Insurance-Consumer-Advisor

The REAL Reason Your Hospital Bill's Outta Sight (ps - it has nothing to do with insurance)

2010-07-06T14:56:00.000-07:00

by LAS

Please read about this shocking story on Associated Content at http://www.associatedcontent.com/article/5632476/the_real_reason_your_hospital_bills.html?cat=3

Please read the original article at Washington Monthly and then raise some hell with Congress: http://www.washingtonmonthly.com/features/2010/1007.blake.html

Choosing a Certified Financial Planner? Finally you can weed out the crooks first

2010-06-07T17:21:00.000-07:00

by L.A.S.

Please go to http://www.associatedcontent.com/article/5632362/finally_you_can_weed_out_the_crooks.html?cat=3
to read this news item and get a link to the files of CFP misconduct cases.
Thank you.

One Dental Discount Card is Actually Worth Something

2010-04-02T19:46:00.000-07:00

by LAS

Recently I came across a detailed report on how to save money on your dental bills using one of those discount cards. The author gives actual prices from earlier this year to show you how much you might save on your bills.

Anyway, for $12 a month, it sounds very good.

An excerpt: The card from Aetna clearly says “This is not insurance.” There is no excuse for any customer to not realize that this is different from their usual dental insurance coverage.

The normal charge for a tooth extraction at my provider was $168. The dental card took $100 off that fee.

The normal charge for a root canal was $706; the discount was $351. The normal charge for a core buildup for that same tooth was $265; the discount was $137.
(end of excerpt)

For the full story please go to http://www.associatedcontent.com/article/5632542/one_dental_discount_card_is_actually.html?cat=3

For full information on how to save on dental bills, go to www.vitalsavings.com to see if this program might work for you. You may also call with your questions to 1-877-698-4825.
Best wishes to all and I hope you find something useful on these pages.

Even Congressional Reps Have Had to Sacrifice Their Gold-Plated Healthcare Plan

2010-04-01T02:13:00.000-07:00

by LAS

The official language from Section 1312 of the Senate plan (HR 3590 ):
(D) MEMBERS OF CONGRESS IN THE EXCHANGE-
(i) REQUIREMENT- Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are--
(I) created under this Act (or an amendment made by this Act); or
(II) offered through an Exchange established under this Act (or an amendment made by this Act).

Some of us may be quite familiar with the fact that current members of Congress are covered under the Federal Employees Health Benefits Program. The program, which covers over 8 million employees of the federal government, is a private plan which is the envy of most non-governmental employees.

Congressional members may also choose to be treated at a military hospital or at the office of the Attending Physician of the U.S. Capitol for a fee.

Now when the provisions of the new law roll into effect, the Cadillac plan will be phased out and replaced with the same coverage given to the rest of America. You may read the notice posted at Congress dot org at http://www.congress.org/news/2010/03/25/how_will_lawmakers_insurance_change

Amish and Mennonite Exempt from New Healthcare Reform Law

2010-04-01T02:07:00.000-07:00

by LAS

The old order Amish and the Mennonite communities are exempt from the provisions of the new healthcare reform bill recently signed into law by President Obama. Their religious beliefs reject assistance from outsiders such as the government.

These churches typically take up collections to pay for any medical bills incurred by their members. These groups are defined, by the language of the bill, as nonprofit organizations whose "members share a common set of ethical or religious beliefs and medical expenses among members in accordance with those beliefs."

Like the Amish, members of these ministries believe that the teachings of Christ dictate a philosophy of giving and sharing rather than taking, in this case from the third-party insurance providers. Individuals can opt into a cost-sharing program where regular contributions are distributed to other members in the network to pay for various healthcare services.

Medi-Share , Christian Healthcare Ministries , and Samaritan Ministries International are three such networks. The only requirement for joining, aside from paying your share, is that you practice a lifestyle in strict adherence to Christian philosophy.
Congress dot org has posted a short article on this topic. http://www.congress.org/news/2010/03/24/which_religious_groups_are_exempt

Keeping Up With Wendell Potter's Bulletins From the Front

2010-04-01T02:04:00.000-07:00

by LAS

Please see the latest column from Wendell Potter, the insurance industry whistle-blower, on the pages of PR Watch, a watchdog and consumer service at PR Watch dot org. Potter discusses what provisions of the new healthcare reform bill are worrying insurance industry execs and why, and how they hope to pull the teeth from the new law. Take for example the Medical Loss Ratio (aka MLR).

To quote Mr. Potter: The insurance industry tried unsuccessfully to strip the minimum medical-loss ratio provision from the bill. It wanted to have the freedom to keep spending less and less on medical care because every dollar not paid out in claims is a dollar that can be used instead to increase profits and to pay CEOs millions of dollars every year. Having lost the battle on Capitol Hill, the insurers are now turning their attention to the NAIC, which Congress gave the responsibility of determining the nitty-gritty details of how insurers will have to comply with the law.

Rest assured that the insurers will be pulling out all the stops to persuade the insurance commissioners to make it easy for them to meet the requirements of the new law by manipulating the definition of medical care. One of the things insurers will try to do, for example, is to get the NAIC to let them shift a lot of what insurers now count as administrative expenses into their medical expense category. If that happens, the insurers will look like they're suddenly spending more on medical care without changing anything at all.

The devil is ever in the details. And if you let the devil define all the terms of the law's provisions, then the industry will have gutted the law without seeming to have lifted a finger to do so.

So keep an eye peeled for shifty little maneuvers like this. And more power to Mr. Potter. Read the last column of his at http://www.prwatch.org/node/8977.

Health Insurers Discussed Delaying Covering Children with Pre-Existing Conditions

2010-04-01T01:56:00.000-07:00

by LAS

According to a March 28 story in the New York Times, and just days after President Obama signed the historic healthcare bill into law, insurance companies were insistent that they did not have to provide coverage to children with pre-existing conditions. President Obama called that element of the healthcare bill a 'centerpiece' of the new law.

President Obama, speaking at a rally in Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”

This provision of the reform bill was meant to protect youngsters who suffer from conditions such as leukemia, cystic fibrosis, birth defects, sickle cell disease, etc from being denied coverage under current business practices.

But the insurance industry tries to redefine what 'is' is, and what 'coverage' and 'insurance' mean.

While insurers agree that if they write a policy for a child, that they must cover pre-existing conditions. However, they still feel that they are not compelled to write a policy for a given child, and that at any rate this provision does not go into effect until 2014.

A few days after expressing their reluctance to implement this provision of the healthcare reform bill, the industry was compelled to announce that they would, in fact, observe this feature of the new law. But that came only after public outrage at insurance industry statements, including criticism from Senator John D. Rockefeller, among others.

According to the New York Times: Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”

The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.

But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then. This is what ignited the firestorm of protest and criticism from those in Congress and the reform movement.

SOURCE:
Pear, Robert, Coverage Now for Sick Children? Check Fine Print, March 28, 2010, New York Times, http://www.nytimes.com/2010/03/29/health/policy/29health.html

Steep Increases in Health Insurance Premiums Cited as Reason to Pass Reforms NOW

2010-03-04T12:50:00.000-08:00

by L.A.S.

Several stories are in the news and are the talk around water coolers everywhere, regarding the steep increases in premiums for individual health insurance. As millions of Americans face unemployment and losing their group health coverage, they eventually fall past the coverage period for COBRA extensions of their group plan.
Shopping for healthcare insurance on their own has provided many rude surprises. It is made worse by the steep increase in premiums over the past year, in some cases hitting 40 to 60 percent.

Insurers say that healthy people are opting to go without insurance coverage, leaving the insurers to issue policies to the sicker people filling out applications.

That may be true, but increases of 8.5 percent all the way up to 60 percent can put one in the emergency room with chest pains!! Those percentages appear in a Chicago Tribune story on this problem. The Illinois insurance commissioner's office apparently does not receive information from insurance carriers regarding premium increases on an annual basis, although many states do.

Premiums commonly reach $1000-2000 per month for individual policies. This pushes people into choosing between paying for rent-food-utilities OR for health insurance coverage.

The recent increases have spurred increased attention from the Obama administration and calls to pass healthcare reform now. HHS Secretary Sebelius convened a meeting with the CEO's of several larger insurance carriers to discuss the recent premium hikes in the White House Roosevelt Room.

The CEO's of the following insurers came to the White House: Wellpoint, Aetna, Cigna, UnitedHealth Group and other companies not named. Also state insurance commissioners from Kansas, West Virginia and Pennsylvania came.

Ronald Williams of Aetna praised the administration for bringing them together to discuss the problem and said “this is what we need more of, everyone at the table collaborating.”

The Kansas insurance commissioner, Sandy Praeger, stated that “people are reaching the breaking point.”

Related stories:
Individual health insurance policy premiums soaring; Illinois consumers to pay up to 60 percent more, data show, www.chicagotribune.com/business/ct-biz-individual-health-insurance-premiums-mar04,0,223417.story

Sec'y Sebelius huddles with insurers, states over double-digit health insurance rate increases, www.chicagotribune.com/business/sns-ap-us-health-insurers,0,1976793.story

Congress demands explanation of California Blue Cross' rate increases when profits are up

2010-02-15T18:23:00.000-08:00

by L.A.S.

California's Blue Cross operations must be doing great. They experienced record profits in a troubled economy in 2009, yet have raised rates as much as 39 percent. The Los Angeles Times reported on Jan. 28 of this year that Wellpoint's profits soared eightfold.

This news was shortly followed by an article on Feb. 4 in the same paper that Anthem Blue Cross was raising rates on individual health policies in California, in some cases by as much as 39 percent. The same paper reported on Feb. 10 that Congress was opening a probe into Anthem Blue Cross; the Department of Health and Human Services (HHS) was also interested in the case.

Wellpoint is the corporate parent of Anthem Blue Cross; its profits soared to 4.7 billion dollars last year, a record for them and extremely impressive in the current economic climate. There might be a link behind the improved profits and the fact that Blue Cross dumped 1.4 million policyholders last year, who were no doubt the most-expensive-to-insure and the least-desirable-actuarially.

Besides these U.S. government departments, interest in this development has also been expressed by public-interest or progressive social/political organizations such as MoveOn. You might like to visit the latter's website at MoveOn dot org where they are gathering signatures for an electronic petition demanding an explanation and rollback of the Blue Cross rate increases.

The need for prompt intervention in this corporate abuse is needed because not only is Blue Cross refusing to explain the rate increase, it is threatening to deliver further rate increases without warning. Even though many states require stringent reporting and forecasting of claims and payouts, there is no national regulation of rate increases. By that I mean, no limits on how much they can raise rates, nor on how often they can raise rates. This is the next best thing to having a license to print money.

So far, Blue Cross is stonewalling on an explanation and will continue to do so until this issue becomes a public-relations problem. That is why I urge you to spread the news of this case and to sign petitions, write letters to the editors, and blog AND do whatever else you can think of to be a thorn in Blue Cross' butt.

UPDATE: As of Monday, Feb. 15, Blue Cross announced that they will delay the rate increases for two months. This is evidence that public pressure has made them uncomfortable, but a short delay is not enough. Keep applying the pressure and we believe that they will be forced to abandon the effort.

Your Health Insurance Industry Spent $38 Million NOT on Health Care, but on LOBBYING Congress; and, Pre-existing Conditions Covered Only for Minors?

2010-01-26T17:45:00.000-08:00

by L.A.S.

There is no recession in the lobbying industry. In fact, you might be cheered to note that the major insurers increased their lobbying budgets by anywhere from 7 to 80 percent. Yes, I said 80 percent. Little-big Humana upped its investment (ahem) in our Congress by 80 precent, to hit a mere $3.2 million dollars that might have paid for a life-saving surgery or two.

The increase looks large because their budget is tiny compared to America's Health Insurance Plans(AHIP), which spent a total of $8.9 million on lobbyists.

And what would YOU have done with that money? Probably spend it on worthless stuff like groceries and gas and rent -- nothing that helps the real economy grow.

But that is water under the bridge now and money gone down the tubes. It is spent, and we have to buckle down and make our voices heard above the din.

One of the things that has been quietly dropped in this season of healthcare reform is the notion of covering everyone regardless of pre-existing conditions. Now we find that only minors will be guaranteed that right. Yes, slipped in between the cracks of the newest version of reform poroposals is one that says children 19 and under will be guaranteed coverage without regard to any pre-existing conditions. According to another story on Alternet:

“The challenge for Democrats: a ban on denying coverage for those with pre-existing conditions went hand-in-hand with a requirement that all Americans carry insurance. Insurance companies conceded that they would accept all patients, regardless of health history, but only if everyone was required to have insurance, which would spread the cost of insuring the sick across a wider pool. Without an insurance mandate, a pre-existing ban would mean that premiums would almost certainly rise.”

Whoa. Wasn't that going to be UNIVERSAL, in those heady days when we thought that a major reform bill might get pushed through?
Insurers wanted that provision to be linked to mandatory purchase of insurance by everyone; that was the only way that risk could be spread out among the whole population.

Details of any reforms for this year (if any) are sketchy at best. But if this is the best that can be done for America, then I wonder if it is worth all the paper it will be printed on.

See whole stories at the AlterNet website at --
http://www.alternet.org/story/145389/are_democrats_dropping_the_ban_on_preexisting_conditions http://blogs.alternet.org/speakeasy/2010/01/25/health-insurers-spent-38-million-lobbying-congress-in-2009/

SEC Charges 2 Companies in 'Green" Ponzi Scheme

2010-01-04T21:17:00.000-08:00

by L.A.S.

In November the SEC charged four persons and two companies in a so-called 'green' Ponzi scheme. It targeted elderly investors or those nearing retirement to finance a supposedly green housing community that would use biochar charcoal substitute made from organic waste.

The SEC alleges that the "green" representations were bogus, and investors were falsely promised enormous returns ranging from 17% to "hundreds of percent" annually. In fact, the company's environmental initiatives did generate any significant cash, and any returns paid to investors have been funded almost exclusively from other investors' contributions, the SEC says.

Charged in the complaint were Mantria Corp., Speed of Wealth LLC, Wayde and Donna McKelvy, and Troy Wragg and Amanda Knorr in federal court in Denver. Mantria's only source of revenue has been from its resale of vacant lots for its purported residential communities in rural Tennessee, but those did not generate cash with which to pay investor returns because Mantria provided 100% financing for almost all of its vacant lot sales to buyers using other investors' funds.

See WeRemember dot org to Track Missing Life Insurance Policies

2010-01-04T21:07:00.000-08:00

by L.A.S.

Unclaimed insurance policies may total billions of dollars each year just because family members do not know where your life insurance policies are, or what recent changes to your estate have been made.

This is where a company named WeRemember comes in. They can save family members years of struggle and prevent them from getting over the grief of their loss. They may spend years filing lawsuits against each other or a financial advisor.

Joe Palmer, president and co-founder of WeRemember.org, based in Glenview, Ill., became aware of problems that can arise after his grandfather died in an airplane crash. The family did not know where the final will was, and missing paperwork resulted in family members filing lawsuits against each other.

For a one-time fee of $29.95, an individual can sign up on the WeRemember.org Web site. The person fills out a form listing his or her insurance policies, wills, bank accounts and other pertinent data and where each is or who the lawyer is who holds the information. The forms take about 20 minutes to complete, depending on how many policies and accounts there are.

WeRemember.org sends out regular e-mails reminding clients to update their information. When a client dies, WeRemember.org makes phone calls to heirs to let them know they are entitled to a benefit and tells them how to proceed. No truly personal information, policy numbers or benefit amounts are kept by WeRemember.org.

Sounds like a good service to me.

Things the Healthcare Reform Bill WON'T Fix, and a Handful of Things it WILL Fix and Quickly

2010-01-04T21:02:00.000-08:00

by L.A.S.

The hard truth of the healthcare reform bill passed by the US Congress is that most of the provisions will not go into effect until 2014 (the House version would take effect in 2013).

The even harder truth is that even if it does become law, some things will still not be fixed. This is because the special interest groups lobbied hard and long so that their industry would not have to be the ones to pay for a national healthcare program.

As listed by economics writer Paul Zane Pilzer, these are the items that will still need reform. One wonders if the new bill is even worth all the paper and toner used to print it.

# The American Medical Association, representing doctors, was promised that nothing would be done to cut payments to physicians or tie doctor payments to performance.

# Trial lawyers were promised that no caps would be put on legal liability for medical mistakes.

#Big Pharma was promised that nothing would be done to their net revenues — even things like giving Medicaid patients generic vs. brand-name drugs were taken off the table.

# Local insurance companies were promised that they would not have to compete with larger national insurers over state lines.

# Medical network providers were promised that there would not be "transparency" — the varying charges medical providers give each patient would never be disclosed.

On the other hand, the bill does have the saving grace of offering consumers seven quick fixes that will go into effect almost immediately. My thanks to Congress dot org for posting this information.

1. Insuring high-risk citizens. Both bills would create a $5 billion fund for temporary insurance for citizens with pre-existing conditions who have not been insured for at least six months. The program would end once the insurance exchanges begin in 2013 or 2014.

2. Extending insurance for adult children. The House bill would allow parents to keep unmarried adult children on their health insurance until their 27th birthday; the Senate bill, until their 26th birthday. This would reduce the number of uninsured young adults.

3. Extending insurance for the recently unemployed. Under current law, laid-off workers are allowed to continue buying their existing insurance through the COBRA program for up to 18 months. The bills would extend that coverage until the insurance exchanges begin.

4. Ending lifetime limits on benefits. Both bills would end the lifetime caps on insurance coverage which have sometimes been used to deny payments to consumers with particularly expensive treatments. Both bills would also restrict annual limits on health-care benefits.

5. Ending rescission. Insurance companies often cancel policies for consumers who require expensive medical care because they made honest mistakes on their medical histories. Both bills would prohibit insurance plans from canceling coverage except in cases of fraud.

6. Starting to close the doughnut hole. Both bills would begin closing the so-called "doughnut hole" in Medicare Part D prescription drug coverage by providing an additional $500 in coverage starting in 2010. Over several years, the gap would be reduced until it was closed entirely.

7. Taxing plastic surgery. The Senate bill would include a new 5 percent tax on elective cosmetic surgery. The tax is estimated to raise $5.8 billion over the next 10 years. It does not apply to cosmetic surgery to fix problems caused by accidents, disease or birth defects.

So while the healthcare reform bill is far from perfect, it does have some redeeming value. Let us hope that this is only the beginning, and not the end, of healthcare reform.

Have You Been 'Downcoded'?

2010-01-04T21:00:00.000-08:00

By L.A.S.

It you have been 'downcoded' (this is a practice in which insurance companies revise a claim made by a doctor or hospital with a lower-price procedure instead of the higher-price procedure submitted by the health care provider), could you please leave a comment with how to reach you? The people at Huffington Post are trying to further investigate this practice, but they need documents, or some kind of source material, to work with.

Is It Ever a Good Idea to Decline Employer Insurance Coverage?

2010-01-04T20:58:00.000-08:00

by L.A.S.

Much to my surprise, a recent article on Wise Bread dot com suggested there might be three occasions when you might reasonably consider declining your employer's health plan.

DECLINE your employer's health plan? The very thought at one time would certainly have made one's blood run cold, especially for those who have families on such a plan.

First, to clarify. They are NOT suggesting that you simply go without insurance. They are simply saying that you may have other viable options.

You may be one of the lucky few who can find a better deal by yourself, whether online or just because you have few medical needs; perhaps you wish to go with a medical savings account or one of those self-directed programs. You may be offered a plan for a supplemental type of insurance such as vision or dental that is more than just a few bucks per month -- and has so little benefit that it defies the purpose of insurance. Or you may be able to obtain a fine plan through another group or through your spouse's employment.

I have probably been in any of those situations myself. For a time, I had a high-deductible health plan with my (former) employer that was a free option. Yes, it was free coverage from the very nice employer, as an alternative to the sticker shock from a huge premium increase.

My vision and dental coverage WAS only a couple bucks a month, so I kept it as long as the premiums were so low. But eventually those premiums rose even faster than the medical plan premiums. And when I went in for a service at a local dentist, I was always forced to sign a paper saying that I would pay the balance that the insurance did not cover. Whoa, that defeated the whole purpose of insurance, to my mind. So eventually, when the premiums reached a break-even point, I just dropped it.

And thankfully, I have found some insurances through other groups that I belong to. I have mentioned some of these strategies in my articles here at Blogspot. People over 50 may find coverage through a membership in AARP, if nothing else is available. Perhaps you belong to a fraternal organization or a club, or a professional group, or even AAA. Even your membership in a buying club like Sam's Club may bring you special prices, not on insurance, but on vision and prescription services. Any or all of them may have an insurance plan or plans for their membership, with no medical exam or other pre-qualification required.

You can read the whole article and decide for yourself at -- www.wisebread.com/3-times-to-consider-declining-your-employers-health-coverage

News Stories Poke Holes in Insurers' PR and Spin

2009-10-15T09:17:00.000-07:00

by LAS

News stories galore are popping up all over the internet and inside consumer watchdog newsletters. Over the summer, we have been treated to the ultimate whistleblower, Wendell Potter, the former insurance exec who now reveals all the dirty secrets of the industry's program to wrangle the most favorable legislation from our Congress.

This week a slew of similar stories have deflated industry puffery. The New York Times has admitted that it gave the public option short shrift in a one-sided editorial. The editorial went to great lengths to list every objection to the public option without listing even one benefit espoused by its proponents. The media watchdog FAIR received about 1,000 complaints about the editorial. You can read the admittedly short admission on the pages of FAIR dot org here: www.fair.org/index.php?page=3926

Slate carried an article earlier this week bu Robert Reich, who exulted over the way that insurers' have boxed themselves into a corner while trying to fight the prospect of reforms and/or the public option. The intriguing title is “The Audacity of Greed: How Private Health Insurers Just Blew Their Cover.” Reich wrote: “The only reason these costs can be passed on to consumers in the form of higher premiums is because there's not enough competition among private insurers to force them to absorb the costs by becoming more efficient. Get it? Health insurers have just made the best argument yet about why a public insurance option is necessary.” You can read that article now on his blog, at: http://robertreich.blogspot.com/2009/10/audacity-of-greed-how-private-health.html

Then an AP story today, Thu, carried the headline “FACT CHECK: Health insurers cherry-pick facts.” The headline is not at all surprising; most of us are aware that every industry will put forth its views with the most selective data supporting its position. However, it is unusual that the major media will announce such spin-doctoring while the battle rages on. This article points out that a recent industry ad misleads seniors into thinking that cuts are being made to basic Medicare. It is not; what is being cut is Medicare Advantage, the low-cost alternative that is most similar to an HMO. Costs to administer this program have risen much faster than first projected. Yahoo News has the full article which you can read here: news.yahoo.com/s/ap/20091015/ap_on_go_co/us_health_insurers_fact_check;_ylt=Aol4ud6iH0FiULm5ZbK19E8iANEA;_ylu=X3oDMTMwaGJzOTAwBGFzc2V0A2FwLzIwMDkxMDE1L3VzX2hlYWx0aF9pbnN1cmVyc19mYWN0X2NoZWNrBGNwb3MDNwRwb3MDNwRzZWMDeW5fdG9wX3N0b3JpZXMEc2xrA2ZhY3RjaGVja2hlYQ--

In a related matter, PR Watch has written a good article titled: “Put out the FIRE on Capitol Hill with a Consumer Financial Protection Agency.” Do we need yet another government agency? Yes, if we are to curb the abuses committed by the current generation of banks and other financial institutions. Will we get an agency with teeth, if we set up such a watchdog? It is in doubt whether such an agency will see the light of day. Take a look at the political contributions dispensed to certain key members of Congress, to make them more receptive to the industry's views on reforms and oversight.

To quote: “Take Congresswoman Melissa Bean (D-IL), for instance, she is the top recipient on the committee of FIRE campaign finance dollars in 2009. She is also one of the biggest threats to meaningful reform. Evidently, Bean's take away from the financial crisis – which threw 7 million Americans out of work and cost taxpayers $3 trillion – is that consumers need less protection not more. According to watchdogs at Public Citizen, Bean is planning to introduce an amendment to the CFPA bill tomorrow which would take away the right of states to protect consumers more aggressively than the feds.”

This is serious business, folks. You need to voice your support of a financial watchdog agency WITH TEETH so that more Americans do not suffer for the crimes of our financial system.

Q: Are Insurers Practicing Medicine Without A License?

2009-10-12T14:15:00.000-07:00

by L.A.S.

One of the odder results of our reliance on private health insurers is that insurers are in fact making medical decisions. Those decisions are removed from the doctor-patient relationship. Yet while the insurers claim that they are making decisions on PAYMENT, and not on approving or denying the actual medical treatment, the fact is that in the end, insurers' decisions determine whether patients live or die.

