insurance

Gamers

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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Oh the games people play, now. Every night and every day, now. Never meaning what they say, now. Never saying what they mean.  </span><br />
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiW-UOx_1vGGZUI1dQ3N2c48GjUMsQ5YbvqeYua0_Kq2de3365RjfB2uE1n_WR9yW-JzWTkZeAB72ebHzUuNBQgGnplx1mys8BY-C-3-1g2jDyyeKa835Bz9uKQOk62XK_N29eY3fVznK8/s1600/Obama-Mart.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiW-UOx_1vGGZUI1dQ3N2c48GjUMsQ5YbvqeYua0_Kq2de3365RjfB2uE1n_WR9yW-JzWTkZeAB72ebHzUuNBQgGnplx1mys8BY-C-3-1g2jDyyeKa835Bz9uKQOk62XK_N29eY3fVznK8/s1600/Obama-Mart.jpg" /></a></span></div>
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Comes now the biggest taxpayer funded give away in the history of the United States. Obamacare subsidies are nothing more than an invitation to game the system and get more "free" benefits.</span><br />
<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">"Mike" is a low paid, full time worker in a company that still offers health insurance.</span><br />
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<span style="background-color: white; color: #333333; line-height: 17px;"><i><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Mike’s $3,241 contribution is tax-deductible. Still, that’s a hefty 11.6 percent of his wage income, which might make it appear that Mike’s coverage meets Obama-care’s definition of “unaffordable.” In that case, he would qualify for subsidized coverage on the exchange. Unfortunately, exchange eligibility is restricted to those whose cost for “self-only” coverage under their employer plan exceeds 9.5 percent of household income, and Mike has family coverage. Since Mike’s share of a “self-only” premium would be only 4.9 percent of his income, he is not legally permitted to buy subsidized coverage through the exchange.</span></i></span></blockquote>
<span style="background-color: white; color: #333333; line-height: 17px;"><b><a href="http://m.weeklystandard.com/articles/dishonor-system_741026.html" target="_blank"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Weekly Standard</span></a></b></span><br />
<span style="background-color: white; color: #333333; line-height: 17px;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span></span><span style="background-color: white; color: #333333; line-height: 17px;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Do you see his predicament?</span></span><br />
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="background-color: white; color: #333333; line-height: 17px;"><i>The way Mike sees it, Uncle Sam is levying a substantial tax on him simply for working for a large employer that responsibly offers health benefits.</i></span><span style="background-color: white; color: #333333; line-height: 17px;"><i><br /></i></span><span style="background-color: white; color: #333333; line-height: 17px;"><i></i></span></span></blockquote>
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<span style="background-color: white; color: #333333; line-height: 17px;"><i><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">The administration’s ineptitude in rolling out Obama-care has given Mike a lucky break. In 2014, his employer may not be reporting to the exchange any details about the coverage offered him at work. The final rule on premium tax-credit eligibility verification requires that any applicant for premium tax credits attest to the exchange whether he or she has employer coverage, its cost, and extent</span></i></span></blockquote>
<span style="background-color: white; color: #333333; line-height: 17px;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span></span><span style="color: #333333; font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="line-height: 17px;">Now he has a plan.</span></span><br />
<span style="color: #333333; font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="line-height: 17px;"><br /></span></span><span style="color: #333333; font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="line-height: 17px;">Work the system in his favor. If he gets caught, he figures nothing will happen or he can always plead ignorance and promise not to do it again.</span></span><br />
<span style="color: #333333; font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="line-height: 17px;"><br /></span></span><span style="color: #333333; font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="line-height: 17px;">Wonder how many "Dan's" there are who will find a way to game the system?</span></span><br />
<span style="color: #333333; font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="line-height: 17px;"><br /></span></span><span style="color: #333333; font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><span style="line-height: 17px;">We may never know unless they go on TV and brag about it like the woman who got the free Obamaphone.</span></span><br />
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Gamers

Oh the games people play, now. Every night and every day, now. Never meaning what they say, now. Never saying what they mean. Comes n...

