Insurance Talk

ObamaCare

2010-03-30T15:52:00.002-05:00

Today, President Obama signed into law a companion bill to the bill that was passed almost two weeks ago. This has been called a 'fixer' because it modifies some of the language in the first health care bill which was written by the US Senate. This companion bill clarifies a few items from the first bill.

The first health care bill is over 2,000 pages long and it is going to take a long time for the business community and consumers to understand all of the changes in the health care delivery system for people not currently in government programs. Regardless of the good and bad in this new law, Stark & Associates will be here to advise the public and our clients on issues relating to health insurance for both the over and under 65 age groups.

Open Enrollment Period for Medicare

2010-03-08T22:19:00.002-05:00

From January 1 to March 31 of each year Medicare has Open Enrollment. This means that folks on Medicare can make a change to their insurance, on what is called a like to like basis. Medicare beneficiaries cannot choose stand alone Rx coverage if they don't have it now. They are, however able to sign up for it if they want to drop coverage with Medicare Advantage plan that had Rx coverage included. Unlike the Annual Election Period, where people can elect Medicare advantage, Rx coverage, and make changes before Jan 1, they can only make one change at this time.

Annual Election Period

2009-10-11T10:55:00.002-05:00

Each year, from Nov 15 to Dec 31, is the Annual Election Period for Medicare beneficiaries. What this means, is that during this 6 week period, people with Medicare who would like to enroll for the first time, or change insurance plans with Medicare Part D, the outpatient prescription drug program of Social Security, can do so. This is also the time of year that Medicare beneficiaries can enroll with a Medicare Advantage HMO, PPO or PFFS, or elect to opt out of one of these plans and become covered by Original Medicare. Coverage changes become effective on January 1st of next year.

You would think that maybe government sponsored health insurance planning is simpler than private insurance planning, but it is not. For more information please go to the contact us page of starkinsurnce.net for our telephone number and e-mail.

Will I Be In Business Tomorrow

2009-03-05T23:46:00.002-05:00

We have a new President and administration, and they would like to reform the health care delivery system. I agree, it needs reform. The question is, what changes are necessary. When compared to the rest of the world, we lead in new Rx development, surgical proceedures, and technology. Don't get me wrong, I am not an elitist. Developments happen in the rest of the world, I am just saying that we lead the way disproportionately. It is also known that people with means who are ill in other parts of the globe most often choose the USA for treatment.

I think the real issue is just cost. We have not been able to contain the increase in the cost of health insurance, which is a reflection on how much the cost of health care is rising too. If it wasn't rising, then neither would the premiums for the insurance.

I played tennis with a MD tonight. He says his reimbursement from insurers is getting lower. So I asked him what he thought, and said he thinks technology is a major player. I am sure that he is right, along with cost shifting from the uninsured, and from providers looking to be paid more than what Medicare (govt run health program) pays.

It has been a downer of a day for me. Most of my insurance practice is in the health insurance marketplace, and I get the impression that the new Pres would like me out of business, and a Canadian type health care system in place, eventhough he says not so. Stimulus is probably not coming my way, so I truly hope that the folks in our industry don't get a double whammy of loss of business due to the economy, and then a push for big government to take over the whole health care delivery system. We have problems, but keeping the system private will keep us with a better quality of health care eventhough some of us think the quality is not always so good. We are spoiled and expect the best, and if we want the best, a private and not public system is best. If you don't like public housing, then don't expect public health coverage to be an improvement, or necessarily cheaper. Medicaid is expensive to run. Medicare is not, because the government lets private carriers administer it, medicaid is administered by government agencies.

Maybe I just want to feel needed. Anyway, let me know your thoughts on this.

BAHU's New President

2006-08-03T15:50:00.000-05:00

This past July the Broward Association of Health Underwriters elected a new President and President Elect. Beginning August 1, Kevin Farrell of Aetna takes over as President, and Tonya Draughon of Renaissance Dental as President Elect. Both have served the Health Association in the past with great distinction and are known throughout the agent community for their integrity.

How Are HSA's and Medicare Part D Related?

2006-07-22T16:36:00.000-05:00

The Medicare Modernization Act became effective on January 1st of 2004. The purpose was to expand the Medicare program to include prescription drugs to all seniors and to be the most cost effective for the neediest citizens. Medicare Part A covers hospitalization, and Part B medical care. Part C created newer Medicare Health Plans called Medicare Advantage, and now the addition of Rx to Medicare is Part D.