This raises the questions then, whether insurers are practicing medicine without a license!
Who gave them this authority?

If the insurance industry were handed the job now of covering medical claims (as they way were back in 1919), would they be able to get away with it?

I wish someone would file a lawsuit and find out if we consumers can set things to rights.

Insurers attacking healthcare reform bill with heavy lobbying

2009-10-12T14:11:00.000-07:00

by L.A.S.

This is no surprise, but insurers are fighting back hard against prospects of real healthcare reform that may or may not include a public option.

Their latest gambit is a claim that this reform movement would add hundreds of dollars to the cost of insurance coverage, contrary to the claim by the reformers that pitching a bigger tent to cover more people (including young, healthy people who currently do not feel they need health insurance) will reduce the cost of covering everyone else.

To quote the article: “The (insurers) study projected that in 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher.

Baucus spokesman Mulhauser said the study is "seriously flawed" because it doesn't take into account provisions in the legislation that would lower the cost of coverage, such as tax credits to help people buy private insurance, protections for current policies and administrative savings from a revamped marketplace.

White House health care spokeswoman Linda Douglass concurred. "This is an insurance industry analysis that is designed to reach a conclusion which benefits the industry, and does not represent what the bill does," she said.” [end of quote]

You can read the whole article (per Newsvine feed) at www.newsvine.com/_news/2009/10/11/3372624-insurers-mount-attack-against-health-reform

A Minnesotan Reports on the Canadian National Health Experience

2009-09-27T20:08:00.000-07:00

by L.A.S.

When Minnesotan Bob McIntosh moved to Victoria, British Columbia, two years ago, he expected long waits for medical attention. But to his surprise, he was shown to a doctor's office after only 20 minutes in the waiting room of a local walk-in clinic.

Service was not only fast but friendly. The building is less imposing than most facilities in the U.S., and clinic rooms might be described as spartan. Yet patients can depend on everything that counts where medical services are concerned, and so it merits serious consideration as a basis for an American plan.

Contrary to what most sources would have you believe, the coverage is not exactly free and excludes some allied health services.
Mr. McIntosh reports that Canadians there pay a monthly premium of just $100. That premium is waived for those who cannot afford it. The national health plan, called Medicare, does include clinic visits, annual checkups, and most lab work. Not covered are a PSA test ($30), eyeglasses, dental care, acupuncture, physiotherapy, massage, chiropractic, non-surgical podiatry, and the like.

The Medicare program is administered by the provinces. That means if a resident of British Columbia travels to another province or country, he needs supplemental insurance. McIntosh found such a plan for another $88 a month, but many people get such coverage provided by their employers.

Why can't the powers-that-be in this country accept the irresistible logic of a national healthcare plan? Perhaps they like seeing huge, luxurious hospital wings with their names on a plaque up front. And they like even better the large inflow of money each month from insurance policyholders and annual bonuses for denying medical care to those who need it.

Wouldn't You Love to Have 100 Percent Income Replacement thru Your Disability Insurance?

2009-09-26T10:07:00.000-07:00

by LAS

Wouldn't we all love to be assured of full income replacement if we were disabled, either short term or long term? Well, unfortunately Americans cannot get that kind of coverage, at least not if they live in the United States.

I viewed the film Sicko again and there was so much covered in there, that it was difficult to sort out all the issues. But one of the issues apart from those related to health insurance was the matter of disability insurance.

Here in the United States, one cannot get more than about 60 or 65 percent income replacement through a disability policy, whether from a private policy or through the federal government's SSI program. It is felt that people should not profit by getting injured or disabled. Well, they should not be forced to choose between rent and food, or rent and medications -- and so many of those on disability rely on several medications just to get through the day.

Tony Benn was quoted in Sicko as saying that choice depends on freedom to choose, and if you are shackled with debt, then one does not have the freedom to choose. I might add that if you are shackled with healthcare bills beyond your ability to pay, then you do not have choice or the freedom to choose, either.

But in France, the law requires that disabled people receive full pay while on disability. The government pays 65 percent, and your employer pays 35 percent. Sicko related the story of a Frenchman who was too exhausted after a course of chemo to go back to work right away, so his doctor gave him a note for a three-month leave. So the guy goes on vacation, soaks up some sun and recoups his old energy, and voila, he's a new man again.

So if you should be so lucky as to work for the French office of an American corporation, you could reap the best of both worlds. American pay with French social security -- real social security, not just a retirement check that won't cover rent, but retirement, healthcare, disability, full maternity coverage, and more.

I have read that recent years have found the French hard-pressed to pay for rising expenses even in a system that pays its doctors well but not extravagantly. Perhaps they will have to cut the less necessary fringe items like paying for vacations, or for college beyond the first two years, or or home services for new mothers.

But I sure hope that the French maintain their militant insistence that even foreign corporations have to obey French labor laws. Someone has to keep the corporations in line. And if the French will do the job, then more power to them.

Remember the Part in 'Sicko' When Sick People Had Policies Canceled Back to Starting Point?

2009-09-26T10:05:00.000-07:00

by LAS

The Michael Moore film Sicko threw light on many kinds of problems that ordinary people have with their health insurers. One such problem is rescission, where a company decides that it issued a policy in error (often claiming the policyholder lied or omitted required information on the application), and cancels that policy all the way back to its starting date.

This sticks the hapless policyholder with all the bills that the insurer had paid while the policy was in force. Sicko related the story of one such victim of the rescission power, who had omitted a history of yeast infection and was stuck with a $7000 surgery bill for an unrelated illness. NAIC, the regulating body for the insurance industry, has decided to take steps to curb abuse of rescission and bolster consumer protection.

NAIC sent a letter to the House Energy and Commerce Subcommittee on Oversight and Investigation. In this letter, NAIC outlined its plan to analyze rescission-related consumer complaints, and develop procedures for external reviews of these rescissions. It stated that it is determined to prevent abuses of the rescission authority, which is used by insurers to cancel policies that it decides were issued in error.

It is nice to see that Moore's film has prodded NAIC to at least examine the practice of rescission and promise to improve consumer protection. We will see what comes of this, or whether the industry will pull the teeth out of any attempts to regulate itself.

Manulife Shareholders Threaten Class-Action Lawsuit

2009-09-26T10:03:00.000-07:00

by LAS

The shareholders of Manulife Financial have proposed a class-action lawsuit against the executives of the firm. They charge that the execs made “false and misleading statements” about the company's risk management ability. The shareholders equate this with violating federal securities laws.

The proposal was filed with the US District Court for the Southern District of New York. Manulife has responded by saying that its financial disclosure met all legal requirements and that these issues have nothing to do with policyholders or company products.

The Canadian regulators responded first, with the Ontario Securities Commissioner issuing a statement in June. In that response, Canada's preliminary conclusion was that the company did not meet its obligation to disclose regarding market risk in its variable annuity products and segregated funds.

Geez, why is it so clear to the Canadians that Manulife was playing fast and loose with the law? Will there be any justice for the American shareholders? And why is it so difficult for Manulife to do right in the first place?

Insurance Companies See Losses, Downgraded Fitch Ratings

2009-09-26T10:01:00.000-07:00

by LAS

The year 2009 has seen insurance companies taking hits both in their bottom lines and in their ability to sell bonds. Fitch has downgraded all health insurers that it covers to a negative outlook. Part of the reason for the downgrades is the uncertainty of what health insurance reform will entail.

Fitch has been downgrading ratings on insurers during the first half of 2009, almost across the board. A total of 42 companies had their ratings downgraded. By contrast, only three insurers suffered downgrades in 2007, and 13 in 2008. Fitch does not expect to see more upgrades than downgrades till 2010.

MetLife suffered investment losses of $2.6 billion in just the second quarter of 2009. This loss was mainly due to derivatives, a sector that is still exacting its penalties for the industry's lack of judgment. MetLife had been using derivatives as a hedge against risks like inflation and currency fluctuations. Company net income fell from $4.3 billion in the second quarter of 2008 to $3.9 billion this year.
Oddly enough, MetLife passed the government's stress test earlier this year. It also had the lowest total potential losses compared to 18 competitors.

The Hartford Financial Services also posted a second quarter loss and missed analyst expectations. While expected to finish that quarter with a profit, instead it lost $15 million. Earnings were down 11 percent from a year ago. Earnings per share for common shareholders declined from $2.22 to $1.90 per share.

One of the few insurers to see a healthy gain in business was AAA. A.M. Best attributed AAA's superior showing to its wide marketing and distribution relationships with partner clubs.

2009 List of Providers of Whole Life Insurance

2009-09-20T23:15:00.000-07:00

by L.A.S.

Whole Life insurance has seen a huge resurgence of interest in recent years. Many whole life policies are substituting for long-term care insurance for those who cannot qualify for that specific insurance policy; the fact that most whole life insurance policies can include a rider allowing for “accelerated benefits” in case of terminal illness has been a real boon for both insurers and for consumers. Also the tax benefits as opposed to an annuity or other investment is a consideration.

Many of the products listed below are only for workplace insurance offerings, but many also offer individual policies. This list may not be completely comprehensive. Please also consult the 2008 list for other companies, and your state insurance commissioners office. For the latter you can begin the search by going to NAIC online (National Assn. of Insurance Commissioners) and then click on your state; this will take you to your state's insurance commission and you will find a comprehensive listing of insurers who are licensed to operate in your state.

American Family Life Assurance Co. of Columbus (Aflac): aflac.com; 800-992-3522; all states; issue ages 18-65.
Americo Financial Life and Annuity Insurance Co.: americo.com; 800-231-0801 x 8410; all states EXCEPT AL ME MS NY VT WA, “Ultra Protector” series issue ages 50-85.
Colorado Bankers Life Insurance Co.: cbl-life.com; 800-367-7814; all states EXCEPT MN MT NJ NY ND VT WA WV; “Preferred Golden Protector” issue ages 15-85.
EMC National Life: emcnationallife.com; 800-232-5818; all states EXCEPT DE MD MA NJ NY; Workplace Increasing Whole Life issue ages 18-70. EMC National Life Co., at emcnl.com, also offers “Worksite Increasing Whole Life” for issue ages 0-70.
Equitable Life & Casualty: equilife.com; 800-352-5170; all states EXCEPT AR CA DC FL GA HI MD MA MN NJ NY NC PA WA WV WI; issue ages for Equilife Legacy 3 is 18-84. Equilife Legacy I is offered in all states EXCEPT AL CA DC HI MD MA MN NJ NY WA WI, same issue ages. Equilife Legacy II is offered in all states EXCEPT AL CA DC FL GA HI MD MA MN NJ NY NC PA WA WV WI, same issue ages.
Illinois Mutual: illinoismutual.com; 800-437-7355 x782; “Interest Sensitive Whole Life Insurance” is offered in all states EXCEPT AK HI MT NJ NY PA; issue ages for employees is 15-79.
M & O Marketing: mandomarketing.com; 800-228-5964; all states; issue ages 0-85.
Medico Insurance Co.: gomedico.com; 800-228-6080; offered in AR CO ID IA KY MO NE NV NM OK OR SC TN UT WV WY; issue ages 50-85 for “Final Expense Whole Life A04 or A05”.
National Life Insurance Co.: nationallife.com; 802-229-3333; NL LifeBuilder offered in all states, issue ages 0-85.
Royal Neighbors of America: royalneighbors.org; 800-770-4561; “Royal Prime” permanent whole life offered in all states EXCEPT AL AK DE DC HI LA MA MT NV NH NY SC VT WI WY; issue ages 0-85. Policies bought at ages 0-60 may be paid up by age 65.
Senior Market Sales Inc.: seniormarketsales.com; 402-397-3311; whole life policies offered in all states EXCEPT NY; issue ages 0-80.
Starmount Life Insurance Co.: insurancelife.com; 1-888-saylife or 888-729-5433 x112; “Value Life Gold” offered in all states EXCEPT AL DE DC HI ID IA MS MT NV NH NJ NY UT WY; issue ages 0-80.
Texas Life Insurance Co.: texaslife.com; 800-283-9233 x6845; “VPL-plus” offered in all states EXCEPT NY; issue ages 17-70 (dependents 6 mos-18 yrs).
Transamerica Worksite Marketing: transamericaworksite.com; 800-322-0426; “Transure” offered in all states EXCEPT CA FL MA MN MT NJ OR PA VT VA WA; issue ages 16-70 (children or grandchildren ages 0-24).
United of Omaha Life Insurance Co.: mutualofomaha.com; 402-351-5770; “Whole Life Express” offered in all states EXCEPT NY; issue ages 0-80.
Universal American: universalamerican.com; 800-538-1053 x8357; “Senior Tribute” final expense offered in all states EXCEPT AK HI MN MT RI WA WY; issue ages 45-85.
Unum: unum.com; 866-679-3054; “Interest Sensitive Whole Life” offered in all states; issue ages 15-80 (dependents 14 days to 24 yrs).

2009 List of Providers of 401k Plans

2009-09-20T23:08:00.000-07:00

by L.A.S.

The following is a list of companies that offer 401k plans. It is up to date as of Fall 2009, but we cannot guarantee that it is an all-inclusive list. Please consult with your certified financial planner regarding specific features of plans that will best fit your needs. Providing this list does NOT imply endorsement, and none should be assumed. You must determine which company's plans best suit you.

All allow tax-free loans from your plan EXCEPT Redwood Administrators, and Underwriters Marketing Service. All provide 401K rollover and consolidation EXCEPT Best 401K Inc., and Omega Recordkeeping.

ADP Retirement Services: adp401k.com; 973-712-2000
Advanced Benefits Consulting: 314-539-0836
Alliance Benefit Group: abgnational.com; 800-242-2356
American Pension Services LLC: americanpension.net; 813-281-0707 x110
American United Life Insurance Co: oneamerica.com; 866-313-7355
The Best 401K Inc.:thebest401k.com; 800-430-8054
CBIZ Retirement Consulting Inc.: cbiz.com/retirement; 407-475-1765
Charles Schwab: scrs.schwab.com; 877-456-0777
CPI Qualified Plan Consultants Inc.: cpiqpc.com; 800-279-9916 x765
Daily Access Corp.: dailyaccess.com; 888-535-4322
Elite Marketing Insurance Designers of Houston: elitemktg.net; 800-477-3548
Expert Plan Inc.: expertplan.com; 609-918-2500
Future Benefits of America: fb401k.com; 901-843-7799
Gradient Investments: gradientinvestments.com; 888-824-3525
Great-West Retirement Services: gwrs.com; 800-537-2033
Guardian Insurance & Annuity Co. Inc.: guardianlife.com or guardianretirement.com; 866-390-7268
Harbor Insurance Marketing Inc.: harborins.com; 866-424-2167
ING: ingretirementplans.com; 888-639-2798
Ingham Retirement Group: ingham.com; 305-671-2200
Lafayette Life Insurance Co.: lafayettelife.com; 765-477-7411
Lincoln Trust Co.: LincolnTrustCo.com; 303-658-3000
Managed Resources: mgdresources.com; 208-773-6924
MBM Advisors Inc.: mbm-inc.com; 713-221-3117
McCready and Keene: mcak.com; 804-639-1395
Mercer: mercer.com; 857-362-2000
Mutual of Omaha: getretirementright.com; 877-401-7253
MVP Plan Administrators Inc.: mvpplanadmin.com; 866-687-6877
Noble-Davis Consulting Inc.: noblepension.com; 440-498-8408
Omega Recordkeeping Group: onlineretirement.org; 864-699-6900
The Online 401K: theonline401k.com; 877-775-4015
Paychex Inc.: paychex.com; 800-322-7292
Principal Financial Group: principal.com; 800-986-3343
Putnam Investments: putnam.com/401k; 800-719-9914
Redwood Administrators Inc.: redwoodadmin.com; 866-724-7770
The Retirement Advantage Inc.: tra401k.com; 888-872-2364
The Revzon Consulting Group: revzonconsulting.com; 877-254-7085
Securian Financial Group Inc.: securian.com; 877-876-4015
The Standard: standard.com; 877-805-1127
Transamerica Retirement Services: ta-retirement.com; 888-401-5826
Underwriters Marketing Service Inc.: callums.com; 856-727-1900
USI Consulting Group: usicg.com; 860-633-5283
Vaughan & Associates Inc.: retirementplansolutions.com; 864-271-1298
Wells Fargo: wellsfargo.com; 800-368-1225
Wellth Counselors: inthesafe.com; 970-744-4626

Best wishes!

Do You Think Insurers Should Get Away with Denying Maternity Coverage by Calling a Prior C-Section a "Pre-Existing Condition"?

2009-09-20T22:56:00.000-07:00

by L.A.S.

Another horror story seems too ridiculous to be true, but unfortunately it is. It seems that due to the lack of explicit regulation by some states, insurers can refuse to cover maternity care. This is not just a matter of a few cases of women being denied payment by the insurance company for their maternity stays in the hospital. This is built-in sexism.

Even though the Pregnancy Discrimination Act of 1978 requires employers with more than 15 workers to include maternity benefits in their insurance packages -- only 14 states require comprehensive maternity care to be included in coverage in policies sold on the individual market. Most individual insurers don't cover maternity care, and the number of plans without maternity coverage continues to rise.

See the article from SIEU at http://www.seiu.org/2009/09/insurance-companies-consider-c-section-birth-pre-existing-condition.php

Even those women who thought they had good insurance, and maternity coverage, have found themselves stuck with as much as $25,000 in health care bills that they were expected to pay out-of-pocket.

Funny, somehow it seems to me that if MEN had the babies, the insurance companies would not even try to pull stuff like this. What do you think?

Getting Beaten by Your Husband Is an Excuse to Deny Ins. Coverage?

2009-09-17T20:55:00.000-07:00

by L.A.S.

This is unbelievable. I keep saying that I am not an apologist for the insurance companies. I try to portray them as reasonable, given the fact that they do have to make a profit to stay in business. And then they pull stuff like this.
A woman was dropped from her insurance plan because she was abused by her husband. Their rationale appears to be that because, she was beaten badly enough to need medical attention, she will probably wind up in the hospital again. Abusive husbands tend to repeat their behavior, in other words.
But to penalize the woman by denying her continued coverage is just unconscionable. That is penalizing the victim, and it is unacceptable.
You may read the whole article plus some commentary by clicking on this story: http://minnieapolis.newsvine.com/_news/2009/09/16/3279449-heartless-logic-getting-beaten-by-your-husband-is-an-excuse-to-deny-ins-coverage
A quote from the article: "Under the cold logic of the insurance industry, it makes perfect sense: If you are in a marriage with someone who has beaten you in the past, you're more likely to get beaten again than the average person and are therefore more expensive to insure."
ARRGGHH!! Sometimes I just have to scream, you know what I mean?
--30--

Looking for a Company to Handle Enrollments? Lots to Choose From

2009-09-17T20:40:00.000-07:00

by L.A.S. --

If you cannot find a company to handle the enrollment process for your group health plans (or other insurance plans), then by gosh, you just are not looking. There are so many companies that handle this service, that I cannot give a comprehensive listing of all the variables in types of policies they service, whether they do online enrollment (most do) or webcast, or how big your group has to be. I will just give you the company name, website and phone number.

I will, however, also list here those that do phone enrollment: 4MyBenefits, Aegias Corp., Alliance Benefit Group, American Insurnet, ATD Employer Solutions, Benefit Associates, Benefit Communications, Benefit Enrollment Services, Benefit Express, Benefit Resources, Benefit Decisions, Benelogic, Black Mountain Group, CB Solutions, Clear Benefits, Colonial Life has an enrollment call center option, Complete Benefit alliance, Cornerstone, Corporate Benefit Solutions (call center), Corporate Benefit Specialists, Cost Containment Group, Emerson Reid, Empliant, Employee Benefit Comm., Employee Family Protection, Employee Security Plans (call center), EOI Service, Government Benefit Services, H & G Benefits, HR Technology Advisors, Impact Enrollment, ING (thru enrollment firms), National Benefit Consultants, National Benefits Group of America, National Enrollment Services, Online Insurance Services, OptiMed Health Plans, Parker Group, SHPS, Titan Benefit (dedicated call center), United Group Programs, Univers Workplace Benefits (3 call centers across the country), Wachovia Insurance, Workscape, Worksite Services.
This info is dated from 2008, the most recent available -- so bear in mind that some details may have changed. Good luck!

4MyBenefits: 800-734-5144; 4mybenefits.com; all states.
A.D.A.M. Inc.: 516-414-7000; adam.com, all states.
AEGIAS Corp.: 800-537-5154; aegias.com; all states.
Alliance Benefit Group: abgnational.com; all states.
American Insurenet: 800-333-4638 x125; americaninsurnet.com, all states EXCEPT HI, NY.
Andrew & Alexander Inc.: 888-636-0404; only in AR, LA, OK, TX.
ATD Employer Solutions: 877-782-8060; atdemployersolutions.com; only in IL, IN, IA, MO, WI.
Benefit Associates Inc.: 800-400-8016; benecenter.com; all states.
Benefit Communications Inc.: 800-489-3786; benefitcommunications.com; all states.
Benefit Enrollment Services Inc.: 800-838-1320; besibenefits.com; available in AZ, CA, FL, IL, IN, KY, MD, MI, MN, MS, NY, NC, OH, PA, SC, TN, TX, UT, WV, WI.
Benefit Express: 847-637-1551; benefitexpress.info; all states.
Benefit Resources Inc.: 800-339-4793; britulsa.com; available in AZ, CA, CO, GA, IA, KS, LA, MO, NE, OK, PA, TX.
BenefitDecisions: 312-376-0442; benefitdecisions.com; all states.
Benelogic: 877-716-8778; benelogic.com; all states.
BeneTrac: 619-788-5800; BeneTrac.com; all states.
Black Mountain Group: 312-376-0442; blackmountaingroup.com; all states.
Brokers National Life Assurance Co.: 800-798-1125; bnlac.com; available in all states EXCEPT CT, ME, MA, NH, NJ, NY, RI, VT.
CBSolutions: 800-941-9714; cbsolutionslic.net; all states.
ClearBenefits: 888-398-9534; myclearbenefits.com; all states.
Colonial Life: 800-845-7330; ColonialLife.com; all states EXCEPT NY.
Complete Benefit Alliance: 800-211-2797; cba-companies.com; all states.
Cornerstone Enrollment Services: 866-370-3401; Cornerstonevb.com; all states.
Corporate Benefit Solutions Inc.: 888-313-7299; cbs-ga.com; available in AL, FL, GA, KY, MS, MO, NC, SC, TN, TX.
Corporate Benefit Specialists: 800-264-0073; available in AR, CO, IL, IN, IA, KS, KY, MI, MN, MO, NE, NC, OK, PA, SC, TN, TX.
Cost Containment Group: costcontainmentcorp.com; all states.
EMC National Life Co.: 515-345-4219; emcnl.com; all states EXCEPT NJ, NY.
Emerson Reid & Co.: 484-421-3414; emersonreid.com; all states.
Empliant: 919-968-9898; empliant.com; all states.
Employee Benefit Communications: 813-639-0099; ebcfl.com; all states.
Employee Family Protection Inc.: 860-659-1323; www.EFP@NOW.com; all states EXCEPT AR, HI, NM, WA.
Employee Security Plans Inc.: 800-373-3771; all states.
EOI Service Co. Inc.: 800-229-4364 x3303; eoiservice.com; all states.
Government Benefit Services: 561-427-7264; govbenefit.biz; all states.
H & G Benefits: 800-929-9525 x109; hngbenefits.com; all states except WY.
HR Technology Advisors: 508-520-9800; hrtadvisors.com; all states.
HRCG: 801-765-4417; hrconsultinggroup.com; all states.
Impact Enrollment Solutions: 888-846-1176; impactenrollment.com; all states.
Infinisource Inc.: 800-300-3838; all states.
ING Employee Benefits: 800-537-5024; ingemployeebenefits-us.com; all states.
Lincoln Financial Group: 877-Ask-Lincoln; LincolnFinancial.com; all states.
National Benefit Consultants Inc.: 480-940-0070; nbcbenefits.com; all states.
National Benefits Group of America: 800-330-7735; nbgamerica.net; all states.
National Enrollment Services: 800-966-6637; nesbenefits.com; all states.
Online Insurance Services Inc.: 866-266-3966; www.oisworld.com; available in AL, AK, AZ, AR, DE, FL, GA, HI, IL, IN, IA, KY, LA, ME, MA, MS, MO, MT, NE, NH, NJ, NM, NC, ND, OH, O, PA, RI, SC, TN, TX, VA, WV, WI, WY.
OptiMed Health Plans: 800-482-8770 x215; optimedhealth.com; all states EXCEPT CT, NH, VT, WA.
The Parker Group: 800-655-3161; parkerbenefits.com; all states.
Paylogix: 800-622-4131; paylogix.com; all states EXCEPT AK, NV, NH.
Rae Rocco: 702-897-9929; only in AZ, CA, NV, UT.
SHPS: 888-421-7477; carewisehealth.com; all states.
Titan Benefit Communications: 888-35-Titan; titan-benefits.com; all states.
Transcend Technologies Group: 877-426-8750; transcendtechgroup.com; all states.
United Group Programs Inc.: 800-482-8770 x215; ugpinc.com; all states.
Univers Workplace Benefits: 800-343-0240; universworkplace.com; all states.
Voluntary Benefits Systems Inc.: 800-229-1119; voluntarybenefits.net; all states.
Wachovia Insurance Services Inc.: WachoviaInsurance.com; all states.
Workscape: 508-573-9000; workscape.com; all states.
Worksite Services Inc.: 800-862-8963; worksiteservicesinc.com; available in FL, GA, NC, SC, TN, VA.

