2008 was a lousy year for many people, so kick it to the curb and get ready for 2009. As far as insurance, we’ll see what actually changes in the health care arena. It won’t be fast or ‘all curing’ but I hope there will be some positive action. 

Especially if it doesn’t mean me losing my source of income! 

So, I wish you all a Happy NYE, and we’ll be ringing it in from the Caribbean. Hope that bodes well for smoother sailing in 2009! I look forward to answering your questions again…..

Be well!

(Merry Christmas from my partner on the right, Aidan, and his gal pal Siobhan. I’m sure you know the other guy)

About 6-8 weeks before your anniversary date, you and your agent will get the next year’s rates for your group health plan. What I tell my clients is that we’ll look them over, and when you get over the inevitable sticker shock, I’ll research what else is out there so see if it makes sense to make a change in plans, either within the same carrier or to change carriers.

If you change plans within the same insurance carrier, the paperwork is usually pretty light. But if you are changing carriers, you are starting from scratch so all new paperwork needs to be submitted. When you go through this process close to the renewal date, there is always the concern that something may be missing, delaying the implementation of a new plan. And if you have a January 1 renewal date, believe me, things slow down at the insurance companies because of the Christmas and New Year holiday time off.

Group health insurance renewals are also the time to add new employees. If this process is completed after the first of the month and they need care, there can be hassles in their obtaining care because the insurance company doesn’t know your employee is eligible.

Even though I’m emphasizing January 1 renewals in this article, it applies to renewals at any time of the year. Since money is tight for most companies, talk to your agent about less expensive plans to see what might be possible. You’ve got better things to spend money on than health insurance of course, but keeping a group health insurance plan goes a long way to recruiting and retaining good employees,

Have a wonderful holiday season, and a fabulous 2009!

Be well!

But if you purchase your own coverage or you obtain it through your job, be happy you have it. Even with the higher deductible plans, if you have a couple of minor health issues during the year and you are paying for the care, you benefit from it. I met with a client this week who is moving out of the country and we were assessing what she might need to do for coverage.

She asked me what good her coverage had done for her the past few years since she was paying for everything. We dug out some of her explanation of benefits (EOBs) she had gotten from the carrier. We went over a few and it made sense. Fortunately she hadn’t needed a lot, but the benefit could be seen. One column shows the ‘billed charges’ which is the amount the doctor submitted. The next column showed the ‘allowable amount’ which is what the contracted rate was the doctor had with the carrier, or the discounted amount. The next two columns showed the amount paid by the carrier which was zero, and the amount she owed.

The benefit in this scenario was the discounted rate for the services. When selecting a care provider it is always in your best interest to see someone contracted with your insurance carrier in order to pay a discounted rate. Once you hit your deductible on a PPO plan, if you see providers not contracted with your health plan the reimbursement will be at a lower rate than a contracted provider. So you still get some help with costs. This doesn’t apply to HMO plans, as only emergency care is covered.

So coverage for bigger problems, discounted rates, these things help with your costs when seeking care. Compare your health insurance to your homeowners or auto policies. People usually try not to submit claims to either of these types of coverage out of fear that their rates will go up, or they will be cancelled. Your health insurance cannot go up because of YOUR claims specifically. Nor can it be cancelled because of claims, whereas your homeowners insurance can. Something to think about……….Be Well this holiday season!

But the question I want to address in this article is one aspect of setting up the actual HSA. When a family has an HSA eligible plan, should they set up one HSA or two? Well, when you set up an HSA for your family there can only be one account holder listed, but the money in the account can be used for all members covered by their family health plan. In 2008 the maximum contribution for an individual is $2900 and for a family is $5800. So, no big difference at this point whether you need one account or two? Maybe if you file your taxes separately, you could each use the deduction of what you’ve contributed during the year.

Here’s where the potential benefit comes in; after age 55, people with HSAs are eligible for ‘catch up’ contributions! In 2008, that would be an additional $900. If you have one account, there can only be one catch up contribution. But if you and your spouse have separate accounts, you could both take advantage of the catch up contribution. So,with a family HSA allowable contribution of $5800 (if you choose to make the maximum contribution) plus $900, that would give you $6300 in the account. With separate accounts you could each make the maximum contribution of $2900, plus $900, times 2, giving you a total of $7200 that you could put away. Something to think about!

Every year these numbers are adjusted for the coming year; see below for the HSA numbers for 2009:

• Maximum HSA contribution–individuals $3000, families $5950
• Catch up contributions for account holders over age 55–$1000
• Minimum health plan deductible–individuals $1150, families $2300
• Maximum out of pocket max on a plan–individual plans $5800, family plans $11,600

Whatever you do, you need to have health insurance these days. HSA eligible plans can be less expensive than conventional PPO plans and you are basically are ’self insuring’ for the smaller issues. Look at it further to see if it’s a fit for you.

Be well!

