bloginsurance

A few weeks ago, I wrote about international travel and medical insurance . And that was an interesting situation. But this one�s better. In some ways, this case encapsulates the future of the global economic model. Imagine, if you will: A nice, normal, middle class suburban family . Dad works in IT, Mom�s a homemaker raising their three young children in Midwest Suburbia. Dad�s a contract employee at a local firm, which contract is up at the end of the month, and he�s off to the next one. And so, you may ask? So, this family moved here from Ireland several years ago, and Dad�s new job is in Germany, so naturally he�s leaving for France in a few weeks to look for a house. About a month after Dad leaves, Mom and the kids �will cross the pond" to join him. Keep in mind, none of these nice folks is an American citizen. But Dad�s employer provided health coverage while they were here, and will pick it up again after they�ve settled down in their new home in France. Meantime, though, ...

UPDATE: Welcome Grand Rounds visitors! Please take a look around, and feel free to leave a comment (or three). Recently, the debate about using genetic testing in underwriting has heated up. Newswise is an online news aggregator, a sort of Lexis-Nexis wannabe. In their most recent release, they found that � 40 percent of people already undergoing genetic testing are worried that participation might affect their future insurance coverage .� Now, at first glance, this would seem to be a pretty significant problem, and an issue which the insurance industry should address. But things aren�t always what they seem. The poll asked participants whether or not they agreed that: � (g)enetic testing is not a good idea because you might have trouble getting or keeping your insurance. � The problem is, the question is useless. First, there is a difference in how life insurance is underwritten and renewed, and how health insurance is underwritten and renewed. So to ask about the generic �insurance...

A while back, I wondered what would happen when United�s contract with Premier came up for renewal. Would the two sides reach an acceptable deal, or would Premier find itself cut off from BOTH of this area�s largest carriers? Well, now we know: United and Premier have inked a deal seven months ahead of schedule . And this one�s a doozy � a 5 year contract, instead of the typical 3 year deal. This means that United customers who use Premier providers can breathe a little easier, knowing that they won�t find themselves in the same boat as Anthem insureds. And having such a long-term agreement in place means that the stress on everyone involved is put to bed for quite a while. Well, not for everyone . Now that this deal is in place, it would appear that United is in position to take a good chunk of business away from Anthem. Why, you ask? Well, because United�s contract was due to expire this year, there was apprehension that they�d be in the same boat as Anthem, vis-a-vis Premier. Wh...

For many of us, health insurance is provided by our employer, so we have little opportunity to access typical Consumer Driven Health Care (CDHC) products. High Deductible, catastrophic plans and HSA�s are not often available, and not every company has a knowledgeable HR person (or even any HR person) to answer questions or address concerns we might have. But there are ways to empower ourselves and take advantage of at least some of the benefits of CDHC. Most cafeteria plans now include a high-deductible option, or one with higher co-pays for office visits. Some even offer plans with no office co-pays, where one pays a percentage (typically 20% to 30%) of these smaller claims, in return for a lower premium. By choosing one of these plans, we realize savings that can go toward paying the smaller, routine claims, but maintain the safety net portion of the plan for those unexpected �big ticket� items. Years ago, before HIPAA, I sold quite a few MSA (Medical Savings Account) plans. Of co...

My last post looked at a new reimbursement model � well, maybe a �tweak� of the current model would be more accurate. In a recent New York Times item , Dr Thomas Gross suggests still another: � The current medical reimbursement system pays by the job performed, not by the time spent�Your family doctor receives the same reimbursement for diagnosing a sinus infection in 6 minutes as he does if he takes 30 minutes�In our current system, there is no way to buy an hour of your doctor's time just to talk. � First, in fairness, one most likely COULD purchase an hour of the doc�s time; it would just be VERY expensive, and not a covered expense under one�s medical plan. But I see Dr Gross� real point, which is that medicine has become outcome-based, as opposed to health-based. And that this is at least partly a result of the current medical insurance system. In previous posts, I discussed Consumer Driven Health Care (CDHC). The primary goal of CDHC is to empower patients/insureds in taking...

We routinely tip our waitress at the local diner, and our barber�er, uh Hair Stylist, even the pizza delivery guy. But how much do we tip our physician when we�ve recovered from the surgery, or just stayed healthy? Of course, I ask this with tongue firmly in cheek, but I was prompted to bring this up because of an article over at Fox News . Apparently, physicians who participate in the � Bridges To Excellence � program are eligible for cash bonuses based on the health of their patients. The idea is that, if docs can keep their patients healthy, they�ll lower overall health care costs. Which makes sense. Of course, it hearkens back to capitation plans (e.g. staff model HMO) which actually penalize physicians who have negative outcomes. This approach has had mixed success; apparently sticks don�t work as well as carrots. As one can imagine, not everyone who learns about this arrangement is a fan: " It's disturbing that the only way we can get physicians to do the right thing for...

