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Can I check out health insurance rates? What’s involved in them always going up?

08-04-2010by Colleen King

Okay, I realized today that I’ve evolved into the ultimate insurance nerd. A few of weeks ago I subscribed to a service with the California Department of Insurance (CDI) where I can receive certain updates as they come in. Previously I got things on licensing requirements, you know, the usual professional stuff.


But now I’m getting information on when insurance carriers file their new rates for ‘approval’ with the CDI. This isn’t easy stuff to read, so if you’re having a bout of insomnia one evening, you might consider checking out rate increase information as it is submitted.


So I started out with Aetna, and wasn’t going to be deterred by the fact that it was 93 pages. What you will see if you check this stuff out is what’s being proposed for new business rates quarter by quarter. Aetna and most other carriers have a 12 month rate guarantee so your rates don’t go up right away but as you all know they do go up at least once a year. But reading all that is taken into consideration, hhhmmmm. I knew the basics but looking at this was a bit daunting.


Then I decided to check out Anthem–their latest filing was 386 pages. But that’s because they have a billion plans and a somewhat convoluted way of assembling their rate sheets. But I went through it all anyway, looking to see what would potentially be happening with my rates once my guarantee expires. I’m not thrilled. If it read it right, it will be going up about $50/month.


You have to know that all carriers in our area are going to have to be doing something in order to comply with the new health care reform bills. And that is listed in these filings as a reason for the rates; no more lifetime maximums, preventive services covered with no cost sharing, no limits on complex radiology and lab tests, and so on. These are all going to add to their costs, once people catch on to particularly the preventive services piece. Check out what is being included in the preventive services arena.


My advice? Not only are rates going up, but many plans will be changing as well. If you are in the market for an individual/family plan, get rolling on it ASAP so you can take advantage of the carriers that offer a 12 month rate guarantee.


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Category: Uncategorized


Leslie Margolin leaving Anthem Blue Cross–is that good?

07-29-2010by Colleen King

The news came out last week that Leslie Margolin was leaving Anthem Blue Cross and I had to wonder why. Of course, there’s the obvious, the blow out earlier this year when the rate increase craziness hit. But that was months ago, and things had toned down considerably. Click here for a short story on this.


I heard her speak at a forum earlier this year in Woodland Hills, and she seemed like a very nice, nose to the grindstone kind of person. In asking my account rep at Anthem about here, he commented that people would be surprised at how geared toward a desire to provide a more universal type of health care she was.


Let’s face it, NO ONE was going to win in the position she was in. She did diversify the product portfolio considerably in her time there, which makes me wish some of the other carriers would do a bit of that too. While overall I like what they’ve done, I like to have more than one carrier to chose from and when their pricing beats everyone out overall, there’s not a lot to suggest outside of Anthem. People these days have to watch their budgets. I regularly have account execs tell me I should be selling on the benefits of a plan, not just the price. I do that to an extent, but if you have two similar plans, one $100/month less than the other, that’s usually the only benefit most folks want to look at. And I can’t blame them.


I hope Ms. Margolin does well at her new job, and would love to pick her brain one of these days on this whole mess!

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Category: Uncategorized


How is the IRS going to ‘enforce’ mandatory health insurance in the new health care reform bill?

07-14-2010by Colleen King

I came across an article last month that was published by USA Today on April 30th that to me, outlines just a part of the big wake up call we have coming in 2014 when the bulk of the health care reform measures go into effect. If you can find it, check out the article by Sandra Block, “IRS lack clout to enforce mandatory health insurance.” Sorry, I waited to long to post this and lost the link. But my article will give you the basis for my concern.


This article lists estimates of needing 16,000+ IRS agents to enforce this eventually. The Congressional Budget Office is estimating the cost at $5-10 billion to administer this. And that’s just the start.


My concern along with other agents in California is the price tag on all the changes. Even though people aren’t happy with rates in LA and Ventura counties, you are definitely paying less than places like Massachussettes, New York and New Jersey. And now that you are looking at eventually subsidizing people, not excluding for pre-existing conditions, rates will soar. But the IRS can’t apparently enforce these new provisions in the law.


For example–30 year old male in New York City, hospital only plan would run $176/month. No deductible, but no coverage for office visits, most outpatient care or prescriptions. Which is more of what a 30 year old would need. You could get something comparable in the SFV area for $78-99/month, but there would be a deductible.


