insurance

Movember: Men's Health Alert

Movember: Men's Health Alert

A few weeks ago, we highlighted October as Breast Cancer Awareness Month, and raised $800 towards research to fight this terrible illness. This month, we turn our attention to the Y-chromosome side:(And watch through to the end for more info on how to help) …

12Dec2014

PresBo lied, Healthcare Died

PresBo lied, Healthcare Died

The right-wingers at CNN have released a video showing - conclusively - that the goal of the ACA ObamaTax was always to destroy the previous system and increase taxes: [Hat Tip: Ace of Spades] …

12Dec2014

Web (in)Security

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<span style="font-family: Verdana,sans-serif;">Yesterday,  I received the following from CoveredCA:</span><b><span style="color: #33cccc; font-family: "Verdana",sans-serif; font-size: 10.5pt;"> </span></b></div>
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<span style="font-size: small;"><b><span style="color: #33cccc; font-family: "Verdana",sans-serif;">New!  iPad Online Application:  Replace "HTTPS" with "HTTP" in URL Address</span></b></span></div>
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<span style="color: #545454; font-family: "Verdana",sans-serif; font-size: small;">If you are using your iPad for enrollment and already have an URL saved to get to the open enrollment online application, you will need to update the URL Hyper Text Transfer Protocol Secure (HTTPS) address by removing the “S” from the “HTTPS” in the URL address so you can access the open enrollment online application. </span></blockquote>
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<span style="font-family: Verdana,sans-serif;"><b>Seriously?</b>   <b>HTTPS is the secure protocol</b> for transmitting information over the internet. HTTP is open text that's readable by anybody who intercepts the transmission.  Nobody should EVER use HTTP for any kind of sensitive work...even Facebook uses HTTPS:</span></div>

Web (in)Security

Yesterday, I received the following from CoveredCA: New! iPad Online Application: Replace "HTTPS" with "HTTP" in URL Address If you are using your iPad for enrollment and already have an URL saved to get to the open enrollment online application, you will need to update the URL Hyper Text Trans…

12Dec2014

GruberGate in 2 1/2 Minutes

GruberGate in 2 1/2 Minutes

[Hat Tip: Ace of Spades] …

12Dec2014

Killing Time

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<span style="font-family: Georgia, Times New Roman, serif;">Obamacare 2015 open enrollment is here. </span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><a href="http://cdn.theatlantic.com/static/mt/assets/science/mailletter.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="103" src="http://cdn.theatlantic.com/static/mt/assets/science/mailletter.gif" width="200" /></a></span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"></span><span style="font-family: Georgia, Times New Roman, serif;">Good news is, the site seems to be working, kind of .........</span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><br /></span><span style="font-family: Georgia, Times New Roman, serif;">Bad news?</span></div>
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<span style="background-color: white; color: #333333; line-height: 23px;"><i><span style="font-family: Georgia, Times New Roman, serif;">Consumers there were having a hard time logging into their accounts, retrieving old passwords and proving they were who they said they were — a process known as identity proofing, which also vexed many people last fall. Some people did complete their applications at the Manassas clinic on Saturday, but it often took them<b> 90 minutes</b>.</span></i></span></blockquote>
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<span style="background-color: white; color: #333333; line-height: 23px;"><b><a href="http://www.nytimes.com/2014/11/16/us/health-insurance-marketplace-opens.html" target="_blank"><span style="font-family: Georgia, Times New Roman, serif;">NY Times</span></a></b></span></div>
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<span style="background-color: white; color: #333333; line-height: 23px;"><span style="font-family: Georgia, Times New Roman, serif;"><br /></span></span><span style="background-color: white; color: #333333; line-height: 23px;"><span style="font-family: Georgia, Times New Roman, serif;">Babies are birthed faster than that.</span></span></div>
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<span style="background-color: white; color: #333333; line-height: 23px;"><span style="font-family: Georgia, Times New Roman, serif;"><br /></span></span><span style="background-color: white;"><span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;">Who has 90 minutes, or longer, to wait to get into their account? And that's on top of queuing up at your local Obamacare office.</span></span></span></div>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;"><i>Similar problems frustrated Lorena Ortiz, 40, of Woodbridge, Va., who tried to switch plans in a conference room at the clinic that Ms. Burwell visited on Saturday. Ms. Ortiz had signed up for coverage in the first enrollment period, but could not remember the password for her account on HealthCare.gov.</i></span></span></blockquote>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;"><i>She and a certified application counselor, Kathleen May,<b> spent an hour trying to retrieve Ms. Ortiz’s old password</b> — even making a call to the HealthCare.gov call center — to no avail. They waited for a new password to come to Ms. Ortiz’s email address, but it never did.</i></span></span></blockquote>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;"><i>Then they tried creating a new account. At first that did not work, either, so they tried using a different email address for Ms. Ortiz. When Ms. Burwell walked into the conference room to greet clients, Ms. May and Ms. Ortiz did not even look up.</i></span></span></blockquote>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;"><i>They finally succeeded in creating a new account for Ms. Ortiz with a different email address. But <b>then they could not link her old health plan to her new account.</b></i></span></span></blockquote>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><i><span style="background-color: white; line-height: 23px;"></span></i></span><br /></div>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;"></span></span><span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;">Smooth ..............</span></span></div>
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<span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;"><br /></span></span><span style="color: #333333; font-family: Georgia, Times New Roman, serif;"><span style="line-height: 23px;">Rube Goldberg would be jealous.</span></span></div>

Killing Time

Obamacare 2015 open enrollment is here. Good news is, the site seems to be working, kind of ......... Bad news? Consumers there were having a hard time logging into their accounts, retrieving old passwords and proving they were who they said they were — a process known as identity proofing, which …

12Dec2014

Helping Sarah Kliff Solve Her Medical Bill Issue

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Former WaPo Wonkblog health policy writer Sarah Kliff is a huge proponent of Obamacare and the expansion of health insurance. She's also been a recipient of excellent employer sponsored insurance benefits. Sarah has a problem. Here is what she tweeted:</div>
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<i>2/20 at 11:27am</i></div>
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<span style="color: #050005;"><u><i><b>Sarah Kliff</b>     <a href="mailto:%E2%80%8F@sarahkliff">‏</a></i></u></span><u><span class="username js-action-profile-name"><s><span style="color: #696669;"><i>@</i></span></s><b><span style="color: #050005;"><i>sarahkliff</i></span></b></span></u></div>
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<i>Received today an $820 medical bill that I was not expecting nor can I decipher because American health care.</i></div>
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<i>2/20 at 11:35am</i></div>
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<i><span style="color: #050005;"><b class="fullname js-action-profile-name show-popup-with-id">Sarah Kliff</b>     <a href="mailto:%E2%80%8F@sarahkliff">‏</a></span></i><span class="username js-action-profile-name"><s><span style="color: #696669;"><i>@</i></span></s><b><span style="color: #050005;"><i><a href="mailto:%E2%80%8F@sarahkliff">sarahkliff</a></i></span></b></span></div>
<div class="tweet original-tweet js-stream-tweet js-actionable-tweet js-profile-popup-actionable js-original-tweet                          with-social-proof focus" data-expanded-footer="<div class="js-tweet-details-fixer tweet-details-fixer">         <div class="entities-media-container js-media-container" style="min-height:0px">     </div>    <div class="js-machine-translated-tweet-container"></div>     <div class="js-tweet-stats-container tweet-stats-container ">     </div>      <div class="client-and-actions">   <span class="metadata">     <span>11:35 AM - 20 Feb 2014</span>               <a class="tweet-geo-text" href="//maps.google.com/maps?z=13&amp;ll=38.8936%2C-77.01458&amp;q=Washington%2C%20DC" target="_blank">from Washington, DC</a>          &middot; <a class="permalink-link js-permalink js-nav" href="/sarahkliff/status/436539675206221824"  tabindex="-1">Details</a>          </span> </div>   </div> " data-feedback-key="stream_status_436539675206221824" data-item-id="436539675206221824" data-name="Sarah Kliff" data-screen-name="sarahkliff" data-tweet-id="436539675206221824" data-user-id="19734832" data-you-block="false" data-you-follow="true" style="text-align: justify;">
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<i>I've never tried to negotiate down a medical bill before, but excited for this new personal and professional adventure!</i> </div>
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<span class="metadata">Sarah, please allow me to help you out.</span><br />
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<span class="metadata">First, you can't blame the American health care system as the reason for not being able to understand the bill. It's probably an issue with the coding - the little thing called ICD-9 soon to be ICD-10 that you<a href="https://www.blogger.com/null" target="_blank"> wrote about just a week ago</a>. If the coding was incorrect then the insurance company might have pended the claim until additional information was received.</span></div>
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<span class="metadata">Second, since the bill came from the provider my guess is that the $840 probably is retail charges. Having insurance provides you with a discount on the service. There are a few other things that could have caused you to receive the bill.</span></div>
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<li><span class="metadata">Could it be that the service isn't covered under your plan? </span></li>
<li>Could it be that you went to a non-network provider?</li>
<li><span class="metadata">Could it be because your plan has a deductible that you haven't met yet? </span></li>
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<span class="metadata">You need to find an EOB that matches up to the bill you received. You should also review your SBC to make sure that the healthcare service was covered under the plan. </span><br />
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These are the questions a professional advisor would be asking you. From there we would take your bill and your EOB and work with your provider and insurance company to have the claim fixed. It is NOT an easy process - something I'm sure you are finding out.</div>
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Helping Sarah Kliff Solve Her Medical Bill Issue

Former WaPo Wonkblog health policy writer Sarah Kliff is a huge proponent of Obamacare and the expansion of health insurance. She's also been a recipient of excellent employer sponsored insurance benefits. Sarah has a problem. Here is what she tweeted: 2/20 at 11:27am Sarah Kliff ‏@sarahkliff R…

06Dec2014

My new article is up...

My new article is up...

At Answers.com:"A Business Owners Policy offers a reasonably priced alternative to buying insurance coverage ala carte. By pre-packaging common benefits, and offering appropriate customization options, BOP's can save companies money and administrative headaches." …

06Dec2014

Oh, sure - NOW they tell us!

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<a href="https://blogger.googleusercontent.com/img/proxy/AVvXsEiIlMuVqVA57jT3eKUrwt-sRcXN7hqbnpvFKKmguRgu3Yu3BJ1l4eL916lu0YAJMW8ot59P7BxYy5bp2GyZDzvQSY7m44fmeRSKHhc6uXhPj6s3A9qgJTkr1hvYqQGPGE0Qpq7au0e2U5ZtX_OfGzJRdcvRl5PGKdNN4Dxy6Q0H2g=" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="300" src="http://ritakml.info/wp-content/uploads/2013/12/PiracyPicture.jpg" width="400" /></a></div>
<span style="font-family: Arial,Helvetica,sans-serif;">As we've long noted, the ObamaTax Exchange sites are a veritable <a href="https://www.blogger.com/null" target="_blank">treasure trove of ID-theft opportunities</a>. Turns out, though, we may have <i><b>under</b></i>-estimated the breadth and scope:<br /><br />"<a href="https://www.blogger.com/null" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">Security experts worried that 35 state health exchange websites were vulnerable to hackers and were rated as "high risk" for security problems before ObamaCare's launch</span></i></a>"<br /><br />Really? That's a tad over 60% of the Exchanges, and they were <u><b>known</b></u> to be high-risk? Thanks, Ms Shecantbeserious, for the heads' up.</span></div>

Oh, sure - NOW they tell us!

