Ask Colleen King

In my last article I talked about the impending herd of new graduates, high school and college, and that people are now needing to address what to do about their health insurance.

Again, If your high school grad is going to college, then of course they can stay on your group health plan if you want them to. The health care reform bill has passed, one of the FEW things that comes into effect this year is allowing overage dependents up to age 26 to stay on their parents’ plan. That is supposed to to go into effect September 23 this year, but most major carriers have said they will implement this early. But should you do it?

Check the cost of doing this–if you only have one child it might be more expensive to go that way. if you have more than one child on the group plan, usually it is the same cost regardless of the number of kids. So ask.

Other options to consider–There are short term health plans available that I refer to as ‘accident and illness’ plans. Generally they don’t cover maternity, routine care or anything pre-existing. But if someone gets sick or injured, which tends to happen in your 20s, then you are covered subject to the deductible. Because they don’t cover pre-existing conditions, the underwriting review period is very quick and these can be set up in a couple of days usually. They can either be purchased on a month to month basis for a maximum of 6 months, or if you know specifically how long you will need it you can purchase a certain number of days. It’s affordable–one carrier I use for these, in Los Angeles County a 22 year old can get a policy with a $1000 deductible for $87/month. Or if you knew you only needed one month, or 30 days, that same coverage would cost $51.30.

Or, if you’re not sure what the future holds for your new grad, no job prospects on the horizon, you would probably want to consider a regular individual health plan. Rates on these really run the gamut, so I won’t go into a lot of detail here, but for a 22 year old male, in a Northridge zip code, standard rates range from $44 – $440/month.

So there are ways to get your new grad covered; consider talking to an independent agent to sort through the best options for you.

Subscribe above, and keep apprised of insurance happenings. It’s not necessarily as dry as it sounds.

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May into June is such a great time for families as their kids are getting ready to graduate from high school or college. A time of pride, sense of accomplishment, it’s great. As I drive around the LA area I see the signs of upcoming graduation ceremonies and it takes me back. We won’t go into how far back.

But it’s also the time to figure out what to do about health insurance. If your high school grad is going to college, then of course they can stay on your group health plan if you want them to. But in general the landscape has changed. Many people are unemployed, or their companies have dropped their health plans. Or it is way too expensive to keep dependents on the plan. Or new grads are coming into an environment where jobs are scarce, and jobs with benefits, even more scarce.

Now that the health care reform bill has passed, one of the FEW things that comes into effect this year is allowing overage dependents up to age 26 to stay on their parents’ plan. That is supposed to to go into effect September 23 this year, but most major carriers have said they will implement this early. But should you do it?

Check the cost of doing this–if you only have one child it might be more expensive to go that way. if you have more than one child on the group plan, usually it is the same cost regardless of the number of kids. So ask. Many times it is more cost effective to go to an individual plan, but if you child has a health condition that will keep them from getting coverage, then leaving them on the plan is the way to go.

Next, some options if you decide to buy insurance on your own
A 3 minute Video on what’s happening this year because of health care reform.

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I saw this article title and had to look at it a couple of times. Deductible on a life insurance policy? That brought up all sorts of morbid concepts for me so I decided to read it.

Thomas Jurek, an agent in the Midwest, had an interesting article published in the Agent Sales Journal on this last December, and what he was pointing out was a different way to assess your life insurance needs and planning. His definition was that it was the difference between what a family needs and the amount they will receive at the time of the breadwinner’s death.

Most agents recommend an annual or biannual review of insurance in place. That way you can make sure there’s enough, or equally as important, do you still need all that you have? When kids have left the nest and are financially independent, a couple nearing retirement might not need as much life insurance.

Basically, the way I read this, is rather than the deductible being what you pay before insurance kicks in, this is more like what are you going to be stuck paying for, or going without, based on how much life insurance there is when the primary earner dies. For younger families with kids you have to allow for college and weddings. What assets do you have that you need to protect? Rental property? what if you lose the tenant? What do you have in savings and are you willing to deplete that if someone dies and the life insurance isn’t enough to meet your mutual obligations?

