insurance

Cavalcade of Risk #212: Skynet edition

Cavalcade of Risk #212: Skynet edition

RJ Weiss presents this week's round-up of risk-related posts , with a heavy emphasis on risk, from cyber liability to under-reserving...

8:12 AM

Rx Conundrum

<div class="separator" style="clear: both; text-align: center;"><a href="https://academics.utep.edu/Portals/860/rx.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="93" src="https://academics.utep.edu/Portals/860/rx.jpg" width="140" /></a></div><div style="text-align: justify;">In the wake of the Hobby Lobby decision, there's been a lot of discussion about whether or not employers (and their health insurance providers) should be forced to provide "free" <strike>birth control</strike> convenience items coverage to their employees/insureds. [I put the scare-quotes around "free" because of course they're not: someone is paying an insurance premium. Or did Ms Shecantbeserious think that Big Pharma was giving it away?] It's also important to remember that this is a purely administrative issue - BC is nowhere to be found in the ObamaTax law itself. With that in mind, consider this: "<a href="http://betsyspage.blogspot.com/2014/07/cruising-web.html" target="_blank">It has always struck me as rather strange that that is the one prescription that the administration wants to insist should be provided at no cast to insured employees. Think of all the possible medicines that they could have chosen to be provided for free - prescriptions for heart problems, cancer, diabetes, asthma, HIV, or psychiatric treatments. But none of those were considered worthy of mandating that they be provided free of cost. Only contraceptives</a>." I'm embarrassed to admit that this rather obvious - and critical - point had gone completely under my radar. But it rings true, doesn't it? Why this one particular medication, and no other? Thanks to increased transparency, it's not really difficult to find the average cost of medicines. A few minutes online yielded this information: Average cost of BC: <a href="http://money.usnews.com/money/blogs/alpha-consumer/2012/03/05/the-real-cost-of-birth-control" target="_blank">$15 to $50 per month</a> (or $180 to $600 a year). That's about the cost of maybe a dozen latte's a month, max. Average cost of chemo: up to <a href="http://www.livestrong.com/article/153376-the-average-cost-for-cancer-chemotherapy-treatment/" target="_blank">$15 thousand a month</a>. Or how about HIV treatment? This averages <a href="http://www.npr.org/blogs/health/2012/07/27/157499134/cost-of-treatment-still-a-challenge-for-hiv-patients-in-u-s" target="_blank">$2,000 to $5,000 a month</a>. And yet the two life-saving regimens are subject to deductibles and co-payments, while the convenience items must be "free?" If it's truly about "women's health," are we to assume that no females get cancer or HIV? Reality says otherwise. [Hat Tip: <a href="http://www.ace.mu.nu/" target="_blank">Ace of Spades</a>]</div>

Rx Conundrum

In the wake of the Hobby Lobby decision, there's been a lot of discussion about whether or not employers (and their health insurance pro...