As we've long noted, the ObamaTax Exchange sites are a veritable treasure trove of ID-theft opportunities. Turns out, though, we may have under-estimated the breadth and scope:"Security experts worried that 35 state health exchange websites were vulnerable to hackers and were rated as "high risk" f…

06Dec2014

Dabney Coleman gets...

Dabney Coleman gets...

The last laugh: …

06Dec2014

TRAGIC Wins Shallow Victory in SHBP Battle

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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkn6KVT5urhkwwOOdFzN1vpiiVVe8sD23oDIYB52BG8VJI9liQ2NKaPw-DFl6orSxDKEYqbktVAfksiz37XAjTk3Uh7ELwGotBnKJEoAvUnqZbxco5G9otP8cu8LiSigEFSH6GSghfwZ4/s1600/tragic+shbp.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkn6KVT5urhkwwOOdFzN1vpiiVVe8sD23oDIYB52BG8VJI9liQ2NKaPw-DFl6orSxDKEYqbktVAfksiz37XAjTk3Uh7ELwGotBnKJEoAvUnqZbxco5G9otP8cu8LiSigEFSH6GSghfwZ4/s1600/tragic+shbp.jpg" width="457" /></a>T.R.A.G.I.C, the teacher group we <b><a href="https://www.blogger.com/null" target="_blank">blogged about in January</a></b> formed to protest #Obamacare changes to the Georgia SHBP (State Health Benefit Plan) won a shallow victory. State and local government groups and school systems that use SHBP as their health plan received an email today, announcing <b><a href="https://www.blogger.com/null" target="_blank">retroactive changes</a></b> in the health plan.  </div>
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Readers may recall the uproar over the loss of copay plans and the announcement that BCBSGA was awarded the contract as the sole claims administrator for the health plan that covers 650,000 Georgia residents.</div>
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But Blue Cross was awarded the business in August of 2013 and there were no protests then.</div>
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During October SHBP particpants were given details on the new benefit packages. It was obvious there were no copay options. We had three choices, Bronze, Gold and Silver. All were high deductible HRA plans.</div>
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Where was TRAGIC then?</div>
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Crickets chirping</div>
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The state caved and agreed to overlay a doctor copay RETROACTIVELY to January 1, 2014. Yeah, that's going to be fun when Blue has to calculate refunds and then figure out if they restore dollars to an HRA or pay them to the policyholder.</div>
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So why is this a shallow victory?</div>
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The new copay's only apply to ER and doc visits.</div>
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Copay's do not count toward the major medical deductible.</div>
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SHBP participants still have the lousy Blue Cross POS limited provider network.</div>
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The Rx plan is still managed by Express Scripts. The amounts paid for Rx copay's still do not count toward the major medical deductible or OOP (out of pocket) limit.</div>
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Like I said. Shallow victory. The people behind TRAGIC fought to have doc copay's reinstated and completely missed the big picture.</div>
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Now that is tragic.</div>
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TRAGIC Wins Shallow Victory in SHBP Battle

T.R.A.G.I.C, the teacher group we blogged about in January formed to protest #Obamacare changes to the Georgia SHBP (State Health Benefit Plan) won a shallow victory. State and local government groups and school systems that use SHBP as their health plan received an email today, announcing retroact…

06Dec2014

Cavalcade of Risk #223: Call for submissions

Cavalcade of Risk #223: Call for submissions

Bob Wilson hosts next week's edition. Entries are due by Monday (the 8th).To submit your risk-related post, just click here to email it.You'll need to provide:■ Your post's url and title■ Your blog's url and name■ Your name and email■ A (brief) summary of the postPLEASE remember: ONLY posts t…

05Dec2014

Moving Goalposts (Again)

<div class="separator" style="clear: both; text-align: center;"><a href="https://jazzroc.files.wordpress.com/2008/11/goalposts.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="118" src="https://jazzroc.files.wordpress.com/2008/11/goalposts.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">So it appears that erstwhile Senate Majority Leader Harry Reid has conveniently forgotten the President's <i><b>explicit</b></i> promise to lower health insurance costs <a href="http://insureblog.blogspot.com/2010/03/health-insurance-premiums-drop-3000.html" target="_blank">by 3000%</a>. Today, Mr Reid was thrilled that:<br /><br />"<a href="http://thehill.com/blogs/floor-action/senate/225975-reid-lauds-low-healthcare-cost-increase" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">Spending on healthcare grew in 2013 at the lowest rate ever recorded</span></i></a>."<br /><br />Which, while nice, rather misses the point: growing slower <i><b>≠</b></i> decreasing. Shame on you, Mr Reid.</span></div>

Moving Goalposts (Again)

So it appears that erstwhile Senate Majority Leader Harry Reid has conveniently forgotten the President's explicit promise to lower health insurance costs by 3000%. Today, Mr Reid was thrilled that:"Spending on healthcare grew in 2013 at the lowest rate ever recorded."Which, while nice, rather misse…

04Dec2014

(No) Need to Know

<div class="separator" style="clear: both; text-align: center;"><a href="https://annabelfrage.files.wordpress.com/2014/04/for-your-eyes-only-stamp.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="140" src="https://annabelfrage.files.wordpress.com/2014/04/for-your-eyes-only-stamp.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Alt title: "<i>We could tell you, but then we'd have to kill you</i>."<br /><br />The story:<br /><br />"<a href="http://www.lifehealthpro.com/2014/12/02/3-things-you-cant-know-about-irs-ppaca-problems?eNL=547e46b3160ba0104fd05e28&utm_source=HCRW&utm_medium=eNL&utm_campaign=LifeHealthPro_eNLs&_LID=107687085" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">[O]fficials at the Treasury Inspector General for Tax Administration ... are giving members of the public just enough information about a TIGTA review of IRS security testing to suggest that there might be cause for concern</span></i></a>."<br /><br />That's the take-away from security audits of the 404Care.gov site (which many of us have been using of late). Aside from the usual spinning wheels (both visual and metaphorical), there's a heightened sense that the site itself is just a bit, well, creepy: this morning, I met with a client who received a text message on her cell last Friday, admonishing her to complete her enrollment (which we're in the process of doing). But the overarching concern is that the site is unsecure, and the latest dope from DC does little to assuage this:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">TIGTA officials have put the results of their review in a heavily redacted report.</span></i>"</span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;">Just <i><b>how</b></i> redacted, you ask? Well, here's a sample 1000 words:</span><br /><br /><div class="separator" style="clear: both; text-align: center;"><span style="font-family: Arial,Helvetica,sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYm552kTKBl5KsPqfBk1W42ftBcMcrN91U2T_0wLuaUt47_f1q63XzbYr2DNQvrRGLnx5nU_8eeW9ESoMLXyCAN3XDVVY1lkqGzWnoT6PXF9U0Wm4Fn37ZvaGKFdHGPA3z7VbUfYUKfik/s1600/404care+screencap.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYm552kTKBl5KsPqfBk1W42ftBcMcrN91U2T_0wLuaUt47_f1q63XzbYr2DNQvrRGLnx5nU_8eeW9ESoMLXyCAN3XDVVY1lkqGzWnoT6PXF9U0Wm4Fn37ZvaGKFdHGPA3z7VbUfYUKfik/s1600/404care+screencap.jpg" width="239" /></a></span></div><div style="text-align: center;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: x-small;"><span style="color: red;"><i><b>[click image to embiggen] </b></i></span></span></span></div><br /><span style="font-family: Arial,Helvetica,sans-serif;">And that's just the highlights. Even the Table of Contents page is edited like that, and it only gets worse. One wonders, not unreasonably, what the folks at HHS and their partners are so concerned about letting us know. After all, their own resident guru <a href="http://insureblog.blogspot.com/2014/11/obamacare-moments-of-honesty.html" target="_blank">thinks we're too stupid</a> to understand it, anyway.<br /><br />And this statement, intended to make us feel all warm and fuzzy, does nothing to allay that sense of foreboding:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">Our concern is that the expected results should be accurate and complete in order for the testers to fully understand what they are testing and for the testers to be able to adequately compare the actual results to the expected results</span></i>."<br /><br />Un-hunh.</span></div>

(No) Need to Know

Alt title: "We could tell you, but then we'd have to kill you."The story:"[O]fficials at the Treasury Inspector General for Tax Administration ... are giving members of the public just enough information about a TIGTA review of IRS security testing to suggest that there might be cause for concern."T…

03Dec2014

Patrick Hits the Big Time (Once Again)

Patrick Hits the Big Time (Once Again)

Co-blogger Pat is once again featured at The Federalist, with his latest take on why rate increases are mist definitely built-in to O'Care. …

02Dec2014

Breaking News

Breaking News

This just in from the geniuses at the GAO.FLASH!As a result of Obamacare, Blue Cross expanded their market share in the majority of states at the expense of other carriers.Long version here.No (poop). …

01Dec2014

More GruberGate Cannon-fire

<div class="separator" style="clear: both; text-align: center;"><a href="https://img1.etsystatic.com/005/0/6612690/il_fullxfull.385791005_kmb6.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="111" src="https://img1.etsystatic.com/005/0/6612690/il_fullxfull.385791005_kmb6.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">As we've noted<a href="http://insureblog.blogspot.com/2010/01/herr-gruber-i-know-nussing.html" target="_blank"> for a while</a>, Herr Dr J Gruber has managed to talk himself into quite a corner. While making big coin (for apparently small work) designing and implementing the ObamaTax, casually demeaning the poor, feckless congresscritters who voted for it (that we might then learn what's in it), and then doubling down on both, he's managed to raise quite a few hackles.<br /><br />Once of his most vociferous - and successful - hacklers has been FoIB Michael cannon (oh, yeah, he's also the Cato Institute's director of health policy studies). Today, Michael has a special treat in store:<br /><br /><a href="http://www.cato.org/blog/grubergate-mini-series" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;"><span style="font-size: large;">Grubergate, the Mini-Series</span></span></i></a><br /><br />Presented in eight parts (from Stupid Voters through What the Future Holds), you'll be entertained and enraged (likely in equal measure). It's the Don't Miss hit of the season!</span></div>

More GruberGate Cannon-fire

As we've noted for a while, Herr Dr J Gruber has managed to talk himself into quite a corner. While making big coin (for apparently small work) designing and implementing the ObamaTax, casually demeaning the poor, feckless congresscritters who voted for it (that we might then learn what's in it), an…

