Monthly Archives: June 2013

Aetna Has Joined The ObamaCare Wall Of Shame

From our sister Coverage California Facebook Site:

“The latest blow was struck June 15th when Aetna announced certain California individual health plan holders would lose their coverage effective December 31, 2013…”

https://www.facebook.com/notes/coverage-california/wall-of-shame-bad-insurers-need-to-be-shamed/187046321455419

 

An Early Look At California’s New Health Insurance ObamaCare Marketplace

October 2013 marks a milestone in the implementation of ObamaCare national health care reform, as a new California public healthcare exchange kicks off its first open enrollment season. We have been monitoring preparations for this event, and offer a sneak preview of coverage in California’s new health insurance marketplace.

Reacting quickly to new federal law (ObamaCare) and guidelines, California is the first state to implement its version of the public health benefit exchange system, named “Covered California.”

What is a Health Benefit Exchange?

CoveredCA Health Plan Benefits Summary

“It is a new insurance marketplace in which individuals and small businesses will be able to purchase competitively priced health plans using ObamaCare federal tax subsidies and credits beginning in 2014,” according to Covered California Director Michael Lujan.  Also see www.healthcare.gov.

After attending meetings and listening to new Covered-CA Director Michael Lujan, I have accumulated a personal stack of Post-its, which I find particularly interesting, and I hope you do, too:

Facts & Features of the Covered California Health Benefit Exchange

  • There will be separate exchanges for individuals and small business.
  • Medical questions will not be asked; all will be accepted.
  • Financial questions will be asked only to qualify you for possible subsidies.
  • Applicants must be U.S. citizens or otherwise “legally present.”
  • The private insurance market will continue to exist and compete with public exchanges.
  • Rates & Information can be obtained through certified Assistors and Agents (e.g. Derendinger Insurance).
  • An Assistor is limited to providing information on Covered California quotes, whereas a certified agent may provide Covered California quotes as well as quotes from competing private health benefit exchanges and even individual insurers e.g. Kaiser, Aetna. (See updated story on Aetna) Also, a certified Agent can provide ongoing claims assistance and other service issues.
  • There is no extra cost to consumers for using the services of an Assistor vs. a certified Agent.
  • Open Enrollment is expected to begin in October, with coverage effective January 1st.
  • There are four enrollment methods:  Paper, Phone, Fax, or Web.
  • Public exchanges will limit plans to four categories, Platinum, Gold, Silver, and Bronze, which must line up with a coverage value of 90%, 80%, 70%, and 60%, respectively.
  • Participating insurance companies will develop new plans to fit into these “metallic” categories.
  • Rates will be updated this summer.
  • Rate Bands will vary according to one-year brackets, versus the current 5 or 10 year brackets.
  • There may be no greater than a three to one ratio from the most expensive to least expensive age band.  (This should present some challenges to the status quo, in my opinion.)

Is The Health Benefit Exchange Marketplace Good for California Consumers?

Paraphrasing Alan Katz, a long-time health industry observer:  “The new Covered California Health Benefit Exchange is not going to be as good as some people hope for, yet it is not going to be as bad as others fear.”  In between these lines lies the potential of this reform, which include guaranteed medical plans for early retirees, hope for families burdened with pre-existing medical conditions, and affordable healthcare plans for 7 million* uninsured Californians. *California Healthcare Foundation (December 2012)

For updates on California’s changing healthcare system, follow us on Twitter:

Follow Us: https://twitter.com/DerendingerIns

Editor’s Note:  The Derendinger insurance agency has served the California insurance market for 54 years.  Marc can be reached at (408) 252-7300.  You may find more information at www.derendingerinsurance.com.

 

Updated Travel Assistance Plan From FrontierMedex

Many California residents have a free travel assistance program through FrontierMedex.  If you are covered by a group life insurance plan, underwritten by Standard Insurance Company, then this applies to you. TravelAssistance  FrontierMedex can be found at several local organizations (see a partial list below).

Who Offers A Travel Assistance Plan

The San Jose Police Officers’ Association, the City of Campbell, City of Santa Clara, City of San Jose, San Andreas Regional Center, Mountain View Police Officers’ Association, Santa Clara County Central Fire District and much more.

IS THE RIGHT PERSON GETTING YOUR MONEY? Life Insurance Beneficiary Designation

The Bad Life Insurance Beneficiary Designation

Since 1968, our insurance office has handled many Life Insurance death claims, and seen some unfortunate cases where a bad life insurance beneficiary designation directed death benefits to unintended recipients e.g. old and long forgotten girlfriends, boyfriends, former spouses (even the wrong former spouse), and

A Good Life Insurance Beneficiary Designation

so on. Please be advised your Will or Living Will (Revocable Living Trust) cannot override a life insurance beneficiary designation in California. What this means is if you intend your trust to receive life insurance benefits directly from the insurance company, then it is necessary that your life insurance beneficiary designation be updated to include the trust/trustee’s name. Failure to do this has unintended consequences.

Unintended Consequences

For example, we recently handled a death claim in which the deceased’s disabled son was named beneficiary, and a Special Needs Trust had been established. However, the insurance company refused to pay death benefits directly to the trust/trustee because the trust was not mentioned in the beneficiary designation. Such a situation has negative implications for State and Federal disability benefits. We all want to avoid unintended consequences. If you have any type of trust, we encourage you to discuss the issue of the life insurance beneficiary designation with your attorney and update personal, employer and union sponsored life insurance policies accordingly..

Remember, your employer, union, retirement plan administrators, and your private insurance policies all have separate life insurance beneficiary forms. Keep a list!

The Beneficiary Form

Now is the perfect time to review your Life Insurance Beneficiary Designation. There are two areas on most Beneficiary Change forms, which require completion in order to name or change your Beneficiary:

1). Primary Beneficiary Name
2). Contingent Beneficiary Name

How it works: If you die while the Primary Beneficiary is still living, the Primary Beneficiary (or Beneficiaries) will receive 100% of the policy benefits, and the Contingent Beneficiary will receive zero benefits. Remember, the Contingent Beneficiary is a “back-up” beneficiary, in the event your Primary Beneficiary has pre-deceased you. Also, it is acceptable to name more than one Beneficiary by listing each name, with the corresponding amount of insurance.

Life Insurance Beneficiary Designation Examples

For example: John Smith, Brother, born March 21, 1963- $50,000 and Sally Smith, Sister, born August 1, 1959- $100,000.

If the Beneficiaries are receiving equal amounts, then you may state “Equal Shares” after their names. Please do not name minor children as Primary Beneficiaries nor as Contingent Beneficiaries. This leads to all sorts of problems, as the insurance company will not pay death benefits to a minor. Your survivors will be required to go to court and ask a judge to name a financial guardian. Even if the judge appoints the same financial guardian as requested in your Will, the court’s permission may still be required for certain types of investment decisions. A mishandled life insurance beneficiary designation results in a cumbersome, frustrating, and costly way of fulfilling your wishes.

NoVisionInsuranceConclusion

Let’s be smart and think: Is the right person getting my money? Review your life insurance program today!