Way back in February , I wrote a series of posts about the Anthem Insurance versus Premier Health issue. Briefly, Anthem is this area�s largest health insurer, while Premier encompasses the most actual healthcare providers. Their contract expired, and as a result, folks covered by Anthem who see Premier docs and use Premier facilities must pay a much higher rate for services provided. At the time, I predicted that � more and more folks (will) have to switch docs, leaving Premier�s physicians with a shrinking customer base. � Well, lo and behold, this week�s issue of the Dayton Business Journal brings us this news: � Five months after Anthem coverage ended, Premier-owned physician practices are feeling the squeeze. Doctors are expected to lose 10 percent of their salaries this year as patients go to other doctors who take Anthem or delay appointments, which can complicate patient care. Doctors across the group are opening to new patients, some for the first time in years. � Business is ...

A long-term client (and friend) recently referred his brother and sister-in-law to me for their life insurance needs. Aside from the fact that this is one of the best compliments one can pay an agent (any referral is terrific, but a relative is the highest kudos), this was an interesting case on its own merits. An aside: I try to update this blog every few days. This past week, though, I hit an intellectual dry-spell. Thank you for your patience as I get back up to speed . My client�s brother (whom I�ll call �Tom�) is a private pilot. But he is not an amateur pilot: he flies a corporate jet for a (presumably wealth) family. They travel extensively overseas, including England and Europe. While traveling, his employers pick up the tab for all his expenses (food and lodging, entertainment, etc). I think I�m jealous. Tom�s wife also has an unusual vocation: she�s a free-lance news reporter. I must confess that, although I�ve insured media folks before, this is a new niche for me. Tom and ...

I�m often bemused by politicians and hucksters (but I repeat myself) who try to equate �uninsured� with �unable to access health care.� To add insult to injury, there�s a perception that most � if not all �- such folks have little or no opportunity to purchase health insurance, or cannot afford it. For the most part, of course, the poorest among us � who I believe we do have a duty to at least try to help � already have access to health coverage and health care, through the auspices of Medicaid (Medicare�s another can of worms). I was pleased to find that I�m not way out in left field in this: According to the National Underwriter, � (m)any uninsured American adults are healthy, and many who are uninsured do appear to be getting some kind of medical care .� According to the article, over � of all uninsured adults (excluding those on Medicare) are free of chronic conditions. On top of that, almost � of such folks who ARE chronically ill have accessed needed medical care in the previou...

Over the years, I�ve had the privilege of becoming the local �international medical expert.� Primarily, this is because I write a handful of these plans each year, whereas most agents don�t get much call for it, or don�t have the inclination to learn about it. International medical is a burgeoning industry: as we become more and more a global economy, business doesn�t �stop at the shore.� Many executives travel overseas, a lot of seniors like to take those Italian cruises, and there are folks who engage in humanitarian efforts. Once such gentleman � my client, in this case -- is headed over to Tanzania later this month. He�s part of a medical supply effort undertaken by the Rotary Club. They�re delivering over 400,000 doses of medication, donated by one of those evil, greedy, profit-driven pharmaceutical companies, obviously in direct violation of said company�s pact with Satan. My client and his daughter are accompanying the life-saving medications as distribution auditors. He is cove...

A long time ago, I had a sales manager who told me �you can�t compensate for other peoples� ignorance.� What he meant by that was that, when other folks make stupid decisions, I shouldn�t take it personally. In the post below, Bob Vineyard tells of two of his clients who either bought coverage or chose not to, and the consequences of those decisions. He characterized the stories as two sides of a coin. In a flippant e-mail, I asked �only two sides?� Well, turns out there�s a third: Recently, I wrote a policy for a family. There were some health issues, but we were able to get coverage from one of the two more lenient carriers in this market, at what I considered a reasonable cost. After a month or so, they asked me if there was a better plan available, and I suggested that we apply to the other lenient carrier. Of course, I urged them to continue the existing plan until we had the new one in place. This shouldn�t have been a problem, since we didn�t need to send a check with the new a...

My friend and colleague Bob Vineyard has a new post up on his blog, one that really touched me. He tells the (true) stories of two young people who had the opportunity to purchase inexpensive coverage, and who subsequently had significant claims. One purchased the insurance. The other didn't. Sometimes, my clients (and prospects) don't heed my advice. Most of us who take this vocation seriously are loathe to engage in the "hard sell." Bob's clients' experiences really drive home why coverage is important, but in a way that is most definitely NOT a "hard sell." As they say in the blogosphere, read the whole thing.