01Dec2014

Obamacare's Bill of Goods: Subprime Insurance at Higher Costs

<br />The ACA promised us <a href="http://insureblog.blogspot.com/2010/03/health-insurance-premiums-drop-3000.html" target="_blank">$2500 per family savings</a> and better benefits. The reality is we are going to pay thousands of dollars more for our care and thousands of dollars more for our premiums. This is because of obscure provisions called the Applicable Percentage Table and the Annual Limitation on Cost Sharing. You’ve almost certainly never heard of these, yet both can deprive you of care and take a lot of money from your wallet.<o:p></o:p><br /><br /><b><u>Your Benefits Will Be Getting Worse</u></b><o:p></o:p><br /><br />The ACA sets limits on cost sharing to<b><i> </i></b><i><span style="mso-bidi-font-weight: bold;">protect</span></i> individuals from excessive out-of-pocket expenses. One of the concerns of ACA supporters revolved around high out-of-pocket limits for consumers. This amount, set at $6350 per person in 2014, was one of the largest objections individuals had when deciding what plan to purchase. Even with a subsidized premium, having to potentially come up with such a large percentage of their income to cover claims made coverage and care unaffordable. <o:p></o:p><br /><br />The Annual Limitation on Cost Sharing requires that these high out-of-pocket limits be updated annually. The formula for determining the new Maximum Out-of Pocket (MOOP) is based on the increase in average premiums per person for health insurance coverage. That means if premiums increase annually the MOOP will go up. For 2015 the premium adjustment percentage is 4.21% which increases how much you spend on medical care to $6600. That’s $250 more out of your pocket.<o:p></o:p><br /><br />According to the <a href="http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CB4QFjAA&url=http%3A%2F%2Faspe.hhs.gov%2Fhealth%2Freports%2F2014%2FRateReview%2Frpt_RateReview.pdf&ei=mPQ7VMumMITgsATp44GwBA&usg=AFQjCNH609ZPhWwDvx_14o3HQ6eVGv7zag&sig2=keSZ0eU1CZcXOeV7eJGrMg&bvm=bv.77412846,bs.1,d.cGU"><span style="color: blue;">September 2014 HHS Rate Review Annual Report</span></a> small group health insurance premiums have increased substantially since 2008. As long as it continues we will see a higher MOOP every year. Worse yet, the growth rate of insurance premiums are still rising faster than average income and inflation. The result is clear: consumers will have worse insurance every year. The chart below shows what will happen to the MOOP at a (lower than average) 4% premium growth rate.<br /><span style="mso-no-proof: yes;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"><v:stroke joinstyle="miter"><v:formulas><v:f eqn="if lineDrawn pixelLineWidth 0"><v:f eqn="sum @0 1 0"><v:f eqn="sum 0 0 @1"><v:f eqn="prod @2 1 2"><v:f eqn="prod @3 21600 pixelWidth"><v:f eqn="prod @3 21600 pixelHeight"><v:f eqn="sum @0 0 1"><v:f eqn="prod @6 1 2"><v:f eqn="prod @7 21600 pixelWidth"><v:f eqn="sum @8 21600 0"><v:f eqn="prod @7 21600 pixelHeight"><v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"></v:path></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas></v:stroke></v:shapetype></span><br /><div class="separator" style="clear: both; text-align: center;"><span style="mso-no-proof: yes;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiH7IzZ-9aNGenfERZpOaIjWNp0dtvn59U5jmB0S-fzIQ-ti7hinQEmyg_RAt5Zi6seLKlMPCY0RQhYm5V_ckVHmUTfC9mjotmTfV_rc3hYrq2xGef_D7mLfJAKbIGgfioeCPT2OVAFQh8/s1600/MOOP+at+4+percent+final.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiH7IzZ-9aNGenfERZpOaIjWNp0dtvn59U5jmB0S-fzIQ-ti7hinQEmyg_RAt5Zi6seLKlMPCY0RQhYm5V_ckVHmUTfC9mjotmTfV_rc3hYrq2xGef_D7mLfJAKbIGgfioeCPT2OVAFQh8/s1600/MOOP+at+4+percent+final.jpg" width="320" /></a></span></div><span style="mso-no-proof: yes;"></span>Under this scenario by 2018 an Obamacare-compliant plan will have an out-of-pocket maximum that is $1,000 more than it is today. Worse yet, the plans that are currently considered Silver plans will now be Gold plans. This is because of the "Actuarial Value Drift" my friend Bob Graboyes pointed out in this <a href="http://insureblog.blogspot.com/2014/10/no-you-cant-keep-your-plan.html"><span style="color: blue;">video and article</span></a>. <o:p></o:p><br /><br /><b><u>You Will Have To Pay More For Your Insurance Plan</u></b><o:p></o:p><br /><br />The percentage of your income you must pay for insurance will likely increase every year, too. When the rate of insurance premiums increases more than the rate of incomes another ACA provision is triggered. This is the Applicable Percentage of Income adjustment. <o:p></o:p><br /><br />In 2014 a family of four earning $59,625 is paying $4,800 for the baseline plan. Because of this adjustment, by 2019 this family will likely pay $5,725 for the new baseline plan. In six years this family will be paying $1,000 more for insurance premiums per year.<o:p></o:p><br /><br />The Congressional Budget Office explained in May of 2011 how these indexing provisions work, and recently CMS released the chart below showing how people will pay a greater percentage of their income for insurance next year.<o:p></o:p><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhziiIzrInDoPvOmAYHahjH0_-fXTTeO8HaelHNMFIXSKpRAuTIi2_pTWQERXh8Ck3yUrF7bZ1vKH92pAXoXDy82diQAzfHOc_wZ8j5qgxaMGakCeMRk9uP2lBR7YgL6BsJPfnefVM9As/s1600/Applicable+Percentage+of+Income+2014+vs+2015.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhziiIzrInDoPvOmAYHahjH0_-fXTTeO8HaelHNMFIXSKpRAuTIi2_pTWQERXh8Ck3yUrF7bZ1vKH92pAXoXDy82diQAzfHOc_wZ8j5qgxaMGakCeMRk9uP2lBR7YgL6BsJPfnefVM9As/s1600/Applicable+Percentage+of+Income+2014+vs+2015.jpg" width="400" /></a></div><div align="center" style="text-align: center;"><span style="mso-no-proof: yes;"><v:shape id="Picture_x0020_3" o:spid="_x0000_i1025" style="height: 253.5pt; mso-wrap-style: square; visibility: visible; width: 417.75pt;" type="#_x0000_t75"> <v:imagedata o:title="" src="file:///C:\Users\paule\AppData\Local\Temp\msohtmlclip1\01\clip_image002.jpg"></v:imagedata></v:shape></span><o:p></o:p></div><br />These provisions bring to mind the subprime loan catastrophe that happened not long ago in the mortgage world. Consumers were sold low-interest loans and given high mortgage limits. Lenders didn't explain that the interest rates and payments would increase over time. The ACA's Applicable Percentage Table and Annual Limitation on Cost Sharing provisions work the same way. Over time you will pay more and get less. It's time these ACA shenanigans were brought to the forefront of the discussion.<br /><br />Because no one can afford to pay more for insurance that keeps getting worse.

Obamacare's Bill of Goods: Subprime Insurance at Higher Costs

The ACA promised us $2500 per family savings and better benefits. The reality is we are going to pay thousands of dollars more for our care and thousands of dollars more for our premiums. This is because of obscure provisions called the Applicable Percentage Table and the Annual Limitation on Cost S…

01Dec2014

Helpful Thanksgiving ICD-10 Codes

<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">As co-blogger Kelley last mentioned <a href="http://insureblog.blogspot.com/2014/09/headline-chuckle-of-dayfirm-date-for.html" target="_blank">a couple of months ago</a>, the "new and improved" ICD-10 codes are on the way (maybe). And just in time, too; the folks at <a href="http://www.healthdatamanagement.com/" target="_blank">Health Data Management</a> have helpfully compiled a list of handy dandy ICD-10 codes specifically geared for Thanksgiving:<br /></span></div><div class="separator" style="clear: both; text-align: center;"><a href="http://cdn.healthdatamanagement.com/media/gallery/p197d69ncd10iu94na241ob31br17.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="213" src="http://cdn.healthdatamanagement.com/media/gallery/p197d69ncd10iu94na241ob31br17.jpg" width="320" /></a></div><br /><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">"<i><b><span style="font-family: Times,"Times New Roman",serif;"><a href="http://www.healthdatamanagement.com/gallery/handy-icd-10-codes-for-the-thanksgiving-holiday-49297-1.html" target="_blank">Ah, the turkey is roasting and the potatoes are boiling. And Cousin Carl just chopped the end of his finger off while preparing the veggie tray</a></span></b></i>."</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br />Click through for the whole list.</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">And Happy Thanksgiving to you and yours!</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-size: x-small;"><span style="color: red;"><i><b><span style="font-family: Arial,Helvetica,sans-serif;">[Hat Tip: FoIB <a href="http://more-distractible.org/#about" target="_blank">Dr Rob</a>]</span></b></i></span></span></div>

Helpful Thanksgiving ICD-10 Codes

As co-blogger Kelley last mentioned a couple of months ago, the "new and improved" ICD-10 codes are on the way (maybe). And just in time, too; the folks at Health Data Management have helpfully compiled a list of handy dandy ICD-10 codes specifically geared for Thanksgiving:"Ah, the turkey is roasti…

27Nov2014

"I forgot"

<div class="separator" style="clear: both; text-align: center;"><a href="http://pastparallelpaths.files.wordpress.com/2014/06/bb-belushi.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="76" src="http://pastparallelpaths.files.wordpress.com/2014/06/bb-belushi.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">It's hard to beat this Steve Martin excuse:</span></div><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;">"<i><span style="font-family: Times,"Times New Roman",serif;"><a href="http://snltranscripts.jt.org/77/77imono.phtml" target="_blank">You.. can be a millionaire.. and never pay taxes! You can be a millionaire.. and never pay taxes! You say.. "Steve.. how can I be a millionaire.. and never pay taxes?" First.. get a million dollars. Now.. you say, "Steve.. what do I say to the tax man when he comes to my door and says, 'You.. have never paid taxes'?" Two simple words. Two simple words in the English language: "I forgot!</a></span></i>"</span><br /><span style="font-family: Arial,Helvetica,sans-serif;"></span></blockquote><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Funny, but what does this have to do with insurance?<br /><br />Glad you asked.<br /><br />The folks at LifeHealthPro have complied a list of <a href="http://www.lifehealthpro.com/2014/11/25/5-great-individual-ppaca-mandate-exemption-excuses?eNL=5475002e150ba00561a66adf&utm_source=HCRW&utm_medium=eNL&utm_campaign=LifeHealthPro_eNLs&_LID=107687085" target="_blank">the 5 best excuses</a> one might use to duck the (Evil) Individual Mandate. Here's a sampling:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">I don't earn enough to even file a return</span></i>."<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">Missed it </span></i><span style="font-family: Times,"Times New Roman",serif;"><span style="font-family: Arial,Helvetica,sans-serif;">[the cut-off date]</span></span><i><span style="font-family: Times,"Times New Roman",serif;"> by <b>that</b> much!</span></i>"<br /><br />And this gem:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">I get my care from Drs Tonto and Geronimo</span></i>."<br /><br />Jake must be jealous.</span></div>

"I forgot"

It's hard to beat this Steve Martin excuse:"You.. can be a millionaire.. and never pay taxes! You can be a millionaire.. and never pay taxes! You say.. "Steve.. how can I be a millionaire.. and never pay taxes?" First.. get a million dollars. Now.. you say, "Steve.. what do I say to the tax man when…

26Nov2014

Cavalcade of Risk #222: Gratefully risky

Cavalcade of Risk #222: Gratefully risky

Van Mayhall hosts the pre-Thanksgiving round-up of risk-related posts. As usual,Van does a terrific job of tying together seemingly unrelated items, providing a fantastic narrative.Thanks, Van! …

26Nov2014

Sprechen sie Deutsch?