Getting Down to the Truth Behind Wild Claims that Reform Bill will Put Grannies to Death

2009-09-14T15:27:00.000-07:00

This week my thanks go out to another writer in the blogging universe called Minnie Apolis. He or she writes a varied column and this past week had a great article about the truth behind those wild emails. You know, the ones that claim that Pres. Obama's healthcare reform bill will encourage suicide as a way to keep Medicare's costs in line.

The title says it all: The Truth About Page 425 of the Healthcare Reform Bill; NO, They are NOT Going to Put Granny to Death!

PLEASE go to this link -- http://minnieapolis.newsvine.com/_news/2009/09/10/3250470-the-truth-about-page-425-of-the-healthcare-reform-bill-no-they-are-not-going-to-put-granny-to-death?threadId=673317&commentId=9395279#c9395279

and read, and then send out emails to your friends spreading the truth behind this unfounded and irresponsible claim about the healthcare reform bill.

From the article:
The rumor or rumors maintain that a House bill would require Medicare beneficiaries to have a class or review every five years “to decide how to end their lives sooner.”
These spurious emails always add that “They're going to push suicide to cut Medicare spending!” All these emails seem to point to page 425 as the source of their claims.

What is actually on page 425?
There is a page 425. That is about all that the emails have gotten correct.
It says that Medicare is required to pay doctors for consultations regarding advance care planning, which may include things like making a living will, appointing a health proxy (a medical power-of-attorney), or indicating a preference for hospice care if necessary.
Medicare would pay for these sessions a maximum of once every five years.
And why would any bill even mention such consultations?
Because as it is now, no one is paid for their time to talk to you about things that need to be said and done. You may get a few minutes with a nurse or a hospital patient-representative. You may get a few forms pushed at you. But there is no incentive for anyone to actually sit down with you and go through all the options you have and what they really mean if one day you cannot indicate what you want done.

Thanks, Minnie! Speak the truth, everyone!

Hear Ye! Hear Ye! Change to Roth IRA Plan

2009-09-06T21:49:00.000-07:00

Dear Readers,

Beginning in 2010, there will no longer be income limitations for those wishing to open a Roth savings account. So in other words, if you wish to rollover your plan assets to a Roth IRA, you no longer have to fork over 20 percent as mandatory withholding.

Your accountant or investment advisor will need to meet with you to ensure that you are both observing IRS rules regarding rollovers to a Roth IRA. Such as there has to be a “triggering event”, that is retirement, or being laid off, or qualifying under a hardship provision. For more complete information on these qualifying events, you may go to the IRS site at irs.gov/publications/p590/ch02.html.

Hear Ye! Hear Ye! This has been a public service announcement.

Sick of the Insurance Industry Whining

2009-09-06T21:47:00.000-07:00

by L.A.S.

Sorry, insurance executives, but I am just about sick of your whining that healthcare reform will threaten your business. OF COURSE, it will threaten your business! But it became necessary because the system is in danger of breaking down completely.

You, the insurance industry, found every dodge that you could to get around having to pay claims promptly. You, the insurance industry, found every way of weeding out the people who might actually use your product and cost you money. You, the insurance industry, then had the gall to flaunt your swollen purse by spending millions on lobbying and on extravagant getaways for your executives. Do you see the problem?

Some people just don't get it.

Now let me just say that my heart is not going to bleed for the insurance executives of this country. HOWEVER, I am going to be concerned that an abrupt change in the business model of the total insurance industry will affect the security of the investment. In other words, changing the business model could topple not only health insurance but also the life insurance, auto insurance, and annuity branches of the insurance tree, since many insurers cover all those bases.

We cannot go from a completely private model to a mostly public healthcare model unless we develop some kind of phase-in plan.

We would not be in this predicament if we had taken the opportunity in 1919 to start a national healthcare program at about the same time that other nations tackled this issue. Instead, we were sweet-talked by the life insurance industry which convinced us all that it was ready, willing and able to develop a private health insurance industry from scratch.

We never got such a golden opportunity again, not even when Pres. Johnson pushed through a Medicare and Medicaid program in the 1960s.

So that is why I have reluctantly concluded that we must go slow in this drive to develop some kind of public option for every American. We have to develop some long-term planning to phase in this program.

While I am on the subject of public option, I would appreciate it if people stuck to real numbers. The number “one hundred million” or even “a hundred fifty million” has been bandied about as the number of Americans who already have insurance that would switch to a public option if it were made available. That IS NOT TRUE.

The number came from a preliminary study, and yes, at first it did come up with about 125 million or so who might switch to a public option, as yet undefined.
HOWEVER, and I apologize for using so many capital letters in this article, but however, that number was rescinded when the study went back again when it had more specifics to go on.

The corrected final number was about 150 THOUSAND, not million! Repeat, 150 THOUSAND Americans might drop their private coverage and opt for the public option. That is a fraction of the original number and nothing that would drastically endanger the financial underpinnings of the insurance industry or of the public option.

Also I am not happy to see that Obama is proposing adding another layer of bureaucracy to our swelling government payroll. We could get the processing done more efficiently by farming it out to the private sector. We could process claims more efficiently by using private industry, because it already has more advanced computer software for processing medical insurance claims.

So while I readily admit there are pros and cons to the healthcare reform provisions and to the implementation of reforms, I am nonetheless going to stuff some cotton in my ears so I will not have to listen to any more whining from those insurance execs. OK?

How Much Will You Spend on Healthcare In Retirement?

2009-09-06T21:45:00.000-07:00

By L.A.S.

Will Medicare really cover all or most of your health care expenses while you are retired? I witnessed the bills and stress that my parents went through after my father retired, and I am pretty sure that the answer is no.

The most recent surveys of annual out-of-pocket expenses for seniors show that seniors pay anywhere from $3800 to $8300. Again, this is OUT OF POCKET expenses. This does include your premiums for Medicare, which seem to increase every year.
The truth is that seniors spend MORE on out-of-pocket health care expenses than any other age group. Seniors 65 and over spent an average of $4888 per year on out-of-pocket, according to a 2004 study; that included deductibles, copays, insurance premiums, and miscellaneous expenses not covered by insurance.

I might as well take the opportunity to remind you that Medicare does not cover hearing aids, dental care, or vision needs. My mother was actually rather lucky that she had gotten dentures rather early in life and so did not have the rude awakening as to how expensive dental care has become.

Breaking down the senior demographic into smaller divisions shows that the older you are, the worse it gets. Those 65 to 74 spent $3850 a year; those 75 to 85 spent $5060 a year; and those 85 and older spent $8300 a year.

Try to stay out of the hospital. The deductible for a hospital stay under Medicare was $1068 in 2009. If you are unlucky enough to stay in the hospital for more than 60, you will then incur daily charges of $267 a day. After 90 days as an inpatient, those daily charges increase to $534. As a practical matter, the hospital and your doctor will do all they can to get you transferred to an intermediate care facility or released to your home. By an intermediate facility is meant a rehabilitation hospital, a day-care facility, or perhaps an assisted living home.

Medicaid was never intended to pay for long-term care in a nursing home. However, seniors have hit on ways of spending themselves down to poverty-level in a way that allows them to stay in a nursing home they already live in. These strategies include but are not limited to: divorce, transfer assets to children, or setting up irrevocable trusts.

Transferring assets to children is becoming less and less successful with increasing “look-back” periods for determining if you are trying to hide assets. You are subject to a five-year “look-back” period by the state in which you live, and any tangible assets that have been transferred during that time (especially cash, stock, real estate) Medicaid will add to your list of assets.

Seniors eligible for long-term care under Medicaid can keep a house and car, but the house's value is limited to $500,000. The cash assets cannot exceed $2000 for singles and $3000 for couples.

Everybody's for Healthcare Reform, Till You Ask Them About Specifics

2009-09-06T21:43:00.000-07:00

by L.A.S.

Polls show that the vast majority of us, 80 percent, are in favor of health care reform. But when you ask about specifics, then you have a much harder time arriving at a consensus. Each group that is being surveyed has concerns about different portions of the reform bills on the table (whether the so-called Kennedy bill or the moderate Baucus version) -- and each group has a different portion that it does not like.

When the survey asks whether the respondent favors a particular bill, support drops to 20 percent. And when you ask the public in general if they support improved records efficiency, again, 80 percent approve. BUT if you ask them if they favor centralized electronic medical records, then again, support drops way below half.
At this point, it is apropos to insert a lovely statistic regarding the cost savings that come from adopting computerized medical records: $81 BILLION annually!! BILLION!! PLUS we could improve accuracy and reduce medical errors, which is worth far more than money.

In regards to that last question, I suspect that it is the word “centralized” that upsets people, and frankly I do not blame them. I am all for electronic medical records; those with experience in using electronic records (such as the Veterans Administration) have a very good reputation for speed, efficiency and accuracy as a result of using electronic records.

But my point is that there is such a wide range of thoughts on what specific measures would improve American health care that it is extremely difficult to forge a common list of goals for what that reform ought to accomplish.

One of the major bones of contention is whether government ought to duplicate coverage offered by the private sector. I am of the belief that yes, if you want a public option, then the government is going to have to also insure people who are perfectly healthy and do not have chronic ailments -- in other words, the very people that the PRIVATE insurance sector dearly wants as a customer. To do otherwise is to wind up with a public option that is really the equivalent of the high-risk pool for drivers who can no longer get private automotive insurance.

Having government get stuck with a high-risk, high-expense pool of policy-holders is to invite economic disaster. The premiums will be high, because their usage of healthcare is high and they have serious or multiple health problems. This is NOT a good use of taxpayer dollars, and this is NOT going to be able to deliver on its promise of affordable health insurance for all those in the plan. The government will have to force young, healthy people to participate in the same pool as these high-risk or high-cost policy-holders, if it is going to remain financially sound and if it going to be able to cover a sizable number of Americans who do not currently carry health insurance.

I am sorry to have to explain this to you. And I am sorry if it is not what you want to hear. I do not like the prospect of forcing anyone to participate in any government plan or program, but I recognize the actuarial necessity for it.

Maggie Mahar's New Book on Moyers re Money-Driven Healthcare

2009-09-06T21:40:00.000-07:00

by L.A.S.

I have been citing and linking to Maggie Mahar's web site for at least a year. To my great joy she has finally published a book and has appeared on PBS's weekly Bill Moyers program. The book is titled, “Money-Driven Medicine: What's Wrong with America's Healthcare and How to Fix It.”

Let me say that I am so glad for Ms. Mahar that her hard journalistic work has finally come together into a book and documentary. She demonstrates what it is really like for doctors who came out of medical school eager to heal people, and then get bulldozed by a corporate form of medicine that tells them they have to bring in X amount of dollars per week for the practice.

Patients who do not have a primary care doctor wind up going to see several specialists. This fragmentation of medical care not only is more expensive, but less cohesive and may even endanger your life. Lack of oversight by one coordinating physician means no one is checking whether your medications are duplicating or cancelling each other out.

Moyers spared no mercy on the current Obama administration for how it has changed since Obama was a candidate and promised and end to the bad old ways of negotiating programs behind closed doors.

BARACK OBAMA: The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what, the chairman of the committee who pushed the law through went to work for the pharmaceutical industry making $2 million a year. Imagine that. That's an example of the same old game-playing in Washington. I don't want to learn how to play the game better. I want to put an end to the game-playing.

BILL MOYERS: Now look at this recent story in the LOS ANGELES TIMES. Lo and behold, since the election, the pharmaceutical industry's $2 million dollars a year superstar lobbyist Billy Tauzin has morphed into President Obama's pal. Tauzin says the President has promised not to pressure the drug companies to negotiate with the government for lower drug prices and has agreed not to allow cheaper drugs to be imported from Canada or Europe - contrary to the position taken by candidate Obama…

Bill Moyers featured the book on his Friday PBS show on Aug. 28. Please visit his site at http://www.pbs.org/moyers/journal/08282009/profile.html for the interview and the broadcast of the Alex Gibney documentary by the same name. You can also click on a box on the right-hand column to ask Maggie Mahar a question about health care reform.

The web site for the book with clips and transcripts of the interview on Bill Moyers is at http://moneydrivenmedicine.org/

Canadian Drug Prices Up Too -- by Almost 16 Per Cent

2009-09-06T21:39:00.000-07:00

by L.A.S.

If you've been idealizing the Canadian health care system because it appears to work while keeping costs under control -- that may be. But the fact remains that overall medical care costs (that is, everything except medications) rose 13 percent in 2008 and just over 14 percent in 2009. And prescription prices rose 15.9 percent so far in 2009.

Canadians are feeling squeezed by the recession just as much as we are. Nervous Canadians are taking advantage of their healthcare benefits, and paying more attention to wellness issues. Among employers, wellness programs are gaining support as a way to control costs while reducing absenteeism and increasing productivity.

Declined for Disability Insurance? Common reasons why, and what to do

2009-08-30T17:10:00.000-07:00

by L.A.S.
The most common reasons for being declined for a disability insurance policy are:
1. Age
2. Dangerous occupation (often this includes building trades like electrician or roofer)
3. Employee of the U.S. Government
4. Income (too low or too high)
5. Lack of U.S. citizenship or green card.
6. New business or occupation (lack of actuarial data)
7. Overall poor health
8. Overweight, occasionally severely underweight people may be denied also)
9. Work or travel in foreign countries.
10. Works out of one's home.
In addition, the fact of having a dangerous hobby can cost you any kind of life or health insurance. A hobby of flying a plane is most often cited in insurance courses.

Common Diseases or Conditions that Cause Denial of Disability or Long-term Care Policies:
1. Asthma
2. Arthritis
3. Alcoholism or Drug Abuse
4. Carpal Tunnel Syndrome
5. Cancer
6. Crohn's Disease
7. Diabetes
8. Epilepsy
9. Heart Attack
10. Hypertension, especially if you take multiple medications
11. Lupus
12. Mental Disorders
13. Multiple Sclerosis (BTW, Minnesota has a statistically high incidence of M.S., and so dread disease policies exclude it in the list of conditions covered by the policy)
14. Overweight
15. Respiratory Diseases such as emphysema
16. Sleep Apnea

What kinds of strategies or limitations might you have to accept in order to get any type of disability insurance?
1. An exclusion for conditions related to the reason for the denial. Example: exclude injuries related to on-the-job accident/injury if the reason for denial was that you are in a dangerous occupation. This would still cover you for off-duty injuries or illnesses.
2. A longer elimination period (the wait between an injury or illness and the time you may first draw benefits).
3. A shorter benefit period. Perhaps you only have six years between now and planned retirement at age 65; you could structure a policy to stop when you turn 65.

4. A smaller benefit. To me, this is the least satisfactory option because almost all disability insurances pay you a maximum of 65 percent of your regular income anyway. (And that is based on your base pay, not your paycheck with all overtime and bonuses included.) You may as well just stash away as much cash as possible for a rainy day.
5. OR all of the above.

But just because you have accepted an exclusion for your occupation does not mean that you can never collect on an on-the-job injury. You may be able to prove that an accident causing a broken back, for example, would have incapacitated even a person with a healthy back. So the fact that you declared a back problem when buying the policy may not affect the legitimacy of your claim.

This is just a few things to think about when considering buying disability insurance or finding some other strategy for replacing lost income when you are laid up -- or laid off.

Insurance Agents Don't Want to Scare Off Seniors with Too Much Information

2009-08-30T17:07:00.000-07:00

by L.A.S.
I am going to assume that older readers out there will take offense at this. But financial advisors assume that seniors' decision-making skills will decline with age even if one does not have Alzheimer's or any other form of dementia.

Our brains temporarily store incoming streams of data -- numbers, words, phrases, pictures, and so forth -- while at the same trying to decide which of these data is important to us, to our own situation and values. We quickly go through processes of comparison and ranking of these bits of data. We also compare what is coming in to our own 'data banks', in other words what we have learned to be true about the world in general and about managing money in particular.

Brilliant people can juggle more bits of data than the rest of us. But all of us experience a bit of a slowdown in this process as we age. We can easily miss important facts because we are still trying to hold onto as many information bits as we can handle. We also tend, as ALL of us do, to look for the easy solution, which may not be in our best interests. As we get older, we also are more easily distracted or interrupted, so that we have to start over.

Seniors tend to compensate by taking more time to make a decision. This is perfectly all right. However, most sales people know that the decision delayed, is the decision NOT MADE. So give yourself a deadline to make a final decision. Write out what you feel you need to know to make an informed decision, then when you have gathered that information, sit down with your significant other and discuss what looks best for you.

My personal experience is that I can never find the absolute perfect choice, even when selecting so mundane an item as my apartment. I have to decide based on the best overall package of location, cost, space, and other amenities. I have made errors even after all that, but it is the best I know how to do.

Which features of a policy, annuity, or other financial package are MOST important to you? Weed out those options that do not offer them, but perhaps you might call the company rep to make sure that this is the case. The company might have another group of options that they did not even think you would be interested in.

I might mention that some features are not commonly advertised and you might not even know they are out there. For example, many insurance companies have policies with a return-of-premium rider. (This may be true of some term life insurance and of some 'dread disease' policies; the premiums are somewhat higher but the fact that it is virtually free after the return of your money, makes them very attractive.) A company may be allowed to offer certain riders in one state but not in another, but that is out of our control.

An example of a weeding-out process with annuities would first ask if you need it for an immediate payout, for the near future, or for 20-30 years from now. If tax considerations (for the beneficiaries) are paramount, then you might consider buying insurance instead. BTW if you cannot qualify for a long-term care policy, then maybe you could look into raising the value of your current life insurance if it has an accelerated benefit option.

To help you with the information-gathering phase, you might avail yourself of free lectures given by local banks or savings & loan offices. I went to one such lecture several years ago about the Roth IRA when that was a new option. I took notes and kept them for reference. Keep a notebook of notes taken at such lectures or seminars, so you can draw upon them when sorting through company offers.
Good luck!

SEC Files Against Prime Capital

2009-08-29T07:06:00.000-07:00

by L.A.S.
It just goes to show that wherever there's a free lunch, you're paying for it in the end.
Prime Capital Services, Inc., was named in a complaint filed by the SEC. Prime Capital allegedly lured seniors into buying unsuitable annuities with free lunches as bait.
Customers were told they could access their investments whenever they needed funds, but Prime Capital omitted informing them of fees for early withdrawals above a certain amount.

Proposed Bill SB 1297 Would Give Tax Break for Annuities

2009-08-29T07:05:00.000-07:00

by L.A.S.
You would get an fifty percent tax exclusion on your annuity under a pair of proposed Congressional bills called the Retirement Security for Life Act. Senators Kent Conrad of North Dakota and Senator Pat Roberts of Kansas are co-sponsors of this bill, SB 1297.
If you do not have an employer-sponsored retirement plan, you would benefit from this law. It provides for a fifty percent tax exclusion on up to $40,000 in annual income received from a non-qualified lifetime annuity.
A companion bill was introduced in the House, sponsored by Reps. Early Pomeroy of North Dakota and Ginny Brown-Waite of Florida.

Are Agents Employees or Independent Contractors?

2009-08-29T07:04:00.000-07:00

by L.A.S.
Three former agents for Northwestern Mutual Life Insurance Company sued NML in a class-action lawsuit. They claimed that they were wrongfully designated independent contractors, and denied minimum wage, overtime, and other benefits.
The lawsuit is for $200 million.
It has been traditional that agents for almost all insurance companies are independent contractors who receive only commission for whatever they sell. I can tell you now that these agents would have to prove that NML closely supervised and controlled their hours and other details of their work.

Beneficial Will Stop Selling Life Insurance and Annuities

2009-08-29T07:02:00.000-07:00

by L.A.S.
Another victim of the subprime debacle has hit the skids. Beneficial Financial Group, a Mormon-owned company, declared it will have to stop issuing new life insurance and annuities by Oct. 31 of this year. It will put 150 people out of work promptly, and concedes it cannot compete against bigger companies offering more products.
The cause of this turn of events is that Beneficial had about one-fourth of its assets in securities containing subprime mortgages.
Existing contracts will be honored, although the company is expected to expire in about 50 years.
To repeat, the current policies are good and will be honored. It is just not going to be able to sell new policies.

Movement for Federal Controls of Insurance Industry Misguided

2009-08-29T07:01:00.000-07:00

by L.A.S.
The federal government has seized on the problems with one segment of one company, AIG, as a pretext for more government control of the whole insurance industry. The truth is that the insurance division of AIG, American General, was doing just fine (and BTW was under state regulation). The problems were in the division that was already supposedly being supervised by the federals, the Financial Products Corp., which indulged in risky equities investment.
However, neither do I see any value in creating an optional federal charter, called an OFC. The OFC would give insurance companies the option of being regulated at the state or at the federal level. One must acknowledge that in some states, it is possible for the insurance commissioner's office to be much too cozy with the industry, and refrain from too close scrutiny of financial records or safety.
I have mixed feelings about this proposal, I admit. I have already opined on the frustration of not being able to buy certain riders or products in one state that are easily available in another state, simply because the insurance commissioner's office of one state decided to allow that product.
The Financial Regulatory Reform report strongly recommends the creation of an Office of National Insurance (ONI). One of the jobs proposed for this ONI is the identification of insurance companies that should be supervised as Tier 1 Financial Holding Companies (FHCs). A Tier 1 FHC is defined as a holding company “whose combination of size, leverage and interconnectedness could pose a threat to financial stability if [they] failed.” They would come under the supervision of the Federal Reserve who would supposedly hold them to a higher standard and do everything to prevent these companies from failing.
Insurers are expressing concern that the Fed would not be working in harness with an actual insurance regulator. This is in contrast with the rest of the financial services industry which has a federal regulator in the SEC. The Fed would not concern itself with solvency, but rather with the company's impact on the overall economy.
The Fed already has many critics of its authority. Does it really serve anyone's best interest to allow it to insert itself into another segment of the finance industry, when it already seems stretched to the limit in trying to monitor the banking industry?
Besides the creation of the ONI and an expansion of the Fed, the report is also spurring talk of creation of a Consumer Financial Protection Agency (CFPA). This agency is supposedly going to represent consumer interests at the administrative level regarding credit, mortgage and title insurance coverage. Whether it will also monitor the insurance industry in spite of intense lobbying against it, is anyone's guess at the moment.
Again, I have mixed feelings about this new agency. Much depends on exactly who will be appointed to serve in this agency and whether they will just be another shill for the industry. The devil is always in the details.
On the one hand, it has the potential to finally bring the credit industry to heel and cap interest rates on credit cards and other abuses. Have you never wondered why your credit card bills are always addressed to processing stations in Delaware and Dakota? That is because those states have no cap on credit card interest rates or any other meaningful regulation. It would also give consumers the option to buy new plain-vanilla insurance products and provide transparent pricing.
On the other hand, adding another layer of bureaucracy because the regulators we have, failed to do their job, is hardly cost-efficient. It is hardly an example of good government. Although if the Congress writes the bill so as to streamline (make that read 'fire') ineffective federal agencies like the SEC or FINRA (the SEC's enforcement arm) or the Federal Reserve itself, then that would be a net gain for consumer rights and for the bean-counters.
If any or all of the existing agencies had been doing their job, and regulating the finance and investment community, we might have averted the bloodbath of last summer and fall. How did earlier administrations allow the annulment of the Glass-Steagall rules? Rules that had prevented a recurrence of the errors and wild ways of the heady 1920's?
And then there is the really scary problem that is not addressed by any legislation anywhere, and that is that most of the people working for the federal government just cannot understand the complicated financial instruments now being used and marketed across the globe. What if Congress convened a hearing or an investigation into bank failures, and the crooks got off because our representatives really don't know a bundled mortgage from a certificate of deposit? Or an ARM from their leg??
Sorry to joke, but tragically, the American public does not generally have senators and representatives who can fathom the technical jargon of the industry. It is not that they are dumb; they are just in the dark. As are we all.

Texas Liquidating Memorial Life Insurance

2009-08-29T06:56:00.000-07:00

by L.A.S.