11:01 AM

Genworth LTCi in the crosshairs

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<span style="font-family: Arial,Helvetica,sans-serif;">Genworth, one of the last remaining "players" in the Long Term Care insurance (LTCi) market, is about to drop the hammer on some of its long-time policyholders:<br /><br />"<a href="http://www.lifehealthpro.com/2013/07/31/genworth-conducting-deep-review-of-ltci-business?eNL=51f95dfe160ba03d0100014d&utm_source=HealthInsuranceInsider&utm_medium=eNL&utm_campaign=LifeHealthPro_eNLs&_LID=107764095" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">We're conducting an intense, very broad and deep review of all aspects of our [long-term care] insurance business ... believe the company has to increase the price of products sold before 2002 to bring them closer to the break-even point</span></i></a>"<br /><br />Yikes!<br /><br />Actually, this is far from unexpected, and arguably overdue:<a href="http://insureblog.blogspot.com/2013/07/in-news.html" target="_blank"> as we've seen</a> over the years, the current long term pricing models just aren't sustainable. For one thing, too many folks have kept their policies (not a <b>bad</b> thing, <i>per se</i>, just that carriers count on a certain amount of attrition), so both claims and reserves continue to mount.<br /><br />And, of course, as the LTCi business itself matures, it becomes more and more obvious that earlier plans were substantially under-priced. While that may have been a good deal for early adopters, over time it's a problem.<br /><br />Which is not to say that the LTCi market is 'kaput;' indeed, more folks than ever seem to be taking a serious look at these plans. But it's important to keep in mind that, with few exceptions, rates will continue to climb for at least a while.</span></div>
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Genworth LTCi in the crosshairs

Genworth, one of the last remaining "players" in the Long Term Care insurance (LTCi) market, is about to drop the hammer on so...

11:00 AM

Aetna Touch-N-Go, and the Big Picture

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<span style="font-family: Arial,Helvetica,sans-serif;">A couple of days ago, we reported on Aetna's apparent <a href="http://www.insureblog.blogspot.com/2013/07/aetna-back-in-game.html" target="_blank">change of heart</a> regarding the sale of individual medical insurance here in Ohio. Today, they're back in the news:</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">"<a href="http://www.lifehealthpro.com/2013/07/30/aetna-touts-private-exchanges?eNL=51f93d0d150ba0aa4c00022d&utm_source=HCRW&utm_medium=eNL&utm_campaign=LifeHealthPro_eNLs&_LID=107687085" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">Aetna Inc. execs remain skeptical about how the [Obamaax] public exchanges will perform ... New and expanded private exchange programs could get off to a faster start</span></i></a>"</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">There are three essential differences between the Public (FFE) and Private Exchange models:</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">First, only plans purchased on the Public Exchange will be eligible for subsidies (maybe: the subsidy rules <a href="http://insureblog.blogspot.com/2013/07/the-obamatax-subsidy-cheat.html" target="_blank">keep changing</a>);</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">Second, plans available on the Public Exchange are expected to have much smaller ("skinnier," in the vernacular) provider networks;</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">And third, fewer carriers are expected to participate in the Public Exchanges (limiting competition and choice).</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">It's that third item that's key: absent a robust marketplace, even subsidized plans are likely to remain out of the financial reach of many folks. That's due partly to premiums, and partly to plan design. The least expensive ObamaTax-compliant plans ("Bronze" level) have potential out-of-pocket maximums much higher than many plans available today, further exacerbating the (un)affordability issue.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">If (when?) major players like Aetna take a pass on the Public version in favor of the Private, it will cause an even greater strain on the former's sustainability. The Private Exchange model, on the other hand, looks poised to be reasonably successful: for the most part, these will offer more choice (and thus competition) and better service.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">Wait, what's that about service, Henry?</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">Well, it's like this: agents (you know, the folks who are <b>trained</b> and <b>experienced </b>in the actual business of health insurance) are effectively shut out of the Public Exchanges. But a lot of us have signed up for the Private Exchanges. So when a consumer needs an <i>accurate, knowledgeable and credible</i> answer, to where do you think he will turn?</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">On the other hand, we know that a lot of agents have already thrown in the towel (and/or are<a href="http://insureblog.blogspot.com/2013/07/monday-morning-obamatax-news.html" target="_blank"> planning to do so</a> in the near future), so that may not be a realistic assessment, either.</span></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">Yeah, I'm just full of warm fuzzies today.</span></div>
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Aetna Touch-N-Go, and the Big Picture

A couple of days ago, we reported on Aetna's apparent change of heart regarding the sale of individual medical insurance here in Oh...