More proposed Obamacare rules to improved the customer experience.<br /><div class="separator" style="clear: both; text-align: center;"><a href="http://moodyeyeview.files.wordpress.com/2013/11/hello-my-name-is-peggy.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="133" src="http://moodyeyeview.files.wordpress.com/2013/11/hello-my-name-is-peggy.jpg" width="200" /></a></div><br /><blockquote class="tr_bq"><i>The Centers for Medicare & Medicaid Services Nov. 21 issued a massive 324-page notice of proposed rulemaking aimed at improving the consumer experience in the health insurance marketplace by increasing pricing and plan transparency and making information more accessible to consumers, among other changes.</i></blockquote><blockquote class="tr_bq"><i>Key among the controversial proposals is the requirement that all exchanges, qualified health plan insurers, and Web-based brokers and agents provide telephonic interpreter services in at least 150 languages. That requirement <b>does not extend to navigators and assisters,</b> although HHS is asking for public comment on whether it should.</i></blockquote><b><a href="http://www.insurancebroadcasting.com/news/eba_hc_health_reform/proposed-aca-changes-could-offer-navigators-unfair-advantage-over-brokers-2744866-1.html?utm_campaign=insurance%20newscast%20daily-nov%2025%202014&utm_medium=email&utm_source=newsletter&ET=broadcasting%3Ae3397826%3A3500486a%3A&st=email" target="_blank">Insurance Broadcasting</a></b><br /><br />Seriously?

Sprechen sie Deutsch?

More proposed Obamacare rules to improved the customer experience.The Centers for Medicare & Medicaid Services Nov. 21 issued a massive 324-page notice of proposed rulemaking aimed at improving the consumer experience in the health insurance marketplace by increasing pricing and plan transparency an…

25Nov2014

Hunh: CCC's no more

<div class="separator" style="clear: both; text-align: center;"><a href="http://i.bnet.com/blogs/homer_doh.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="129" src="http://i.bnet.com/blogs/homer_doh.png" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Had a "d'oh!" moment when I received this in email:<br /><br />"<a href="http://broker.uhc.com/articleView-14612?ETMID=20349&ETSubscriberKey=hstern@centervilleinsurance.com&ETEmailName=BKR_dynamic_11-26-14&ETJobID=51785421&ETHealthPlan=OHIO:SOUTHWEST&ETLinkAlias=Creditable+Coverage+Certificates+Requirement+Update&ETUABroker=False" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">[G]eneration of HIPAA Certificates of Creditable Coverage (CoCC) upon member termination will no longer be necessary because the pre-existing condition limitations are fully eliminated in 2015</span></i></a>."<br /><br />Since 1997, group plans have had to issue Certificates of Creditable Coverage when a covered employee (and/or dependent) dropped off. They were essentially "hall passes" to the next group plan, so that one wasn't subject to pre-existing condition limitations.<br /><br />[<i>ed: Contrary to popular belief, they were of no avail when moving from group to individual plans - but <b>were</b> applicable when moving from individual to group. Clear as mud, no?</i>]<br /><br />These cert's have been part of the landscape for so long now that it just didn't occur to me that, once the ObamaTax is in full swing, they're no longer necessary.<br /><br />Think I'll miss the little buggers.</span></div>

Hunh: CCC's no more

Had a "d'oh!" moment when I received this in email:"[G]eneration of HIPAA Certificates of Creditable Coverage (CoCC) upon member termination will no longer be necessary because the pre-existing condition limitations are fully eliminated in 2015."Since 1997, group plans have had to issue Certificates…

25Nov2014

Missing the Mark, MVNHS©-style

<div class="separator" style="clear: both; text-align: center;"><a href="http://howtoberichandhappy.com/site/wp-content/uploads/2010/12/Archery-target.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="135" src="http://howtoberichandhappy.com/site/wp-content/uploads/2010/12/Archery-target.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Last month, we questioned whether the Much Vaunted National Health System© <a href="http://insureblog.blogspot.com/2014/10/saving-mvnhs_23.html" target="_blank">was worth saving</a> (assuming it <b>could</b> be, of course). Thanks to <a href="https://plus.google.com/107944168110103829411/about?rel=author%3E+Bob%20Vineyard" target="_blank">co-blogger Bob</a>, we have more evidence supporting the "No" position:<br /><br />"<a href="http://www.bbc.com/news/health-30115493?print=true" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">The NHS in England has repeatedly missed a key target for rapidly treating cancer patients ... Cancer charities said thousands of patients were being failed</span></i></a>."<br /><br />Of course, that pre-supposes that the actual goal was saving lives, not pounds sterling.<br /><br />So how does that translate into real-world, real-people numbers?<br /><br />Well:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">[O]f the 33,404 people who started cancer treatment between July and September, more than 5,500 were not treated within the 62 day target</span></i>."<br /><br />Depending on the3 type and stage of the cancer, that two months can very easily mean the difference between life and death, lumpectomy or double mastectomy. And it's not getting any better for our Cousins Across the Pond:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">These breaches have become a trend and they are worsening, which is why urgent action must be taken to support the NHS</span></i>" according to Sarah Woolnough, from Cancer Research UK.<br /><br />It's also worth noting that the shortage of radiologists, which has exacerbated the problem:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">Patients are waiting too long for imaging test results</span></i>."<br /><br />Coming soon to an ObamaPlan near you.</span></div>

Missing the Mark, MVNHS©-style

Last month, we questioned whether the Much Vaunted National Health System© was worth saving (assuming it could be, of course). Thanks to co-blogger Bob, we have more evidence supporting the "No" position:"The NHS in England has repeatedly missed a key target for rapidly treating cancer patients ... …

25Nov2014

Blast from the Past

<div class="separator" style="clear: both; text-align: center;"><a href="http://www.insuranceforus.com/2/Solutions-from-MSsIC-w-P3_files/v3_slide0001_image001.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="36" src="http://www.insuranceforus.com/2/Solutions-from-MSsIC-w-P3_files/v3_slide0001_image001.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">I first became a fan of Medical Savings Accounts (since evolved to Health Savings Accounts) way back in 1992, when they were first introduced by Golden Rule Insurance. GR's president at the time, <a href="http://en.wikipedia.org/wiki/J._Patrick_Rooney" target="_blank">Pat Rooney</a> (whose family, if I recall correctly, founded the company), eventually left to found <i>another</i> carrier, Medical Savings Insurance Company (MSIC), which marketed MSA's exclusively.<br /><br />In 2008, <a href="http://www.in.gov/idoi/files/Medical_Savings_Press_Release.doc" target="_blank">MSIC went into receivership</a> to protect its over 6,000 policyholders. Having fallen on hard times, the company faced substantial financial hurdles. On the bright side (and in a bit of irony), policyholders were transferred to Golden Rule.<br /><br />Reason I bring this up is that I had written a couple cases with MSIC back in the day, and over the weekend I received a "<i><span style="font-family: Times,"Times New Roman",serif;">Notice of Hearing</span></i>" for final liquidation of the firm's assets.<br /><br />Or not:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">[T]he Liquidator reports that all assets and/or property ... have now been recovered ... does not have sufficent assets ... no MSIC assets are available for payment</span></i>."<br /><br />Shorter: if you think MSIC owed you anything, don't count on it.<br /><br />The better, more positive lesson for me, though, is that this doesn't affect policyholders: the system worked, and they weren't left holding the bag.<br /><br />Well, at least not by the Indiana Department of Insurance.</span></div>

Blast from the Past

I first became a fan of Medical Savings Accounts (since evolved to Health Savings Accounts) way back in 1992, when they were first introduced by Golden Rule Insurance. GR's president at the time, Pat Rooney (whose family, if I recall correctly, founded the company), eventually left to found another …

24Nov2014

Chicken Soup for the Health Care Policy

<div class="separator" style="clear: both; text-align: center;"><a href="http://www.finecooking.com/CMS/uploadedImages/Images/Cooking/Articles/Issues_91-100/051092w-matzo-ball-soup_xlg.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="116" src="http://www.finecooking.com/CMS/uploadedImages/Images/Cooking/Articles/Issues_91-100/051092w-matzo-ball-soup_xlg.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">We've long documented the utter failure of nationalized "health care" schemes to rein in costs any more efficiently than our previous, market-based system. From <a href="http://insureblog.blogspot.com/2014/10/saving-mvnhs_23.html" target="_blank">Jolly Old</a> to <a href="http://insureblog.blogspot.com/2014/10/mvnhs-and-canuckcare-update.html" target="_blank">The Great White</a>, failure is, in fact, an option.<br /><br />And so it goes in the Holy Land, as well:<br /><br />"<a href="http://www.jpost.com/Israel-News/Health/With-growing-privatization-in-healthcare-insurance-costs-reach-new-high-382606?utm_source=dlvr.it&utm_medium=twitter" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">The cost per household for supplementary health insurance from one’s public health fund and for commercial (private) health insurance increased significantly – by 8.5 percent – in 2013, compared to only 4% in 2012</span></i></a>."<br /><br />Catch that? Even (especially?) in nationalized systems, "supplemental" coverage is <i>de rigueur</i> . And what does that portend for the Israeli (to name just one) system?<br /><br />Well:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">This is a likely sign that public insurance coverage is not regarded by citizens as enough and that accessibility to care from the public health funds and hospitals is declining</span></i>."<br /><br />No kidding.<br /><br /><span style="font-size: x-small;"><span style="color: red;"><i><b>[Hat Tip: FoIB <a href="http://themoderatevoice.com/author/holly" target="_blank">Holly R]</a></b></i></span></span></span></div>

