Due to higher than expected voter turnout, election officials have decided to allow only Conservatives to vote on Tuesday – Liberals to vote on Wednesday. Please pass this on to all your liberal friends.
Archive for October, 2010
If you are a Health Insurance Agent, you might want to read this story:
Once upon a time, there was a great business called health insurance where an agent could get a license to sell this fabulous product and make a great living. But then the government decided to make drastic changes to this fine business and the rules and regulations became almost unbearable. As time went by, the government decided the health insurance business needed to be changed completely and to be run under the direction of the government themselves.
Well, it’s not just a story because the new health care reform bill has passed and we know major changes in the health market are coming. The most serious of those changes will directly affect how those of us are who sell individual health are paid commissions. The days of $600 to $800 advance commission you earn per sale are all but over.
Some companies have decided to limit advances to $300 per sale for a period of time, others will suspend ALL advances for a period of three months and when re-instituted, (if at all) will be limited to $150. What that really means, is that if you were writing 4 applications per week and earning $2,000, you will now have to write 13 applications per week to earn the same amount and common sense tells us that it’s impossible for that to happen.
This is an excerpt from an article written by a Health Insurance News writer:
“In my opinion (which is based on the General Accounting Office numbers) individual health insurance will eventually end, at least in terms of agents, just like it has in Massachusetts, where everyone buys insurance from the exchange. So again, individual health insurance will still be available, but only in health insurance exchanges where each state is responsible for their own exchange and which companies offer plans through the exchange.
Most Americans, probably don’t realize this, but in New York for example if you shop individual plans right now, the cost for an 18 year old male is the same as a 64 year old with diabetes and any other condition you can think of. And this premium is currently about $1000 per month for both the 18 and 65 year old, to get only average benefits.
Under this new law, the only people buying health insurance will be people who have insurance now and everyone who has been declined. (though many of them will elect instead to pay the $695 penalty, I know I probably would) The rest will head towards Medicaid and to their employer where premiums will be incredibly high, and already are.
The other nail in the proverbial coffin for health insurance brokers is the 80% rule, which simply states that 80% of premium must go to health care costs. This will eliminate most of the room to pay brokers even a reasonable commission after factoring in administrative costs.
Sadly for us this law takes effect as soon as 2011, which will in effect either put us out of business right away or dramatically hurt our bottom line. What is strange is that the health insurance exchange doesn’t become law until much later, which means that most health insurance brokers will be forced out due to this 80% rule in the very near term, and some have already started.
Finally and most importantly, young people and most of the uninsured right now for that matter, will not buy health insurance because the law only penalizes them $695 which is not even significant when compared to what premiums are and what they will become under this law.
Folks, these are facts not guesses. This marketplace as we know it, is over.”
John Holms – Ocean Equity Payment Solutions LLC
Editor’s Note: This article pertains to health insurance agents who sell individual health policies. Group health insurance producers will not be affected as quickly, but many will slowly disappear over the next 24 months. An uptick of panhandlers at every intersection may become apparent.
Fri, October 29, 2010 12:09:57 PM Essential Viewing – We must Defend, Repeal and put an end to Obama care!
This is absolutely essential viewing for every American!!!
Subject: We must Defend, Repeal and put an end to Obama care!
Date: Tue, 26 Oct 2010 16:06:57 -0700
Watch this compelling explanation of what Obama care will really look like if put into practice. (2013) Dr. David Janda testified before Congress…Listen to what he was told by the folks in Congress.
We have no idea of how insane this will be until it’s too late.
Editor’s Note: Limited Benefit Plans do not have to comply with the onerous requirements mandated by ObamaCare. We are getting numerous email like the one above on a daily basis. This is an example of a free market offering competitive solutions. We are not endorsing this product, this is for general information only.
Lubbock’s City Council unanimously approved a settlement agreement Thursday, ending part of a complex legal battle that dates back four years.
In 2006, the council ended the city’s health insurance benefit administration contract with the Ted Parker group of companies.
The Parker Group sued then-mayor David Miller and three senior city staffers, claiming defamation, amid questions about whether Parker and his companies profited beyond that contractual agreement.
Earlier this year the Parker Group, now known as Healthsmart, dropped its suit for defamation and all other claims against the four defendants.
The settlement agreement ends those defendants’ countersuit against the Parker Group for malicious prosecution and other claims.
Mayor Tom Martin says the $850,000 the city gets out of this deal, together with a $500,000 settlement recently reached with the city’s legal liability insurer, recovers “virtually all” of the attorney fees the city spent in this part of the legal battle.
The city is still in arbitration with the Parker Group in a dispute over records the city is seeking to conduct an audit. But those documents are apparently part of the settlement for the individuals’ countersuit.