7:00 AM

Whiner's and Deadbeats

The Unaffordable Care Act (UCA) is still being promoted as a success. Only a politician with a big ego would say the UCA is working and helping people obtain health care they would not otherwise get.  <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiv44W3JS5qC7mMatgc006u_yXQ7JU-BB9tO8hkyz80nBmMICgVmQP-2rBAeXyPvDvxvGOQfZSAXZzDSJUjJpmfbmc0iwFvWv1K5BSjqOp3gllxhtShM9M0XIOABobCC6xSMiKZ23eC3mA/s1600/govt+wasteful+spending.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/AVvXsEiv44W3JS5qC7mMatgc006u_yXQ7JU-BB9tO8hkyz80nBmMICgVmQP-2rBAeXyPvDvxvGOQfZSAXZzDSJUjJpmfbmc0iwFvWv1K5BSjqOp3gllxhtShM9M0XIOABobCC6xSMiKZ23eC3mA/s1600/govt+wasteful+spending.jpg" /></a></div> If the UCA is so great, why are there so many whiners and deadbeats? <blockquote class="tr_bq">A <a href="http://kff.org/report-section/survey-of-non-group-health-insurance-enrollees-section-3/" style="background-color: white; color: #003399; line-height: 24px; text-decoration: none;" target="_blank">Kaiser Family Foundation survey</a> found that 43% of those buying ObamaCare plans say they are having difficulty paying premiums, with 14% finding it "very difficult."</blockquote><a href="http://news.investors.com/politics-obamacare/070814-707833-obamacare-enrollment-numbers-unreliable-government-audit-finds.htm?p=2" target="_blank">Investors Business Daily</a> I can understand if these people were my clients who are paying the FULL UNSUBSIDIZED PREMIUM for their coverage, but 87% of those surveyed are receiving taxpayer premium and cost sharing subsidies. <blockquote class="tr_bq">Widely followed industry analyst <a href="http://healthpolicyandmarket.blogspot.com/" style="background-color: white; color: #003399; line-height: 24px; text-decoration: none;" target="_blank">Robert Laszewski of Health Policy and Strategy Associates</a>, said that "generally, carriers are saying that 85% paid the first month and that enrollment deteriorates after that at a rate of 2% to 3% per month."</blockquote>That's a 15% fall off the first month in people who never paid their first premium. Six months later that is another 12 - 18% drop off. I have been in the health insurance business almost 40 years and if I had those kind of results I would have bailed a long time ago. It's difficult enough to grow a successful business, but losing as much as half your business the first full year is an insane business model. <blockquote class="tr_bq">An additional problem with the official enrollment numbers turned up in a <a href="https://oig.hhs.gov/oei/reports/oei-01-14-00180.pdf" style="background-color: white; color: #003399; line-height: 24px; text-decoration: none;" target="_blank">separate IG report</a>, which found 2.9 million "inconsistencies" between what applicants said and what government data show about income, citizenship and the like in the first five months of open enrollment.</blockquote>Roughly 40% of applications submitted via hc.flub have inconsistencies and 60% of those may never have been eligible for coverage. I wonder how many of those "inconsistent" applications originated with navigators? Recapping, of the reported 8 million that signed up: <ul><li>1.2 million never paid their first premium</li><li>Another 1.9 million will drop off during the first year due to non-payment of premium</li><li>And 1.6 million may be disqualified because they were never eligible for coverage</li></ul><div>Whiners and deadbeats are wrecking Obama's grand scheme.</div><div> </div><div>We spent almost $1 billion on a website that still isn't working and who knows how much money for navigators and other paid enrollers and only insured a net enrollment of 3.3 million people.</div><div> </div><div>This is how Washington politicians define success.</div><div> </div><div>Pitiful.</div>

Whiner's and Deadbeats

The Unaffordable Care Act (UCA) is still being promoted as a success. Only a politician with a big ego would say the UCA is working and help...

6:40 AM

If you like your current agent...

<div class="separator" style="clear: both; text-align: center;"><a href="http://kisstheschoolbondgoodbye.com/wp-content/uploads/2014/04/pinocchio-long-nose.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="140" src="http://kisstheschoolbondgoodbye.com/wp-content/uploads/2014/04/pinocchio-long-nose.jpg" width="133" /></a></div><div style="text-align: justify;">Well, you know... Still another broken ObamaTax promise: "<a href="http://www.bizjournals.com/seattle/blog/health-care-inc/2014/07/side-effects-half-of-brokers-consider-leaving.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+bizj_seattle+(Seattle+-+Puget+Sound+Business+Journal)" target="_blank">Nearly half of insurance brokers polled nationally have considered leaving the industry in the wake of the [ObamaTax] ... Companies' use of brokers has increased to 61 percent in 2013, compared to 56 percent in 2011</a>" So just when we're needed the most, a chunk of us are contemplating bailing. I must admit to having (briefly) considered this option last year. Not leaving the business, of course, just the health insurance side of it. Eventually, I abandoned that plan, but I know that quite a few others did decide to pull the plug (and several have been referring their health insurance clients and prospects my way, which is nice). Still, I'll need to make time soon to re-certify for the Exchange, which means another half-day on a .gov site that's barely navigable. And this news comes as we learn that "45 percent of companies surveyed said they plan to increase their reliance on brokers ... when making changes to their employee health plans." So, a lot of potentially disappointed, and frustrated, small business owners. The other (bigger) problem, of course, is the plight of individuals trying to navigate (Heh) the Exchanges (both public and private) by themselves. Although the ObamaTax was sold as a means to simplify consumer choice, it's really had the opposite effect. People have questions about subsidies, and plan designs, and networks, and they're not getting answers from the 404Care.gov folks. So <a href="http://insurance.answers.com/methods-to-obtain-insurance/why-you-need-an-insurance-agent" target="_blank">to whom will they turn</a>?</div>

If you like your current agent...

Well, you know... Still another broken ObamaTax promise: " Nearly half of insurance brokers polled nationally have considered leaving ...