Better check the name on that pre-need funeral policy of yours -- if you bought it from Memorial Life Insurance, it is now being liquidated by the state of Texas. Memorial Life Insurance sold funeral benefit contracts. After suffering a net loss of $2.3 million in 2008, the company was barred from accepting any more applications.
Fortunately your loss is protected under the Texas Life, Accident, Health and Hospital Service Insurance Guaranty Association Act. You must keep up the payments to maintain the policy in force, but check with the State of Texas insurance commissioner's office to see how to make out your checks.

Ameritas Fined by Financial Industry Authority (FINRA)

2009-08-28T17:01:00.000-07:00

The Financial Industry Regulatory Authority (FINRA) fined Ameritas in a case in which one of its brokers convinced customers to borrow against their homes to buy life insurance.
FINRA took action against Ameritas for failing to adequately oversee New Jersey broker Nancy Ziering. She convinced customers to borrow against their homes in order to buy variable universal life insurance policies to fund college or retirement expenses. The company was fined $100,000.
FINRA issued a statement in which it said that customers should not put their homes at risk in order to buy securities. Ziering recruited customers in seminars and other college-planning presentations. She sold at least 90 variable universal life policies through Ameritas. FINRA feels that the plans she presented were much too complicated and required customers to adhere to strict plans for 20 years.
Ameritas had already rescinded such policies issued to six customers before the disciplinary action.

Ohio Advisors Busted by SEC for Inflating Fees

2009-08-28T16:59:00.000-07:00

The SEC charged two Ohio-based investment advisors with fees-related fraud. The two advisors, Robert Pinkas and Tab Keplinger, of Brantley Capital Management (which was also charged), with overstating the value of the investment portfolio so they could charge higher fees.
Two failing private companies unfortunately made up more than half of the investment portfolio of BCM, an investment company based in New York.
The investment period in question was from 2002 to 2005. Pinkas was CEO of both Brantley and BCM. Keplinger was the part-time CFO of both companies.
Pinkas has engaged an attorney to fight the charges, while Keplinger has settled the charges without admitting or denying the allegations. He consented to a fine with a five-year ban on serving as an officer or director of a public company.

Health Co-ops Are Making Medicine Fun Again

2009-08-24T19:55:00.000-07:00

by L.A.S.

Another option when it comes to dispensing health care is the health co-op, where the patient members are in control of the entity.
One example is the Group Health Cooperative in Oregon. It was created way back in 1947 by farmers and loggers who pooled their resources to cover the most basic primary care. Since that time, the co-op has grown to over a half million members, the third largest insurer in Oregon.

It operates similar to an HMO. It has premiums and co-pays. Patients have to see providers who are in the network. Doctors work for the company and are paid a salary. This means they are not forced to cram twenty or more patients into their daily schedules.
They have more time with each patient and can be more proactive.

One of the great features of the Oregon co-op is that they have invested in electronic medical records which reduces errors, enables doctors to coordinate care, and also lets patients check their charts online. Whether it was this innovation or the emphasis on primary care, the result has been a drop in emergency room costs by 29 percent.
But replicating the success of Group Health is a real challenge. Many health care co-ops were born in the Great Depression and folded later when government funding was withdrawn.
However, HHS Cabinet Secretary Kathleen Sebelius has signaled that the Obama administration might support the idea of co-ops as an option to reduce the cost of health care.
It is an option worth serious consideration, even with all the challenges of starting one from the ground up.
An article on health co-ops ran in USA Today and you may read it here: http://www.usatoday.com/money/industries/health/2009-08-20-group-health-insurance_N.htm

Five Reasons You Need Health Insurance

2009-08-24T19:39:00.000-07:00

by L.A.S.

I came across this list the other day and it is a good reminder of why people benefit from having some form of health insurance. With all the hoopla over Obama-care or public option or any of the other forms of health insurance, we may need to step back a second and remind ourselves why we need it.
Number One on the list is that having insurance improves your access to quality care. I am embarrassed to have to list this item. To me it is shameful that in the richest country on earth, you are looked at as if you were a bank robber if you walk into a clinic or hospital without insurance. But there it is. And don't tell me that anyone can get health care if they are willing to pay the price. I have been turned away from local providers (years ago) because the clinic was not accepting patients without insurance.
Number Two: You get better access to preventive care. This is a biggie for those with chronic conditions such as high blood pressure or diabetes, because good monitoring of your condition can keep you out of the hospital with serious complications! The flip side is that people are not getting access to information to help them stay healthy. The doctors are so rushed that he has no time to do much more than write another prescription. You have to pester the nurses or get to work digging up information from online, or from support groups, or from nutritionists, or from health food centers.
Number Three: It can keep you from facing financial ruin due to medical expenses. While some people still have to deal with financial hardship if their treatment is out of network or not covered, insurance is the best bet against losing one's home or savings.
Number Four: You pay a lower rate. The insurance plan negotiates a better rate for services, lab tests, and hospital beds under group coverage. The truth is, those without insurance usually are charged the top-gouge price.
Number Five: Peace of mind -- aka being able to sleep at night. It is hard enough to handle your health worries without also having the weight of the final bills on your mind. Just concentrate on getting well and let the providers and insurers handle the bills.

-- Best wishes to all

Patient Recounts 'Death Panel' Experiences in 2007

2009-08-24T19:32:00.000-07:00

by L.A.S.

It may shock you to know that there really have been so-called 'death panels' employed to triage organ transplant cases. One patient who went through what must have been a draining experience wrote about it on another blogspot blog called Southeast to Southwest (at swse.blogspot.com).
Death panels, aka God committees, have to evaluate the patient's chances for a good outcome for the terribly expensive organ transplant surgery. It is a fact of life that there are not enough organs to go around, and we really ought to push for more of us to volunteer usable organs upon our passing so that another can live.

The whole fascinating, engrossing account can be read here at: http://sesw.blogspot.com/2009/08/i-went-before-real-death-panel.html

Whistleblower Leads to $302 Million Fine Against Quest Diagnostics

2009-08-24T19:18:00.000-07:00

(by L.A.S)
(Not sure if I ever referred to this case before, but it bears repeating anyway.)
The New York Times reported in April of this year that Quest will pay a fine of $302 million as a result of a defective test kit produced by its subsidiary, NID. NID produced a kit that was supposed to detect levels of parathyroid hormone. However, the kit produced such inaccurate and unreliable lab results, that doctors complained.
Shockingly, there are no standards regarding how reliable a lab test has to be, nor testing to ensure that it is reliable. To put it another way, there is no standardization and no FDA approval needed.
A California businessman and biochemist named Thomas Cantor tried to blow the whistle with detailed complaints about the test, but was rebuffed. He later hired some attorneys to help him.
Cantor will receive a share of the settlement amounting to about $45 million, which he states he intends to donate to drug research.

The NY Times article is here: www.nytimes.com/2009/04/16/business/16tests.html?_r=1&partner=rss&emc=rss

Ohio broker barred after stealing sisters' inheritance

2009-08-24T19:09:00.000-07:00

Richard Wood, an agent in Miamisburg, Ohio who was with American General Securities Inc., promised to invest two sisters' money but used the funds for himself.
The sisters were beneficiaries of an aunt who had been a client of Wood. Wood provided both sisters with a false account number for a fake brokerage account. He was eventually found out, and forced to repay one of the sisters. The firm repaid the other sister.
The Financial Industry Regulatory Authority (FINRA) barred Wood in an agreement in which Wood did not have to admit or deny the allegations.
Lucky for the sisters, they have their money back.

The Truth Comes Out About Insurers Fighting National Healthcare for Years

2009-07-25T18:07:00.000-07:00

The truth has come out at last about how the big insurers mounted large campaigns to defeat previous attempts to institute a national healthcare plan. If you have not seen or read Bill Moyers' interview with Wendell Potter, a former exec with Cigna health care, then go there now.

Mr. Potter tells of how he finally had an epiphany in mid-2007, after years of working for Cigna. "I was beginning to question what I was doing as the industry shifted from selling primarily managed care plans, to what they refer to as consumer-driven plans. And they're really plans that have very high deductibles, meaning that they're shifting a lot of the cost off health care from employers and insurers, insurance companies, to individuals. And a lot of people can't even afford to make their co-payments when they go get care, as a result of this. But it really took a trip back home to Tennessee for me to see exactly what is happening to so many Americans."

He heard about a health care expedition that was being held down the road, while he visited relatives back in Wise, Virginia. He decided to go there, and take pictures. He had no idea what he would see, but he had a vague idea that it would be a public clinic for people without insurance.

What he saw were people being treated in animal stalls at a Wise County Fairground. Some patients were on gurneys. People had come from miles around, from Georgia, Kentucky, South Carolina, Tennessee. "There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me. It was absolutely stunning. It was like being hit by lightning. It was almost-- what country am I in? I just it just didn't seem to be a possibility that I was in the United States. It was like a lightning bolt had hit me."

Nevertheless, Potter did not know what to do about the fact that real human beings had no health care access.

Potter also related what happened when the film "Sicko", by Michael Moore, came out. He saw the film himself and felt that Moore was pretty accurate in depicting the situation as it really is. However, he participated in the industry effort to dampen political reaction to the film for fear that it would fuel a real effort to institute a national health care plan.

(from the interview)
BILL MOYERS: And there was a political strategy. "Position Sicko as a threat to Democrats' larger agenda." What does that mean?

WENDELL POTTER: That means that part of the effort to discredit this film was to use lobbyists and their own staff to go onto Capitol Hill and say, "Look, you don't want to believe this movie. You don't want to talk about it. You don't want to endorse it. And if you do, we can make things tough for you."

BILL MOYERS: How?

WENDELL POTTER: By running ads, commercials in your home district when you're running for reelection, not contributing to your campaigns again, or contributing to your competitor.

This is the truth about why, in spite of poll after poll that shows the majority of Americans favor a national healthcare program, we still have none and Europe and other countries have had national healthcare for nearly a century.

The full story and links to more is at Moyers' PBS website, at http://www.pbs.org/moyers/journal/07102009/watch2.html

You can also view Wendel Potter's congressional testimony online or read the text. At Commerce Dept. site on dot gov: http://commerce.senate.gov/public/index.cfm?FuseAction=Hearings.LiveStream&Hearing_id=6f02dcc8-ad5b-445c-81ca-36c9b06ebdd5

In addition, the Frank Lutz memo strategizing opposition to health care reform Bill Moyers mentions in the interview. -- RAN in Politico: www.politico.com/static/PPM116_luntz.html

Kucinich Supports Single-Payer Plan

2009-07-25T17:05:00.000-07:00

by L.A.S.

With all the news coming out of Washington this week regarding Obama's national health care proposal, it is difficult to focus on just one or two threads for an article or discussion. But one major thread is that Dennis Kucinich is again taking the lead regarding national healthcare, and has come out in support of a single-payer plan.

The alternative news site AlterNet has been very enthusiastic about his version of healthcare reform. You may read their article here: www.alternet.org/blogs/politics/141404/how_dennis_kucinich_may_save_the_health_reform_battle/

Kucinich would allow states to create their own single-payer programs. This is a positive step. However, in the current economic climate, I doubt that many states are in any shape to start up a new public benefit program. Some states, like California, are dropping eligible people from the public healthcare programs that they already have.

Perhaps Obama's plan is meant merely as a transitional phase from the present multi-payer, all-private (except for Medicare) situation to a true single-payer plan such as one finds in many European countries and Canada. I could live with that, but I think that the insurance companies are bound and determined to avoid covering the people that they do not want: those who have pre-existing conditions, and those who run up large bills.

We saw when Medicare first was rolled out as a result of the President Johnson initiative under his "Great Society" programs, that the insurance companies could not dump the seniors fast enough. In fact, they terminated policyholders even before they had been formally enrolled into Medicare! Let us hope that someone has thought to insert verbiage to prevent a similar fiasco this time around.

One approach to reducing the cost of medical care that is not used enough is to manage cases for improved drug therapy (and other management of chronic conditions) so that patients spend fewer days in the hospital. This requires a progressive attitude!

One may read a rather long article on the Nursing Center website about interventions with high-risk or at-risk families on Medicaid, or on a public health plan in other countries. Typically, visiting nurses make regular home visits and help to educate parents and monitor the progress of children in the studies. Overall, such intervention returns about $17,000 per family in the program (they take into account not only hospitalizations that have been avoided, but also crime and domestic violence, and other costs to society: "Cost-benefit analysis of the NFP reveals that there is a $17000 return to society for each family served by the program.13 These benefits were calculated on the basis of the program's impact on societal outcomes such as crime, substance abuse, teen pregnancy, child abuse and neglect, and domestic violence.")

Let's hope that such relatively low-cost interventions will be the norm, and produce better management of childhood asthma and other chronic conditions.

Sorry to Dump So Much On You at One Time

2009-07-03T13:23:00.000-07:00

by L.A.S.

I apologize for dumping so much in your laps all at once. I have been trying to catch up a bit on my backlog of stories I wanted to pass along to you -- and this has led to posting SEVEN articles all in one day on this blog. Sorry about that. But you at least have the luxury of clipping or bookmarking this site so you can come back and mull over all these tidbits at your convenience.

Have a wonderful -- and safe -- Fourth of July weekend!

Texas Proposes Regulation of Annuity Schemes Aimed at Seniors

2009-07-03T13:22:00.000-07:00

by L.A.S.

Texas bill HB 961 and SB 2650 would regulate maturity dates on all annuities sold to seniors. No longer can insurers set the maturity date as high as 115. Such unreasonable maturity dates force beneficiaries to pay high surrender charges in order to settle an estate.

The bill would also allow the Texas Department of Insurance to investigate any pattern of conduct by carriers that may violate this regulation, and empower the agency to issue 'cease and desist' orders.

Florida Bill Regulating Annuities Dies in Committee

2009-07-03T13:20:00.000-07:00

by L.A.S.

A proposed bill that would require annuities sold to seniors to provide a 60-day “free-look” period died in committee. The bill was labeled SB 724 with the companion House bill labeled HB 141.

Even though the billed died in this session of the state congress, it could be resurrected in the next legislative session.

Provisions of the bill include not only the above clause, but also: would allow return premiums on said annuity sale for 60 days after purchase; no surrender charges after the fifth year of an annuity contract; bars family members of an insurance agent from being beneficiaries of an insurance policy.

The bill also would tighten standards of conduct for insurance agents by: expanding grounds for suspension or revocation of a license; in cases of “twisting” or “churning” of policies belonging to clients age 65 or more, such practices would become third degree felonies.

Summer is the Time for Disabling Injuries

2009-07-03T13:17:00.000-07:00

by L.A.S.

More disabling injuries occur during the summer than any other time of the year, according to a study by The Hartford insurance company's research department.
Accident claims were lowest, in general, in the fall of the year. They climb slightly in the winter quarter and begin to soar in the spring. Summer is by far the busiest period for accident claims, and the most common type of injury was the fracture for both men and women.

The most common injuries for men were: open wounds, internal injuries, sprained joints (shoulder, leg, knee, arm), and fractures (skull, neck, back). The most common injuries for women were: Fractures of lower limb, sprained neck or back, and dislocated knees.

Taking a look at different regions of the country provided some puzzling results. One might expect that skiing accidents would be the main cause of accident claims out West, but winter and fall both had very low accident rates compared to a rising slope for spring and summer accident rates. The Northeast had this pattern of accident rates, going from highest to lowest accident rates: summer, winter, spring, fall. I suppose that people drove themselves too hard in summer sports, and fell on the ice in the winter.

But Midwesterners had virtually the same accident rate for winter as for spring. Fall had the fewest accidents, while summer again was significantly higher; in fact, Midwesterners had the highest rate of summer accidents of all the four regions. The South had the fewest accidents in the winter of all regions, but nearly tied with the West in high spring accident rates, and was second-highest in summer accident rates.

But the main question is: how many months could you go without having any income? How soon would you have to make lifestyle changes if you or your spouse lost their income? Almost all respondents said they would have to change their lifestyle if they or their spouses lost income for three to six months. Only 41 percent had short-term disability insurance, and only 36 percent had long-term disability insurance.

A caveat: disability insurances only pay about 60 percent of your pre-disability income, so plan accordingly. Also, that 60 percent is based on your BASE salary, not including whatever overtime or bonuses you have been earning. Have a reserve fund for emergencies, and/or a source of income that keeps coming in regardless of whether you can get out the door or not.

Seniors Will Have Fewer Agents Calling and Knocking

2009-07-03T13:15:00.000-07:00

by L.A.S.

Revised rules governing marketing to seniors have put a crimp on cold calls by insurance agents. No longer may insurers call or knock on doors of seniors who are not already policyholders with their company. That includes a ban on calling former policyholders and referred prospects.

This will make it harder for people just turning 65 to find and compare different supplemental plans. However, since 64 percent of seniors already go online to compare and research insurances, that avenue will only grow.

Insurers will need to provide senior-friendly web sites that allow visitors to choose their type size and increase contrast. The web site should also give you a way to request more information, such as a request form online to receive a packet of Medicare-supplemental information brochures or booklets.

It makes for a kinder and gentler selling and buying environment.

It Pays to Take ALL Your Meds to Dr. for Review

2009-07-03T13:13:00.000-07:00

by L.A.S.

It just goes to show that an annual review of all your medications can save your life and keep you out of the emergency room.

Premera Blue Cross sponsored what they called a “Polypharmacy” program. They encouraged policyholders to put all their medications in a brown bag and take them to their primary physician for review.

What was the result of this review program? Emergency room visits and hospitalizations decreased among those who took part in the program.

Many patients are taking two forms of a same drug under different brand names, and never realize it. With all your medications in one place for review, physicians can spot duplication and other errors that could lead to serious health complications. Do it this month and live better!

Class-Action Suit Fines Insurers for Concealing LTC Increases

2009-07-03T13:10:00.000-07:00

BY L.A.S.

Three companies were fined for concealing planned rate increases on long-term care policies in the state of Missouri. The companies were: Mutual of Omaha, American Heritage Life, and Wakely & Associates (a third-party administrator).

Under the court settlement of the class-action suit, Mutual of Omaha will have to maintain benefits on current policies with a value of $8.5 million. American Heritage will have to provide benefits to lapsed policies valued at $2.5 million. Wakely has paid a $4 million fine.

Wakely had helped American Heritage with the design, marketing and sale of the long-term care policies.

Those affected included 1670 people in Missouri who bought long-term care insurance policies between 1995 and 2000.

Have You Looked into Indexed Universal Life Yet? It Offers Safety and Good Returns

2009-07-03T13:07:00.000-07:00

by L.A.S.

Many Boomers, discouraged by their investment returns after the debacles of the 1990s and 2008, have checked into the indexed universal life insurance.

Boomers, stung by hard losses in previous stock market downturns, have found one likely candidate for safe investing. Indexed universal life insurance offers the investor the ability to lock in gains during the good years, and protection of your account during the bad years.

Indexed universal life offers a zero percent floor, meaning you will not lose your principal even if the market goes bad. This provides preservation of capital. The only drawback is the the investor has fewer investment options than with other forms of variable universal life, but for many of us, simpler is better. Owners of these policies can sleep better at night, too.

More than 50 percent of the sales of this product are to Boomers. They trade off not receiving dividends for their participation in the plan.

Other types of investment vehicles that have seen increased sales are fixed annuities and multiyear-guarantee (aka CD-type annuities).

Insurance carriers have guidelines regarding the suitability of annuities for a client. The parameters include: age 40 or more, has considered alternative investments, is appropriate for the client, has funds to sit in this account for an extended period, has sufficient liquidity so that he or she will not have to dip into their annuity for the foreseeable future, and maintains at least 20 percent of their net worth for immediate needs and emergency funds.

A Must-Read from Mother Jones on Healthcare Proposal

2009-06-30T22:24:00.000-07:00

Not as lengthy as some of the more important Mother Jones articles, but nevertheless it was very insightful.
Please click this link to an article titled: Congress's $1.2 Million a Day Drug Habit—and Pharma's Phony "Gift" to Health Care Reform at http://www.motherjones.com/mojo/2009/06/pharmas-phony-gift-seniors

Many seniors on the Medicare Part D plan go on generics as they enter the "donut" phase of the plan -- and never go back onto the brand-name drugs after exiting the donut.

Under this proposed plan seniors may decide they are better off staying with the brand name drug through the whole year. Big Pharma will like that.

Some States Already Refusing National Healthcare

2009-06-28T12:12:00.000-07:00

Arizona is one state that has made it clear it wants no part of a national healthcare plan. It has refused other federal programs before, so this is not a sudden policy change.

EXCERPT: Right on the heels of a successful state-by-state nullification of the 2005 Real ID act, the State of Arizona is out in the forefront of a growing resistance to proposed federal health care legislation.
This past Monday, the Arizona State Senate voted 18-11 to concur with the House and approve the Health Care Freedom Act (HCR2014). This will put a proposal on the 2010 ballot which would constitutionally override any law, rule or regulation that requires individuals or employers to participate in any particular health care system.
HCR2014, if approved by voters next year, also would prohibit any fine or penalty on anyone or any company for deciding to purchase health care directly. Doctors and health care providers would remain free to accept those funds and provide those services.
Finally, it would overrule anything that prohibits the sale of private health insurance in Arizona.
Five other states — Indiana, Minnesota, New Mexico, North Dakota and Wyoming — are considering similar initiatives for their 2010 ballots.

You may read the whole article at this forum page: http://usfreestar.newsvine.com/_news/2009/06/26/2972841-arizona-hcr2012-national-health-care-nullification -- We has lots of good discussions on this site so you might want to browse awhile.

How Would Your Life Be Different if We Had National Healthcare?

2009-06-28T12:06:00.000-07:00

A provocative article ran recently in the pages of AlterNet regarding the writer's experience living in Canada for a while. Her five years in Canada were a real eye-opener in how a healthcare system could work, sparing people the economic drain of continual insurance and medical bills.

She wrote:

This was one of the things that struck me hardest when I arrived in Canada five years ago. The swamp-blindness was so dark and deep that it took a while to adjust to a world without alligators. It's almost impossible to describe to folks back home how different life is when health insurance simply doesn't factor at all into how you choose to live your life. There's almost no language for it. Rather than even attempt it, I sometimes just ask my American friends and relatives to open up their imaginations, and answer the question for themselves:

* How would your life be different if you never had to worry about getting, keeping, or affording health care again?
* What other choices might you have made?
* Where else would you be right now?
* How would it change your plans for the future?

You can read the whole article here at http://www.alternet.org/healthwellness/140918/what_did_you_sacrifice_to_afford_health_care_/?page=entire -- AlterNet is a wonderful website with many such interesting and provocative articles. I hope you like it.

Annuities Have Become 'The New Black'

2009-06-19T20:15:00.000-07:00

by L.A.S.

In 2008, to no one's surprise, investors, suddenly shifted funds into plain old boring fixed annuities. How many investors did this? Just to quote some startling stats that came out earlier this year, sales of fixed annuities in 2008 jumped to $107 billion, up nearly 60 percent over 2007.

We are talking about the most snore-inducing sector of the financial investment field, the fixed or fixed index annuity here. Perhaps the only item that qualifies as duller is the savings bond. Now normally, we are told to have a portion of our investments in safe instruments such as bonds or insurance, vehicles like that. And some of us actually do that.

But traditional diversification did not work for most of us in 2008. So that explains the rush to the safety of the fixed annuity. It is very simple to understand: you just toss a lump sum into the kitty and draw upon it to suit your needs. There are variations in how long a waiting period before you begin drawing on the annuity, and there are also some that allow you to deposit small sums during your working life in order to draw upon it in your retirement, just like an IRA or 401K.

But the deferred accounts are nice because the interest they accrue is tax free. The longer the deferred period, the better, of course, so that they can swell into very nice nest eggs indeed. The downside has always been that you had to accept a rather low rate of return in exchange for this level of boring safety. The other downside is a rather steep penalty for dipping into your fund in case of emergency.

Deferred annuities generally produce a 5 percent rate of return, while immediate annuities may give only about 3.5 percent. And because you are locking into just one company, you want to know for sure that the company is very strong. Everyone thought that AIG was too big to fail, to coin a phrase, but we found out differently.

There are several reputable insurance companies that have avoided the flash and the sizzle, and as a result are in very good financial shape today, even after the stock market bloodbath. Northwestern Mutual Life, headquartered in Milwaukee, is one. (I am not an agent of NML nor am I reimbursed in any way for mentioning them; but I am rather proud that they are based in my birthplace.)

Another Scandal Looming for Big Banks, Financial Houses

2009-06-19T20:12:00.000-07:00

by L.A.S.

Yet another scandal and heavy fines loom for the big banks and investment houses, this time due to investigations of tax cheating. The IRS has been bearing down on advisors who have helped the wealthy shelter money in offshore accounts. This is not breaking news but little attention has been paid to the financial consequences of the heavy IRS fines in such cases.