11:00 AM

Wednesday Potpourri

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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwt7qHlkv3JTsMSbX3ogKQk0MXfYdqEGqV8A1sPSXzplvopE-r7SN6mdPmspvHn8U5MUvmHb0kgdfgjvZpybpqik1UihUGL1BU7zrniU5tcT8pkZPtjPsZvL9a0p1Kv6thv1BAOd-Z61eH/s320/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/s200/potpourri+basket.jpg" width="140" /></a></div>
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<span style="font-family: Arial,Helvetica,sans-serif;">■ While you're busy planning that end-of-summer trip to Rome or London (or Istanbul, for that matter), you should know that your health insurance <a href="http://www.daytondailynews.com/news/business/prepare-for-your-health-care-needs-overseas/nY6bk/?utm_source=dlvr.it&utm_medium=twitter" target="_blank">works a bit differently overseas</a>. One way to help protect yourself is with a <a href="https://www.worldtrips.com/quotes/default.asp?referid=24353" target="_blank">Travel Medical plan</a>.<br /><br />■ As if the ObamaTax train-wreck wasn't causing enough damage to the health care and insurance sectors, its broad "appeal" has rippled through the whole economy:<br /><br />"<a href="http://washingtonexaminer.com/obamacare-train-wreck-is-crashing-employment-too/article/2533624" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">This letter was written by the three of the nation's largest labor unions ... Right now, unless you and the Obama Administration enact an equitable fix, the ACA will shatter not only our hard-earned health benefits, but destroy the foundation of the 40-hour workweek that is the backbone of the American middle class</span></i></a>."<br /><br />Ooops.<br /><br />■ Earlier this month, the (Evil) Employer Mandate was <a href="http://www.insureblog.blogspot.com/2013/07/what-breaking.html" target="_blank">put (temporarily) on hold</a>. Before we start singing and dancing for joy (Hi, Joy!), though, here's some sobering news. According to the Congressional Budget Office:<br /><br />"<a href="http://online.wsj.com/article/SB10001424127887324809004578638282900414410.html" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">The Obama administration's move to delay a mandate on businesses to provide health coverage will mean $12 billion in lost tax revenue and additional costs ... one million fewer people will get employer coverage in 2014 as a result of the postponement</span></i></a>"<br /><br />So we get higher costs and fewer people insured. Yup, sounds like a plan!<br /><span style="font-size: x-small;"><span style="color: red;"><i><b><br />[Hat Tips to <a href="http://themoderatevoice.com/author/holly" target="_blank">Holly R</a> and Gail S]</b></i></span></span></span></div>
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Wednesday Potpourri

■ While you're busy planning that end-of-summer trip to Rome or London (or Istanbul, for that matter), you should know that your hea...

11:00 AM

Rakin' in the ObamaTax Bucks

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<span style="font-family: Arial,Helvetica,sans-serif;">As Patrick noted last week, the ObamaTax Medical Loss Ratio (MLR) provision seems to have been a wonderful gift to the health insurance industry:<br /><br />"<a href="http://insureblog.blogspot.com/2013/07/how-much-did-that-rebate-cost-you.html" target="_blank"><i>So, thanks to MLR, insurance companies took in an additional $50 Billion in 2012 and paid out $800 Million less in rebates</i></a>"<br /><br />Lest our readers think that this is an exaggeration, we learn today that at least one carrier, WellPoint, is making some serious coin off of the ObamaTax:<br /><br />"<a href="http://www.lifehealthpro.com/2013/07/30/wellpoint-expects-20-billion-ppaca-windfall?eNL=51f82d98150ba06d5200003d&utm_source=LifeHealthProDaily&utm_medium=eNL&utm_campaign=LifeHealthPro_eNLs&_LID=97611471" target="_blank"><i><span style="font-family: Times,"Times New Roman",serif;">[N]ewly minted CEO Joseph Swedish said the company expects a windfall of sorts from the [ObamaTax] — as much as $20 billion by 2016</span></i></a>."<br /><br />While that's only partially due to the MLR (other factors include increased market share and more folks buying coverage through the Exchanges), it's certainly looks to be "<i>berry, berry good</i>" for the folks at Blue Cross.<br /><br />By the way, take a look at your renewal and let us know how well <i><b>you're</b></i> faring.</span></div>
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Rakin' in the ObamaTax Bucks

As Patrick noted last week, the ObamaTax Medical Loss Ratio (MLR) provision seems to have been a wonderful gift to the health insurance ...

11:00 AM

Insurance as a loss leader

Insurance as a loss leader

It's often asked how long carriers will put up with low margins and tight regulations. It's not a very attractive market to be in r...