Medicare Supplements and Medicare HMOs, also known as Medicare Advantage plans, are something to choose wisely. This is because as time goes on, like with regular insurance plans, benefits change and what you chose originally might not be working for you now.

November 15 through December 31 is Medicare open enrollment every year, and if  you have a Medicare Advantage/Medicare HMO plan and you aren’t happy, or your doctor is no longer accepting the plan, NOW is the time to make a change and you don’t have to go through medical underwriting to be accepted.

Medicare Supplements don’t have quite as liberal rules around changing, but there are ways of doing it. BUT, generally you will have to be able to go through underwriting screening and be accepted. And that’s usually the problem. When you initially become eligible for Medicare, you have a six month window (three months before and three months after your birthday) to enter any supplement plan that you want. No underwriting. You can be a medical train wreck and they will still take you. However, if you have a supplement and it’s become too expensive, you can make the change to an HMO plan during the annual open enrollment period.

In Los Angeles County, and several other counties in California, the Medicare HMOs (aka Medicare Advantage plans) are free, so if money’s getting tight a Medicare HMO might be a good solution to your situation. If you are having trouble navigating the coverage waters of Medicare associated plans, call your agent. Or me; I’d be glad to help you figure out your options.

Be well!

Many people think this is something you get in your late 60s or early 70s. You can, but the problem is that rates are significantly higher at that point, and there’s always the risk that you may have developed something rendering you uninsurable.

The time to really start looking is in your late 40s or in your 50s.  Reasons why:

1. Rates will be lower; for with each birthday, the rates will go up.
2. When you have no health conditions, you may qualify for a 10% ‘preferred health’ discount with most carriers. That can add up to worthwhile savings.
3. If you are married and you both apply there is usually about a 25% spousal discount. So you buy two policies for about 25% less each! Unfortunately, as we know, once you hit the ‘older years’ you risk one spouse possibly passing away and you lose that possible discount. Or, one of you may not qualify for coverage, so you lose the spousal discount possibility.

Case in point–I recently had two requests for quotes. My initial presentation was for a $170/day benefit, 5% compound interest inflation protection, a 3 year benefit period, and a 90 day elimination period. One lady was 52, the other was 72.  Standard rate, without any discounts, not taking into consideration the possibility of a preferred health discount. The 52 year old woman’s rates per year were $2329/year. The 72 year old woman’s rates were $7800/year! And those were the least expensive rates from the three companies I queried.

So even though $2300+ a year is not cheap, long term care costs in California at this time can be as much as $80,000 per year, or more. Compare $2300 vs. $80,000. All of a sudden, it seems manageable doesn’t it?

Also, while carriers won’t guarantee it, the majority of the time carriers will not raise rates on existing policies. So locking in that $2300/year could be helpful in a few years as you are looking to retire and your income is going down.

So at least do some checking; you can’t make a good decision without good information. If you have an agent you trust, get a quote or if they don’t sell long term care insurance, ask for a referral to an agent that does. And if you’re in California, I’d be glad to help you.

Be well

Even though I sell insurance for a living I don’t like to see people pay more than they need to. That doesn’t mean the least expensive coverage is the best way to go either. But there is a happy medium often times.

Life insurance rates overall have come down over the past few years so if you purchased life insurance more than 4-5 years ago, it might be time to see if there is something less expensive for you. Why not? You also have to see if what you have is sufficient. If you’ve had another child or two since you last bought a policy, it’s time to make sure that is still okay.

Long Term Care insurance–well, none of us are getting any younger, so if you are in your late 40s and up, you might consider at least learning about it. Maybe get a quote too. The old thinking was that this is something you buy in your late 60s, early 70s. By then, rates can be at least double what they would be in your 50s. Plus there’s the risk of developing a health condition that could either keep you from getting a 10% preferred health discount or rendering you uninsurable in general.

Annuities–see my September 30th post on annuities. They can be a great move in this economy if you don’t need the money right away and there aren’t enough antacids in your house to withstand the stock market volatility.

So don’t participate in the recession. If you are a business owner, you still need to market. Those that stop, their businesses don’t grow. You might not grow as much, but growth of any kind is good right now.

Be Well!

An annuity is actually an insurance product that gives people a guarantee on their investment. At least the fixed annuities and fixed indexed annuities do. The stock market is a scary place to have your money these days, especially if you saw the Dow drop nearly 800 points Monday! It didn’t plummet that much after 9/11, which doesn’t make me feel very good.

Annuities are life insurance products that guarantee your principal. Fixed annuities will make the commitment.  The variable annuities won’t, as they are directly invested in the stock market. If you are in your 20s and 30s, you may not mind the loss because you have time to make the money again or wait for the market to rebound. Not that it did after the mess of 2000, but it could.