A recent case in which a former banker at UBS, the the Swiss bank, pleaded guilty last year to helping a client hide $200 million in an offshore account. The banker turned whistleblower and revealed that the bank holds billions of dollars for American customers in those secret Swiss bank accounts.

According to one source, there are roughly 52,000 suspected accounts; that is just the UBS accounts and there could be many thousands more with other banks such as Credit Suisse, HSBC, and others. It is difficult to imagine how the IRS might seek out so many cheats but their strategy is to offer amnesty to the depositors.

Depositors will still have to pay back taxes, otherwise they could eventually face five years in jail and fines of $100,000 or half of the amount in the foreign account (whichever is more).

Now, supposing the investment house failed to keep on file a form that properly advised the client (the depositor) that they have to file this account with the IRS. In that case, the investment house (or the advisor) faces being dragged into court and face similar jail time and fines for tax fraud.

How many such accounts are out there with American firms or at least American offices? How many of their American staffers stand in danger of being dragged into court and probably losing their licenses as financial advisors? And what will Wall Street make of those companies when the you-know-what finally hits the fan? It could get ugly out there.

The fact that even foreign stock exchanges are now highly correlated with the fortunes of the American stock exchanges is changing the axiom that there is safety in diversifying one's stock among domestic and foreign companies. You may have stock in some foreign banking interests without realizing it, just because you bought into global mutual funds, perhaps. The world markets and financial linkages are now so pervasive that nothing is isolated from general trends in the U.S. as it once was.

It is a difficult time to correctly evaluate the relative risks of mutual funds or any other foreign investments, so perhaps the right kind of diversification is between betting on the rising market and betting on the sinking market. People still have not quite recovered their confidence that times are getting better, in spite of a partial recovery of the Dow Jones.

Your Pharmacist Does NOT Have a Right to Change the Rx to a Generic!

2009-06-11T19:31:00.000-07:00

Stories have been coming out from consumers regarding how their pharmacist changed their prescription to a generic -- and this was done without telling them, and without asking their permission!

This has led to some horror stories of inadequate medication in the bloodstream for an epileptic. Her pharmacist, she learned, had exchanged her Tegretol for a generic that worked a little differently. "Just imagine what could have happened had I been behind the wheel of a car," she says. Luckily she was on a bicycle and while she sustained serious injuries, at least there was no fatality.

Pharmacists are so afraid of running afoul of insurers' pressure to use generics that they mistakenly tell patients that it is the law that they do so. Under a practice called "therapeutic substitution", pharmacists may substitute a generic for a brand-name drug even if your doctor specifies the brand name.

According to an article on MSNBC:

A pharmacist legally switched a drug prescribed by her doc — but without telling her or her physician. Usually, pharmacists replace a brand-name drug with a generic formulation of the exact same medication. Therapeutic substitution is similar but with one crucial distinction: The new drug is in the same class as the old and treats the same condition, but it's not precisely the same medication.

To understand the nuance, think of statins. They constitute a single class of medication because they all lower cholesterol by reducing its production in the liver. But not every statin lowers cholesterol by the same amount or with the same balance of LDL to HDL. So if your doctor orders a brand-name drug but your pharmacist switches it for the cheaper version of a different medication (but still a statin), you may not get the precise benefit your doctor had in mind — and may, in fact, suffer unexpected side effects.

This is horrendous -- we are all in favor of lower drug costs and in favor of using generics where appropriate, but no pharmacist should ever spring a surprise on any customer.

To read the whole article you may go here: http://www.msnbc.msn.com/id/30627962/
In one way, at least, patients can benefit from substitution — smaller co-pays. But two-thirds of people who reported having meds switched in a National Consumers League survey said they weren't consulted. Of those, 40 percent said the new drug was not as effective, and a third said it had more side effects. "It's not okay for your insurance company or pharmacist to change your drugs without your knowledge," says NCL Executive Director Sally Greenberg.

Is it Right that Insurance Companies are Profiting from Smoking Twice?

2009-06-09T18:33:00.000-07:00

A Canadian newspaper recently ran a story investigating how much insurance companies have invested in the tobacco industry. The June 5 issue of The Province found that Sun Life, a major Canadian insurance company, has a billion dollars invested with two tobacco companies. About $890 million of that is in Philip Morris. And the insurance industry as a whole has over four billion dollars invested in tobacco.

This brings up not only a question of business ethics, but of sending a mixed message to the public. Insurers have penalized smokers with higher rates for every type of insurance, and yet they continue to invest heavily in tobacco.

Clearly they place a higher value on profits, and obviously tobacco has been a steady producer of profits for investors of every size.

As long ago as 1995, we have known that insurance companies were rather heavily invested in tobacco. That is the year that Lancet ran an article on the subject. Insurers profit twice from tobacco: once from the higher rates charged to smokers, and again from their tobacco stock holdings.

The Province article also states that Prudential, which sells health and disability insurance, has $1.38 billion in two tobacco companies, including British American Tobacco (BAT).

Northwestern Mutual (NML), Massachusetts Mutual and the Scottish firm Standard Life also have large holdings in tobacco firms.

Do we as consumers have a right to criticize insurers for having these investments, whether or not we hold stock in the insurance companies? Or is tobacco such an old and traditional social vice that it is useless to rail against it? Remember that Prohibition against alcohol did not work.

We can simply choose to not invest in companies that invest in industries we do not want to encourage. We can simply choose to invest in green, sustainable industries and companies.

The article may be read at: http://www.theprovince.com/Health/Canadian+life+health+insurers+investing+heavily+tobacco+companies/1664704/story.html

An Alphabetical List of Insurers Offering Supplemental Insurances

2009-05-07T22:09:00.000-07:00

by L.A.S. --

The following is a list of the major insurers offering supplemental insurances which employers may choose to offer instead or as an alternative to standard group coverage. You may also wish to investigate other companies such as AdminiStaff, which offers supplemental insurance in addition to payroll services.

AEGIS ADMINISTRATIVE SERVICES INC.
888-881-2307
www.mini-meds.com
Offered as Limited Health Benefit Plans. Offered in ALL states. Issue ages 18-65. No deductible. Guaranteed issue. Details: defined benefits for inpatient hospital, surgery, outpatient, office visits, pharmacy, dental.

AIGILIS CORP.
407-324-3921
www.Rethink-Healthcare.com
Offered as eHealth Companion. Offered in ALL states. Issue ages not stated, but available to all employees. No deductible. Details: intended to be a personal health care management system to help you transition to a Consumer Directed Health Plan. Compatible with HSA, HRA.

AIGILIS CORP.
ALSO offers another plan called Way2SaveRx which is a discount pharmacy card. Minimum age 18. Available in all states. No deductible. Over 53K participating pharmacies. No enrollment or membership fees.

ALTERNET BENEFITS
877-815-2121
www.Alternetbenefits.com
Offered as Fusion. Offered in all states EXCEPT ID, MN, NY, VT, WA. Issue ages 18-70. Deductible $750 to $15,000 on catastrophic medical. Guaranteed issue. Details: Voluntary major medical.

AMERICAN FIDELITY ASSURANCE CO.
877-967-5748
www.afadvantage.com
Offered as Hospital GAP Plan. Offered in all states EXCEPT ID, MD, MN, NH, NJ, NY, ND, WA. . Issue ages 18-69. Details: supplemental coverage to cover your out-of-pocket costs. Not portable.

AMERICAN PUBLIC LIFE INSURANCE CO.
800-256-6736
www.ampublic.com
TWO PLANS: One is offered as Hospital Indemnity. Available in all states EXCEPT NJ, NY, VT. Issue ages 17-64. NO DEDUCTIBLE. Details: includes Rx discount, flexible plan designs, options for surgery, outpatient, emergency, wellness, etc.
The other is offered as MEDlink. Issue ages 18-69. No deductible on inpatient. This is not portable.

AMERICAN WORKER PLANS INC.
866-215-9300
www.theamericanworker.com
Offered as The American Worker Plan. Available in all states EXCEPT HI, MA, NY. Issue ages 18-70. Not portable. Limited benefit, critical illness, dental, disability, mini-med.

EQUITABLE LIFE & CASUALTY
800-352-5121
Offered as EquiChoice. Available in states EXCEPT AK, CA, CT, DE, DC, FL, GA, HI, ME, MD, MA, MN, NH, NJ, NY, RI, VT, WA, WI. Issue ages 65 and up. Guaranteed renewable. Designed as a Medicare Supplement.

GREAT AMERICAN SUPPLEMENTAL BENEFITS GROUP
866-459-4272
www.gasbinsurance.com
Offered as Medicare Supplement Plans. Offered in all states EXCEPT AK, DC, HI, MA, NJ, NY. Issue ages 65-99. Guaranteed issue, with pharmacy discount card.

HARBOR INSURANCE MARKETING
866-424-2167
THREE PLANS, first is Offered as the Gap Plan. Offered in all states EXCEPT CA, CT, FL, MN, MT, NJ, NY, ND, VT. Issue ages 18-70. No deductible. Not portable but can be continued under COBRA. Details: hospital benefit, fills gaps, flexible with several optional riders like surgery, outpatient surgical facility, office visits, diagnostics, wellness, ambulance, ER, accident, Rx card, etc.
Second plan is called Hospital Indemnity. Issue ages 18-64. No deductible. Covers expenses up to $1000 per day. Optional riders include AD&D, diagnostics, emergency, ICU, outpatient, private duty nursing, surgical, wellness, etc.
Third plan is called The Answer Plan. Issue ages 0-63. No deductible on inpatient. Covers medical expense inpatient and outpatient up to $250,000 per covered person per injury.

HEALTHPLAN SERVICES
800-545-6441
www.healthplan.com
Offered as Golden Rule Medicare Supplement. Available in AK, AR, CO, IL, IN, IA, LA, MD, MI, MS, MO, NE, OH, OK, SC, TN, TX, VA, WV. Issue ages 65 plus. Deductible varies.

KEY BENEFIT RESOURCES
877-907-5511
www.keybenefitresources.com
Offered as Keygap and KeySelect. Available in all states EXCEPT CA, CT, DE, FL, MA, NH, NY, WA. Issue ages 18-no limit. COBRA eligible. One is a group supplemental policy, the other is a limited benefit group plan.

MAGNA BENEFITS SOLUTIONS INC.
616-949-1199 or 800-278-2323
www.magnabenefits.com
Offered as Retiree Group Health and Prescription Drug Plans. Available in ALL states. Issue ages 65 unless already retired and Medicare eligible. Options include dental, vision, identity theft.

TRANSAMERICA WORKSITE MARKETING
800-400-3042
www.transamericaworksite.com or transchoiceplus.com
Offered as TransChoice Plus. Available in all states EXCEPT CA, CT, HI, NH, NJ, NY, VT, WA. No age restrictions for issue. No deductible. Limited group benefit for full or part-time employees. Options include diagnostics, surgical, inpatient, wellness, ambulance, hearing, pharmacy, etc.

UNUM
207-575-4942
www.unum.com
Offered as MedSupport. Available in all states EXCEPT CT, FL, KS, MA, MN, NJ, NY, WA. Issue ages 17-64 and spouse. No deductible. Inpatient confinement and outpatient surgery, diagnostics, ER.

What is in the New ARRA Law that Obama signed? Some details on COBRA changes, while we wait for details on implementation.

2009-05-07T22:04:00.000-07:00

by L.A.S. --

While the thousand-page ARRA law (American Recovery and Reinvestment Act) became law on March 1, 2009 when President Barack Obama signed it on Feb. 17, your employer was awaiting the details on the law in order to be in compliance with it. This means as a practical matter that thousands desperately waiting for help in keeping up their former employer's insurance under COBRA provisions could not be assured of a smooth transition to the emergency provisions of the law.

The law itself is written rather vaguely and so employers are scrambling for guidelines on implementation of the new rules. Granted, the ARRA law was written under pressure and so some parts are less defined than others.

THE OLD COBRA LAW: a qualified beneficiary who elected to continue health insurance coverage under his former employer's group plan had to pay the full premium, plus a small percentage (two percent) toward handling fees.

THE NEW COBRA LAW: Employees who were terminated between Sept. 1, 2008 and Dec. 31, 2009 “due to an involuntary loss of employment” will have 65 percent of the premium subsidized by the federal government for a period of UP TO nine months. Included in the group of employees covered by this new provision are those former employees who already declined COBRA coverage. Former employees will be covered for a total of 18 months: nine months of subsidized coverage and nine months of unsubsidized coverage.

The subsidy is NOT available to employees whose modified adjusted gross income exceeds $145,00 (or $290,000 for joint filers). Those with incomes between $125,000 and $145,000 will see a proportional decrease in their subsidy.

The subsidy is supposed to paid out of credits against the employer's payroll tax liability. In other words this is an immediate tax exemption for the employer and should not be a crushing burden to them financially. Anyone who claims otherwise is not understanding the ARRA provisions.

To restate it more simply: eligible individuals pay 35 percent of the total premium while the employer pays the other 65 percent, which is then reimbursed to the employer as a tax credit.
Some confusion may exist over some proposals that did not become part of the final bill. One major item that was changed was the proposal to allow those former employees over age 55 to re-enter the COBRA umbrella of coverage, at least until they became Medicare eligible or obtained coverage through another employer. Again, that proposal failed to become part of the final bill.

Other proposals that died in the talking phase includes one that would have extended coverage under COBRA ; it would have been far too costly and would have essentially rewritten the whole COBRA program. While we might discuss such issues again one day, it was deemed entirely inappropriate for emergency or stimulus legislation.

Will the sickest former employees likely rush to get covered under this new COBRA provision? It is likely that the answer will be yes, just because of the fact that people with ongoing health issues need uninterrupted checkups and medications. People do not elect COBRA unless they already have health issues that make it difficult to be accepted for other health insurance policies.

Nevertheless, one must bear in mind that for most people, even those with serious health challenges, do recover and return to the realm of the healthy.

The other significant part of the ARRA bill which impacts health care costs is the provision to speed up conversion of medical records to an electronic, computerized form. Nineteen billion dollars was earmarked for this huge effort. We already have the proven example of the VA which has converted its medical records to an electronic format, and has seen it raise levels of accuracy and speed of transmission to other providers.

A major barrier to this conversion is agreeing on a format that is compatible with the majority of providers, and observing the laws regarding privacy and security of medical records as per HIPAA requirements. While the impetus for writing the HIPAA law was to maintain security of medical records when electronically submitted to insurers, it is at times used to block or deny proper access to those medical records.

An E.R. doc makes a documentary prescribing tough medicine for "Our Ailing Healthcare System"

2009-04-08T18:49:00.000-07:00

(reprinted by permission of Minnie Apolis, from her Newsvine column)

A documentary made by an emergency room physician would seem have an edge at giving viewers an up-close look at the pressures faced by doctors from insurance and drug companies. And this film, titled Health, Money and Fear by Dr. Paul Hochfeld is an intelligent and incisive analysis of the myriad problems facing the healthcare industry in the United States.

The documentary is ninety minutes of well-done analysis and interviews with physicians and other health care professionals about the reasons why healthcare costs are out of control. The list includes:

*Insurance and Administrative Expenses: Processing costs eat up too many healthcare dollars and are inefficient.
*Malpractice Issues: Fear of being sued leads most doctors to order unnecessary tests just to cover themselves.
*Medical Records Chaos: Paper records are prone to errors and are not shared in a timely fashion with emergency or other providers.
*Pharmacy Costs: Pharmaceutical companies claim that drug prices are high because they need to recoup research expenses, yet marketing expenditures are twice what is spent on research.
*End of Life Care: If an elderly person develops a grave illness like a brain tumor, should we spend a half million to a million dollars on surgery and therapy, or just make them comfortable?
*Primary Care Crisis: The lack of new doctors going into primary care means that no one is encouraging positive lifestyle changes that could keep symptoms from becoming chronic diseases.

And the completely rational proposals to solve each of these problems are:
*Adopt a Single-Payer Health Plan
*Liability Reform
*Electronic Medical Records
*Disallow Mass Marketing of Prescription Drugs
*Public Education
*Funding of Primary Care

Stay tuned to the end of the DVD where the single-payer plan is compared to a Prom Committee that can negotiate better prices, and more efficiently, than many payers each trying to contract for different services from a plethora of providers.

More information on the Single-Payer plan is available online at: Health Care Meltdown by Bob Lebow from Amazon.com, Single-Payer FAQ from pnhp.org/facts/singlepayer_faq.php, and Campaign for a National Health Program at cnhpnow.org.

The 48-minute DVD, Health, Money and Fear is by Dr. Paul Hochfeld and produced by Dr. Graham Walker. It is dated February 2009. Dr. Hochfeld can be reached at phochfeld @ msn.com. More information is available at ourailinghealthcare.com.

A Strategy to Keep Inheritance Taxes Low as Possible

2009-03-25T17:28:00.000-07:00

By the Columnist
What might be your best strategy for maximizing growth while shrinking the tax bite from your estate? Most of us want to leave as much as possible to our heirs, rather than to the government, or to other beneficiaries like a college, school or charities.

And there is nothing illegal in that. Designing your portfolio to legally minimize the tax bite is perfectly rational and legitimate. Using well-designed life insurance policies, which are not taxable, is one way to do that.

One option to do so is to pay a single-premium immediate annuity. This HAS to be a life-only annuity, in order to avoid being included in the estate. This immediate annuity will generate a comfortable annual income. Depending on how high-value a plan you buy into, you could hit the 40 percent tax bracket. But this is still going to be a smaller hit than the estate tax to the full value of the the estate had you not purchased the annuity.

You could still use money that you do not need to live on, and pay that into a life insurance policy in an irrevocable trust. This will sweeten the inheritance pot for your heirs. You can also
use this idea for joint and survivor plans in the case of husband and wife. Designate the surviving spouse as the primary beneficiary, and the children as secondary beneficiaries who receive an equal share of the payout. Seek advice on how to minimize gift taxes to your beneficiaries.

Some number-crunching backs this up. If you deposit one million dollars in certificates of deposit for say, 5 percent interest, you generate income of $50K and a tax of $20K. The inheritance tax will take a large bite, and you will leave $550K (roughly) to your heirs. If you put a million dollars into this immediate annuity, your yearly income could be $90K (if the plan pays 9 percent), but the tax bite is lower, only $5,600. In the end, your estate is still worth $1.1 million at the end of the tax year. You have managed to leave twice as much to your heirs, and much less to the government.

Of course, should you be so lucky as to die in 2010, you would avoid the federal estate taxes altogether. But few of us a privileged to know when we will leave this earth and this mortal shell. And that also brings up the only possible negative about this strategy: if you outlive your life expectancy, the proceeds of the annuity will be fully taxable once you have received all your original principal. Natch.

The parameters of the ideal candidate for this strategy are as follows: is over age 70, is insurable, and possessing an estate worth at least $3.5 million and facing tax liability on that estate. 'Estate' includes all forms: cash and other liquid assets, stock, property, insurance policies, art or collectibles, etc.

Improve Your Financial Advising Skills For Pennies, or Less!

2009-03-19T17:20:00.000-07:00

What is the cheapest way to improve your financial advising skills and business? Is it to go to some posh seminar (at a cushy spa) that you earned for free on a company contest? That might be a very pleasurable way to do so, sure. But how about doing something all year to improve your business, and yet it costs only pennies or better yet, is FREE? Yes, free.

You may qualify for free magazine subscriptions that will keep you abreast of all the top news and tips in your field.

Do you know what is the hottest area of interest now in investing? It is still global investing; where are the new burgeoning economies? Where do we go now? Is China's economy going to flatline because of the United States recession? And what about Europe? Europe is even more dependent on monetary issues than Americans are.

How about a free subscription to Global Finance magazine? All you have to do is click. Keep up with currencies, risk management, mergers, banking, capital markets, and more. Click this link and get smarter.

Are you an accountant? Do you know what it takes to grow your small firm into a medium or regional company? Would you like to keep up with your field without adding to the cost of maintaining your skills? Would you like to keep up with the issues in the accounting field?

You can learn how to grow your accounting practice into a healthy regional firm. Read feature stories and case studies that illustrate tax, accounting and financial issues. Would you like a FREE subscription to Practical Accountant? All you have to do is click this link and get smarter.

But come back and get a second free magazine subscription. We have yet another free professional magazine called Accounting Today. Do I have to tell you why this is the most popular accounting magazine out there? You need to keep up with the news that affects the way you conduct business to stay on the right side of the law -- a law that keeps changing every time you turn around. Just click here and get smarter.

Those are not the only FREE magazine subscriptions for professional people we have to offer. No, we have magazines for financial advisors, too. Are you an investment advisor? We have Investment Advisor magazine -- an authoritative voice on products, planning and improving customer relationships. Just click here for a FREE subscription and get smarter.

You are even welcome to sign up for yet another FREE subscription to a fine financial magazine. Financial Advisor is exclusively for independent financial planners and RIAs. Helping your clients achieve their goals is how you achieve your goal, which is growing your practice. Just click here and learn how to prosper in a more competitive market than ever.

Do you manage pensions and investments? Don't you need to keep up with what's happening in the money management business? Get two free issues of Pensions and Investments and see if it isn't worth your while to get smarter. (and subscribe for half price)

And of course there is the established leader in business news: Business Week. Get four free issues of Business Week and see if it doesn't explain current events in a whole new light. Click here and start getting smarter now.

Are you in the collections field? Do you process payments in plastic or online? Keep up with progress in everything related to the electronic payments field. Marketing, loyalty, debit cards, stored-value cards (one of the hottest fields of growth), and more. Sign up for a FREE subscription to Cards&Payments. Just click here and get smarter.

Alphabetical List of Long-Term Care Insurance Carriers

2009-01-28T15:59:00.000-08:00

Accurate as of January 2009. Most plans use as a trigger the inability to meet 2 of the 6 ADL's (activities of daily living which are bathing, continence, dressing, eating, toileting, and transferring), and many also accept Cognitive Impairment. No endorsement is implied or given by listing these insurance carriers. You must determine which plan is best for you.

Advanced Resources Marketing --
www.armltc.com 617-783-2622. Group and individual. Available in all states. Issue ages 18-85. Minimum group size 10. Trigger: TQ. Portable. Elimination periods zero to 100 days.

Aim Marketing & Ins. Services --
www.AimMarketing.com 600-245-2467. Available in all states. Issue ages 25-80. Minimum group size three. Portable. Elimination periods – all available.

AJF Consultants --
www.ajfconsultants.com 866-901-5323. Available in all states. Issue ages: any. Minimum group size: any. Portable. Elimination periods: none.

Allianz Life --
www.allianzlife.com 800-950-7372. Available in all states EXCEPT CA HI MA NY. Issue ages 18-84. Minimum group size 10. Trigger: Unable to meet 2 of 6 ADLs. Portable. Elimination periods – 7, 30, 60, 90, 180, 365.

American Financial --
www.afmus.com 800-880-3072. Available in all states. Issue ages 18-84. Minimum group size five. Trigger: Unable to meet 2 of 6 ADLs or cognitive. Portable. Elimination periods – zero to 365.

American Independent --
www.aimforltc.com 800-672-7202. Available in AK AZ AR CA CO HI ID KS LA ME MI MO MT NE NV NM NY OK OR TX UT VT WA WY. Issue ages 18-99. Minimum group size five. Portable. Elimination periods – many options. Many benefit triggers to choose from.

American Insurnet Agency --
www.AmericanInsurnet.com 800-333-4638. Available in all states. Issue ages 18-89. Minimum group size five. Trigger: Unable to meet 2 of 6 ADLs or cognitive. Portable. Elimination periods – zero day for home care; zero-30-90-180-354 for nursing home.

American Life & Health --
www.amlifegroup.com 800-992-1492. Available in all states EXCEPT CA CT KS ME MA NH NJ NY PA RI VT AND WA. Issue ages 18-84. Minimum group size: case by case. Trigger: Unable to meet 2 of 6 ADLs. Portable. Elimination periods – 90 days only.

Assurity Life Insurance Co. --
www.assurity.com 888-276-7619, x 3774. Available in all states EXCEPT FL NY AND VT. Issue ages 40-84. Minimum group size, none, but discount with 10 members. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment. Portable. Elimination periods – 0, 30, 90, 180.

Berkshire Life Insurance --
www.TheBerkshire.com 888-505-8743. Available in all states. Issue ages 40-84. Minimum group size, none, but discount with 10 members. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment. Portable. Elimination periods – 0, 30, 90, 180.

Equitable Life & Casualty --
www.Equilife.com 800-352-5121. Available in all states EXCEPT AK CA CT DE DC FL GA HI ME MD MA MN NH NJ NY PA RI VT WA WI. Issue ages 18-84. Minimum group size, none. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment (requires physician statement). Portable. Elimination periods – 0, 30, 60, 90, 120, 180, 365.

