Friday, December 08, 2017

ANOTHER Baby Charlie? The MVNHS© Strikes Again

Regular readers may recall the tragic story of Baby Charlie:

"The parents of terminally-ill baby Charlie Gard are 'utterly distraught' and facing fresh heartbreak after losing their final appeal in the European Court of Human Rights."

Well, turns out the caring, compassionate Angels of the Death Mercy at the Much Vaunted National Health Service© apparently haven't met their quota:

"Ader Hey Children’s Hospital has applied to the High Court to switch off life support for a baby in a coma, the ECHO understands. Alfie Evans’s family said they were now in a “living nightmare” after the hospital said they had exhausted all options in trying to diagnose and treat his mystery brain condition."

Get that?

They don't even know what's wrong with the poor boy.

Adding insult to (fatal) injury:

"An Italian children’ hospital has offered to take the child as a patient for further inquiries and treatment. But the UK hospital administration and doctors are not only saying NO, seeks a court order allowing them to withdraw life-sustaining treatment."

But hey: Free health care.

(For certain values of "care")

[Hat Tip: FoIB TPH]

Thursday, December 07, 2017

From the P&C Files: Is this big?

Because it seems big:

"The accusation is the result of a department investigation that found that from 2008 to 2016, Wells Fargo customers were issued approximately 1,500 insurance policies and charged premiums without their knowledge or permission."

The result of this investigation  may be the revocation of WF's license to sell insurance in The Golden State.

[ed: Which, to be fair, may be to their benefit, based on the fires currently raging out of control]

I reached out to my P&C guru Bill M, who pointed out that:

A) Yes, this certainly appears to be fraud, and

B) In the grand scheme of things, 1500 incidents over 10 years seems more likely the actions of a "rogue" agency than systemic. Doesn't make it right, but probably easier to contain and remediate.

Will be interesting to see which licenses are pulled, and for how long.

[Hat Tip: FoIB PC360]

Wednesday, December 06, 2017

From the Comments

We're privileged to have some really interesting and informed commenters here, and the discussion can get lively (but always  civil!).

But we also get some .... well, unusual feedback, such as this one from Regina Raymond in reply to our recent MedMutual post:

"My husband of six years left me for another girl because I accused him of seeing another girl and since then I have been trying to get him back but he refused to come back to me, he was not responding to my calls or email and he even unfriended me on face-book and also unfollowed me on IG and he told me that he was done with me and my two kids.

I got really confused, I was searching on the internet for help and I saw a testimony of how a spell caster helped them to get their exes back so I decided to give it a trial, but i was even more confused because of many testimonies that i saw, but my heart told me to go for Dr [REDACTED] because I did many researches on him and I found nothing bad about him, that was how I contacted him and I explain my problem to him and he casted a love spell for me and guaranteed me 7 days that my ex will come back to me and to my greatest surprise the third day a great miracle fell on me and my ex came back to me and he begged for my forgiveness.

Dr [REDACTED] you are just the best, I will continue to publish his name because he is my Savior, we are now one big happy and united family, If you need his help you can Email him Do not loose hope too soon contact him If you need his help you can Email him ...  for easy and fast communication you can also call or add him on whats-app.

Well gosh, thanks so much, Regina, and congratulations!

Pretty sure this isn't considered an EHB, though.

Tuesday, December 05, 2017

Questionable Client Tricks

Well, not so much "tricks" as judgement:

One of our P&C clients is going through Open Enrollment at work, and the voluntary term life for both himself and his wife is going up pretty dramatically. This happens because most of these plans use age-banding; that is, your premium is (for example) $10/week from age 30 to 34, then $115 from 35 to 39, etc.

So he called to see if buying his own plan might be a better way to go.

It usually is: group term plans are generally guaranteed (or at least simplified) issue, which means little or no underwriting, which means carriers inflate the rates to cover for the unhealthier employees. Healthy ones can almost always do better on their own. The biggest advantage for these plans is that they're payroll-deducted, so a lot more convenient than cutting a check (although most carriers will do auto-withdrawal for monthly premium, which is pretty close).

Anyway, Joe is in good shape, but Kelly's not quite tall enough for her weight, which adversely affects her rate going in. I suggested 20 year term plans, and the numbers looked good for Joe, but they're thinking about going with a 10 year plan for Kelly in the hope that she'll shed a few pounds in the meantime and qualify for lower rates down the road.