Chicken Soup for the Health Care Policy

We've long documented the utter failure of nationalized "health care" schemes to rein in costs any more efficiently than our previous, market-based system. From Jolly Old to The Great White, failure is, in fact, an option.And so it goes in the Holy Land, as well:"The cost per household for supplemen…

24Nov2014

MVP Struggling - Part 2

<div class="separator" style="clear: both; text-align: center;"><a href="http://www.ballardspahr.com/people/attorneys/~/media/Images/People/Attys/Philadelphia%20PA/anderson_kurt_010.ashx" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="140" src="http://www.ballardspahr.com/people/attorneys/~/media/Images/People/Attys/Philadelphia%20PA/anderson_kurt_010.ashx" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">A few days ago, we broached the subject of Minimum Value Plans, and their potential role in mitigating group health insurance costs. <a href="http://www.insureblog.blogspot.com/2014/11/mvp-struggling-part-1.html" target="_blank">In that post</a>, co-blogger Nate shared with us a TPA's view of how this might play out.<br /><br />At the time this whole concept hit my radar, I was invited to interview a benefits attorney with expertise in this area for another perspective. <a href="https://www.blogger.com/www.ballardspahr.com%20(http://www.ballardspahr.com/people/attorneys/anderson_kurt.aspx)" target="_blank">Kurt Anderson</a> has specialized in employee benefit, and especially <a href="http://insurance.answers.com/health-insurance/aca-advanced-self-funding" target="_blank">ERISA</a>, plans for the past quarter century, and is co-author of a <a href="http://www.amazon.com/Employers-Guide-Health-Care-Reform/dp/1454842865/ref=sr_1_1?ie=UTF8&qid=1416346848&sr=8-1&keywords=employer%27s+guide+to+health+care+reform+wolters" target="_blank">book on health care reform</a>.<br /><br />Kurt, like myself, believes that insurance should really focus more on risk-based, catastrophic events (such as illnesses or injuries) and less on predictable, routine items (such as preventive care, vaccines, etc). In fact, he offered this absolutely terrific take on the problem with mandated benefits and the ACA:<br /><br />"<i><span style="font-family: Times,"Times New Roman",serif;">If you can budget for it, you shouldn't have to purchase insurance for it</span></i>."<br /><br />This <a href="http://insureblog.blogspot.com/2010/09/obamacare-roll-out-good-or-bad.html" target="_blank">comports <b>precisely</b></a> with our own comparison of auto insurance paying for oil changes.<br /><br />This led us to a discussion of how the employer mandate/tax will be enforced. To understand the current controversy, it's necessary to understand the stakes:<br /><br />An employer (of specified size) that offers <u><b>no</b></u> group health plan is subject to a $2,080/employee <strike>fine</strike> <strike>tax</strike> penalty, period. This is called the "strong" penalty because it counts <i>all</i> employees.<br /><br />If that same employer offers a group health plan, but that plan is either "unaffordable" or lacks "minimum value" the penalty is $3,120 per employee, but applies only to the number of full-time employees that opt out of the group plan and buy subsidized plans on the Exchange instead (and <a href="http://www.insureblog.blogspot.com/2014/11/killing-time.html" target="_blank"><b>rotsa ruck with that</b></a>). This is known as the "weak" penalty. What's interesting is that an employer that offers a "minimum value" plan that costs less than 9.5% of take-home pay ducks this penalty. <br /><br />And that's the crux of the <a href="http://www.mondaq.com/unitedstates/x/352238/Healthcare/HHS+and+IRS+Issue+Guidance+on+Skinny+Plans" target="_blank">proposed IRS ruling</a>: as Kurt explains it, employers want to save money while (legally) avoiding taxes, but still provide basic coverage. The problem is that, if the employer's affordable plan offers "minimum value" but that plan is so skinny that it doesn't provide coverage for hospitalization and other costs that folks need "real" insurance for, then the employee is screwed – he isn't eligible for a subsidy if he chooses to reject the skinny plan and get "real" insurance from the Exchange. By regulating that a "free oil changes only" plan can't satisfy minimum value, the IRS "fix" means that more employees would be subsidy-eligible. And from the employer perspective, it's still (likely) cheaper to pay the penalty for those employees who get subsidies than to provide and pay for more comprehensive coverage.   Win-win.<br /><br />A big IB <span style="color: red;"><i><b>Thank You</b></i></span> to Kurt Anderson for his time and expertise, and Joan Heider for putting us together.</span></div>

MVP Struggling - Part 2

A few days ago, we broached the subject of Minimum Value Plans, and their potential role in mitigating group health insurance costs. In that post, co-blogger Nate shared with us a TPA's view of how this might play out.At the time this whole concept hit my radar, I was invited to interview a benefits…

21Nov2014

Cavalcade of Risk #222: Call for submissions

Cavalcade of Risk #222: Call for submissions

Van Mayhall hosts next week's edition. Entries are due by Monday (the 24th).To submit your risk-related post, just click here to email it.You'll need to provide:■ Your post's url and title■ Your blog's url and name■ Your name and email■ A (brief) summary of the postPLEASE remember: ONLY posts …

21Nov2014

Close enough for gummint work

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5EiStqZJZ2fRLwq4iQUkj4r-B0pA0mIM56ExCmSt5o1flkFjFTH8cQ5UdyEuVACEyFWNWrADWmZ1a6abH8pjDQxNbpGxU4UGx6qrZjOeW0pUhdiU0Mf8GLfmZ9ZB-Rx6LQmZk9PVCr_DZ/s1600/ls2_113SteveMartin.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="90" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5EiStqZJZ2fRLwq4iQUkj4r-B0pA0mIM56ExCmSt5o1flkFjFTH8cQ5UdyEuVACEyFWNWrADWmZ1a6abH8pjDQxNbpGxU4UGx6qrZjOeW0pUhdiU0Mf8GLfmZ9ZB-Rx6LQmZk9PVCr_DZ/s1600/ls2_113SteveMartin.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">So it seems that, as <a href="http://insureblog.blogspot.com/2014/04/truth-serum.html" target="_blank">we'd already surmised</a>, the reports of how many people actually bought ObamaPlans were, well, less than truthy:<br /><br />"<a href="http://www.thefiscaltimes.com/2014/11/20/oops-obama-administration-inflated-obamacare-enrollment-numbers?onswipe_redirect=no&oswrr=1" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">A report by Bloomberg’s Alex Wayne revealed that the administration quietly lumped as many as 400,000 dental plans into the total enrollment number without telling anyone</span></i></a>."<br /><br />So almost a half million "false positives." Par for the course, no?</span></div>

Close enough for gummint work

So it seems that, as we'd already surmised, the reports of how many people actually bought ObamaPlans were, well, less than truthy:"A report by Bloomberg’s Alex Wayne revealed that the administration quietly lumped as many as 400,000 dental plans into the total enrollment number without telling anyo…

20Nov2014

Unintentional Medical Tourism

<div class="separator" style="clear: both; text-align: center;"><a href="http://i2.wp.com/vipmedia.globalnews.ca/2014/11/million-dollar-baby2.jpg?zoom=1.5&crop=0px%2C979px%2C2445px%2C1628px&resize=720%2C480" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="93" src="http://i2.wp.com/vipmedia.globalnews.ca/2014/11/million-dollar-baby2.jpg?zoom=1.5&crop=0px%2C979px%2C2445px%2C1628px&resize=720%2C480" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Before we begin, it's important to note that there's a LOT of information missing here. Of course, that hasn't stopped folks from piling on. As best we can tell, these are the bare facts:<br /><br />A 6-months pregnant Canadian woman took a personal trip to Hawaii. While there, she gave birth to a daughter, who ended up in the Neonatal ICU for several months, <a href="http://globalnews.ca/news/1679588/dream-vacation-in-hawaii-turns-into-financial-nightmare-for-saskatchewan-couple/" target="_blank">racking up $1 million in medical bills</a>. Her national health insurance plan paid $20,000, and (for some undisclosed reason) the US paid an additional $12,000. <br /><br />The controversy arises due to the fact that, prior to departure, she had apparently purchased a travel plan from a Canadian Blue Cross affiliate, and they have denied the claim. According to Ms Huculak, they are citing pre-existing conditions as the basis for their denial.<br /><br />[<i>ed: In case you're wondering, one of the worst kept secrets about the Canadian national health care scheme is that folks "in the know" <a href="http://insureblog.blogspot.com/2005/06/oy-canada.html" target="_blank">purchase private coverage</a> to supplement it</i>]<br /><br />And here's where it gets, well, interesting. For example, Ms (Mrs?) H claims that her doctor had given her a "green light" to take the trip, despite the fact that, only two months previously, she'd had a bladder infection and hemorrhaged. She says that her "<i><span style="font-family: Times,"Times New Roman",serif;">doctor saw no reason for me not to go</span></i>." Which is nice, but entirely irrelevant. Perhaps she could turn the delinquent bills over to him for payment.<br /><br />She also says that "<i><span style="font-family: Times,"Times New Roman",serif;">her doctor sent a letter to Blue Cross confirming that Huculak’s pregnancy was stable when she went on vacation, but the claim was still denied</span></i>." Again, without more detail as to <b>why</b> the claim was denied, we can only speculate. Regardless, an insurance company has no obligation to give any weight or credence to anything a doctor not in their employ has to say.<br /><br />I reached out to the folks at Saskatchewan Blue Cross to see if they could shed some light on some of these issues, and will have an update when (if?) I hear from them. The Canadian Blue Cross is not affiliated with the one here in the states, and has a different product line, including travel medical plans.<br /><br />So, since traditional media continues to do such a shoddy job of basic research, I went to the SBC site and took a look at the <a href="http://www.sk.bluecross.ca/site/pdfs/Daily_Travel_Plans_Policy_brochure.pdf" target="_blank">policy details</a>, and specifically the exclusions. And lo and behold, we find this at the #3 spot:</span><br /><blockquote class="tr_bq"><span style="font-family: Arial,Helvetica,sans-serif;"><i><span style="font-family: Times,"Times New Roman",serif;">Any expenses related to a medical condition (whether or not the condition has been diagnosed or the diagnosis has changed) for which any symptoms occurred during the six (6) months prior to the Effective Date for Covered Persons: </span></i></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><i><span style="font-family: Times,"Times New Roman",serif;"></span></i></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><i><span style="font-family: Times,"Times New Roman",serif;">• consulted a physician</span></i></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><i><span style="font-family: Times,"Times New Roman",serif;">• was hospitalized</span></i></span></blockquote><span style="font-family: Arial,Helvetica,sans-serif;">Well, she'd obviously consulted a physician, and it's entirely likely that she'd been hospitalized for the hemorrhaging. The fact that she had failed to read the policy (and note its exclusions) is on her.<br /><br />Oh, the most profound lesson here: turns out nationalized health care doesn't work. Who'da thunk it?</span></div>