GamePlan Financial --
www.gameplanfinancial.com 770-517-2765. Available in all states. Issue ages 18-84. Minimum group size, three. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment. Portable. Elimination periods – 0, to 365.

Gelbwaks Insurance --
www.gelbwaks.cm 954-236-9999 x104. Available in all states. Issue ages 18-70. Minimum group size three. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment. Portable. Elimination periods – 20 to 180 days.

Golden Benefits --
goldenbenefits.com 415-454-3359. Available in California. Issue ages 18-79. Minimum group size, three. Trigger: Unable to meet 2 of 6 ADLs. Portable. Elimination periods – 0, 30, 60, 90.

Great American Life --
www.aimsltc.com 800-325-9876. Available in all states EXCEPT CA CT HI NJ NY. Issue ages 18-89. Minimum group size, five. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – 30, 60, 100, 180, 365.

Guaranty Income Life --
www.gilico.com 800-535-8110 x292. Available in AL AZ AR CA CO FL GA IL IN IA KY LA MI MS MO MT NE NV NM NC ND OH OK OR SC TN TX UT WY. Issue ages to age 85. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment (requires physician statement). Portable. Elimination periods – 90.

Harbor Insurance --
www.HarborIns.com 866-424-2167. Available in all states EXCEPT NY. Issue ages varies by carrier. Minimum group size, any. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – varies by carrier.

Insurance Network America --
www.InsuranceNetwork.com 800-456-7999. Available in all states EXCEPT CA HI MA NY. Issue ages 18-84. Minimum group size, one. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – 7, 30, 60, 90, 180, 365.

John Hancock --
www.JohnHancockLTC.com 800-330-4598, 800-330-4582. CareChoice plan available in AL AK AZ AR CT DC GA IL IN IA KS KY ME MA MS MO NV NH NM NY OH OK OR RI SC SD WV WI and WY. Corporate Choice plan available in all states EXCEPT CA FL TX WA. Corporate Solutions plan available in all states EXCEPT CA NY. Issue ages 18 to retirement. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment. Portable. Elimination periods – 30, 60, 90.

LifeSecure Insurance Co. --
www.YourLifeSecure.com 810-220-4613. Available in AL AZ AR CO DE DC FL GA HI ID IL IN IA KS KY LA MD MI MN MS MO MT NE NV NM ND OH OK OR SC SD TN TX UT VA WV WI WY. Issue ages 18-84. Minimum group size, three. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment. Portable. Elimination periods – 90.

LTCi Decision Systems --
www.LTCia.com 800-360-9853 or 720-922-9060. No details were furnished to reporting group.

MedAmerica Insurance Co. --
www.medamericaltc.com 800-544-0327. Available in all states. Issue ages 18-85. Minimum group size ten. Trigger: Unable to meet 2 of 6 ADLs. Portable. Elimination periods – 30, 60, 90, 180 days.

Metropolitan Life Insurance --
www.metlife.com 888-776-3882. Available in all states. Issue ages 18-84. Minimum group size, three. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment. Portable. Elimination periods – 20, 45, 100 days.

Nationwide Financial --
www.nationwide.com 800-321-6064. Available in all states EXCEPT MN MT WA. Issue ages 21-80. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – 90 days.

Pacific Advisors --
www.PacificAdvisors.com 877-455-9580. Available in all states. Issue ages 18-84. Minimum group size, three. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – 30 to 180.

Rampart America --
www.RampartAmerica.com 800-221-4623. Available in all states. Issue ages 18-85. Minimum group size, three. Trigger: Unable to meet 2 of 6 ADLs. Portable. Elimination periods – 30, 60, 90.

Roster Financial --
www.RosterFinancial.com 800-933-6632. Available in all states. Issue ages 18-85. Minimum group size, five. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – 30, 60, 90, 180 days.

Senior Market Sales --
www.SeniorMarketSales.com 800-786-5566 x4. Available in all states. Issue ages 18-84. Minimum group size, three. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – zero to 730, depending on carrier.

The Prudential --
www.Prudential.com 800-732-0416. Available in all states. Issue ages 18-79. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – 30, 60, 90, 120, 180 out of 365 days.

Transamerica --
www.TransamericaLTC.com 817-285-3604. Available in all states EXCEPT GA ID MT PA VT. Issue ages 18-79. Minimum group size, five. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – zero, 30, 60, 90, or 180.

Trustmark --
www.TrustmarkSolutions.com 800-840-4692. Available in all states. Issue ages 18-80. Minimum group size, 100. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – 90 days.

Underwriters Marketing Service --
www.Callums.com 800-524-1774. Available in all states. Issue ages 18-84. Minimum group size, three. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – varies.

Unum --
Unum.com 800-421-0344. Two plans, GLTC Advantage and Group LTC. Available in all states. Issue ages 18-80. Minimum group size, ten or 15 depending on which plan is selected. Trigger: Unable to meet 2 of 6 ADLs or cognitive impairment. Portable. Elimination periods – 20 to 730 days.

Wachovia Insurance Services --
www.Wachovia.com 803-765-3520. Available in all states. Issue ages 18-75. Minimum group size, ten. Trigger: Unable to meet 2 of 6 ADLs. Portable. Elimination periods – most have 90-100 days.

Zenith Marketing Group --
www.ZenithMarketing.com 800-733-0054. Available in all states. Issue ages 18-79. Minimum group size, four. Trigger: Unable to meet 2 of 6 ADLs or severe cognitive impairment. Portable. Elimination periods – 30, 90, 180, 365.

Alphabetical List of Pharmacy Benefit Managers

2009-01-28T15:55:00.000-08:00

(accurate as of November 2008) Providing this list does NOT imply endorsement, and none should be assumed. You must determine which company's plans best suit you.

Aetna Pharmacy --
www.aetna.com More than 59K pharmacies in network. Available in all states. No minimum number in group. Disease management programs. Has mail order and call centers.

DrugsBestBuy.com --
www.DrugsBestBuy.com 207-439-2600. Available in all states. No minimum number in group. Save up to 46 percent on generics, up to 15 percent on brand name drugs. Does not offer disease management. Has mail order, internet pharmacy and call centers.

Express Scripts Inc. --
www.Express-scripts.com 866-408-3719. More than 60K pharmacies in network. Available in all states EXCEPT DC AND ME. Minimum number in group determined by plan sponsor. Disease management programs administered by LifeMasters. Has mail order, internet pharmacy and call centers.

Independent Health's Pharmacy Benefit --
www.IndependentHealth.com 716-635-7873. More than 50K pharmacies in network. Available in all states. Minimum number in group: 250. Disease management programs. Has mail order, internet pharmacy and call centers.

InformedRx Inc. --
www.sxc.com 630-577-4710. More than 55K pharmacies in network. Available in all states. No minimum number in group. No disease management programs. Has mail order, internet pharmacy and call centers.

Millennium Administrators Inc. --
www.millennium-tpa.com 866-644-2489. More than 60K pharmacies in network. Available in all states. Minimum number in group: 20. Disease management programs. Has mail order, internet pharmacy (thru mail order) and call centers.

Navitus Health Solutions --
www.navitus.com 480-838-1105. More than 55K pharmacies in network. Available in all states. Minimum number in group: 100. Disease management programs. Has mail order, internet pharmacy and call centers.

Outlook RX --
www.OutlookVision.com 800-342-7188. More than 55K pharmacies in network. Available in all states. No minimum number in group. No disease management programs. Has call centers, but no mail order or internet pharmacy.

Partners Rx Management --
www.PartnersRx.com 480-624-9400. More than 60K pharmacies in network. Available in all states. Minimum number in group: 25. Disease management programs. Has mail order, internet pharmacy and call centers.

Prescription Solutions --
www.RxSolutions.com 760-215-3639. More than 62K pharmacies in network. Available in all states. No minimum number in group. Disease management programs. Has mail order, internet pharmacy and call centers.

Prime Therapeutics --
www.PrimeTherapeutics.com 651-414-4198. More than 58K pharmacies in network. Available in all states. No minimum number in group. Disease management programs thru Prime's clinical program PrimeImpact. Has mail order, internet pharmacy and call centers.

Restat --
www.restat.com 800-926-5858. More than 60K pharmacies in network. Available in all states. No minimum number in group. No disease management programs. Has mail order, internet pharmacy and call centers.

ScripNet Inc. --
www.ScripNet.com 818-878-0296. More than 58K pharmacies in network. Available in all states. Designed for groups that spend over $500K annually on workers' compensation prescription drugs. Disease management programs. Has mail order, internet pharmacy and call centers.

Seven Practical Icebreakers that you can use during your next meeting

2009-01-28T15:51:00.000-08:00

Looking for ways to break the ice at your next office meeting? Here are some surefire winners.

Have participants write down one question that they would like to have answered during the training session. Have them introduce themselves and read their question.

Have participants introduce themselves and explain one thing they have learned the hard way about the topic you are covering. Post the "Lessons Learned" on a flip chart and refer to them throughout the session.

Use a quiz as an icebreaker. Ask questions that the participants may all know. Sample questions: What are the names of the planets, starting from the one closest to the sun? Name the seven continents of the world?

Ask each person who they would most like to have dinner with and why.

Explain that many companies have slogans or mottos about their corporate values. Ask each person to write (or borrow) a slogan to describe himself or herself and share it with the group.

Ask each person to share one thing that makes him or her unique.

Ask for volunteers to share something good or new that they have experienced in the last 24 hours.

Alphabetical List of Providers of 401k Plans

2009-01-28T15:39:00.000-08:00

The following is a list of carriers and administrators that offer 401k plans. It is up to date as of Fall 2008, but we do not guarantee that it is an all-inclusive list. Please consult with your certified financial planner regarding specific features of plans that will best fit your needs. Providing this list does NOT imply endorsement, and none should be assumed. You must determine which company's plans best suit you. The data is accurate as of October 2008; my apologies for not getting this up sooner.

401kBrokers.com and 401kAdministrators.com --
www.401kBrokers.com. 800-474-3826. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: 0.25% and no extra charge for setup, loans, termination, tax returns, agency or placement fees. For COMPANY 401k plans, the charge is 0.25% plus $1000. Distributions upon request.

Advanced Benefits Consulting --
314-539-0836. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Varies with complexity of plan.

Alliance Benefit Group --
www.abgNational.com. 800-242-2356. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Quotes are per plan, and are based on average account balance. Distributions within 8 days of request.

Alliance Pension Consultants --
www.AlliancePension.com. 847-291-9440. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Quotes based on plan specs and parameters. Daily retirement distributions.

American United Life Insurance Co. --
www.OneAmerica.com. 866-313-7355. Available in all states except New York. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Varies by product. Daily retirement distributions.

Assurity Advisors Inc. --
www.AssurityAdvisors.com. 800-284-8576. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Varies. Daily retirement distributions.

Belanger and Co. Inc. --
www.BelangerandcCompany.com. 610-239-9750. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: $1850 plus an additional $10 per participant. Setup fees: $750 plus $150 per participant per year. Billed monthly.

Benefit Consultants --
www.bcionline.net. 888-968-2422 x22. Available in AL FL GA MS TN. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Vary based on assets. Distributions subject to plan designs.

BenefitStreet Inc. --
www.BenefitStreet.com. 925-328-4547. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: $450 setup, $500 conversion.

Century Benefits Consulting Inc. --
www.Benefits-shmenefits.com. 415-647-8144. Available in all states. Offers plan consolidation, and benefit statements. Annual administrative fee: Varies with plan structure.

Charles Schwab --
www.scrs.schwab.com. 877-456-0777. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Quotes on case-by-case basis.

CPI Qualified Plan Consultants Inc. --
www.cpiqpc.com 800-279-9916 x765. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Varies depending on plan selected.

Daily Access Corp. --
888-535-4322. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee:$85 loan set-up fee; $50 annual maintenance fee.

EBS Benefit Solutions, Inc. --
www.ebsbenefitsolutions.com. 585-421-4400. Available in all states. Strictly an administrator, does not offer rollovers etc. Fees depend on product plan, support or “open mutual fund architecture”.

Employee Benefit Systems Inc. --
www.ebspesnion.com. 570-223-8402. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: $1000 set-up; on-going $900 plus $30 eligible.

Entrust New Direction IRA Inc. --
www.NewDirectionIRA.com 303-546-7930. ONLY in CO HI MT WY. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Varies depending on assets. Set-up fee: $350; Annual fee $300 plus investment costs.

Expert Plan --
www.ExpertPlan.com 866-929-2525. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Set-up fee: $75-$750; Annual recordkeeping fee: $75-$750; Annual participant fee: $0-$36 depending on assets.

Future Benefits of America –
www.fb401k.com 901-843-7799. Available in all states. Set-up fee: $1200; $1000 base fee; $35 per participant with balance.

Great West Retirement Services --
www.gwrs.com 877-630-4015. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: not specified here, but it does charge fees for loan origination and annual maintenance fee for each loan.

Guardian Ins. & Annuity Co Inc. --
www.GuardianRetirement.com 866-390-7268. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: Setup: $750; $1250 conversion; other fees depend on assets.

Harbor Insurance Marketing --
www.HarborIns.com 866-424-2167. Available in all states EXCEPT NY. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies with size of plan.

ING --
www.ingretirementplans.com 888-238-6243. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies with assets, number of participants, and/or if there is a TPA involved.

Insurance Designers of Houston, Elite Mktg. Gp. --
www.EliteMktg.com 800-477-3548. Available in all states EXCEPT AK, DC AND HI. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies with size of account.

Iron Corporate Retirement Services --
888-396-4766. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies with plan size and number of participants.

Lafayette Life Insurance Co. --
765-477-7411. Available in all states EXCEPT AK AND NY. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: if one participant $250; all others $1000.

Lincoln Financial Group --
www.lfg.com 877-533-9710. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies.

MassMutual Financial Group --
www.MassMutual.com 866-444-2601. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies with plan size and complexity.

Mercer --
www.mercer.com 866-454-6477. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies by plan.

Milberg Consulting --
www.milbergconsulting.com 800-965-0988 x101. Available in all states. Offers no rollovers, but does offer plan consolidation, and benefit statements. Annual administrative fee: setup - $1750-$3,500; ongoing fee - $2,000-$5,000.

Mutual of Omaha Retirement Services --
www.GetRetirementRight.com 877-401-7253. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies with plan size.

Newport Group --
www.Newportgroup.com 800-230-3907. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies with plan participants and assets, funds, etc.

Ohio National Financial Services --
www.OhioNational.com 877-999-6637. Available in all states EXCEPT AK, HI, NY. Offers rollover plans, plan consolidation, and benefit statements. Administrative fee: setup $375; annual $675.

Online 401k --
www.TheOnline401k.com 877-775-4015. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Setup fee: from zero to $495.

Paychex Inc. --
www.Paychex.com 877-283-9520. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: starts at $95/month and $5 per participant.

Principal Financial Group --
www.principal.com 800-952-3343. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies with plan size.

Putnam Investments --
www.putnam.com 800-719-9914. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: setup starts at $250 and $500/year annual administrative fees.

Revzon Consulting Group --
www.RevzonConsulting.com 877-254-7085. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies.

Securian Financial Group Inc. --
www.SecurianRetirementCenter.com 877-876-4015. Available in all states EXCEPT NY. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies.

The Standard --
www.retirement.standard.com 877-805-1127. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: varies.

Sterling Trust --
www.Ster.lingTrustCompany.com 800-955-3434, option 5. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Administrative fee: base fee of $1250 for up to 20 participants; $1500 for 20+. Lots of features available.

Symetra Life Insurance Co. --
www.symetra.com/401k. 800-706-0700. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: None for the product. Symetra partners with Third Party Administrators to provide plan administration.

TGA, The Green Agency --
www.GreenAdvisory.com 508-224-9646. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Administrative fee: $900 bundled plan for less than 100 participants.

Transamerica Retirement Services --
www.TA-Retirement.com 888-401-5826. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: no setup fees, other plan fees vary with size.

Unified Trust Co. --
www.UnifiedTrust.com 859-296-4407 877-411-8781 Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Annual administrative fee: vary depending with services. Fees are online.

Wells Fargo Bank --
wwwWellsfargo.com/retirementsolutions 800-368-1225. Available in all states. Offers rollover plans, plan consolidation, and benefit statements. Administrative fee: setup is only $75.

Two Kinds of Long-Term Care Policies? Yes, Cash Model and Indemnity

2008-12-24T10:34:00.000-08:00

While most people know that there are two basic forms of life insurance (term and whole life), they do not realize that long-term care insurance also has two basic forms, ie cash model and indemnity model.

It is hard enough to sort through the variables of setting up a long-term care plan. You have to select a coverage period, how much a month you think you might need for a nursing home, whether to include home health, whether to include an inflation protection rider.

First, the Cash Model: Once the policy-holder qualifies to become claim eligible, the insurer will mail out a check each month for the full amount of the monthly benefit. This money is his or hers to spend as they see fit to cover their bills. The cash model does not require the use of licensed care for the insured to be covered. The insured has complete freedom of choice of providers to tend to their needs. He can even buy a lift-equipped van if that what is needed to maintain independence.

These cash payments are tax-free up to $98,550 in 2008. It is an ideal plan for the insured, because he will know exactly how much money is coming in each month, and gives such complete freedom of choice in how one can spend it. Any excess funds can be stashed away in savings or investments for such time as the LTC policy coverage period expires. And if the insured does pass away, those funds will be in their accounts to cover any debts and be passed along to their estate's beneficiaries.

The second type is the Indemnity Model, which is what most of us have been exposed to. This model requires that in order for benefits to be paid, they must be performed by a licensed caregiver AND for eligible expenses. The insured typically has to receive at least one hour of licensed care per day to remain covered by the policy.

The insured under this plan has a daily amount allotted to him; at the end of the month, the insurer totals up the days in which the insured received at least one hour of care, multiplies by the daily coverage amount, and then issues the check to the insured.

Now think about this. This means that the insured could potentially receive wild variations in the level of benefits under this format. True, they are tied to actual services received. But the insured may have a real need for some type of adaptive equipment in the home so that they can remain in their own homes. This equipment is normally going to have a monthly bill no matter whether the insured has a lot of home visits or not – and MAY NOT be covered under your policy. That means the insured is paying out of his own pocket for whatever is needed to maintain independence.

The indemnity policy is generally 40-60 percent less expensive than the cash model, and I hope you readers can see why. People are scared of the cost of a LTC plan as it is, so insurers just show this model to their prospective clients. Your agent may not even be trained in the cash model plan because so few people know enough to ask for it.

You are wiser to save money by cutting down the coverage period rather than by going to the indemnity plan. Industry studies show that most long-term care plans have a claim history of only 2 to 3 years. And yet many clients select the lifetime option because they are terrified of outliving their money. This is one case where fear is costing people thousands of dollars in premiums unnecessarily.

I should also add that in case you do not qualify for coverage under a long term plan (in other words, you are rejected by their underwriting department), you still have other options. Many life insurance policies now have an accelerated benefits provision, where you can draw upon the value of your life insurance plan to pay your nursing home or other end-of-life expenses.

I hope this information is of benefit to you in planning your insurance coverages.

[Disclaimer: This article is not intended to sell the reader anything. But you must still consult with a financial planner (preferably certified) or your local insurance representatives to find a policy that fits your needs.]

What features should you look for in a Long-Term Care insurance policy?

2008-11-21T18:04:00.000-08:00

You have finally decided to bite the bullet and check around for a long-term care policy for yourself or a loved one. But where do you begin? What features should be included in a plan?

You do not have to re-invent the wheel when seeking a LTC policy. The folks at the National Association of Insurance Commissioners (NAIC, found online at NAIC.org) have kindly provided a mini checklist for your benefit. The list includes:

At least one year of nursing home or custodial care, and should also include intermediate care.
You probably want home health care included, too. Home health should not be limited to skilled care (meaning a registered nurse). You will probably need to call in unskilled help to assist with household chores, to help bathe and feed your loved one, or any of the myriad things that need to be done.
Coverage for Alzheimer's disease, if the policyholder develops the illness after the policy is issued.
Inflation protection option. No one knows just how expensive it will be ten years from now to keep someone in a decent nursing home; prices have risen sharply over the past ten years for all health care. It will cost you more to have this rider or option.
The insurance carrier is obligated to provide you with a free copy of the “long-term care insurance shopper's guide”. They prefer to hand this out after you have signed on the dotted line for an application, but you are NOT obligated to buy or express an interest in buying, in order to get this booklet.
A guarantee that the policy cannot be canceled, nonrenewed, or otherwise terminated because you get older or develop a chronic illness/serious disease.
You have the right to a 30-day period – known as a 'free look' – in which to examine the policy and return it if it does not seem to be what you wanted. The insurer will return your check. This is a standard provision, not a gift from each insurer, but do mention it anyway.
There should not be any requirement such as the following: that the policyholder first be hospitalized before admission to a nursing home in order to be covered; that the policyholder first receive skilled nursing home care before entering an intermediate or custodial nursing home; or that the policyholder first receive nursing home care before receiving benefits for home health care. Why are these important? Because most people prefer to keep a loved one at home for as long as possible before finally transferring him or her into a nursing home. These provisions we have listed all are intended to keep someone in a healthcare facility of some kind rather than at home.
In addition, you might see a 'waiver of premium' rider. This allows you to stop paying premiums during the time you are receiving benefits. Read closely to find what restrictions there are on this rider. Commonly, you will have to be in a nursing home for 90 days before the waiver goes into effect.
Pre-existing conditions. Insurers usually say in the policy that pre-existing conditions are excluded for 6 months or a year. However, often they will simply not write a policy for someone with certain diagnoses. For example, I once tried to get a long-term care policy for a lady who was 72, in great shape – but underwriting turned her down because she had diabetes. Even though her condition was controlled and her weight was in the normal range, they felt her disease was progressing enough so that they did not want the risk. Also, some diseases may be quite common in your state and some insurers will not cover it. In Minnesota, multiple sclerosis is quite common (statistically speaking) and so it is excluded from dread disease policies. (In other words, if you have a family history of this disease, move to another state if you want to buy a dread disease policy.)
What exclusions are in the policy? It is common that injuries or illnesses that result from self-inflicted causes are excluded. But you may be surprised that those who have a history of drug or alcohol abuse will also be excluded from coverage if their condition is deemed related to that history. (Example: liver disease, brain damage from a drug overdose, etc.)
Possible return of premium. Some policies allow you to get a healthy refund of premiums paid if you do not use the insurance provisions or decide to cancel. You will not get 100 percent of your premiums back. You will however pay more for this rider. Why would you want this rider? If at some point you can no longer afford the premiums, or some other option opens up for you that will replace the coverages of this policy, you could decide to cash it in, so to speak, and use the cash to buy into another coverage.

People generally buy far too much long-term care insurance. From the statistics that I have seen, most people only spend one, two, or three years in a nursing home. And yet people are terrified of the possible expenses of spending twenty years in such a facility.

Although I personally know of a classmate's father, an Alzheimer's patient, spending six years in a nice facility, he was not the norm. He was a big, strong guy before he came down with the disease, and he died as result of complications of pneumonia.

On the other hand, my own grandmother only spent about six months in a skilled care facility before she died. But you have to play the odds here, the reasonable odds. And most likely, three years of nursing home care is all that one can reasonably be expected to afford premiums for.

My other recommendation, as a past professional in the area of senior products, is that IF you cannot get a long-term care policy due to health history or whatever, then increase your life insurance coverage to the most you can reasonably afford. Most life insurance policies are 1) cheaper than LTC policies, 2) easier to get than a LTC policy, and 3) have acceleration of benefit provisions so that if you are diagnosed with a terminal illness or have to go into a nursing home, you can draw upon the policy limits. At the very least, you can put up the life insurance policy as a form of collateral on the final bill from the nursing home.

SEE ALSO:
America's Health Insurance Plans (AHIP) – online at AHIP.org; they have an office in Washington, DC.
American Health Care Assn. -- 1201 I (as in Illinois) Street NW, Washington, DC 20005, 202-842-4444, or online at ahca.org.
National Assn. Of Insurance Commissioners (NAIC) – 2301 McGee Street, Suite 800, Kansas City, MO 64108, 816-842-3600, or online at NAIC.org.
National Council on the Aging – 300 D Street SW, Suite 801, Washington, DC 20024, 202-479-1200, or online at NCOA.org.
Area Agency on Aging – 1-800-677-1116 to find a local office.

Take a Load Off Your Mind With Advance Directives for Medical Care

2008-11-10T15:07:00.000-08:00

Have you still not done anything about formalizing an Advance Directive for your medical care? Thousands of people rushed to do it when the Terry Schiavo case mesmerized the nation. But now some years have passed, and we need another reminder to get it done.