The same 30 year old, wanting a more comprehensive plan, opts for a $2000 deductible, $30 office visits, 80/20 coverage, sounds great right? Are you willing to pay $529.06/month for that? That’s a real figure for the 10009 zip code. I can find $2500 deductible, 70/30 plans with three office visits per year with generic and brand coverage for $111/month.


So you might want to look for coverage now, while it’s affordable in California. No one really knows what will happen once all this starts to kick in. Pretty scary!

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Category: Uncategorized


What are some key items I need to know when opening a health savings account?

07-04-2010by Colleen King

In my last article I mentioned the first key point with a health savings account (HSA) that in order to use the money to pay for expenses, the expenses MUST occur after the account has been opened. Not necessarily fully funded because you can deposit money and and reimburse yourself after the fact. You just have to have opened the account prior to incurring the expense. And the account has to be opened after you have the appropriate insurance plan, as a reminder.


Other things to consider when opening an HSA:


* Once account or two? Well, only one name can go on the account. For a married couple or domestic partners, once account may be okay. But if both are over age 55, and they are both on an HSA eligible plan, consider opening separate accounts. The reason is after age 55, people can deposit an extra $1000 per year on top of the $3050 maximum for 2010. If you only have one account, only the person on the account can do that, so consider talking to your tax professional for the best route. I don’t consider an HSA the first place to put money, but if you’ve maxed out all your other pre-tax options and you are looking for another place to put some money that can grow tax FREE, this can be an option.

* Fees–You really have to look at this. If you are like most people and you don’t want to dump a large amount in right off the bat, fees of $3-$10 a month will eat into your principle. Many accounts offer low or no monthly fees. You also want to look and make certain there are no ‘per transaction’ fees.

* Investment options–As your account grows, hopefully, because you’ve been able to put money in it and not had sizable expenses, some people want their money to get some growth. Many accounts offer mutual funds after you reach a certain balance. But be sure you aren’t gambling with the rent money, so to speak.


So these are the main things people have questions about, or don’t know to ask. Many banks, credit unions and others are now offering HSAs. You can go to your regular bank but again, look at the fees in particular. If you want to see what’s available, go to HSAFinder.com. This web site is like a central repository that lists many entities that offer HSAs, and I go there regularly to look.


Remember, an HSA is like most other accounts, in that you can transfer it to another HSA if you find better rates. Just don’t have the old agency give you the check to redeposit, as that might trigger fines and penalties you shouldn’t have to pay.


One last thing–Happy Birthday Mr. Obama–talk about a lonely job right now!


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Category: Uncategorized


When should I set up my health savings account–does it really matter?

07-03-2010by Colleen King


Health Savings Accounts (HSAs) have been a great way to go to ”self fund’ eligible health care expenses. You can even use it for most vision and dental expenses even if you don’t have vision or dental insurance.


But the reason you have an HSA usually is for the fact that the money you put into the HSA is tax deductible. if you had a sizable expense, wouldn’t you like to be able to maximize the tax benefit? Here’s something most people miss. First, what most people do know is that in order to have an HSA, you have to have a qualified high deductible health plan. Once you have that approval or enrollment, then you can open the HSA.


Here’s what catches most people off guard though. There are different ways to fund your HSA, either by putting a full contribution in, maybe electronic fund transfer of a couple hundred a month or my personal favorite, I’ll anticipate an upcoming expense, approximate what it will cost and deposit that amount. But if you have an expense that catches you with a low balance in your HSA, you can pay for it in a regular way, credit card or check and reimburse yourself.


But to legitimately pay for an expense out of your HSA by any of the aforementioned ways, the account MUST be established prior to incurring the expense. Most people don’t know that, they think it just has to happen after you have the health plan. This basically is an honor system, meaning that generally no one is looking over your shoulder on this but if you faced an IRS audit, you do need to keep your receipts for expenses and you’ll potentially need to prove that the medical issue occurred after the HSA was established.


That’s why I tell my clients who are wavering as to whether or not they want to establish the HSA to open one as soon as you are eligible, then just put some nominal amount in it. That way you can add to it later in case something major happens. This came to light when one of my clients called and asked me where again to open their HSA. The husband had an emergency, they were going to open the HSA, drop the maximum amount into it and pay the hospital bill. Unfortunately, that wasn’t going to work.


So set up your account. Lots of banks, credit unions and others offer them. For a nice clearing house web site that lists who is offering them, go to www.hsafinder.com. But be sure to verify the details on the account, because sometimes this site misses a couple of things.


NEXT–tips on what to look for when you set up your HSA

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Category: Uncategorized