The addition of Health Savings Accounts takes up 8 pages in the Medicare Modernization Act (MMA). The idea behind this as part of the Medicare Program is to allow people who have funds in their H.S.A’s the ability to purchase prescriptions and Long Term Care with Tax Advantaged dollars.

When Would You Like to Retire?

2006-07-22T16:34:00.000-05:00

Rick Stark and Len Harris

By Len Harris of  FutureCare Services
www.futurecare.com

Many people think they have the wherewithal to retire and enjoy their golden years. Travel, volunteer your time, visit family and friends-Surprise! Health care costs, never expected, are the biggest threat to retirement savings.

Yes, the government will provide some coverage and some employers will pay some retirement health costs, but the lion’s share will still come from the retiree.  Deductibles and co-payments are not considered when putting money aside.  These expenses can be huge, especially to people susceptible to illness just as they near retirement.  It’s estimated that the onset of an illness could siphon approximately 20% of a household’s wealth.  “You could easily burn close to $1 million of your nest egg with out-of-pocket expenses for a major illness,” according to George Ciccotello, director of Graduate Personal Finance at Georgia State University.

People think Medicare will cover it all. It doesn’t.   Without a Medicare supplement, the average couple aged 65 will spend $200,000 to cover medical costs in the average retirement. That’s just for deductibles, the cost of Medicare, co-payments, non covered items and prescription drugs.  That’s based on the husband living to 82 and the wife to 85 with no employer provided health insurance.

Unfortunately, one of the most overlooked forms of protection is Long Term Care Insurance  (LTCi).

So many people say they’ll wait until they retire to look at or even think of purchasing a policy. A policy at age 50 might cost 40%-50% less than at age 65.  In addition 40% of those needing long term care are between the ages of 18-64.  Debilitating illnesses and   serious injuries can strike anyone. People don’t plan for this, because “It can never happen to us”.

There are those agents who understand this and are making inroads at the worksite.  Showing an employer how this coverage can reduce absenteeism allows the agent to either have the employer offer a “core” plan and let the employee enhance the program, or allow the agent to talk directly to the employees.  Either way, LTCi helps both the employer and employee.

It is a fact, long term care insurance is the last thing people think of to protect their later years, but once purchased, there is a 97% retention rate.  After they’ve seen the light, it’s kept for life.

7/06

Fla Long Term Care Legislation 2006

2006-04-11T21:04:00.000-05:00

Often, legislators sponsor bills with good intentions that when implemented, have negative consequence. At the present time, both the Florida Senate and House of Representatives are promoting similar bills regarding Long Term Care Insurance which to both the insurance professional and the public appear ok. The main jist of the legislation is to protect the public. The main points of these bills are to limit the contestability period of LTCi to two years like Life Insurance and to protect consumers in closed blocks of business (discontinued policies). Consumers in these closed blocks would have protection if the premium is raised beyond a certain percentatage point.

This looks like good legislation, yet most if not all insurers of Long Term Care writing business in Fla are opposed to the new legislation. Their actuaries are telling them that rates will have to go up, and that insurers protection from fraudulent claims would now become greatly limitted.

The purpose of this blog is to create a dialog between professionals within the Life and Health Insurance industry. If you want to post a comment and have not set up a free account with blogger.com (a google company), you can post as an annonymous individual. It is requested that you do let us know who you are. This post will be sent to people in the Fla legislature, Office of Insurance Regulation, and to insurance professionals. It is of utmost importance that we help make this legislation free of unintended negative consequences. The bill sponsors and the OIR have been friends of the industry, and it benefits us all to keep it that way.

The New Generation of Insurance Scams

2006-01-25T22:33:00.000-05:00

Yesterday my Dad called me about an offer he received. Dad is 85, soon to be 86 in March. He is in great health for his age. He goes to the GYM 2 times a week. This man who he sees there a lot, is an insurance agent. He told him about a great deal. He’s going to get him (my Dad) a $1 million Life Insurance policy, and then pay him something like $100k or more. What a deal!

In fact last year, we had an 85th birthday party when Dad turned 85, and one of his friends brought up a similar sounding idea to me that I should investigate. If you have read my bio, you should notice that I too am an insurance agent. Well, this sounded awfully too good to be true to me, so I blocked out even thinking about this until hearing about this again yesterday. So tonight I went on the internet to investigate, and the alarm bells have now begun to go off.