This article is prompted by a very nice column by a former LPN, who goes by the name Kyana Belle in her column, urging people to create an Advance Directive for their care. She had brief stories to tell of the nightmarish, ugly situations that could have been averted with some well-thought-out planning ahead.

I might add that hospital staff is obligated to make available to you whatever forms are needed to create this Advance Directive. It need not cost you a thing unless you need to consult an attorney if you have multiple marriages, multiple families from those marriages, or no current spouse.

Kyana explains what a Do Not Resuscitate order really means, and explains the difference between that and a Living Will, plus she provides links for all you need. She has just three basic points to make:

1) A "Do Not Resuscitate," "DNR,"or "No Code" is ONLY an order that prevents attempts to restart your breathing and/or heart beat should either cease.

2) If you have not legally appointed someone to make decisions for you when you are unable to do so yourself, someone will be appointed for you according to your state laws.

3) It can NOT wait - get it done now!

Thank you Kyana! You rock! Readers may find the entire article here at: http://kyanabelle.newsvine.com/_news/2008/11/06/2080706-how-to-protect-your-rights-with-advance-directives?email=html&threadId=412008&commentId=4007241#c4007241 .

In Honor of the Upcoming Veterans Day – How To Make Claims on Your Military Life Insurance

2008-11-09T08:44:00.000-08:00

In honor of Veterans Day this year, I want to help the families of military veterans get their proper benefit checks for life insurance policies held by service persons. IF you have kept up your military group life insurance policy during service (if still in uniform) or after discharge, you (or rather your beneficiaries) should be able to get the VA to accept your claim. Just read this article and go to the link given below to find the claim form.

Several years ago a scandal broke out about the Veterans Administration denying all phone inquiries inre making claims on veterans group life insurance policies. It seemed that the staff was using the funds to pay for department parties and other nonsense.

I was also surprised to hear of one widow of a WWII veteran making a successful claim on her late husband's policy not long before this scandal broke out (about ten years ago). Fortunately for her, she had an adult child who sent in a request for a claim form instead of just accepting the erroneous information that had been received by phone. The veteran had kept policy status updates on file, and so they had a policy number and an address to send the request to.

So to make a long story short, they received the claim form – a mere half-page long – and filled in the necessary information. The only difficult section asked for the veteran's discharge date, an item they luckily had on the discharge papers.

Do you want to guess how much money the widow wound up with? The policy had been paid up some time before and was accruing interest. The final valuation was for over $6200. That was a very welcome hunk of change to help make up for the loss of her husband's pension check from work.

Below is the link to the VA insurance page. There are several forms available but to make a claim, click on the one that says: SGLV 8283, Claim for Death Benefits. There is also a related form to make claims for the death of a spouse (or other covered family member) of a military service person.
http://www.insurance.va.gov/sgliSite/forms/forms.htm

It does not matter how long ago your military service person or veteran died; the policy still accrues value until the claim is made. Just dig up your insurance policy and discharge papers, and you will have enough information to fill out the claim form.

Good luck to all of you, and thank you to all our United States veterans out there (and their families). Have a good day.

[The erroneous information given by phone was possibly a mixup; the VA continually has to deny inquiries about a mythical veterans insurance dividend payout. You can read a full article explaining that confusing urban myth at http://urbanlegends.about.com/library/weekly/aa050698.htm .]

Wall Street Journal Has Story on Fighting Insurance Denials

2008-09-26T17:52:00.000-07:00

Pushing Back When Insurers Deny Coverage for Treatment --
By Anna Wilde Mathews, The Wall Street Journal
http://www.marketwatch.com/News/Story/Story.aspx?guid=b6e08398424d449bb8ac46fc3c8a2565&siteid=nwtpf&sguid=LlOmLCZmMkSOlLZa0_8Pmw
Battling a health insurer when it refuses to cover certain treatments can be aggravating and time-consuming. But if you choose to join the growing number of people who are appealing coverage denials, there are several strategies that can bolster your case.

State, insurers, doctors in battle over billing

2008-09-19T20:07:00.000-07:00

-- from the Ventura County Star, Sept. 12, 2008
A person injured in a car crash is treated in the emergency room. The insurance company pays the out-of-network doctors involved in the care less than they think they're owed.
So a doctor or the hospital sends a bill for the remainder directly to the patient।

It's called "balance billing" and has spawned a turf battle among state officials who are trying to outlaw the practice, insurers who support the ban and doctors who fight it and see themselves as victims।

"Legislate, regulate and litigate। We'll do whatever it takes," said California Medical Association President Richard Frankenstein, before a meeting with Ventura County doctors this week. He laid responsibility for balance billing on insurers trying to protect their profits by underpaying doctors.

"It's a very clever ploy of multimillion-dollar companies to avoid their responsibilities," he said.
But some patient advocates say there's enough blame to share। They say the fight over compensation for emergency care ends up wounding patients who worry that if they don't pay the doctor's bill, their account will end up with a collection agency.

"We're caught between these two institutional providers," said Beth Capell, an advocate with Health Access California. "It's a temptation to say a plague on both your houses."
Many of the problems occur in emergency rooms where neither patients nor doctors control who they see। People may be treated by providers who don't contract with their insurance company. The doctors are paid a lesser, out-of-network rate.

According to the California Association of Health Plans, 1।76 million Californians who went to emergency rooms over a two-year period were billed by doctors or hospitals for money not paid by insurers.

The total bill was about $528 million.
The California Department of Managed Health Care plans to roll out a regulation next month that labels balance billing for emergency care as an unfair practice, opening the door to enforcement action against doctors or hospitals।

A bill by Sen। Don Perata, D-Oakland, would ban ER doctors from balance billing and would set up a process to mediate insurance disputes as well as an interim rate of payment. The bill was approved by the Legislature two weeks ago and awaits Gov. Arnold Schwarzenegger's signature. It would supersede the managed care regulation.

The doctors' association will sue the day after the state implements its new rules, said Frankenstein, in Camarillo for a meeting of the Ventura County Medical Association. The state group also opposes Perata's bill, though a group of emergency physicians supports the measure.
Frankenstein said insurance companies need to expand their networks to include more emergency room and on-call doctors। They also need to pay more, he said.

"It's up to the health plan to either serve up the doctor or pay the bill," Frankenstein said, suggesting insurers maximize profit by saying, "This is what we feel like paying today."
Nicole Kasabian Evans of the California Association of Health Plans fired back।

"Health plans are not the ones that are sending the bill to the consumer," she said। "We don't think it's appropriate strategy to hold patients hostage."

Evans said the insurance group supports a ban on balance billing and an independent process to deal with disputes with doctors। But the group opposes Perata's bill because the rate of payment may be too high. Doctors who currently contract with insurance companies might drop out to get the out-of-network rate, she said.

Eliminating balance billing is great if it comes with reform that transforms the healthcare system and provides insurance coverage to everyone, said Jim Lott, executive vice president of the Hospital Association of Southern California। But hospitals aren't happy about measures that eliminate the bills but not the underlying causes, he said.

"Balance billing is a tool hospitals use to force health plans into negotiating fair rates," he said. "Consumers need to know. If their health plan is screwing up, they need to know that."
Patients shouldn't be seen as a tool, said Cindy Ehnes, director of the state Department of Managed Health Care।

"It's inappropriate to put a vulnerable, potential sick patient in the middle of a billing dispute just to provide leverage," said Ehnes, calling on doctors to take their disputes to her department.
Local doctors say balance billing isn't about getting rich but about staying in business। Some predict that eliminating the mechanism will amplify other healthcare problems such as getting doctors to serve on call.

"I think that will be the death knell to taking call in the emergency room," said Dr। Mark Ghilarducci of Oxnard.

Jerry Flanagan of the Consumer Watchdog group in Santa Monica feels sympathy for doctors who can't break what he called the stranglehold of insurance। But he also blames the medical association for holding up years of efforts to end balance billing.

"As sympathetic as we are for the physician, we think there is no excuse for billing the patient because of disputes between the doctor and the insurance company," he said। Referring to strategies that would solve the problem, he said: "That's what we've been waiting five years for."

Ventura County Star, Sept. 12, 2008, http://www.venturacountystar.com/news/2008/sep/12/state-insurers-doctors-in-battle-over-balance/

Just try to find a primary care doc when on Medicare

2008-09-19T20:04:00.000-07:00

[Read an interesting, developing discussion of the article here at http://minnieapolis.newsvine.com/_news/2008/09/13/1863658-where-have-all-the-doctors-gone-just-try-to-find-a-primary-care-doc-when-on-medicare?last=1221363391#last_1 ]

He needed a neurologist. But nobody would see him unless we had a primary care doctor, and we couldn’t find one, Donna says. We pounded the phones day after day, going through the whole list [of primary care doctors] in Salem. But everyone who accepted new patients would not accept people on Medicare. The Brys’ experience is not an isolated case. At least 56 million Americans, almost one in five of the population, are now medically disenfranchised —having inadequate access to primary care physicians because of shortages in their area—according to Access Denied, a county-by-county study by the National Assn. of Community Health Centers and the Robert Graham Center.---
[read whole article at http://bulletin.aarp.org/yourhealth/caregiving/articles/where_have_all_the_doctors_gone_.h tml?NLC-WBLTR-CTRL&DET=F2-91208 ]

NEW Autism Center Opens in Minnetonka, MN But Insurance Limits Treatment

2008-09-02T16:25:00.000-07:00

Great news on the autism front as a new treatment center opened in Minnetonka, MN with Governor Pawlenty doing the honors. The new ABA approach to treating autism has showm remarkable promise in a short time.
It is a very intensive therapy, however, with upwards of 40 hours a day of therapy. The insurance company – in this case the high-risk pool for Minnesotans – has capped coverage at 40 hours a week. The children receive more than that, so providers are forced to limit treatment.
ABA is an acronym for Applied Behavioral Analysis, a new technique that has been remarkably successful in turning non-verbal youngsters into normal expressive children who can express their wants and needs.
From a story in WCCO.com on Aug. 20 --
On Tuesday, Gov. Tim Pawlenty appeared at the Grand Opening of the Minnesota Autism Center's new facility in Minnetonka. The center focuses on applied behavioral analysis, or ABA therapy, in which children with autism work intensively with therapists on speech, language and daily living skills. "This center is a modern, capable, wonderful place that's going to provide these services and provide hope and improvement in the lives of these families and the children it serves," said Pawlenty. However, the governor's appearance comes as some parents are questioning the likelihood their insurance will continue to cover as much ABA as their children need. For Amy Dawson, the value of the ABA therapy her son Mac receives is without question. "He was non-verbal a year ago and now he scores in the gifted range for spoken vocabulary," said Dawson. [http://wcco.com/local/ABA.therapy.insurance.2.799665.html]
The Cambridge Center has an excellent source of information about the ABA approach to autism and explains what Applied Behavioral Analysis is. See this link for more information about it. [http://www.behavior.org/autism/]

Maybe a French-style National Healthcare System Might Be More Compatible With Ours?

2008-08-30T22:39:00.000-07:00

A proposal for a Canada-style healthcare system has been floundering around our Congress for several months, (Rep. John Conyers National Health Insurance Act --HR 676) but shouldn’t we ask if a French-style system might be a less disruptive solution?
Let me compare the Canadian and French systems briefly --

Canada has a SINGLE-PAYER system, in which the government pays the bills according to a fee structure it negotiated with health care providers. Patients can still choose their own doctor. The doctor in turn may be either paid by the government or in private practice. (Patients who are in a hurry might choose a private-pay doctor; the government physicians are often overworked and months-long delays to get an appointment are common.) The United States’ Medicaid and Medicare are most similar to single-payer systems.

By contrast, in the British style of socialized medicine, the doctors are actually government employees. Hospitals are run by the government. Hospitals are run comparable to the Veterans Administration. Given the repeated VA scandals in healthcare and hospital conditions, one would much prefer any private hospital over the VA. This is a sad thing to say, although to be fair, the VA facilities are just showing their age and need a great deal of renovation.

The French system is called a non-profit MULTI-PAYER. Clinics and hospitals are all private, and may be either non-profit or for profit. Medical providers are paid according to a negotiated fee structure. The funds come from payroll contributions from both employers and employees.

This is somewhat similar to what we have now in the private sector. A major difference is that the French government has far better leverage in negotiating what the fees are than any single employer has, and unlike the U.S. federal government, it uses that leverage.
French payroll taxes replenish a sickness fund which covers 75% of the medical bills. The balance comes from patients, government and supplementary insurance.

Coverage is universal under all three templates -- British, Canadian, and French. By contrast, the current American system has nearly 50 million of us completely uninsured -- 9 million of the uninsured are children.

The patient has the ultimate power to choose his or her doctor under all three plans displayed here. Popular American plans commonly limits our choice of providers to those who are part of a given network.

The average cost of medical care per Briton is $2,389, and the average Briton ranks 24th on WHO‘s health ranking. For a Canadian it is $2,989, and he ranks 35th. For a Frenchman it comes to $2,902, who marches all the way up to 4th on WHO‘s list. And for an American, it comes to a whopping $5,711, and in return for that, he places 72nd on WHO’s ranking.

Recent years have seen several so-called reforms, with limited results. In 2004, consumers were given the option to create Health Savings Accounts. These allow pre-tax dollars to be set aside for any medical or health expense not reimbursed by insurance. The downsides: they require more paper handling by both consumers and insurance companies, and some discourage preventive care.

States such as Massachusetts have moved to require insurance coverage, with a government subsidy to those who cannot afford it. While it does not result in universal coverage, it has cut the numbers of uninsured by nearly two-thirds.

When you add up all the co-pays, premiums, deductibles, etc., even those with insurance often pay the full cost of the medical care. There is little downward pressure on medical expenses.
Allowing the poor to buy into Medicaid, Medicare, or SCHIP has become controversial even tho it seems very direct and logical. This proposal came from a plan studied by the National Coalition on Healthcare. Consumers pay in according to a sliding scale, with subsidies for the poor.

Everyone gets covered. The monetary savings can be significant. NCHC says in the first decade health care savings would total $320.5 billion; businesses that now provide health insurance would save $848 billion, and families who currently buy insurance would save $309 billion.

Since the end of the 1960s, the number of doctors in France increased from 60,000 to more than 185,000 at the beginning of the 21st century. There are three doctors for every 1,000 habitants, which is a superior ratio when compared to other Western nations (Great Britain 3:1800, USA 3:2700, Germany 3:3400 and Italy 3:5900).

A sector of the French healthcare system consists of not-for-profit private hospitals. Private hospitals were originally denominational and provide 14% of the inpatient services among French Medical Care Institutions. They are financed through endowments like public hospitals, but they still have the right to privacy like private clinics.

A positive feature of the French healthcare system is the cooperation between the public and private sector. The long waiting lists for surgery that everyone associates with socialized medicine are avoided here. Indeed, private medical care in France provides more than 50% of surgeries.
Yes Magazine has an online chart - http://www.yesmagazine.org/article.asp?ID=1515
More specifics of the French plan is at FrenchEntree.com -- http://www.frenchentree.com/fe-health/DisplayArticle.asp?ID=197

CARRIERS OF CRITICAL ILLNESS INSURANCE POLICIES

2008-08-30T20:50:00.000-07:00

NAME OF CO. NAME OF POLICY STATES AMT
AFLAC.com -- Specified Health Event -- All except MA NY VT WA; $5K 1st occurrence with other amts. for specific bills; only issue age restrictions; 10 question application
AIG.com -- Group Critical Illness -- All except CT MT NY VT WA; $10K and up; issue ages 18-64; terminates age 70; simplified underwriting
AIGebs.com -- AIG Group Critical Care Ins. -- All except CT MN NY WA -- amt varies; issue ages 18-69; terminates age 75;
ALLSTATEatWork.com -- New Lifeline Critical Illness -- All except CT MD NH NY VT WA; issue ages 18+ payroll only; three levels of underwriting depending on benefit level
CAICworkSite.com -- Critical Illness -- All except CO CT MN NH ND RI WA; issue ages 18-69; benefits levels $5 to $50K; benefits reduce age 70; three underwriting questions
Century Benefits (TodaysMedicare.com) -- Medicare Plans -- In CA CT FL ME MA NH NJ NY PA SC TN TX; issue ages 64 and up; no health restrictions
ColonialLife.com -- Critical Illness -- All except CT; issue ages 16-69; choice of $5K to $50K indemnity or lump sum; benefits reduce at age 75; underwriting depends on benefit level (2-7 questions)
CBL-Life.com -- Timber Ridge Series of Critical Illness Ins. Plans -- All except CT NY VT; issue ages 18-64; benefits $10K to $250K; no age restrictions; underwriting restrictions on history of cancer, heart disease, insulin dependent, diabetes.
CONSECO.com -- C. worksite Critical Illness -- All except CA CT FL GA ID IL MD MA MN MS NH NJ NY NC ND SD TN VT WA; issue ages 18-69; lump sum up to $70K; no coverage for pre-existing conditions first year of policy
EMCnationalLife.com -- Worksite Critical Illness 3.0 -- All except CT DE MD MA NH NJ NY PA VT; issue ages 18-65; lump sum; policy expires age 70; simplified issue
EquiLife.com -- Life Guard -- All except AK CA CT DE DC FL GA HI ID LA ME MD MA MN NH NJ NY PA RI SD VT VA WA WI; issue ages 20-70; lump sum; reduces at age 65; underwriting restrictions
FDL-Life.com -- Critical Illness -- All except CA CT GA ID IA KY MN NH NY SC WA; issue ages 20-90; one-time payment, $5K to $50K; benefits reduce age 70; health restrictions
GUARDIANlife.com -- Critical Illness -- In AL AK AZ AR CO DE DC GA IL IN IA KS KY MI MO NE NM OH OK OR PA RI SC TX WI WY; attained age rating; lump sum from $5K to $50K; benefit reductions with age; simplified underwriting
HARBORins.com -- Simplified Critical Illness -- All except CT MD NH NJ VA WA; issue ages 18-59; policy guaranteed to age 75;
HARBORins.com -- Simplified Critical Illness Plus -- All except FL MA MN NY VT; issue ages 18-69; lump sum; pre-existing conditions not covered in first year of policy
HEALTHplan.com -- Group and Indiv. Critical Illness -- All except CT MA NJ NY; issue ages 18-69 (may vary by state); benefits reduced age 70; health restrictions vary per state
HUMANA.com -- Critical Advantage -- In AL AZ AR CO DE DC GA HI IL IA KS LA MA MI MS MO ME NC OH OK RI SC TX VA WV WI WY; issue ages 18-69; lump sum up to $50K; one year waiting period for pre-existing conditions
SETTLEMENTS101.com -- Viatical Settlements or Life Settlements -- All States; any age; must have short life expectancy (24 months)
MetLife.com -- Critical Illness -- All except CT FL WA; groups of 1000 or more; all ages; lump sum $1K to $100K; NO age restrictions; underwriting varies by plan
MHN.com -- EAP and Managed Behavioral Healthcare -- groups of 50 or more; any age; no age or health restrictions
CRITICALillnessCoach.com -- Critical Illness Plus -- All States; issue ages 18-64; individual product requires underwriting but only 3 questions
TRANSAMERICAworksite.com -- Critical Assistance Plus -- All except CT FL GA IN MD MA MN MT NJ NY TN UT VT; issue age 18 and up; must be actively at work; one year waiting period for pre-existing condition
TRUSTMARKsolutions.com -- Critical Illness -- All except CT; groups of 100 or more; issue ages 18-70; lump sum on diagnosis; no benefit reduction with age
UNITEDamerican.com -- Health Guard -- All except CT KY MA MN MT NH NJ NY SD; issue ages 18-64; one-time lump sum on diagnosis $10K $20K $30K $40K or $50K; benefits halved at age 65; ONLY COVERS heart attack, stroke, TIA, Migraine, Vertebrobasilar ischemia, Cerebral Injury due to trauma or hypoxia, vascular disease affecting eye or optic nerve.
UNUM.com -- Specified Critical Illness -- All except CT; issue ages 17-69; full payout except for coronary bypass surgery and carcinoma in situ (skin cancer) which are paid at 25 percent; only 3 questions in application

Erosion in Savings Helped Create Larger Numbers of UNDERinsured; Critical Illness Insurance Expected to Grow as People Seek to Fill the Gaps

2008-08-30T20:41:00.000-07:00

While the growth in the numbers of uninsured Americans continues to garner the headlines (and the attention of political pundits), the growth in numbers of underinsured has been very similar but unheralded.

Consider the case of the “typical” family with an individual deductible of $2600 and a family deductible of $4800 or more. How is a family that is struggling to keep up with jumps in costs for food and fuel going to cover that cost if serious illness hits a member of the family?
Those high deductible plans can be devastating to a family if a wage earner is hit with a catastrophic injury or illness. The general rule of thumb is that if your deductible is more than 5% of your annual income -- you are underinsured! And this is a conservative definition.

This means that the need for critical illness insurance policies is probably higher now than ever before. A good critical illness policy has a lump sum or cap payment of $100K or more, either on diagnosis or paid out as the bills come in. If they are good, they will even pay a moderate amount on experimental drugs. Conventional insurance will pay zero on experimental drugs -- but the critical illness insurance is a different class of product, not bound by the usual restrictions found in a qualified health insurance plan.

Critical illness policies vary on which diseases are covered -- less expensive policies cover only cancer; their underwriting guidelines are usually less demanding, too. Other policies may cover a dozen diagnoses like heart attack, stroke, kidney failure, and the like.

Another difference with critical illness policies is that the payment is normally sent directly to the insured, and the insured can spend it either on the medical bills or on anything from food and utilities on up to the mortgage.

Forty percent of Americans do not have three months’ worth of cash on hand to cover basic bills if they are out of work. (from a 2006 bankrate.com survey)

Medical bills in the first few months after a heart attack can reach $25,000 -- some of that is paid by major medical insurance but the patient has to shoulder the rest of the bill.

If you are between the ages of 35 and 50, and have a high deductible plan, you are the type of person who is most vulnerable to a large financial hit from a major medical event. And you are also most likely to HAVE a major medical event like a stroke or heart attack.

Even those with dual incomes totaling over $50,000 a year -- or even $75,000 a year -- report that they have difficulty paying for health insurance and their portion of the healthcare bill. They often do not have any (or sufficient) disability coverage to make up for lost income while recuperating. How many are aware that disability insurance, if you qualify, only pays an average of 60 percent of your normal income?

A soft economy also means that your employer may not keep your job open if you file for disability -- or even lay you off outright.

Health Care: The Time Is NOW To Get Healthcare Equity Bill Thru Congress

2008-08-29T11:52:00.000-07:00

We need your help to get MORE Sponsors and MORE support for The Health Equity and Accountability Act. This important proposal (H.R. 3014) will deal with the disparities and discrimination in our nation's health care system. It is sponsored by Rep. Hilda Solis (D-Calif.). While the issue of America’s record numbers of uninsured is complex and has many causes, this bill is an important first step to ensuring that everyone has health care.
Action is needed now!
We know that minorities have higher rates of infant mortality, cardiovascular disease, diabetes, HIV infection/AIDS, cancer, and lower rates of immunizations and cancer screening. LEGAL immigrant children are denied health care! Millions of families in poor, rural communities have little or no health care at all.
We cannot write off millions of children and adults, in rural areas and cities, among the poor and working classes and sometimes even among people who thought they were middle class. They all need the basics, and here they cannot even get an appointment because the clinics and doctor offices will not accept patients without insurance.
Where did this bill come from? Rep. Hilda Solis (D-Calif.) has introduced the Health Equity and Accountability Act (H.R. 3014), a bill to provide health care to the underserved and uninsured. Versions of this bill have been stalled for the last 6 years, but H.R. 3014 is now gaining support with recent hearings in the Health subcommittees of both the House Ways and Means and House Energy and Commerce Committees.
Keep the momentum going! Contact your Representative and ask them to cosponsor this bill NOW. If they are already one of the 113 cosponsors, ask them to take a leadership role in promoting and passing this legislation. The higher the visibility and the larger the support for this bill in the House, the better chance we have for getting it passed, for getting an identical counterpart in the U.S. Senate and then getting the bill signed into law.
It isn't only high cost that keeps people from having health insurance and getting health care. We have reports that as many as 25% of all Latinas haven't even seen a doctor in the past year! Health care is almost unavailable in rural areas because of the shortage of rural doctors combined with the long distances to find medical services.
Do you know that poor areas are often targeted as “ideal” sites for dumping grounds for hazardous materials and waste? Minorities and those living in poor rural areas suffer exposure to environmental health hazards far out of proportion to their numbers. All too often, power plants and waste dumps are built in low income areas; they expect that residents are too ignorant and weak to protest these health hazards. Frankly my dear, your zip code should not determine your life expectancy!
The Solis bill provides grants to eliminate racial and ethnic health care disparities. It requires health-related programs of the Department of Health and Human Services (HHS) to collect basic data on race, ethnicity, and primary language. Imagine -- HHS does not even know for sure how many of us Americans are at home in which language!
This bill will also establish “health empowerment zone” programs in at-risk communities. Plus it includes Immigrant Health Improvement Act (ICHIA) proposals; these provide health care to legal resident children of immigrant parents (who have been denied coverage under the SCHIP program).
Contact your Representative TODAY and urge them to sponsor and support this bill! You can go to NOW.org and they have an easy link to a contact form that goes to your representative. You can also go to https://forms.house.gov/wyr/welcome.shtml for a contact form.