Unintentional Medical Tourism

Before we begin, it's important to note that there's a LOT of information missing here. Of course, that hasn't stopped folks from piling on. As best we can tell, these are the bare facts:A 6-months pregnant Canadian woman took a personal trip to Hawaii. While there, she gave birth to a daughter, who…

20Nov2014

Health Wonk Review: Gobble, gobble edition

Health Wonk Review: Gobble, gobble edition

David Harlow presents a veritable brain-feast, replete with interesting, thought-provoking posts and mouth-watering illustrations.Enjoy! …

20Nov2014

MVP Struggling - Part 1

<div class="separator" style="clear: both; text-align: center;"><a href="http://www.allposters.com/IMAGES/PHOTOFILE/AADU025.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://www.allposters.com/IMAGES/PHOTOFILE/AADU025.jpg" width="162" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Minimum Value (aka MVP) Plans have been touted for groups over 100 (this year, and 50 next year) wishing to meet the letter of the ObamaTax law and yet minimize their costs. The Government published an online calculator where employers could enter their plan benefits and determine whether it met the minimum value test themselves, and avoid the cost of hiring an actuary. As we blogged a few months ago, <a href="http://insureblog.blogspot.com/2014/09/essential-re-calculating.html" target="_blank">the calculator included a "glitch"</a> which allowed employers to exclude in-hospital services (and some other high cost benefits) and still pass the 60% threshold, and therefore some of the <strike>penalties</strike> taxes.<br /><br />That's now changed. The IRS and HHS have now warned plans that they will fix the calculator, and the definition:<br /><br />"<a href="http://www.irs.gov/pub/irs-drop/n-14-69.pdf" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">[C]ertain group health plan benefit designs that do not provide coverage for in-patient hospitalization services are being promoted to employers. A plan that fails to provide substantial coverage for these services would fail to offer fundamental benefits ... plans that fail to provide substantial coverage for in-patient hospitalization services or for physician services ... do not provide the minimum value intended by the minimum value requirement</span></i></a>."<br /><br />Shorter: no, MVP's with no hospital coverage don't make the cut. Interestingly, so-called "skinny" plans with hospital and other Minimum Essential Coverage are still okay.<br /><br />[<i>ed: I'll refrain here from opining as to whether or not it's really the place of unelected, unaccountable bureauweenies to make these determinations</i>]<br /><br />So, what to do? A whole cottage industry has sprung up touting these plans as an affordable alternative to full-blown (and expensive) group plans, and at some point in the (presumably near) future, new rules will be put in place to cut them off. What then?<br /><br />One option, of course, would be to just stop offering group coverage altogether, and just pay the <strike>tax</strike> <strike>penalty</strike> fine (which is likely to be a LOT less than any premiums). Another would be to offer a slightly "less skinny" plan that <i><b>does</b></i> cover in-hospital charges in a way that satisfies Our Betters in DC©. <br /><br />The folks at <a href="http://www.optimedhealth.com/" target="_blank">OptiMed Health</a> claim that their plan offers "<i><span style="font-family: Times,"Times New Roman",serif;">independent actuarial certification and statement of compliance</span></i>." Which is nice, and perhaps a viable alternative for employers who want to avoid both the penalty and bankruptcy. <br /><br />My co-blogger <a href="http://www.blogger.com/profile/10537076312202981750" target="_blank">Nate Ogden</a> has another, intriguing, thought: why not offer a good plan, with around a 55% Actuarial Value, that covers the majority of people’s healthcare expenses. It would <b>exclude</b> hospital inpatient, therapy, and prolonged treatment. But it <i>would </i>cover, at a low cost, the majority of people’s needs for the year. This way most healthy people can get on a low cost plan and the employer won’t pay any penalties for them. Sick people in a group would still be subsidy eligible, so they could buy a more comprehensive plan on the Exchange, and their net cost is reduced by a subsidy. This appeases the government officials who concern with MVP minus hospital was they precluded individuals that needed coverage from getting a subsidy<br /><br />The purpose is to satisfy the "80/20 Conundrum:" insure the 80% of the group that only accounts for 20% of the cost, then pay the $3,000 penalty on the 20% of the group that accounts for 80% of the costs.<br /><br />Of course, you'd want to work closely with your agent and/or <a href="http://insurance.answers.com/health-insurance/aca-advanced-self-funding" target="_blank"><b>TPA</b></a> to make sure all the i's are crossed and the t's dotted.<br /><br />In part 2, we'll hear from a Benefits Attorney with another take on this development.</span></div>

MVP Struggling - Part 1

Minimum Value (aka MVP) Plans have been touted for groups over 100 (this year, and 50 next year) wishing to meet the letter of the ObamaTax law and yet minimize their costs. The Government published an online calculator where employers could enter their plan benefits and determine whether it met the…

17Nov2014

Winner, Winner Chicken Dinner!

<div class="separator" style="clear: both; text-align: center;"><a href="http://upload.wikimedia.org/wikipedia/commons/d/db/Chicken_and_waffles_with_peaches_and_cream.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="105" src="http://upload.wikimedia.org/wikipedia/commons/d/db/Chicken_and_waffles_with_peaches_and_cream.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">So a colleague recently clued me in to a way that the free market is responding to the new reality of an Obamacare-dominated health insurance market. The good news is that the concept seems to be perfectly legit, serving the interests of both the client and the agent (and her carrier). The bad news is that the plan is only available in a dozen states so far, although it has been filed and is pending approval in almost all states (although it's available only from agents of one carrier).<br /><br />Still, it's a fascinating glimpse into how one can "reverse engineer" a desired outcome. I'll let "Donna" take it from here:<br /><br />"<span style="font-family: Verdana,sans-serif;"><span style="color: blue;">You're going to like this, it's damn brilliant. Basically we're offering a <b><a href="http://insureblog.blogspot.com/2013/01/minimed-maelstrom.html" target="_blank">limited benefit</a></b> product that's very cheap compared to Obamacare. Assuming that no major illnesses or injuries come up, it'll pay almost all of one's medical costs with no deductible. The capper, though, is that the plan has a rider that allows the insured, at their discretion (and with <i><b>with no additional underwriting</b></i>) to convert it to a major medical plan with a $3,000 deductible and 100% coverage after that.<br /><br />That major medical plan runs until the insured's next open enrollment period. So, cheap insurance for as long as you need it, the option to switch to a major medical plan even AFTER you get ill (but not requiring you to pay for it until you need it), and a guaranteed transition to O'Care (which, being guaranteed issue, is the appropriate place for high risk individuals). I'm going to sell a boatload of this product, and best of all, nobody loses</span></span>."<br /><br />Indeed. The only real drawback I see would be the potential for the individual mandate <strike>tax</strike> <strike>penalty</strike> fine. On the other hand, I'm told that it's priced to have a lower premium than a "<a href="http://insurance.answers.com/health-insurance/aca-marketplace-exchange-basics-part-2-of-2" target="_blank">metal plan</a>," even with the tax penalty<br /><br />Now here's where it gets, well, <i>weird</i>: almost six years ago, the (<a href="http://insureblog.blogspot.com/2010/06/turn-up-ac.html" target="_blank">now defunct</a>) American Community insurance company rolled out a very similar plan:</span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><br />"<a href="http://insureblog.blogspot.com/2008/12/pay-as-you-go-insurance.html" target="_blank"><i>Called "Community Flex," it starts out as an accident policy (major claims are only paid for injury, not illness), with some coverage for doc visits, preventive care, and a drug discount card ... if you want more coverage, such is available through a "Gold Plan" buy-up. This gets you coverage for more doctor's visits, more preventive care, and better prescription drug coverage</i></a>."<br /><br />So, not <u><b>exactly</b></u> the same, but similar concept. Currently, my colleague's company is the only one (of which I'm aware) that has developed this new-fangled ObamaPlan alternative.<br /><br />Be nice if there were others (hint, hint).</span></div>

Winner, Winner Chicken Dinner!

So a colleague recently clued me in to a way that the free market is responding to the new reality of an Obamacare-dominated health insurance market. The good news is that the concept seems to be perfectly legit, serving the interests of both the client and the agent (and her carrier). The bad news …

17Nov2014

The Gruber Hits The Fan

The Gruber Hits The Fan

You knew this was coming, right?"In Jon Gruber's Newest (Sixth) Video, He Explains How Obama and Democrats Conspired to Get Rid of Tax Exemptions for All Insurance Plans Without Anyone Noticing"Boom. …

14Nov2014

HIX Predix

<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">I have a few predictions about tomorrow morning:<br /><br />■ The sun will rise in the east</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br />■ Water will be wet</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br />■ The 404Care.gov site <a href="http://www.insureblog.blogspot.com/2014/11/not-ready-for-sub-prime-time.html" target="_blank">will be broken</a><br /><br />Why does the last one seem no less obvious than the first two?<br /><br />From the horse's, er, mouth:<br /><br />"<a href="http://nypost.com/2014/11/13/this-years-glitch-how-obamacare-will-screw-you-now/" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">Health Secretary Sylvia Burwell warns, “we will have things that won’t go right. We will have outages, we will have downtime</span></i></a>.”</span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"></div><div class="separator" style="clear: both; text-align: center;"><a href="http://img3.wikia.nocookie.net/__cb20110516212209/simpsons/pt/images/b/bf/Homer-doh-square.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="http://img3.wikia.nocookie.net/__cb20110516212209/simpsons/pt/images/b/bf/Homer-doh-square.jpg" width="200" /></a></div><div style="text-align: justify;"><br /><span style="font-family: Arial,Helvetica,sans-serif;">And it's <a href="http://thehill.com/policy/healthcare/223984-enrollment-lags-for-small-businesses-under-obamacare" target="_blank"><b>no ray of sunshine</b></a> for small businesses, either.</span></div>

HIX Predix

I have a few predictions about tomorrow morning:■ The sun will rise in the east■ Water will be wet■ The 404Care.gov site will be brokenWhy does the last one seem no less obvious than the first two?From the horse's, er, mouth:"Health Secretary Sylvia Burwell warns, “we will have things that won’t go …

