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In Part 1 , we broached the subject of rate increases. And in Part 2 , we looked at the questions we need to ask about why they went up. Now let�s talk about what we can do about it. Well, the first, obvious move is to contact your agent to see what other carriers are available in your area, and how they stack up � both in financial status and rates � to your current carrier. Of course, ones current health status (as well as those of covered family members) will play a role in this process. And remember, just because the new carrier�s rates are better this year, don�t forget that they�re subject to the same issues as your current insurer. That is, their rates are going to go up next year, too. Doesn�t mean that you shouldn�t make the switch, but you need to know that it�s a temporary fix. Another item to discuss is what, if any, different deductible and/or co-insurance levels will do to help mitigate the rate increase. This is especially relevant when discussing an HSA, because if on...

In Part 1 , we broached the subject of rate increases. Insurance underwriting refers to the practice of obtaining and then evaluating information about the current health of the prospective insured. Of course this starts with the information on the application, but it may also include doctors� records, or even a physical exam. All of this gives the underwriter a decent �snapshot� of the applicant's current health. But as the insured ages, so does that underwriting information. In the case of an individual, claims are paid, health conditions arise or worsen, new medications are prescribed. In the case of a group, in addition to those health factors, the make-up of the group also changes over time. The result of all of these changes is that the initial information, on which the rates were based, become obsolete (i.e. �stale�), and this because the risk has changed, the premium will also. Now, take that same principle, and apply it to a block of business (in other words, a large group...

This week's edition of the Carnival of Personal Finance is up at the Free Money Finance blog. Nice job, too! And, after a scheduling problem, the Carnival of the Capitalists is available at Any Letter . Thanx to Any Letter for saving the day!

Sometimes - and I know that this will come as a complete surprise � I tick people off. Not necessarily on purpose, mind you, but by happenstance, or providence, or just plain luck. Today�s episode may be instructive: Sally and I had been playing phone tag all week; we finally connected early this afternoon. Sally was interested in medical insurance for her husband, and she reminded me that we had discussed this last year. At the time, he had been cancer free for 4 years or so, and I had told Sally that carriers really preferred at least 5 years treatment and cancer free. So, Sally informed me that it had now been five years, and asked what kind of plans and rates would be available. I suggested that, before we went through a lot of paperwork, perhaps she could tell me a little more about Rob�s current health. �Oh, he still smokes, but he only takes one medicine, it�s [ name of post-chemo med ],� she informed me. I knew from experience that this particular med would render him uninsurab...

It should be apparent by now that I am hardly any insurance company's shill. But when one does something right , it's appropriate to acknowledge that. Today, I received this email from United Healthcare: "To help affected UnitedHealthcare members receive the care they need without unnecessary delays or disruptions, we are temporarily changing our claims payment policy for affected members. Payment of the health care services provided, regardless of location or network status, will be reimbursed at UnitedHealthcare's in-network benefit level." This means that victims of Katrina don't have to sweat whether or not the providers they see are in-network. It also means there's one less hassle. One could argue that this is hardly altruistic: for one thing, it's good PR. For another, it's probably less of a headache from UHC's end, as well. But I believe that why one does something is less important than that the right thing is done. Kudos to UHC. UPD...

Recently, I received an email from a good friend (who is NOT a client) lamenting the latest increase in his family�s health coverage. I happen to know that said coverage is through a well-known and well-established carrier, and is in fact an HSA plan. He wrote �(m)y Health Insurance premium just went up $400!� Now, there was no indication as to whether that was $400 a month, or a year, nor did he mention what percentage of his premium that $400 represented. And really, that�s the important number: absent some yardstick, there�s no real way on knowing just how grievous that rate increase is. Look at it this way: if his annual premium before the rate increase was $3500, then a $400 dollar increase is about 12%, which isn�t really all that hateful. But I really don�t know, because that information is missing. The reason I mention this is that I often get calls from folks who give me raw numbers, but with no context, so I have no way of knowing whether or not I can help them. The email w...

start before you get there. David Williams over at Health Business Blog has a helpful post about preparing beforehand for your next encounter, " Planned Patienthood ." Check it out.