I mean, can you imagine someone purchasing life insurance on an elderly person and then paying the premiums, and also paying the insured? We all know that expression about something being too good to be true. So here is how it works. Let me know what you think. Remember, I have nothing against people making money through legitimate means, or even making lots of it. I want to be one of those making lots of money, but my moral code says to do it honestly and morally.

This is called Stranger Owned Life Insurance or SOLI. Someone buys Life Insurance on someone else’s life, and then pays the premium and pays them for signing up. If approved, the insured must keep the policy for at least two years. After that they can sell it or sign it over to the people who got them involved in this in the first place. Now I am simplifying this, and here is where the potential illegalities lie. First of all, when Life Insurance is bought, the beneficiaries are supposed to have an insurable interest. Like your wife or kids, or now in the modern era, your significant other, if you know what I mean. Or even a business partner. So a total stranger has an insurable interest? Then how about the upfront money? The agent may not tell you, but the proceeds more than likely come from his commission. In most states, this is rebating, and illegal in the insurance business. Two no-no’s. The insurable interest problem is something that can be explained away, because often life insurance is owned for many years, and the people you bought it for to protect may be gone from your life, and after two years, judicial review (previous lawsuit history) has said policies are no longer contestable by the insurance co’s in most situations, and this is one of them.

Now tomorrow I’ll be at a Life Association meeting to discuss this with my peers. I write mostly health insurance, but have a history in the life end of the business too. Sooo, what d’ya think? Let me know. Please also take a look at my insurance blog. Insurancemaven.blogspot.com. I have this article posted there, but have some other items there too.

Long Term Care Insurance 2006

2006-01-21T16:39:00.000-05:00

Q)Is there a Long Term Care crisis in America?

A)If it’s not here now it will be soon. The Baby Boom generation begins to turn age 65 in 2011. As it is, Long Term Care is very expensive, and the number one payor, the government, wants ‘out’ as much as possible. As of now 40% of Medicaid payments go towards Nursing Home stays. Prominent Republicans, and now Democrats recognize the importance of having the private sector to pay for the cost of Long Term Care via insurance. Organizations such as the National Association of Health Underwriters, www.nahu.org, have been pursuing the overturning of an amendment by Henry Waxman (D, Ca) that began the prohibition of the Long Term Care Partnership Insurance plans. With the partnership program, if an individual purchases Long Term Care Insurance, and exhausts the benefits of the policy, then they do not have to spend down their assets as they do today. Individuals can maintain on a dollar for dollar basis the amount of assets in their name that the policy was worth. For example, if the policy paid $100k in claims as a maximum benefit, the policy owner could then obtain Medicaid and still have up to 100k in assets to qualify. Democrats did not want this type of program fearing that it would benefit the rich, but now with a looming Long Term Care crisis, they are beginning to recognize the value of this program. Many states now have a partnership program in place in anticipation of federal approval. Even Hilary recognizes this program and has placed her name as a sponsor. After this is passed, the next goal will be approval of an above the line deduction for individual Long Term Care Insurance policies.

The Individual Major Medical Market

2006-01-16T23:27:00.000-05:00

There was an article in FLORIDA UNDERWRITER this month about the rebounding of the Individual Health Insurance market in Florida. I don’t know about you, but this is a market I won’t quit, but the days of me going out to someone’s home to go over an individual policy purchase are about 99.5% over. There is a sales assistant in my office who normally handles this, and many of the quotes are sent via e-mail. Face to face selling is done at the home court. On rare occasions, if someone is nearby our office or my home, a home visit will be done.

Due to the time necessary to sell one policy vs. a group with several lives to cover that has virtually no underwriting for medical, and the decision maker being the owner, one might wonder why write individual health insurance at all. Yet there are a lot of employers that offer no benefits and many self employed people who want a relatively inexpensive policy.

The article in the Underwriter magazine talks about Aetna entering the Individual market. By the way, if you haven’t seen the product yet, it looks quite promising. Like Blue Cross and Humana, it follows Florida guidelines, and is not one of those out of state association plans. These three carriers have proven that you can follow Florida regulations and still offer a well priced plan for the consumer. This article also has a list of the top individual carriers offering coverage in Florida whether they are in state or out of state plans like Golden Rule. Categories are In State plans, out of state plans, and individual HMO plans. In case you are not familiar with this company, Preferred Medical Plans is listed with the highest amount of members, and they do not even write group, or have much of a network in Broward.