14Nov2014

Up-Lyfting Update

<div class="separator" style="clear: both; text-align: center;"><a href="http://drhelmspickett.com/wp-content/uploads/2014/06/A-woman-releases-a-balloon-into-the-air-during-the-20th-anniversary-of-the-closure-of-the-Omarska-detention-camp-in-Omarska-on-Aug.-6..-Hundreds-of-former-inmates-released-balloons-with-names-of-missing-persons-into-the-air-during-650x433.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="93" src="http://drhelmspickett.com/wp-content/uploads/2014/06/A-woman-releases-a-balloon-into-the-air-during-the-20th-anniversary-of-the-closure-of-the-Omarska-detention-camp-in-Omarska-on-Aug.-6..-Hundreds-of-former-inmates-released-balloons-with-names-of-missing-persons-into-the-air-during-650x433.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Last week, we noted car-sharing service Lyft's <a href="http://insureblog.blogspot.com/2014/11/rubber-road-and-lyft-insurance-crisis.html" target="_blank">first passenger fatality</a>, and pondered the insurance implications thereof. Since this situation is a bit outside our wheelhouse, we turned to P&C expert (and long-time FoIB) <a href="http://www.consulinsurance.com/" target="_blank"><b>Kevin Sullivan</b></a>. <br /><br />I really didn't know what questions to even be asking, what issues (beyond the obvious) were relevant, and what part the location (California vs, say, Ohio) would play in this whole scenario. He kindly supplied not only the necessary questions, but the <u><i>answers</i></u>, as well Take it away, Kevin:<br /><br /><br /><span style="color: blue;">The insurance test here:  Will Lyft's Commercial General Liability, or Business Auto coverage defend the Lyft driver?<br /><br />IMHO, it doesn't matter if it's the driver's fault.  Everybody's getting sued.  Lawyers cost money [<span style="color: black;"><i>ed: this is a point our friend Bill M made, as well</i></span>].<br /><br />If the driver has a commercial auto policy, and he's not found criminally negligent (drunk, on drugs, etc), they defend/settle.  My guess:  The driver has no such insurance.  Personal Auto expressly EXCLUDES using your vehicle to make money.  However, the coverage exists, otherwise, you wouldn't be able to get a pizza delivered to your house.  The Pizzeria (Lyft) purchases that cover.<br /><br />Back to Lyft:  <br /><br />1.  Is the driver named on Lyft's policy?  Or is he listed on just an "Additional Insured" endorsement?  <br /><br />2.  $1,000,000 Combined Single Limit?  Liability only? <br /><br />3.  What carrier wrote the Lyft policy?  That would tell me a TON...<br /><br />Looks like Lyft's insurance is <a href="http://www.cnet.com/news/after-fatal-lyft-crash-insurance-questions-arise/" target="_blank">prepared to pay or defend</a>.<br /><br />Here's how this is all going to go down:  Settlement will occur, nobody will know how much.  Lyft will either need to find another carrier, or pay a TON more in premium.  A non-renewal (cancellation) is also possible.  Again, I'd need to know the carrier before I'd guess.<br /><br />Lyft <i><b>could</b></i> go out of business for not being able to find a new insurance carrier.  That won't matter: another service will come along, and replace them.  Ride-sharing ain't dying.<br /><br />In the big picture, the carriers are playing "wait and see" with this new auto niche.  Trust me, they are crunching numbers right now, and will develop a product for the "part time TNC (Transportation Networking Company) driver" for Uber, Lyft, Sidecar, etc.<br /><br />If they had HALF A CLUE, the TNC's would create a "driver's association" for ALL ride share drivers.  As a member of the association, you'd get access to the association’s insurance plan at $X,XXX per year [<span style="color: black;"><i>ed: similar to how many professional organizations sponsor life or disability insurance</i></span>].</span><br /><br /><br />Thanks, Kevin!<br /><br />This is still a relatively immature market, with plenty of room for expansion, and missteps. But as Kevin notes, there's just too much pent-up demand, primarily tech-driven (all those iOS and Android apps aren’t going to drive themselves, after all). And the centuries old taxi-cab model with its expensive (and increasingly outmoded) barrier to entry just doesn't seem sustainable. On the other hand, folks want to know that they're protected from the risk of someone else's driving.<br /><br />Something's gonna give, it's now a question of how and when.</span></div>

Up-Lyfting Update

Last week, we noted car-sharing service Lyft's first passenger fatality, and pondered the insurance implications thereof. Since this situation is a bit outside our wheelhouse, we turned to P&C expert (and long-time FoIB) Kevin Sullivan. I really didn't know what questions to even be asking, what iss…

14Nov2014

Peanut Butter and Chocolate

<div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">You got <a href="http://insureblog.blogspot.com/2014/08/kliff-diving-with-sarah.html" target="_blank">feckless, clueless punditry</a> in my O'Care deceit lectures.<br /><br />No! <b>You</b> got <a href="http://insureblog.blogspot.com/2014/11/three-strikes-herr-gruber.html" target="_blank">O'Care deceit lectures</a> in my feckless, clueless punditry.<br /><br />Kiddies, kiddies, please calm down. You're <i><b>both</b></i> right:<br /></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOVzUTEZWZrgzFiQDDGI7lNg3FPvuQe_HKh3kaMynk28xlwv-53Zzo2OPstendeyR2Oma4gwHYh2vZ1AfwJp4hSm4gARbiT3Le9xJqfxZtt5V24W2hnvrpkx67ve_7dBG_IqRd_GLPB5c/s1600/kliff_gruber.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="386" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOVzUTEZWZrgzFiQDDGI7lNg3FPvuQe_HKh3kaMynk28xlwv-53Zzo2OPstendeyR2Oma4gwHYh2vZ1AfwJp4hSm4gARbiT3Le9xJqfxZtt5V24W2hnvrpkx67ve_7dBG_IqRd_GLPB5c/s400/kliff_gruber.jpg" width="400" /></a></div><div style="text-align: center;"><i><span style="font-size: x-small;"><span style="color: red;"><b><span style="font-family: Arial,Helvetica,sans-serif;">[<a href="https://twitter.com/ArikSharon/status/532938734195732480" target="_blank">Source</a>]</span></b></span></span></i></div>

Peanut Butter and Chocolate

You got feckless, clueless punditry in my O'Care deceit lectures.No! You got O'Care deceit lectures in my feckless, clueless punditry.Kiddies, kiddies, please calm down. You're both right:[Source] …

13Nov2014

Now Playing: HIX (Health Insurance Exchange)

Now Playing: HIX (Health Insurance Exchange)

Interesting video primer on how the Exchanges (are supposed to) work: …

13Nov2014

Three Strikes, Herr Gruber....

<div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">If you've been <a href="http://www.insureblog.blogspot.com/2014/11/obamacare-moments-of-honesty.html" target="_blank">following the saga</a> of Jonathan "<a href="http://youtu.be/2X9E9n6GHC8" target="_blank">Fredo</a>" Gruber, you know he's on record for <strike>speaking his mind</strike> calling the American electorate stupid. Now comes word that he's been at it again:<br /><br />"<a href="http://dailycaller.com/2014/11/12/in-third-video-obamacare-architect-talks-about-basic-exploitation-of-american-voters-video/" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">A third video has surfaced of Obamacare architect Jonathan Gruber bragging about pulling the wool over the eyes of the American public in order to help implement Obamacare</span></i></a>."<br /><br />Third time's a charm, right?<br /><br /><iframe allowfullscreen="" frameborder="0" height="284" src="//www.youtube.com/embed/AqHz2XcUGok" width="378"></iframe><br /><span style="color: red;"><i><b><br />                         [Skip to 29:26 for money quote]</b></i></span></span></div>

Three Strikes, Herr Gruber....

If you've been following the saga of Jonathan "Fredo" Gruber, you know he's on record for speaking his mind calling the American electorate stupid. Now comes word that he's been at it again:"A third video has surfaced of Obamacare architect Jonathan Gruber bragging about pulling the wool over the ey…

12Nov2014

Cavalcade of Risk #221: Post-election round-up edition

Cavalcade of Risk #221: Post-election round-up edition

Claire Wilkinson hosts this week's collection of post-election risk-related bloggetry. From upcharges for where you shop to high wire (literally!) acts, you're sure to find something interesting.Thanks, Claire! …

12Nov2014

Obamacare's House of Cards

<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixJopBaxwylcn9aWj21xO9KBO1pwo26D6nK75-LIja8VjhN6QMHZhsaf6pEhYB7Pdyx0_0btY2auN0E7ujWAF8sfq3cUcUdjvY79r_5T4poxFh-AJaz4hwNeW0EQ2oezmiOXQNBKkmXTw/s1600/house+of+cards.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="78" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixJopBaxwylcn9aWj21xO9KBO1pwo26D6nK75-LIja8VjhN6QMHZhsaf6pEhYB7Pdyx0_0btY2auN0E7ujWAF8sfq3cUcUdjvY79r_5T4poxFh-AJaz4hwNeW0EQ2oezmiOXQNBKkmXTw/s200/house+of+cards.jpg" width="140" /></a>Did you know almost 25% of individual health insurance premiums paid for exchange plans go directly to taxes and fees? Did you know that you, as taxpayers, are funding 76% of the total premiums? While <a href="http://insureblog.blogspot.com/2014/11/obamacare-architect-call-it-stupidity.html" target="_blank">some call American voters stupid</a>, the reality is consumers are simply uninformed about the Unaffordable Care Act.<br /><br />While the law passed in 2010, taxpayers are now learning about the complete lack of transparency coupled with misdirection and layers of bureaucracy created in Obamacare. This is because during the first four years all of the<a href="http://www.politico.com/story/2014/05/free-preventive-care-can-still-cost-106864.html" target="_blank"> warm</a> and <a href="http://www.forbes.com/sites/theapothecary/2012/06/11/who-needs-the-slacker-mandate-unitedhealth-to-voluntarily-continue-under-26-insurance-policies/" target="_blank">fuzzy</a> benefits were implemented. These provisions were popular because they were perceived as expanding coverage for no cost. In fact the major cost provisions didn't start until this year. Here is the breakdown of what it costs taxpayers.<br /><br />According to HHS Secretary Burwell through<a href="http://www.cbsnews.com/news/hhs-releases-new-estimate-for-2015-obamacare-enrollment/" target="_blank"> mid-October 404care.gov enrollment was at 7.1 million people.</a> According to HHS, in June the average premium was $346 per month. Taxpayer subsidies pay $264 of the premium while the consumer pays the remaining $82.<br /><ul><li>Taxpayer subsidies ($264 per enrolled)         $1,874,400,000</li><li>Consumer payments ($82 per enrolled)         <u>   $582,200,000</u></li><li>Total Premiums ($346 per enrolled)              $2,456,600,000</li></ul><br />There are numerous taxes and fees such as the medical devices tax, the <a href="http://dailycaller.com/2013/12/18/boehner-rents-capitol-hill-apartment-from-tanning-bed-lobbyist/" target="_blank">Boehner</a> tax (tanning beds), and the hospital tax which consumers don't see. These started in the first four years of Obamacare and are indirectly impacting your premiums. However, the new taxes and fees starting in 2014 have a direct impact on premiums. These are measurable and have a direct impact on what you pay in premiums. Here is the breakdown of four taxes/fees and what they cost based on the enrollment figures from above:<br /><ul><li>PCORI Fees ($2 PEPY)                                         $14,200,000</li><li>Reinsurance Fees ($63 PEPY)                           $447,300,000</li><li>Exchange User Fees (3.5% of premium)            $85,981,000</li><li>Health Insurance Tax (2.4% of premium)       <u>  $58,958,400</u></li><li>Total premiums paid to the government:        $606,439,400</li></ul>[<i>PEPY = Per Enrollee Per Year</i>]<br /><br />It's not rocket science to see that the government is taking in more than consumers are paying. It should also be eye opening to know that the government is taking in more of your premiums than insurance companies are retaining for administrative costs. <br /><br />The next time supporters of the law claim big bad insurance companies are raking in huge profits it would be good to remember that if we really wanted lower premiums the best way to do it is remove government bureaucracy from the equation.