of Consumer Centric Health Care. I make the distinction between Consumer Driven vs Consumer Centric because the plans we�ll be looking at encourage an insured to take at least some responsibility for their care. On the other hand, neither one would be HSA-compliant, so we�ll skip the CDHP label (at least for now). My industry just loves acronyms: CDHP, HSA, HRA, PPO, you name it. Well, let�s add another one to that list: Self Directed Health Plan (SDHP). One of my carriers has just introduced one such, and it�s a pretty neat idea. They start with a high deductible group plan, and while they strip out the doctor�s visit co-pays, they leave intact the prescription drug card, as well as the co-insurance. The high deductible and absence of co-pays helps lower the cost dramatically. � Well, Henry, what�s the big deal ,� you may ask, � after all, we�ve seen low-end plans before .� What makes this one unique is that the carrier is paying the employee to stay healthy: the plan includes a Se...

SoundPractice is hosting Grand Rounds this week. The Carnival of Personal Finance is up over at Optimized Living . And you can find this week's Carnival of the Capitalists at Willisms .

A few weeks ago we heard the story of Haley Knutsen , the brave 9 year old who suffered from leukemia, and whose parents� medical plan had come up short. Folks from around the country rallied to raise funds for her treatment, which was to have included a transplant. Yesterday, we learned the sad news that Haley had lost her 7 year battle with leukemia. We also learned that her parents intend to donate the money that has been raised on Haley�s behalf to another young person who faces a similar challenge. Which raises the question: are such monies fungible ? In other words, is it right that Haley�s parents treat the funds that were raised as solely their own, to do with as they please, rather than return them (if possible) to the folks who actually contributed? On the one hand, it�s hard to imagine that someone who donated money to little Haley would have a problem with that money going to another little girl (or boy) with leukemia . On the other hand, when one donates money on behalf o...

Elisa over at HealthyConcerns reports that little Haley Knutsen has lost her battle with leukemia. Donations to her transplant fund are being forwarded to another young leukemia patient being treated at the same facility. Our hearts and our prayers go out to Haley's parents, and community.

Recently, I was asked by Oxford University Press to review their new title � One Nation, Uninsured � by Professor Jill Quadagno of Florida State University. I met Dr Quadagno (virtually) at the OUP blog where she had posted an article which linked here. I left a few comments, which prompted the blog�s editor to contact me, offering a chance to review Dr Q�s new tome. Dr Q is a proponent of national health care (not necessarily socialized medicine, BTW), while I am a staunch opponent. This seemed like a great opportunity to get inside the mind of someone with whom I vehemently disagree, to see if there is any common ground, and to see what makes such a person �tick.� It�s also a valuable opportunity to test my own thought processes, and my own beliefs. SPOILER ALERT: I�m still a staunch opponent of national health care, let alone socialized medicine. I�ve decided that the fairest way to do this is to offer first my opinion on the quality of the writing , and then on the quality of the...

As in Consumer Driven Health Care, but this time from a different perspective: prescription medications. Under the typical CDHC model, meds are subject to the high deductible that drives the plan. Once that deductible (which includes meds, office visits, etc) is met, then they�re covered at the higher rate (usually 100%). But as we all know, prescriptions account for a disproportionate slice of the health care expense pie. So, is there some way to bring those costs more in line, to underscore the savings available in CDHC? Well, yes: � Medco Health Solutions (has) announced major additions to its consumer-directed pharmacy plan that promotes the use of preventive and chronic medications by lowering the out-of pocket costs of these drugs to consumers enrolled in high-deductible health plans. � As we�ve discussed before , HSA�s (Health Savings Accounts) are the primary vehicle for CDHC (although certainly not the only one). Under new guidelines, HSA plans can include a deductible waiver ...

N Z Bear has a new site that matches those in need with those who can help. InsureBlog readers have already shown a remarkable generosity ; I'd really encourage everyone to keep that momentum going . Thank you!!

�When you�re weary, feeling small, When tears are in your eyes, I will dry them all� So go the lyrics to Simon and Garfunkel�s 1970 hit. And it�s probably fair to say that all of us have bad days, or weeks, or even months. But we don�t have to �go it alone.� EAP�s (Employee Assistance Programs) have been around for years. But they�re kind of under the radar for most folks. They�re part of a group of insurance-related products that people tend to take for granted (like hearing tests, or wellness programs). And that�s a shame, because these programs can be a vital part of one�s well-being. An EAP seeks to � assist employees and family members with substance abuse, mental health, family, and other problems that negatively affect their job performance. � They�re usually part of a group insurance plan that covers employees and their dependents. Most are embedded in the plan; that is, they�re automatically available to any covered family member. Sometimes, it�s as simple as a �nurse-line;� o...