I countered thusly:

"If you can swing the 20 year premium-wise, it's a much better idea. For one thing, you can always request a rate review down the road if/when Kelly drops a few pounds. Plus, who knows what rates will be with these companies 10 years down the road or (even more importantly)  whether her medical history would change where she couldn’t even qualify for a plan – regardless of the weight issue.

She would have to lose about 10 pounds and be stable at that weight for at least 1 year to get to get the next better rate class, and down to another 10 or 15 and stable for 1 year for best.  Of course, that’s assuming overall history and findings look good such as lipids, any other significant history, etc.

Your call, and I’m happy to oblige whatever you want – but also want to give the very best advice I can

We shall see....

Monday, December 04, 2017

Blog Contest Alert

We've been nominated for Healthline's 2017 Most Loved Health Blogs contest (we're a previous award winner).

Voting's now open - We would really appreciate your support.

Thank You!

[First posted on 11/26/17] 

Boy Howdy, A Roaring Success

Well, for certain values of "success:"

[Hat Tip: FoIB Rich W]

Friday, December 01, 2017

From the mailbag: No Choice Health Insurance

So, received this in email this morning:

"Hello, my family and I are looking into health insurance assistance. One of our concerns about it is that we are looking for PPO plan and not HMO. We've been in touch with another agency and was informed that HMO plans were the only thing available. We were given this site to begin and all we can see are HMO plans."

I have no idea who or what a Healthsherpa is, but presume it eventually ends up at the site. Where, in fact, the only options for our area are Molina, CareSource and Buckeye Health, all of which are HMO's, and all of which are generally known as Medicaid "carriers." And that means even narrower networks (fewer providers).

Oh goody.

But it gets better:

"My wife and I have 4 kids and our ages are 29, 26, 9, 6, 4, and 3. 3 girls and 1 boy.Our household income is 40,000 a year."

I ran that through the handy subsidy calculator, which yielded - not surprisingly - this result:


You are likely eligible for Medicaid

"Based on the information you provided, you are likely eligible for Medicaid. Medicaid is a health coverage program run by states and the Federal government

So not subsidy-eligible, either.

There are still choices, of course; we'll see which (if any) they elect.

Thursday, November 30, 2017

Thanks for holding. We know your time is valuable....

Health Net...

Application submitted via fax for an individual plan on November 14.
Check sent via Priority Mail.  Received on 11/16

11/27 - After being unable to log into the broker site to check status, I called their IFP broker service number.  The rep was unable to locate the application and promised to call back the next day.  She didn't.

11/30 - Calling again.  The phone wait time is quoted as 126 minutes.  After 46 minutes, listening to the same inane music and announcements, I believe it.

This is inexcusably rude.  

I don't care what excuse they have.  How can any business be this disrespectful of someone's time?

Thursday LinkFest

■ Remember this: "If you like your doctor (or hospital), you can keep your doctor (or hospital)?"

Too bad, so sad. As FoIB Jeff M alerts us:

"[R]estructuring lawyers are now warning that the healthcare industry is about to experience a massive wave of hospital bankruptcies."

Of course,this isn't entirely unexpected: while insurance rates have skyrocketed, that trend hasn't translated to increased provider revenue. In fact, "[h]ealth-care bankruptcy filings have more than tripled this year."

■ Another FoIB, NDH, tips us to this helpful video explaining the Health Care Sharing Ministry model:

How Does MediShare Work?

■ And speaking of health care sharing ministries: I long ago opted to take a pass on selling them because:

"I'm an insurance agent, and I hold myself out (semi-)professionally as such. So if I sell a Medishare plan, which is specifically not insurance, I'd be concerned about an E&O claim in-the-making."

And lo-and-behold, today's email holds this warning from ARN:

"Recent solicitations from Risk Sharing Groups have caused concerns among Life Insurance Agents.   Consider a few key points when evaluating an Errors & Omissions Policy"

I had had no idea such programs existed. Apparently, they're available for agents who don't want to pay for legit Errors and Omissions coverage. The plans appear to be modeled on the health care sharing ministries, and are therefore not insurance, so there's some questions about whether any claims will actually be paid.

And there's this, which seems to be a show-stopper:

"In a Risk Sharing Plan the right to reimbursement only occurs once the wrongful act(s) have been entered in court and all appeals have been settled.  This could take years."