But if you are in your 40s and up, we baby boomers aren’t going to have the time to re-save. I’ve moved a good part of my money into annuities over the past 3-4 years. There are different kinds, with different time frames, it is not a one size fits all product. Talk to your insurance or financial advisor to see if this if an annuity might be a suitable direction for you to go.  I use them for people that have left jobs and don’t want to leave their 401k or 403b behind. But they don’t have the stomach for the stock market. The other plus on this is that when you leave an employer sponsored retirement plan is that you will be starting an IRA. The main reason to move your old retirement plan is that if something happens to you, ODDS ARE THAT YOUR BENEFICIARIES WILL GET THE ENTIRE AMOUNT AT ONCE! Talk about ugly tax consequences.

By moving it into an IRA, whatever the vehicle, an annuity or whatever, you and your beneficiaries retain control and the money can be taken out over time. This is referred to as a ’stretch’ IRA and you need to know about this.

If you are concerned about the stability of insurance companies, especially after AIG being ‘bailed’ out, or rescued, or ‘whatevered’, what you need to realize is that the insurance segments of AIG are sound. There are reserve requirements of 103% of the face value of policies that must be held, not flying around. What got them in trouble was poor investing by their other business units.  Remember, in 1929, the banks went under. The insurance companies held strong.

So take a deep breath and hang on. It’s going to be a bumpy ride!

I was asking my business partner about these in light of the current economy. His only response was on the economy, and to quote him, ‘Ruff” (see picture at the bottom of this post). Supplemental insurance can be sold in a few ways, and whether or not it makes sense depends on your personal philosophy on insurance. And yes, some people outside of this industry have insurance philosophies. These are plans you will hear about that provide extra coverage for cancer, accidents, hospitalization, critical illnesses such as strokes and heart attacks.

These may be helpful to you, but you really need to evaluate the cost versus what you get, IF you have an occurrence. The main thing that bothers me about the way I hear a lot of agents sell them, and only sell supplements, is that they describe them as ‘paying you money for what your main health insurance doesn’t cover.’ It often sounds like they make up the entire difference, and they don’t generally.

They don’t coordinate with your main insurance most of the time. They send you the specified amount after you file a claim if it meets the criteria. Then it’s up to you, if you spend it on non-medical expenses, which could be helpful, or you use it to pay medical costs.

Some employer groups will offer these to employees at the employees’ expense to enhance the benefit package. Depending on what you buy, it could be paid on a pre-tax basis, which is good for the employer and the employee. Before you go forward with it, ask the following questions:

• Is there a limit to the number of times I can file a claim?
• Will the rates ever go up?
• What does this cost each month, and what is the potential payout?

These are just a few of the questions you need to ask. These types of plans are mostly offered in conjunction with group health insurance, but some can be offered on an individual basis. Wherever you are buying it, make sure you understand what you are getting and keep asking questions until you are satisfied.

Of course, there is always the alternative–Be well!

However, whether you are looking for an individual plan for you and/or your family or a group health plan, if this isn’t your forte, seriously consider using an independent agent. I’ve dealt with several people during my time in business that had gone to a major site to pick their own, then they were unhappy with it. There are several things that can be phrased in different ways, and if you don’t know all the nuances you might end up with something other than you thought. Many of these huge national sites also have agents available by phone you can call for help, but from what some of my clients have told me, trying to get the same person a second time especially if it’s a couple of months or more after you bought the policy can be tough.

By going to an independent agent, whether they are down the street or just established with a private agency in your state, if you have selected a good agent, they will be there if down the line you have a problem. I tell my clients that I don’t disappear after a sale, that I remain available to them in case there is an issue. I also tell them that I return phone calls usually the same day. That may sound like pompous horn blowing over a dumb little thing, but it you’ve ever had an agent evaporate on you, you’ll agree that it’s not.

I also tell my clients that I ‘do the shopping’ for them. On my web site I post the pricing and benefits of all the available carriers that I represent. So you could certainly go to my web site, find information, select a plan and apply online without ever talking to me. But I like to talk to people, so if you do go to my web site, let’s talk about what you have found and see if it will really fit what you are looking for. I look at the nonsense of individual health insurance and group health insurance plans day in and day out, so sometimes I can point out small things you might have missed. My goal is to help people find what fits their needs, not mine, and frequently I talk people down in price, spending less than they would have on their own.

Sometimes people think that by going to a carrier (insurance company) directly, then can save money. My services and those of any other independent agent, are free, whether you end up buying from us or not. We are paid by the carrier we place the business with. So our consultative services work for you–you don’t have to call a bunch of carriers to see what’s available, because I promise you–they all think they have the best thing going and it’s not always true. They won’t tell you about the ‘comparative pitfalls.’ So deal with an independent agent, and get objective information on your plans.

We also know about the subtle differences between carriers when it comes to underwriting health issues. They don’t tell us everything, because honestly, with some agents that would be like giving away the answers to the quiz. But there are some carriers that are certainly easier to work with than others.

So use our expertise and willingness to help you if something goes awry–Be well!