10:59 AM

Detroit Loves Obamacare

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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">The folks in the motor city may have Obamacare to thank for providing a way out of their </span><br />
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<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjD5VY7zjqPEb0Qs8DfXtKufMsdMy-ZPtwYT5eUzeCsk7Xm_-NypN-938Vo1cJkOK11Wd9qdIq_ECIyd6b5D1D6nHcoRpbvsHl6OkqiYzx2xR7Hc6T_miWA45qfz89MXsc00AfNYtnGUEI/s1600/obamacare+saves+detroit.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="236" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjD5VY7zjqPEb0Qs8DfXtKufMsdMy-ZPtwYT5eUzeCsk7Xm_-NypN-938Vo1cJkOK11Wd9qdIq_ECIyd6b5D1D6nHcoRpbvsHl6OkqiYzx2xR7Hc6T_miWA45qfz89MXsc00AfNYtnGUEI/s320/obamacare+saves+detroit.jpg" width="320" /></a></span></div>
<span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">financial mess.</span><br />
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<span style="background-color: white; line-height: 22px;"><i><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">As Detroit enters the federal bankruptcy process, the city is proposing a controversial plan for paring some of the $5.7 billion it owes in retiree health costs: pushing many of those too young to qualify for Medicare out of city-run coverage and into the new insurance markets that will soon be operating under the Obama health care law.</span></i></span></blockquote>
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<span style="background-color: white; line-height: 22px;"><i><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Officials say the plan would be part of a broader effort to save Detroit tens of millions of dollars in health costs each year, a major element in a restructuring package that must be approved by a bankruptcy judge. It is being watched closely by municipal leaders around the nation, many of whom complain of mounting, unsustainable prices for the health care promised to retired city workers.</span></i></span></blockquote>
<span style="background-color: white; line-height: 22px;"><b><a href="http://www.nytimes.com/2013/07/29/us/detroit-looks-to-health-law-to-ease-costs.html?_r=1&adxnnl=1&partner=rss&emc=rss&adxnnlx=1375114035-qqBvTrhzyXSeeX1NEzTq+A" target="_blank"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">NY Times</span></a></b></span><br />
<span style="background-color: white; line-height: 22px;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;"><br /></span></span><span style="background-color: white; line-height: 22px;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">And they are not alone . . .</span></span><br />
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<span style="background-color: white; line-height: 22px;"><i><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Similar proposals that could shift public sector retirees into the new insurance markets, called exchanges, are already being planned or contemplated in places like <b>Chicago; Sheboygan County, Wis.; and Stockton, Calif.</b> While large employers that eliminate health benefits for full-time workers can be penalized under the health care law, retirees are a different matter.</span></i></span></blockquote>
<span style="background-color: white; line-height: 22px;"><span style="font-family: Helvetica Neue, Arial, Helvetica, sans-serif;">Thank you Obamacare for bailing out cities that have no clue how to manage money.</span></span></div>

Detroit Loves Obamacare

The folks in the motor city may have Obamacare to thank for providing a way out of their financial mess. As Detroit enters the federa...

10:59 AM

Lucy (Peanuts fame) found working in Maryland

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Lucy would be called an inflation-denier for her never-ending demand that it cost $0.05. Even today hocking life insurance she is set on five cents being the price. I have to wonder if officials in Maryland aren't giving their price setting just as little thought:<br />
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"<a href="http://www.lifehealthpro.com/2013/07/29/maryland-cuts-some-carriers-rate-requests" target="_blank"><i>The Maryland Insurance Administration is telling some carriers that want to sell coverage through its individual exchange program to make deep cuts in their premiums</i></a>. "<br />
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"<i>In the bare-bones, “bronze level” of coverage, for example, the  monthly premium rates originally requested for a 25-year-old nonsmoker  living in Baltimore ranged from<u><b> $136 to $350</b></u>.</i><br />
<i><br /></i><i>The rates approved in that category of coverage range from <u><b>$124 to $237</b></u>.</i><br />
<i><br /></i><i>The rate reductions demanded range from 1.1 percent for a QHP to be  sold by a unit of Kaiser Permanente to 32 percent for a QHP to be sold  be a unit of  </i><a href="http://www.unitedhealthgroup.com/" target="_blank"><i>UnitedHealth Group Inc</i>.</a>" <i><span style="font-family: Arial,Helvetica,sans-serif;">[emphasis added]</span></i><br />
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It is important to remember that if the actuaries for United are wrong they don't get to keep the money, it would go back to the policy holders; thus they don't have any incentive to be that far off.<br />
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I have to wonder where $237 came from. That doesn't sound far off for a healthy person policy today with maternity. Guaranteed issue with community rating and $350 even sounds aggressive.  </div>

Lucy (Peanuts fame) found working in Maryland

Lucy would be called an inflation-denier for her never-ending demand that it cost $0.05. Even today hocking life insurance she is set on fi...