Obamacare's House of Cards

Did you know almost 25% of individual health insurance premiums paid for exchange plans go directly to taxes and fees? Did you know that you, as taxpayers, are funding 76% of the total premiums? While some call American voters stupid, the reality is consumers are simply uninformed about the Unafford…

12Nov2014

O'Care Potpourri

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwt7qHlkv3JTsMSbX3ogKQk0MXfYdqEGqV8A1sPSXzplvopE-r7SN6mdPmspvHn8U5MUvmHb0kgdfgjvZpybpqik1UihUGL1BU7zrniU5tcT8pkZPtjPsZvL9a0p1Kv6thv1BAOd-Z61eH/s1600/potpourri+basket.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="112" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwt7qHlkv3JTsMSbX3ogKQk0MXfYdqEGqV8A1sPSXzplvopE-r7SN6mdPmspvHn8U5MUvmHb0kgdfgjvZpybpqik1UihUGL1BU7zrniU5tcT8pkZPtjPsZvL9a0p1Kv6thv1BAOd-Z61eH/s1600/potpourri+basket.jpg" width="140" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">■ In keeping with the politically correct stance of providing <strike>vital services</strike> convenience items for women, but <a href="http://insureblog.blogspot.com/2014/07/sexistcare.html" target="_blank"><b>not for men</b></a>, Medical Mutual has announced that "<span style="font-family: Times,"Times New Roman",serif;"><a href="http://www.mmoh.com/" target="_blank"><i>Drugs Used to Treat Erectile Dysfunction No Longer Covered in Individual and Small Group Metal-Tier Plans (On or Off Exchange)</i></a></span>."</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">That<a href="http://cdn.ebaumsworld.com/mediaFiles/picture/1015945/84352150.jpg" target="_blank"> little blue (?) pill</a> is now excluded.</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">#waronmen</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">■ We've talked before about some of the shadier links that are floating around, ostensibly to direct folks to the official 404Care.gov site, <a href="http://insureblog.blogspot.com/2014/10/life-imitates-onion.html" target="_blank">but <b>actually</b> not</a>. Got this one in email today:</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">"<span style="font-family: Times,"Times New Roman",serif;"><i>Sign up For health-insurance Under the affordable Care - act-  avoid Penalties</i></span>"</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">And then this link:</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Times,"Times New Roman",serif;">hXXp://www.XXX.co.at/l/lt7F19079Q1237AD/1245E7599IG115271HC229CT146978585H2202568847</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Which does <b>not</b> in fact, lead to the <i>real</i> site at all.</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">Shocking, I know.</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">■ As we've been saying for quite a while, the whole "Navigator" idea is dangerously attractive to ill-intentioned folks. After all, they're (largely) <a href="http://insureblog.blogspot.com/2014/10/new-hope-for-naughty-navigators.html" target="_blank">unlicensed and unvetted</a>, and, well, <b>this</b> will surely come as no surprise to IB regulars:</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">"<span style="font-family: Times,"Times New Roman",serif;"><a href="http://www.jammiewf.com/2014/former-obamacare-navigator-and-convicted-terrorist-found-guilty-of-immigration-fraud/" target="_blank"><i>A terrorist from Jordan briefly worked as an Obamacare navigator in Illinois while authorities remained unaware of her conviction for involvement in a deadly grocery store bombing and two other attacks</i></a></span>."</span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><br /></span></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">But what could <i><b>possibly</b></i> go wrong?</span></div>

O'Care Potpourri

■ In keeping with the politically correct stance of providing vital services convenience items for women, but not for men, Medical Mutual has announced that "Drugs Used to Treat Erectile Dysfunction No Longer Covered in Individual and Small Group Metal-Tier Plans (On or Off Exchange)."That little bl…

11Nov2014

Bastiat & Graboyes: The Legend Continues

<div class="separator" style="clear: both; text-align: center;"><a href="http://mercatus.org/sites/default/files/imagecache/thumb/Robert-Graboyes.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://mercatus.org/sites/default/files/imagecache/thumb/Robert-Graboyes.jpg" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;"><a href="http://en.wikipedia.org/wiki/Fr%C3%A9d%C3%A9ric_Bastiat" target="_blank">Frédéric Bastiat</a>, a noted 19th-century polemicist, is most widely-known for the Parable of the Broken Window (widely regarded as the underlying reason for New York Mayor Rudy Giuliani's successful cleaning up of Times Square, for example).<br /><br />In the grand tradition of the forward-thinking, our good friend Bob Graboyes (<a href="http://mercatus.org/" target="_blank">Mercatus Center</a> senior research fellow) has just been awarded the prestigious <a href="http://reason.com/reasonmediaawards/bastiatprizeforjournalism.php" target="_blank">Bastiat Prize for Journalism</a> by Reason magazine.<br /><br />A heart-felt Mazel Tov to Bob!</span></div>

Bastiat & Graboyes: The Legend Continues

Frédéric Bastiat, a noted 19th-century polemicist, is most widely-known for the Parable of the Broken Window (widely regarded as the underlying reason for New York Mayor Rudy Giuliani's successful cleaning up of Times Square, for example).In the grand tradition of the forward-thinking, our good frie…

11Nov2014

Not Ready for (Sub-)Prime Time

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNh22zrvr6Ie97JrwSTVhhCYCKBT50LJLym2_37cyXxvnvA3mmw6HolQ4PoNNQdnPSct6sg5lMiHSWE0QSo7ccZ9hRWlEgi3l-pJJtdsdlnALwtP4YFBZ3W-pze_pHSE8k22CsCMLtWBo/s1600/hc+system+down.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="140" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNh22zrvr6Ie97JrwSTVhhCYCKBT50LJLym2_37cyXxvnvA3mmw6HolQ4PoNNQdnPSct6sg5lMiHSWE0QSo7ccZ9hRWlEgi3l-pJJtdsdlnALwtP4YFBZ3W-pze_pHSE8k22CsCMLtWBo/s1600/hc+system+down.jpg" width="400" /></a></div><div style="text-align: justify;"><span style="font-family: Arial,Helvetica,sans-serif;">So I spent a great deal of yesterday afternoon on the phone with the friendly - if hapless - folks at 404Care.gov. Turns out, one of my <a href="http://www.insureblog.blogspot.com/2014/11/renewals-vs-grandma.html" target="_blank">"Grandmothered" Anthem clients</a> <b>may</b> be eligible for a subsidy, which means the (dreaded) Marketplace. We'd already picked out a plan, now we needed to enroll her.<br /><br />Since her December renewal triggers a <a href="http://insurance.answers.com/health-insurance/aca-basics-open-enrollment" target="_blank">Special Open Enrollment</a>, we were looking for a December 1 effective date. She's actually pretty fortunate: as I explained to her, it's not yet Open Enrollment season (<a href="http://www.insureblog.blogspot.com/2014/11/great-expectations.html" target="_blank">that starts this coming Saturday</a>), so there were likely only hundreds, perhaps thousands of folks vying for coverage at any given time today. Come the weekend, and especially next Monday, that will swell into the millions.<br /><br />And yet, well, what you see at the top of this post is what we encountered multiple times. So we took their advice and called the toll-free number.<br /><br />And spent the next two hours (really!) speaking with a delightful young lady named Destiny (last name withheld because <i><b>she</b></i> isn't the problem). Like us, she was unable to successfully access the system; in fact, she had to ask for my client's information several times as the system gobbled it up and spat out error message after error message. If it spat out anything at all (she was experiencing more hang-time than Michael Jordan).<br /><br />Ultimately, we had to bag it (my client had another appointment, as did I) and we'll pick up again in the morning. We did ask Destiny if there was a better time to call, and she assured us that the call center is open 24/7, and one time's as <strike>good</strike> useless as any other.<br /><br />And remember: this is the <i>off season</i> - still think they'll be up for the real deal?<br /><br />I'll let you know how it goes today...</span></div>

Not Ready for (Sub-)Prime Time

So I spent a great deal of yesterday afternoon on the phone with the friendly - if hapless - folks at 404Care.gov. Turns out, one of my "Grandmothered" Anthem clients may be eligible for a subsidy, which means the (dreaded) Marketplace. We'd already picked out a plan, now we needed to enroll her.Sin…

11Nov2014

Great Expectations

It appears that Exchange enrollment for Obamacare isn't going to be what it was cracked up to be. <br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlUgNYGVA__APyImhVLsImlGljnXKycN4oPkqCDorwaPvBpNoyz9rmrfNNcdgAuqzmQWGHL6-R1V6m0TedzafbXYXiZW0go8dldXzUKnivj1H-NkMqmF5FGfE84TEmpr4Y3cnbALONZsE/s1600/Approaching-storm-USCapitol-WashDC-view-LOC-roofview-13June2013.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="135" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlUgNYGVA__APyImhVLsImlGljnXKycN4oPkqCDorwaPvBpNoyz9rmrfNNcdgAuqzmQWGHL6-R1V6m0TedzafbXYXiZW0go8dldXzUKnivj1H-NkMqmF5FGfE84TEmpr4Y3cnbALONZsE/s1600/Approaching-storm-USCapitol-WashDC-view-LOC-roofview-13June2013.JPG" width="200" /></a>Back in 2011 CMS released released their summary forcast showing that in 2014 exchanges were expected to enroll 13.9 million. For 2015 that number was 15.9 million. Now comes word from HHS that actual enrollment as of mid-October there are 7.1 million people enrolled and that they are lowering expectations in 2015 to between 9 and 9.9 million. Why? Because they want it to be "<a href="http://www.washingtonexaminer.com/article/2555982/">accurate...analytically based</a>."<br /><br />I always thought meteorologists had the best job security. They could be wrong half the time and we forgive them. Now I'm thinking the best job is forecasting for Obamacare. When HHS/CMS make a mistake they simply "downgrade" expectations. Only in this situation we shouldn't forgive them.<br /><br /><br /><br />

Great Expectations

It appears that Exchange enrollment for Obamacare isn't going to be what it was cracked up to be. Back in 2011 CMS released released their summary forcast showing that in 2014 exchanges were expected to enroll 13.9 million. For 2015 that number was 15.9 million. Now comes word from HHS that actual e…

10Nov2014

Obamacare Moments of Honesty

Obamacare Moments of Honesty

Rep. Pelosi infamously said "We had to pass the bill in order to know what was in it".Now the truth serum is administered to Jonathon Gruber and listen to what he says.In case you missed it, “And basically, call it the stupidity of the American voter or whatever, but basically that was really, reall…

10Nov2014

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