Lots of questions, and multiple answers for most scenarios. Bottom line, call an agent you trust and see where you stand. It could keep your family from having to make some really tough decisions at a difficult time.

Subscribe and regularly receive little gems like this–have a great week!

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This news at least when it comes to health insurance was better than Nutella pancakes on a weekend. I’m surprised I had to read this in the L.A. Times Sunday morning and didn’t get email notification from Anthem, since they are really good about keeping agents in the loop on things. Especially one this important. Click here to read the full article–it’s short!

As you recall, things went crazy as the media blared stories of rate on individual plans with Anthem going up 39% as of March 1. Of course, the way it was phrased it made it sound like ALL plans were going up, and that was not true. Anthem then agreed to delay the implementation of the increase until May 1 while an independent firm came in and audited the increases. That’s not done yet and I’m still dying to see the outcome.

So now, it’s not clear when the increase will come, but you know it will at some point. Carriers have to give at least 30 days notice when raising rates, so it would be June 1 at the earliest. I’ve spent the past few weeks working with my clients to get them enrolled at the ‘old’ rates if they were changing to Anthem plans. I kept pushing them to apply so we could get effective dates before April 30 so they wouldn’t be hit with the increases and would have a 12 month rate guarantee. At the old rates.

I’m glad I have more time to help people save on their insurance costs wherever possible. Nothing makes me happier than to save people money on their insurance and keep decent coverage. Have a great week!

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Even though the big, massive health care reform bill has passed, not much will be changing for the next couple of years. So if you’re on your own and needing to buy an individual plan for you and/or your family, how should you do it? Call an independent agent, call an insurance company, or just go online and not deal with any of those pesky people?

Well you know what I’m probably going to suggest, but here’s why. If you go directly to a carrier, they can only tell you about their products. You can go to one of the big online ‘anonymous’ type sites, but do you really know what you are looking at? If you are versed in health insurance, of course you can do this on your own, no sweat. But I find most people are still confused and if they do it on their own, they are surprised with what they end up with.

Here’s another reason to go with an agent. I had a client approved this week, and she had a couple of relatively minor issues, but instead of getting approved at a standard rate, she was rated up 50%! I called her, clarified what the circumstances were for the two reasons given for the increased rate and then emailed my account executive at the carrier. I explained the circumstances, and was hoping he could get the rate from a 50% increase to maybe just a 25%. Imagine my surprise when he came back with a STANDARD rate. I was thrilled, my client ecstatic, the world was a happy place.

Does this happen all of the time? No, not even most of the time. To me, in looking at the situations these issues were borderline. And my account guy being the gem that he is, he agreed. There’s a strong probability that if I had just called underwriting, I wouldn’t have gotten the standard rate back. But maybe I would have.

Point is in all this, most individuals wouldn’t have known where to go with this, would have just said oh well, and either kept the plan at the higher rate or dropped it all together. One of the big reasons for health care reform was for the states where there was little or not competition. And there are some states with only 1-2 carriers. But in California we have 6-7 major carriers and some smaller ones, so there is plenty to chose from. That’s another reason to use an independent agent, so they can help you find what you want and with a carrier that’s best suited for your situation.

Be well!

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On April 15th, Tax Day ironically, Congress voted to extend the 65% COBRA subsidy eligibility period through May 31. Meaning, if you are ‘involuntarily terminated’ from your job and not for ’cause’ (’cause’ meaning you did something wrong) you will be eligible for this extension. Eligible folks can have the subsidy of 65% up to 15 months under the current program. Depending on how much that brings down your cost, you might also consider looking at an individual plan but I know that subsidy is tempting.

Since the news came out today that California’s unemployment in March is the highest ever, 12.6%, up from 12.5% in February, that’s probably a good thing. And most likely California’s CalCOBRA program will follow suit as it has before. From the article above, it sounds like Republicans were balking at this bill which also included increasing unemployment benefits and a few other things (click here to see what all) because it supposedly will add $9 billion to the budget deficit.

