the product in counties where they couldn't leverage providers."

Which makes sense, in a macabre way. Again, this is ripe for balance billing.

Will be interesting to see how this fares.

Looking forward to reporting on BX's answers.

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