Help With Medicare Part D

2005-11-27T16:27:00.000-05:00

The new Medicare Part D program has begun. Future Care Services has already become certified to work with the program offered by Mutual of Omaha. We will be working with other carriers too. There is a separate license as well as certification in order to be able to sell this product. For agents and advisors not familiar with the whole scene, please click on the link below. You can contact Len Harris at 954-772-5992 or at lenharris@futurecare.com.

http://www.cms.hhs.gov/FamilyFirst051118c-N.pdf

Marketing Medicare Part D

2005-11-14T23:03:00.000-05:00

As in all aspects of life, there exist the naysayers. There has been alot of naysing on the Medicare Part D topic, but this just may turn out to be a wonderful addition to the Medicare program. Some of the naysaying has been from insurance agents who are negatory on spending time to sell the newly available products. My comment, there could be some great opportunities for new sales. So become educated about Senior insurance products, especially Part D. For more information, contact FutureCare services. www.futurecare.com

What's Up With the Health Insurance Market?

2005-11-08T22:55:00.000-05:00

I am generally optimisitic about the free market, but wonder just how free our Health Insurance Market really is. Rates keep going up, the media keeps portraying lots of uninsureds, and sometimes I really wonder about who's running some of these companies. Among my biggest concerns is the consolidation of the playing field.

It is happening in other industries too, but we are in this one. More competition leads to better pricing, usually. We all like more choice. America prospered and grew with the Mom and Pop businesses. The big businesses of today all did begin as small struggling enterprises.

Well, that's all great, but what I'd like to see is a more vibrant market where start ups have a place, and where consumers have more choice. What this means state governments, and Federal Government, help us with going after the baddies, but allow a vibrant place to do business, not a restraining one.

HMO's, What Goes Around Comes Around

2005-10-13T21:44:00.000-05:00

Within the past several years, the new buzz word in the group health coverage market and the individual market as well, has become HDHP (High Deductible Health Plan). While this is definitely a legitimate way to market health coverage and develop more cost effective products for consumers, I believe that the carriers have missed another opportunity to achieve the same results without the high out of pocket price tag for consumers.

When the PPO and HMO concepts were first introduced, physician and hospital networks were smaller. This allowed the carriers the ability to negotiate better contracts with these facilities and guarantee them lots of business from their covered members and insureds. Due to demand from some consumers, bad press, and even thrashing from Hollywood movies, the industry moved more toward larger networks and easier access. This is good for some consumers, but not all. The open access, large network concept attracts more utilization and higher priced contracts with providers thus putting great upward pressure on premiums.

Keeping the current trend is recommended, but reintroducing the older models of smaller and more restrictive networks as well as the staff model, is a must. There is too much business being lost without this market, as well as an alternative for the uninsured.

I've been informed by at least one HMO rep to expect this type of market to resurface. I agree.

Any other benefits agents out there, your opinions are appreciated.

Medicare Modernization Act and Group Health

2005-09-25T20:11:00.000-05:00

The new Medicare Drug Act of 2003, AKA the Medicare Modernization Act, begins its enrollment period for beneficiaries on Nov 15, 2005. This is the new Medicare Part D.

If you are an agent who works in the Group Marketplace, then this is a great opportunity to hook up with clients. How often do you hear some of your clients say that you only call on them during renewal time? Well, then this is the perfect time to show how interested you are in their well being all season long. The new Medicare law requires employers to notify their employees of their rights if they offer group health benefits. For further details, please view the National Association of Health Underwriters website. www.nahu.org. There is a link to much needed information to help employers in honoring their obligations.

Medicare Part D

2005-09-06T21:26:00.000-05:00

As I stated in the first post, Medicare Part D is shortly becoming a reality. Go to the National Association Of Health Underwriters (NAHU) website for more information.
www.nahu.org. Some people think putting in this benefit for medicare was great, some think it was not worth the effort. What is your opinion? Let me know if you don't know what this is all about. We will know pretty soon if this is worthwhile to sell since the coverage will be offered privately and at different costs. The plan can be modified from what the government published in its outline of coverage.

The Changing Market

2005-09-04T15:23:00.000-05:00

The marketplace for Senior citizens continues to change. This year new plans and carriers have entered, while others have exited. This fall, the new Part D of Medicare begins the enrollment process. This is the new prescription plan being offered to people eligible for Medicare. Your questions and comments are welcome, as well as your help and advice to our fellow agents. There has been much criticism of this benefit. Please let us know if you understand what it is, and if you have an opinion of whether this will be a worth while offering to your clients. Should you have any other insurance topics of interest to you, please comment.