A written statement released by the city states, “The city employees, former mayor, and Healthsmart all expressed that they are pleased an audit can now be completed.”
It continues, “Healthsmart said, ‘We regret that former management filed this suit. We believe that all disputes between our companies and the City of Lubbock should have been and should be resolved in the context of the arbitration in Lubbock. We steadfastly maintain that we did nothing wrong in relation to the Lubbock arbitration issues.’”
The individuals involved, City Manager Lee Ann Dumbauld, Scott Snider, Leisha Hutchison, and former Mayor Miller, according to the statement, say, “We are thankful the city continued to defend us as we have maintained throughout this ordeal we did nothing wrong.”
According to Healthsmart, Ted Parker is no longer involved in the day-to-day management of the companies.
Important information regarding Aetna Individual Medicare Supplement PlansSM in Texas
Effective December 1, 2010, Aetna will no longer be paying any compensation through our external broker distribution channel for new sales of the Aetna Individual Medicare Supplement Plans in the state of Texas.
If you are currently licensed and appointed to sell our Individual Medicare Supplement Plans in Texas, you will receive a letter amendment modifying your Aetna Producer Agreement.
What plans does this apply to? This applies to all Individual Medicare Supplement Plans sold in the state of Texas (Plans A, B, C, and F), including coverage for under-age 65 disabled individuals who qualify for Medicare, as well as for ages 65 and over.
What is the effective date of the change? This applies to all policies with an effective date of December 1, 2010 and later.
What if an application is in process? This will apply to all new business with effective dates of December 1, 2010 and later, even if applications have been submitted for processing.
What will happen to the commissions due to renewal business? Producers will continue to receive the normal compensation for any Individual Medicare Supplement Plan sold in Texas with an effective date before December 1, 2010.
Why is Aetna eliminating compensation paid to external producers? After carefully reviewing Aetna’s business results for the Individual Medicare Supplement Plans in Texas, we determined that a change in strategy was necessary at this time to remain competitive in this market. Aetna will continue to review our business results with the Individual Medicare Supplement product in the state of Texas to determine the best strategy to remain a strong competitor in that Individual Medicare Supplement market.
If you have any additional questions, please contact the Aetna Medicare Broker Service Unit at (888) 247-1050.
Jordan Smith Thu Oct 21, 8:08am
According to the Texas Medical Association, the 2003 tort reforms they pushed so hard for are paying off – for reals.
That’s right, according to a September press release from the TMA (the largest state doctor’s association), tort reform worked so well that that the Texas Medical Liability Trust – that’s the not-for-profit medical malpractice insurer that insures more than 14,000 TMA affiliated docs – has again reduced its premiums and offered a 24% dividend to current policyholders. That’s some scratch!Enough scratch, it seems that the TMLT is among several groups that have organized for tonight (Thursday) a nice meet-and-greet schmooze fest at the Ferrari dealership on North Lamar. “Come as you are – bring your spouse, physician colleagues, and your business cards. Light refreshments served.”
That’s awesome. Just super duper. I mean, sure, it’s great that docs and their insurers can again afford Ferraris (yeah, I know they’re only schmoozing there, but, please: Do you think the Ferrari dealership opens its doors to, say, a public school teachers social? I think not) – especially considering the dire, dire predictions we were given back at the beginning of the decade about how doctors would be run out of business, and out of the state, because of high med-mal rates prompted by frivolous lawsuits.
And to hear Gov. Rick Perry tout the tort reform package in his 2007 State of the State speech, it was the courageous reforms pushed through by lawmakers – that is, a package of measures that limit the ability of individuals to avail themselves of the legal process and to sue in cases of medical negligence – that have lowered med-mal costs and helped to recruit doctors to the state.
Hmmm. That sounds super good, but is it true? Not at all, according to Texas Watch. For starters, the state still has the highest rate of uninsured residents, with nearly 25% of the population without any health insurance. And, moreover, according to the TMA, the state now ranks 42nd in the country for the number of doctors per capita; nearly half of all Texas counties do not meet the national standard for having 114 doctors per 3,500 people, according to Texas Watch.
Yes, it is true, we’re still short on doctors. But how can this be, you ask? I thought tort reform was supposed to take care of everything? Apparently you thought wrong. Indeed, according to Dr. Gary Floyd, the chief medical officer for Fort Worth’s John Peter Smith Hospital, the real problem is that the state hasn’t created enough residencies for all the doctors educated in the state, in part with taxpayer money. If there aren’t enough residencies, he told the House Committee on County Affairs during a hearing held at the hospital, the doctors will go elsewhere to finish training and then will likely stay put in those places.
And you know why there aren’t enough residencies? Frivolous lawsuits? No, no, we took care of those. The real problem, witnesses told the committee, is that Medicare and Medicaid funding caps have “forced” healthcare agencies to “freeze or scale back” residency programs, Floyd said. The TMA, reports the Fort Worth Star-Telegram, is expected to advocate during next year’s Lege session for an expansion of the number of residencies in the state.