Grand Rounds is up over at Sneezing Po (gesundheit!). You can catch the Carnival of the Capitalists at Crossroads Dispatches . And finally, the Carnival of Personal Finance can be found at Smart Money Daily . As usual, they're all chock full of useful info, presented in an easy-to-follow manner.

And let your group insurance pay the fare. Well, it�s not really that simple, but with gas prices so high, even insurance folks are getting into the act. Believe it or not, in addition to healthcare and daycare, some transportation expenses are also tax qualified. No, you can�t just deduct the subway token on your next 1040EZ, but � (q)ualified transportation benefits can be provided directly by you or through a bona fide reimbursement arrangement. � Under a Qualified Transportation Expense Plan (QTEP), employees can save up to 40% on their out-of-pocket expenses on certain transit and parking costs. These expenses, which have to be associated with their commute to work, can be paid with pre-tax dollars. They�re most commonly used in major cities by commuters who take mass transit, but they�re also available to workers who use carpools. In a recent survey, the Society for Human Resource Management found that 14% of employers offered a QTEP (or other transit subsidy). That�s about 1 ou...

UPDATE: This link goes to a clearinghouse that aggregates companies which match donations. You can use it to see if your employer offers matching. UPDATE II: The BlogBurst Katrina Fundraiser is now over, having raised well over $1 million. Thanx and kudos go to N Z Bear , et al for the incredible efforts. Please take a moment to check out the new Web Relief Project Directory , which lists current web-based relief projects. UPDATE III: Thank You !! According to N Z Bear , InsureBlog readers have donated almost $2000 toward the Hurricane Katrina BlogBurst Fundraiser. In fact, we're in the Top 40 of ALL 1,850+ participating blogs. Wow. BTW, you can still contribute here . Regardless of your political pursuasion, fellow Americans are hurting, and we in the blogoshere can help. N Z Bear is coordinating a special page to raise money to help those affected by Hurricane Katrina. The special "blogathon" officially began last Thursday (September 1) here . "There's n...

Grand Rounds is up over at Corpus-Callosum (which is, according to my dictionary, "the largest white matter structure in the mammalian brain." Hmmmm...). The Carnival of Personal Finance is hosted this week by Savvysaver . And the Carnival of the Capitalists may be found at ReThinkIP . Have fun!

In Part 1 , we discussed a recent study that looked at the (hypothesized) relationship between genetic diseases and intelligence. The subjects of the study happened to be a specific population of Jews, who on the one hand display above-average intelligence, but on the other are more prone to a deadly disease. Now, what does this have to do with insurance? We�ve addressed the general topic of genetic testing in insurance underwriting before . It�s been many years since insurance applications asked one�s race, and I�m reasonably certain that (with the exception of certain fraternal carriers), the question of religion wasn�t even brought up [ ed � if any readers know otherwise, please let me know ]. The question arises, however, as to whether or not carriers should be testing for such potential time bombs. In other words, is it necessarily a good thing that genetics-based underwriting is prohibited? If insurance is truly about risk management, then doesn�t it make sense that a carrier sh...

"Your child can be smart, or he can be healthy." Which would you choose? At first blush, this calls to mind the "straw man argument" we've discussed before , but it may not be. A recent study on the relationship between the (legendary?) intelligence of Ashkenazic Jews and their risk of a dreaded genetic disease ( Tay-Sachs ) has sparked an intense debate. First, though, it's probably helpful to explain "Ashkenazic Jew." There are two populations of Jews in the world, although they share a mutual heritage and homeland. One, the Ashkenazi, hail primarily from eastern Europe. The other, Sephardi, come from the Mediteranean area. Because Jews prefer to marry other Jews, there is a limited gene pool, which tends to exacerbate genetic problems. Tay-Sachs is a genetic disorder that almost exclusively afflicts Jews of Ashkenazic descent (similar to sickle cell anemia to those of African descent). This is a bad thing. Ashkenazic Jews tend to score much hig...