After health care reform, what’s another $9 billion?

Be well!

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In the recently passed health care reform bill (yes, THAT again) one of the things that was addressed was eliminating co-pays or cost sharing for preventive services. I haven’t heard how that exactly is going to work, but if it’s like other things I’ve seen, not all things labeled ‘preventive’ will be covered. This link is from another state, but the types of services recommended are pretty standard.

Some carriers on their plans already have low or no co-pays for mammograms, Pap smears and PSA blood tests. Colon cancer screening, usually just a smear but sometimes colonoscopy, is included. Check your plan documents or call your carrier to know for sure. But more expensive things, like most ultrasounds, scans, etc., are not considered regular preventive care. Those are considered more diagnostic in nature, meaning someone is probably looking for a problem, so it’s going to be subject to your deductible.

I’ve come across something in the newspaper and television lately that I’m going to check out and you might want to also. And organization called HealthFair.com offers screening packages of tests. You can get a cardiac screening which includes an EKG, ultrasound and arterial stiffness exam, a vascular/stroke screening which includes a carotid artery ultrasound, abdominal aorta ultrasound checking for an aortic aneurysm, and another test that checks for peripheral artery disease. Or you can do both for $199.

These mobile fairs are all over Southern California and I believe across the country. I’m not endorsing yet them as I’ve not used them before but I’m going to check this out. I had a carotid ultrasound earlier this year that WITH the insurance company discount was over $400. I think it’s something to look into though, if you are in your late 40s and up. They offer different series of blood tests, there’s all kinds of things. Cost for these screenings may vary by locations, so don’t hold me to this, check it out for yourself.

This sounds like a cost effective way to at least get a baseline, but is not intended to replace an exam by your doctor. I’m signing up, you might want to check out their site. Got to save where you can!

HealthFair.com

Be well!

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Okay, health care reform–woo hoo! now what? Today’s Los Angeles Times has a good brief overview of some major points of change and I’ve included some of them here. Along with some questions that I feel still need to be answered.

WITHIN A YEAR
* Provides a $250 rebate to Medicare prescription drug plan beneficiaries whose initial benefits run out. This is good because that whole ‘donut hole’ thing doesn’t make a lot of sense, particularly for people on limited incomes.

AFTER 90 DAYS
* Provides immediate access to high-risk insurance pools for people who have no insurance because of preexisting conditions. Well, we already have a high risk pool in California, referred to as MRMIP. Problem is, it’s really expensive and half the time, you can’t get anyone on it due to a lack of funding.

AFTER SIX MONTHS
* Bars insurers from denying people coverage when they get sick. What does this really mean–ANY coverage, or high cost services, or things that weren’t going to be covered to begin with?

* Prevents insurers from denying coverage to children who have preexisting conditions. Children, not adults yet. And what about rates? Anything about cost containment included in here?

* Bars insurers from imposing lifetime caps on coverage. There are some low end plans that have ridiculously low limits, either lifetime or per year. Most though, at least in the California individual market, have limits of $3-7 million lifetime. Most of us won’t ever come close to that, so this isn’t always as big as it may initially sound. Once again, for me, this means you really need to look at what you are buying and have a good agent you can talk to about what you are buying.

* Requires insurers to allow young people to stay on their parents’ policies until age 26. Well, most plans they could already stay on until 22 or 23 if they were full time students. If they have health issues, this is good. Depending on the family, if they don’t, it could be more cost effective to put them on their own plan.

2011
* Requires individual and small group insurance plans to spend at least 80% of premium dollars on medical services. Large group plans would have to spend at least 85%. With most carriers, that is almost happening now the majority of the time. Problem is, don’t you still want to look at cost containment? If you HAVE to spend it, it will be spent, but what about waiting for a rainy day and keeping something in reserves?

2013
* Increases the Medicare payroll tax and expands it to dividend, interest and other unearned income for singles earning more than $200,000 a year and joint filers making more than $250,000. Really makes you want to go out and achieve, doesn’t it? This moves the tax up to 3.8%

2014
* Provides subsidies for families earning up to 400% of the poverty level to purchase health insurance.
* Requires most employers to provide coverage or face penalties.
* Requires most people to obtain coverage or face penalties.