In other words, it appears now that tort reform wasn’t exactly the panacea we were led to believe. And it certainly didn’t create a rush of doctors flocking to, or staying in the state as we were led to believe it would.
Well, crap. At least we still have the Ferraris.
|SPBA Email Alert – October 25, 2010
Health Reform Insights
Personal candid observations from SPBA President Fred Hunt
There is no question that pieces will be changed, eased, repealed or de-funded. However, they are apt to be more broad & nonsensical items like the 1099 reporting, prescriptions for non-prescription items, etc. The biggest changes in health reform will come from unexpected things, such as how states react in their many implementation duties of health reform, how the Feds will respond if states stall, if exchanges bomb for whatever reasons, if medical IT doesn’t evolve as expected, if millions decide to game the system by just getting insurance when they are sick, etc. The fate of the health insurance industry also hangs in the balance of some flukes and what areas may still be open to them (such as ACOs)
So, this is a pre-election reality check that if Democrats & health reformers go down in flames next week, and the media is on over-drive discussing imminent repeal or big changes, it is unlikely to play out as predicted. That is the reason that these e-mails from me tend to focus on factors that might not seem directly related to TPAs, self-funding, and employee benefits. You need to understand the side issues which will probably trigger any significant changes.
Looking further ahead, pundits will inevitably start pointing to after the 2012 Presidential election as the time of major repeal and change. However, by 2013, the health scene will have already changed considerably, and people will have gotten even more used to things they like (or are told they will like) . Besides, by raising expectations in 2010 for dramatic change which they are pre-doomed to not be able to achieve (not to mention the significant chance of a bloody civil war within the Republican party), by 2012, the Republican party may be seen by fed-up voters as the do-nothing party to be thrown out. So, don’t take the media’s simple predictions too seriously.
Frankly, I think that the biggest changes in health reform will be where it crashes down from its own unworkable assumptions, such as some of the issues described below.
AVOIDING THE TOUGH FIGHT
So…instead, the focus/goal was set on making care more efficient (cutting billions of dollars of waste & abuse), and creating options for coverage, especially for people with high risk situations.
On the over-use issue, Americans already go to the doctor less often, stay in hospitals fewer days, and pop fewer pills than people in other major industrialized countries (with government plans). So, we seem to be world leaders in not over-using. The problem in the US is that each of those fewer medical interactions costs much more than in other countries. But to solve that problem would be to upset the medical folks and unleash their political opposition.
SELLING DESIRED PRODUCTS?
Pre-ex “discrimination” was a major topic reformers used to bludgeon “evil” insurers ad employee benefit plans. Health Reform funded a temporary pre-ex program for states. Those government-assisted pre-ex plans are getting embarrassingly few sign-ups.
Why aren’t the millions of Americans supposedly craving for access to such a plan rushing to sign up? Plans for high-risk and pre-ex is actuarially expected to be expensive, even with state & federal dollars to subsidize. However, states & Uncle Sam are discovering that when Americans say they want “coverage” (and this applies to S-chip, under-26 children, and will apply to many aspects of health reform), they expect FREE or extremely cheap. A recent survey found that the majority of Americans think that the state exchanges in 2014 will be free or super-cheap bargains. When it comes to health care, the national motto is Something for Nothing. This unrealistic expectation is going to undermine many parts of health reform.
So what to do about the dud pre-ex programs?? The government pre-ex programs are going to spend more millions of dollars to hire professional marketing/PR firms and advertising to lure pre-ex people into the plans that the politicians said they had desperately wanted.
FUTURE OF EXCHANGES?
ELECTRONIC HEALTH RECORD STATUS REPORT
Most of us have heard or assumed that HIPAA privacy & security were the providers’ main concerns, and there have been some reports that providers are uncomfortable having such a handy comprehensive record, because it invites fishing by attorneys for malpractice cases. However, the CompTIA survey reports that providers feel that it seems impersonal in the doctor/patient relationship. Also, 80% of doctors say that EHR/EMR users need more training in the technology.
Unwillingness to spend has also been a recurring theme when technology is mentioned to providers (the reason so few providers invested the money to get up to speed with EDI, when payers were required by law to do). However, 1/3 of health care practices reported that they expect to increase their IT spending more than 5% next year.
UNCLE SAM”S HEALTH PLAN
Could Overhaul Undermine Employer Health Coverage ? http://www.msnbc.msn.com/id/39821422/ns/health-health_care
Big Insurance, Big Medicine http://online.wsj.com/article/SB10001424052748704300604575554293656982422.html?mod=WSJ_Opinion_LEADTop