IRS Rule Changes Sweeten HSA Pot for Employers, Employees

2008-08-19T17:24:00.001-07:00

Health savings accounts (HSAs) will likely prove even more popular than ever due to a sweetening of favorable tax treatments and more funding options.

Readers may want to check with their financial advisor about the new IRS guidelines that allow a transfer of individual retirement account (IRA) funds to an HSA; this transfer is tax-free. Second, employees are no longer subject to the 10 percent additional tax if they use their IRA funds to pay for medical benefits -- referring to IRC Sec. 72(t). Thirdly, qualified employees may contribute IRA funds to their HSA without tax.

Q: If I already have an HSA for myself and want to put some money into a high-deductible health plan (HDHP) for my family, can I do that?
A: Yes. If you have an HSA for yourself and you buy a family HDHPan HSA owner has a self-only high deductible health plan (HDHP) and buys a family HDHP, you can make that second transfer during the same taxable year. The fund distribution will still be without tax. One big advantage to doing this is that you will reduce your tax liability AND lower your health insurance premium. That is potentially, at least -- it will all still depend on your total financial picture and for that, you ought to go in to see your own financial advisor.

Fourth, the IRS also raised the ceiling for individuals and families to their HSAs for the 2009 tax year. Individuals will now be able to contribute up to $3,000 per year; families can contribute a maximum of $5,800 per year. (NOTE: The current maximum limit is $2,900 for individuals and $5,650 for families. The catch-up contribution for people who are 55 years old and up is increasing to $1000, from the current $900.)

The IRS released other new guidelines expected to boost the HSA market by further increasing employers’ adoption of HSA-linked consumer-driven health-care plans (CDHP).

Employers received much-clamored-for clarifying guidelines such as these (and employees will probably have to get the full details from your Employee Benefits department):

-- ON-SITE CLINICS that provide free or low-cost services will NOT affect an employees’ eligibility for an HSA. ALLOWED SERVICES INCLUDE: treating on-the-job injuries, immunizations, annual exams.

-- HOWEVER, if the clinic provides more significant medical benefits, you, the employee, are not eligible for an HSA. Example: a hospital permits its employees to receive medical treatment at its facilities for all of their medical needs for either no cost or at a reduced rate. (I and probably millions of you would probably give our eyeteeth to have such a generous employer.)

-- If an employer mistakenly contributes to your HSA, the employer is allowed to retrieve the funds by asking the financial institution holding the account (ie the bank or other seller) to return them. Otherwise, the employer may treat this amount as part of your income. (ie that means this could raise your IRS obligation; you are probably better off returning the money to the employer!)

A special note to HSA holders age 65 and up: You may use money in your HSA to cover Medicare Part D prescription drug PREMIUMS. If your spouse is older than 65 but you yourself are younger than 65, the enrollee’s HSA funds can NOT be used to cover your spouse’s Medicare Part D premiums without being part of your taxable income.

Hybrid financing is new and is expected fuel further growth in HSA accounts. Under this strategy, your employer pays ALL of an HDHP for you and your fellow workers AND gives each employee a defined cash allowance. Employees can decide how to use that cash.

Example: an employer provides a $2,000 deductible HDHP. You (employee) pay all costs under $2,000 while the insurance company covers EVERYTHING above that -- ie, your maximum out-of-pocket amount is $2,000 if you need surgery or pay a hospital bill – an amount similar to many traditional PPO plans. (Actually a lot of PPOs or indemnity policies may have limits of $2500, $3000, or even $5000. That may seem like a lot, but often that is the only way to keep the premiums down.)

Your monthly cash allowance of $125 (or $1,500 a year) also from your employer? You may choose to put that into your HSA, OR use it to buy a better health plan.

An unnamed small company in the communications sector used this hybrid financing strategy to walk away from a traditional insurer that quoted monthly premiums of $1800 per employee. It is no wonder that the employer switched to a high-deductible plan and an HSA, is it? This company is very generous and provides a $10,000 deductible for their employees plus the HSA, which is owned by the company.

Employees who had high medical expenses and depleted their HSAs, were reimbursed up to the deductible out of the HRA. This company pays a premium of only about $600 a month per employee (family coverage). The employees do pay toward the premium; the amount varies depending on whether it is a single or family plan.

It is hoped that the IRS changes will help both employers and employees contain the cost of healthcare. As an example, the above employer calculated that even if every employee got sick, the company would still save 18 percent compared to traditional healthcare insurance. And HSAs are much less likely to suffer annual hikes in premiums like those that plagued small businesses in the past decade.

Industry statistics show that HSAs grew by 73 percent from late 2006 to the beginning of 2008. The total dollar amounts in those HSAs also increased by 140 percent during the same time frame. It is a bit of a mystery why this popularity has not been evenly expressed across the country.

For example, a study showed that only 2.4 percent of residents enrolled in private health insurance in Missouri, 2.1 percent in Oklahoma, and 3.2 percent in Kansas have used HSAs.

Possible reasons that people are not switching to HSAs or other high-deductible plans: 1) they opt to stay with traditional, low-deductible healthcare plans, 2) the HSA is still pretty new, and perhaps they do not have anyone to familiarize them with it.

Should We Change How Much Medicare Pays for Treatment vs. Prevention? --i.e. should smoking cessation cost more than cancer treatment?

2008-08-19T17:18:00.000-07:00

The writer of the HealthBeat blog, Maggie Mahar, writes a very good and sometime provocative journal on healthcare in America. However, while I do see the merits of her recent column on pricing of healthcare services, questions have to be asked regarding how changing the pricing schedule would affect insurers’ behavior.

I can well imagine insurers’ reluctance to fund open-ended smoking cessation treatment even tho it may ultimately cost them less than treating the complications of smoking. The fact is, they are much more nervous about UNKNOWN total costs than they are about KNOWN costs for cancer treatment. For example, they can calculate to the dollar what a given course of treatment for a lung cancer is; they know how many radiation treatments will be requested, they know if chemo will also be part of the treatment protocol and how many chemo treatments, they know how many days of hospitalization will be involved. What makes them really nervous, again, is an unknown dollar amount for something like smoking cessation -- which does not end till the patient can actually give up cigs for good, and who knows how long that will take?

Look, Maggie Mahar, I agree with you completely on the relative worth of preventive or wellness interventions vs. treating the disease. But I think you have a real selling job to get the insurers behind any such pricing system.

It’s worth having a full and public discussion on these issues, tho, so I hope that this is not the last we hear of this idea.

When Medicare first created a fee schedule, critics suggested that it was a Marxist invention. Nevertheless, the schedule, which lists what Medicare is willing to pay for some 7,000 procedures, has become the master list for physician reimbursement in our health care system: most private insurers peg their payments to the Medicare schedule.
The notion of deciding the precise worth of some 7,000 diagnostic and therapeutic procedures is mind-boggling. How exactly does Medicare do it?
The process began in the late 1980s when officials at the Department of Health and Human Services decided that the way Medicare paid doctors should be overhauled. At the time, Medicare was reimbursing physicians based on what was considered “customary, prevailing and reasonable” in a particular market —in other words the “market value” of the service in that region.
Instead, reformers urged Congress to begin paying doctors in a way that reflected the real cost, to the doctor, of providing the service.

Please see her full article on this valuable issue at http://www.healthbeatblog.org/2008/08/today-we-pay-fo.html#more

Coolest Way to Save on Business Cards, Letterheads, Rubber Stamps and Tons More!

2008-08-16T19:49:00.000-07:00

Meet my friends at VistaPrint. If you have never heard of them or done business with them before, you will be amazed at their great service and beautiful customized layouts. Every month brings incredible savings on supplies so you never have to pay full retail again for business cards or any other business or personal communications supplies.
Please use this link to get a special introductory deal -- http://www.vistaprint.com/frf?frf=155732197131

Feel free to pass along that link to anyone who is has a business or is starting up a business, website, or is moving. And thanks for reading this.

Big emphasis on HSAs and high-deductible plans

2008-08-15T18:49:00.000-07:00

Many employers want to take a more active role in enticing workers to form the habits and get the recommended screenings that can protect their long-term health. To encourage employees to stick with preventive-care maintenance medications such as drugs to control high blood pressure, next year Guardian hopes to be able to waive the copay on such drugs, Mansberg said.

A growing number of employers are embracing incentive programs that reward workers who take health risk assessments, attend onsite health fairs or participate in biometric screenings, where they're measured for height, weight, blood pressure and other health-risk indicators, she said. "The vendors we work with make the information available to your primary-care physician so [he or she is] kept in the loop of what's going on."

A break on premiums or a small cash incentive can persuade busy workers to make their health a priority, Mansberg said. "A lot of times people will take care of their kids but they don't take care of themselves the way they should. It's another way to make it top of mind."

Full story from Market Watch -- www.marketwatch.com/News/Story/Story.aspx?guid=38e267addf124ae18d6733a44a95895a&siteid=nwtpf&sguid=-ELWpQNc4kyEAAp-GHdHfQ

Some employers are dropping formal group insurance coverage completely or just sign up with administrative services like AdminiStaff. The advantage of these outside administrators is that it saves the company hours of processing time for check deductions, while allowing employees to pick and choose insurance plans that fit their needs.
Not selling you anything -- just acknowledging that there are other options out there that are catching on.

Taking Path of Travel Provision out of Disabled Americans Law Would Gut It

2008-08-15T18:42:00.000-07:00

The current proposed changes to the Americans with Disabilities Act have several good points but some are strangely contradictory. The most glaring example of a proposed change that would effectively gut the whole law is the one about ‘path of travel’.

According to an advocacy group for the disabled, the Disability Rights Education and Defense Fund (DREDF), the Department of Justice proposal is that “if alterations are made to a public accommodation or public entity’s are of primary function, it does NOT have to bring the path of travel to that area into compliance” with the 2004 Americans with Disability law. In other words, if the local courthouse or library remodels the entrance, it will no longer matter if a disabled patron can get from the parking lot to the lobby? Is that what they really mean to say?

Because if there is no ramp for a wheelchair, or the door is no longer wide enough to admit a wheelchair, or if there is no longer an elevator, or no low buttons on the elevator, etc. etc. then there may as well be a Berlin Wall in front of that library or courthouse or other public facility.

We have come so far in terms of integrating disabled persons of many kinds into public and private buildings and businesses, places of work and play and recreation. I might add that while the numbers of long-term disabled is fairly steady, the ranks of short-term disabled could include any of us reading this story now.

Millions of Americans are “disabled” for a short term whether or not it is formally or informally recognized. Everyone who has broken a limb -- or had a stroke -- or a heart attack -- or any surgery -- has had to learn how to cope like a “disabled” person. They’ve had to try to carry on with normal activities like going to a grocery store, movie theatre, bank, or post office. You haven’t lived till you tried opening a jar of pickles with your left hand because the right one is in a cast.
The husband of friend had a heart transplant several years ago, and his wife said that they would get a few funny looks when they parked in the handicapped parking. Her husband’s disability was not visible, so onlookers assumed they were taking advantage of the parking space without cause.

I have had several experiences of taking my mom (post-stroke) or an aunt (multiple health problems) to the grocery store or doctor appointment and been glad that there were wide doorways, ramps, etc so that we could get from point A to point B without a hitch. Fortunately neither one lived in a fourth floor apartment without an elevator or I really would have been in a jam.

While I cannot speak about the specifics on whether a pool-lift needs to have foot-rests or not, I think I can say with some certainty that an American with Disabilities law REALLY needs a ‘path of travel’ provision.

[Please see a story about proposed changes to the ADA here at http://minnieapolis.newsvine.com/_news/2008/08/11/1740611-appalling-doj-proposals-would-weaken-disability-act-provisions?last=1218505510#dynamicCommentBox_2427716 and the webpage from the Disability Rights Education and Defense Fund (DREDF) with their discussion of the proposed rule changes here at http://www.dredf.org/DOJ_NPRM/ ]

Is there a “Right” to Medicare? Should 'Grandma' Pay for Her Own Cataract Surgery?

2008-08-09T15:03:00.000-07:00

There has been quite a rumpus in articles about whether Medicare should refuse to pay for certain procedures due to the financial straits it once again is in.
In other words, do well-off seniors have the right to have Medicare pay for procedures that they could afford to pay out of pocket? And would this really help Medicare’s financial predicament anyway?

From someone called

the Happy Hospitalist believes that it is time to “say No” to seniors. “No to dialysis. No to life support. No to elective procedures [which would include artifical hips and knees] . No to brand name drugs. No to the latest expensive technology. We will have to place greater weight on quality of life over quantity of life. We will have to demand hospice care in futile situations. We will have to demand palliative comfort over slice and dice. We will have to reject marginally effective proceduralization and imaging of our elderly. We have to. We don’t have a choice. There is no other way.”

When I look at this list I agree on some items. “Futile care” is clearly unnecessary care. But often, we don’t know whether or not it will be futile. Every day elderly people do emerge from ICUs and go home to play with their grandchildren. As for “brand new drugs,” and “the latest expensive technology” regular readers know that I believe that everything depends on whether the new technologies have been tested and proven effective. We cannot afford to squander Medicare dollars on drugs, devices and procedures without knowing whether the patient will benefit. And I certainly prefer palliative care over “let’s try another surgery. Can’t do any harm.” (Except to the patient who suffers through it).

I agree with some measures but not others. Maybe all these joint replacements are unnecessary because we have been going about it all wrong. But cataract surgery keeps seniors active and involved and self-sufficient -- those are good things, dammit.
http://www.healthbeatblog.org/2008/08/do-seniors-have.html#more

Millions With Chronic Disease Going W/O Insurance or Treatment

2008-08-09T14:53:00.000-07:00

A new study to be published this Tuesday in the medical journal Annals of Internal Medicine estimates that one of every three working-age uninsured adults in the U.S. has been diagnosed with a chronic illness -- diseases such as diabetes or high blood pressure.

Even though their conditions could be successfully managed, they are going without even doctor visits to monitor their progress. Instead, they rely on very expensive emergency room visits.

The actual figure now of uninsured Americans is 47 million; the study estimated that about 11 million (of the 36 million uninsured in 2004) had been diagnosed with a chronic condition. Nearly a fourth of the uninsured said they had not visited a doctor in the past year. The total number with such a condition may be higher for two reason: the growth in the number of total uninsured since 2004, and the fact that people may have developed such a condition in past year and not know it.

We can do better than this, people. Forty seven million uninsured is a disaster waiting to happen.

Info from New York Times report at http://www.nytimes.com/2008/08/05/business/05health.html?_r=1&adxnnl=1&oref=slogin&ref=health&adxnnlx=1218316447-mchkYD402MaReOGqwa1txg

McCain Health Care Plan Glosses Over Fact that Key Provider Info Hard to Come By; How Then is Consumer to Choose?

2008-08-08T22:02:00.000-07:00

One of the big campaign issues is what each candidate proposes to improve the state of health care in this country. The United States spends far more per capita and seems to get less for the dollar compared to nations with some form of national health plan.

The McCain campaign claims that consumers will benefit by being empowered to choose their own providers and buy their own health insurance. He plans to eliminate the tax incentives to employers for providing coverage to their employees. It seems reasonable that if the tax breaks are in fact eliminated, then employers will no longer offer any form of insurance coverage as a benefit to their employees.

Left to their own devices, Americans may think that they can just muddle ahead but will soon find that the data one would need to make these provider choices is difficult if not impossible to come by. And while some providers may post some information on their websites, it may not be in the same format as another provider’s. Consumers are left trying to compare apples and oranges.

The federal Agency for Health Care Research and Quality (AHRQ) found that there are 12 different rating schemes for doctors, 26 for medical groups, and 81 for hospitals, and 86 for health plans. Even the most intrepid, determined consumer is hard pressed to research all of that data and find a doctor who meets their needs. How many of us have the time to research even a fraction of those databases or of the health care providers in their county? Good luck to you even if you do have the time.

The Alternet website has a good article in their recent issue. I cannot quote any excerpts, but here is a link to the story -- http://www.alternet.org/mediaculture/94154/?page=entire. You may also check amednews.com

Michelle’s Law Languishes in Congress; Would Allow Medical Leave

2008-08-08T21:58:00.000-07:00

Those of us who live outside New Hampshire probably never heard of Michelle’s Law. But it is a provision for college students to continue their student health insurance coverage even if they have to take a medical leave from school for a year. That way, they do not have to exercise the COBRA provision of the student health coverage, under which policyholders pay 102% of the full premium cost.

HB 2851 was the United States House of Representatives’ version of the bill; this bill passed unanimously on July 30, 2008. The sister bill SB 400 is languishing, however, in the Senate. The bill is endorsed by the American Hospital Assn., the National Patient Advocate Foundation, the American Heart Assn., and America’s Health Insurance Plans.

The bill is named for Michelle Morse, a student at Plymouth State University who took chemotherapy treatment for colon cancer. To avoid losing her student insurance, she enrolled in a full course load. The premium to continue her coverage under the COBRA law would have cost over $500 a month, a charge her family could not afford.
What follows is excerpt from MichellesLaw.com about the bill when it was signed into law by Gov. Lynch of New Hampshire.

Joined by the family of Michelle Morse and legislators, Gov. John Lynch today signed "Michelle's Law," helping ensure that college students do not lose their health insurance when they need it most.
The legislation, HB 37, ensures that seriously ill college students can continue to receive health care insurance through their family's health insurance policy even if they are unable to maintain their full-time student status.
"College students should not lose their health insurance just when they need it the most. Now, in New Hampshire, they won't. Michelle's Law will provide an important protection for New Hampshire families," Gov. Lynch said.
Michelle Morse was a student at a Plymouth State University when she was diagnosed with colon cancer. Although her doctor suggested she take a leave of absence from school, Michelle Morse maintained a full course schedule in order to keep her health insurance coverage. Michelle Morse died in November [2005].

Read the background behind this bill at http://www.michelleslaw.com/index.php.

You May Want to Lower Your Home Insurance to Keep Up with Deflation

2008-08-08T15:16:00.000-07:00

If your home’s value falls due to a softening market, do you still have to insure it for the value it had last year?

This is a question, not a conclusion. And it may be a question that no one can really answer. But the query arises because of a report released this July by the Center for Economic and Policy Research called The Impact of the Housing Crash on Family Wealth. [Note that it acknowledges that there is a housing crash.]

It outlines three different scenarios for housing prices in 2009. Number One assumes no further decline in housing prices. This does not seem likely given the fact that prices are declining about 2% a month this year. That is more in line with Number Two, which assumes a further 10% decline in housing prices in 2009. Then there is Number Three, which assumes a drop of 20% in housing prices in 2009.

[Note that none of these assume a rise in housing prices. The best case scenario is -- stable prices. Pass me the aspirin, Martha.]

In fact, it calculates that some family homes are now worth what they were in 1989.
So that leads to my question: Can I get away with insuring it for less, and at least save a couple bucks a year that way?

You can insure your house for as little as you want, really, but you really should not underinsure. You need to at least figure out the replacement cost. The good news is now that the overheated building boom has cooled off, the prices of every kind of lumber product is down dramatically.

But frankly, I bet a lot of homeowners are going to be awfully tempted to burn down houses to get insurance settlement cash in hand so they can start over.
Few will get away with it, of course. Chemical accelerants can be detected by insurance investigators and law enforcement. So remember that because you really don’t want your next home to be a concrete prison cell.

If You Depend on Your Employer for Health Ins., Don't Vote McCain

2008-08-05T17:54:00.000-07:00

Hi, --
I don't generally talk about politics at all on this site. However, there are some clear differences between the two major presidential candidates when it comes down to how your health insurance will be affected.
It is already pretty clear that Sen. John McCain has plans to torpedo employer-paid health insurance coverage. How can a president do that? Pretty easy if he is able to push thru a proposed elimination of the tax break for the employer.
Currently the only way that employers are able to offer group coverage at all is because of the tax exclusion employer-paid health insurance.
Ostensibly the goal is to push individuals into state-run pools. But that means that individuals will have to pay 100% of their premiums, whereas now they pay anywhere from 20% to 50%. Some employers do not contribute anything now; they just sign up with an outside administrator like Administaff and let employees pick and choose what they need. And pay 100% of the cost.
Americans are being squeezed between spiraling increases in food bills, gas prices, and often in their mortgages if they got caught in the mortgage credit crunch. Where are they going to get the extra dollars to pay for 100% of their health insurance coverage too? AND pay income taxes on the benefits from your insurance plan??? Are they crazy???Here's a link to a great article on the changes being proposed; this is part one of a two-parter. I hope you benefit from reading it.
HEADLINE: McCain's Health Care Plan: Gut Employer-Based Insurance
http://www.alternet.org/mediaculture/93734/?page=entire
An Excerpt: So far, the press has failed to examine what's at stake here for workers and their bosses -- that, in the long run, employer coverage could disappear, and that, in the short run, they may have to pay taxes on some portion of their health benefits, no matter who wins in November. In effect, it's an unspoken tax increase which has yet to surface in campaign conversation.

Do You Have a Vision Plan? A list of carriers to research to find a plan that fits your needs --

2008-08-04T16:44:00.000-07:00

Right now this is just a list of insurance carriers that offer vision insurance plans. I also give their website address and which states they operate in. Will follow up later with something on what to ask for when talking to an agent.

Advantica Eyecare -- AdvanticaEyecare.com (available in all states)
Aegis Administrative Services Inc. -- Aegisadmin.com (all states)
AIG Accident & Health Division -- AIG.com (all states)
AIG Employee Benefit Solutions -- AIGebs.com (all states)
AlwaysCare Benefits Inc. -- AlwaysCareBenefits.com
All states EXCEPT MA, NY
Avensis -- Avensis.com (all states)
BEST Life -- bestlife.com (all states)
Block Vision -- BlockVision.com
ONLY available in CT, DE, MD, NJ, NY, PA, TX, WI
Brokers National Life Assurance Co. -- BNLAC.com
All states EXCEPT CT, MA, NH, NY, VT
Co/op Optical Vision Designs -- COOPoptical.com (all states)
Companion Life -- CompanionLife.com
All EXCEPT CA, CT, HI, IL, ME, MT, NJ, NY, NC, WA
Denali Vision -- DirectBenefits.com (all states)
Dental Select -- DentalSelect.com (ONLY in NV TX UT)
EyeMed Vision Care -- EyeMedVisionCare.com (all states)
Group Link -- GroupLinktpa.com (all states)
Insurance Design Administrators -- idatpa.com (all states)
Kansas City Life Ins. Co. -- KCLgroupbenefits.com
All EXCEPT CT, MN, NJ, NY, PA, VT
New Benefits -- NewBenefits.com (all states)
OptiCare -- Opticare.com
All EXCEPT AL, IN, NY
OUTLOOK Vision Svcs. -- OutlookVision.com (all states)
Patriot Health Inc. -- PatriotHealthFamily.com (all states)
Preferred Vision Care -- PreferredVisionCare.com (all states)
Primary Vision CareServices Inc. -- PVCS-usa.com
ONLY in AR CO FL KS LA MO OH OK TN TX
Principal Financial Group -- Principal.com
All EXCEPT MD, VT
Shenandoah Life Ins. Co. -- ShenLife.com
ONLY in DE IN KY OH SC TN WV WI
Spirit Vision -- DirectBenefits.com
All EXCEPT FL ME MA NH NJ NY RI VT WA
Standard Ins. Co. -- Standard.com
ONLY in AL AR CA CO CT DE FL GA ID IN IA KS KY LA MN MS MO MT NE NH NM ND OH OK
OR SC SD TN TX UT WV WI WY
Superior Vision -- SuperiorVision.com (all states)
Transamerica Worksite Mtg. -- TransamericaWorksite.com (all states)
US vision & dental -- USAvision.net (all states)
Vision Ins. Plan of America Inc. -- VisionPlans.com (WI only)
VSP Vision Care -- VSP.com (all states)

In addition, please note that discounts on laser vision correction are offered by:
All EXCEPT Co/op Optical and Kansas City Life. Discounts vary per carrier.
[Good Luck to all of you considering a plan. Also you could possibly do just as well by shopping the sales, going to a local discount outlet, and buying a spare pair at the same time. Lots of times, I have bought at 2-for-1 sales.]