On all three of these for 2014, let’s hope the economy has turned around otherwise there will be a ton of people on that subsidy level.

Be well!

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With all the furor over the Anthem Blue Cross rate increase on individual health plans, and rate increases in general, there’s a lot to keep track of for us independent agents. And up until now, I would have sworn it wasn’t possible.

When rate increases on health insurance were coming, used to be you would get a list of who was going to have an increase, when and how much. I would always use this to send letters to my clients to let them know hey, this is coming and when you find out how much it is, let me know if you want to look at other plans. Something has been happening in our industry that keeps me from being as on top of that as I used to be.

Now, instead of getting ‘The List’, many carriers have gone to ‘anniversary’ increases. So every twelve months from when you were first approved, that’s when applicable increases apply. Not in one fell swoop in February like Blue Shield used to do, or March like Anthem. NOW, they have places to go to look for these reports. Or its embedded in your client list. My point, I’m just not as on top of this as I would like to be. I want my clients to know I’m there for them in case they want to look at options.

I apologize to my Aetna clients, but Aetna has gone to this, and the system takes some manipulation to get reports so I’m a little behind. But when I did pull the reports, I was really surprised at what I found. In looking at my 20 clients listed for whatever time period this is, the increases ranged from a low of 0.20% to a high of 11.67%. The 11.67% was on a client over 65, so that really was a minimal increase–relatively speaking.

This was amazing to me, since you always expect something horrendous. Not that anyone wants an increase but these were relatively small. In fact, 10 of my folks were going up less than 1%. Aetna has done something different from the other carriers for a while, and that is basing rates on the older spouse when looking at a couple rather than the younger. Some others are just starting to do that now. When this first came about, the agent community didn’t like it, but between that and a couple other things they do, maybe this is a more realistic pricing model. After all, the 62 year old doesn’t get priced as the dependent on his 29 year old girlfriend.

I would estimate 98% of my clients are in Southern California, predominantly Los Angeles and Ventura counties. Health care costs, ergo insurance prices, tend to be higher in Northern California.

Maybe there’s hope for this industry–it is possible to have minimal rate increases, isn’t it?

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Now that I’ve heard this from three different sources, I believe it. Because of all the flack from Anthem Blue Cross has received from the impending rate increase on individual health insurance policies. At the request of State Insurance Commissioner Steve Poizner Anthem will hold off this current round of increases until May 1. During this time period an outside actuarial firm will come in and review everything to make sure the increase overall complies with state law that requires that a  minimum of 70 cents of each dollar is spend on medical care.

Well wait a minute–shouldn’t the commissioner have required this outside audit/review last November when Anthem filed the proposed rate increases with the state? Why wasn’t this a big deal then? You see, it’s not like this totally came out of nowhere. Rate increases are submitted by all carriers to the Department of Insurance, and they are ‘approved.’ Generally speaking. As it stands now, apparently the DOI can’t decline to approve rates. Oh that’s right, Poizner’s running for Governor. Maybe that was it.

It sounds like maybe this wasn’t reviewed line by line, or they looked at an aggregate compilation of the increases. So what can you do about your premiums as they go up?

• Call your agent and see what else is available. Even if you have pre-exsting conditions and can’t change carriers, you often times can downgrade your policy. But be sure it makes sense to do so. If you have an ‘expensive’ condition, it might be worth staying on the more expensive plan to keep your medical costs manageable.
• See if it’s less to put family members on other policies. Not everyone may as high a level of coverage. And couples wanting to have children? Many times I put the husband and wife on separate plans because plans that cover maternity are much more expensive, and they don’t both need maternity.
• Consider a health savings account eligible (HSA) plan–often these are less expensive and if you’re open to paying for the occasionally office visit they work well. Plus there are tax benefits to having the HSA.

And there are other things to consider, but first and foremost, start with your agent. And if you don’t have one, I’m always around.

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