Posted: 11:51 am, 04.23.2014
Before making major changes to small group health plans, agents and brokers should take note of a new Virginia law. If you’ve sold or renewed a plan in 2014 for groups with 50 or fewer employees, you’ve likely run into a situation where the health carrier required the group to cover pediatric dental benefits as part of the health plan unless the group could attest to having an exchange certified stand-alone dental plan. This will no longer be necessary in 2015.
HB33 and SB484 clarify that a carrier offering plans in the small group or individual markets is allowed to offer health plans without pediatric dental benefits as long as two conditions are met: First, there has to be a qualified dental plan available to the small group or individual and, second, the carrier must disclose that the pediatric dental benefits are not included in its health plan. Simple. Since carriers are offering exchange certified dental plans both on and off of the exchanges in Virginia, beginning in 2015, groups and individuals will once again be free to shop for their medical and dental benefits the way they always have.
One of the unintended consequences of health care reform was that employers with 50 and fewer employees and people who shopped for insurance on their own were effectively required to purchase pediatric dental coverage as part of their medical plan whether or not the purchaser had children and whether or not shoppers already had a family plan with the dentist and plan design they preferred.
How did this strange rule come to be? With the launch of insurance exchanges in 2014, people have access to two distinct marketplaces in which to shop for coverage. However, there are significant differences in the rules between the on- and off-exchange markets.
Inside the exchange, people can purchase all of the required “Essential Health Benefits” but they can choose not to purchase the pediatric dental benefit. The mere presence of a stand-alone dental carrier option on an exchange relieves medical carriers of the obligation to provide dental coverage for kids and relieves childless adults of the responsibility to purchase pediatric dental coverage. This makes sense. Nearly everyone with dental coverage gets that coverage separately from their medical plan.
Outside the exchange, individuals and small employers were effectively required to purchase pediatric dental coverage as part of their larger health insurance plan. This inequitable situation led to several negative consequences which are true for 2014 but, in Virginia, go away in 2015 and beyond thanks to the Legislature.
First, in 2014, medical carriers could imbed pediatric dental coverage into their medical plans for individual and small employers and require that a large medical deductible be met before any dental benefits are paid. In such a scenario, parents would take their kids to what they thought was a covered dentist appointment only to discover that they had failed to meet their medical deductible.
Second, medical carriers were essentially forced to sell pediatric dental coverage to adults who had no children.
Third, with children covered by a medical plan, parents might have been tempted to drop their children from the family’s current dental plan only to discover that their child’s dentist was no longer in-network.
Fourth, based on a recent statewide survey, nearly half of Virginians (48%) said they would be at least somewhat likely to drop their own dental coverage if their children were covered through their medical plan. Having fewer adults with dental coverage was certainly not the intention of health care reform.
It appears clear that the unintended consequences of health care reform will not be fixed in Washington, D.C. Thankfully, in this one area, states are in a position to make a difference, and the Virginia General Assembly had the foresight to do just that.
Posted: 7:03 pm, 02.26.2014
Licensed insurance professionals, particularly life insurance agents, understand how uncomfortable some folks can get when the topic of death is brought up.
At the risk of triggering a similar reaction from readers, blogger and insurance agency consultant Paul M. Mallet asked:
“Would you – as an insurance agent – do anything differently if you knew today was going to be your last day?”
It was a good frame of reference not only for life insurance agents, but agents in all lines, and a business owner in any field.
Read Mallet’s blog on the website for Postema Marketing Group, a marketing organization providing life insurance products to independent agents nationwide.
Survey: 7 in 10 of employee benefit advisors predict negative impact on group sales due to Obamacare
Posted: 10:18 am, 02.24.2014
Not surprisingly, employee benefits advisors believe President Obama’s signature legislation – the Affordable Care Act – is not good for their business or the business of their clients.
LIMRA, an insurance industry trade group, recently posted a blog on what members of a panel think about Obamacare and its effect on group benefits.
Here’s what LIMRA wrote:
A full 72% of surveyed members of LIMRA’s Employee Benefits Advisor Panel predict that health care reform will have a negative impact on sales of group medical insurance.
While that prediction alone is not surprising, size of the employer can make a difference on perceived impact. Advisors who represent small employers (fewer than 50 employees) are far more concerned by the impact of Obamacare (with 77% saying it will have a negative impact) than advisors who represent larger employers (50 or more employees), only 62% of whom felt the new health care law would have a negative impact on group benefits.
Members of the employee benefits advisor panel were surveyed in the fourth quarter of 2013 on their predictions and opinions on a number of issues including ACA and its implications. Other findings from the survey include:
- Fifty-five percent of all surveyed advisors say it’s likely or very likely that fewer employers will offer medical benefits in the future. Broken down by client group size, 60% of advisors who sell in the small group market think that fewer employers will offer medical benefits, while just 48% of advisors who sell in the larger market say that is a likely outcome.
- Employee benefits advisors anticipate that about 20% of their employer clients will shift to health care exchanges, as will 40% of their individual clients.
- Four in five advisors believe young adults, commonly referred to as the “Young Invincibles” would rather pay a fine than purchase health insurance.
- Three-fourths of advisors believe that as a result of health care reform, more employers will make any non-medical benefits they offer 100% voluntary in the future.
While employee benefits advisors were negative about group sales of medical insurance, they were more evenly split on individual medical insurance with 42% of advisors citing a potentially positive effect on sales and 45% citing a negative impact on sales.
The survey also covered the impact of the Internet and social media on shopping for insurance. A separate LIMRA study of Gen X and Y consumers found that many expect to have the option to purchase financial products how and where they want — including online. Employee benefits advisors are clearly aware of this trend with nearly two thirds believing more simple, lower-cost insurance policies will be offered to consumers who prefer to shop online.
Posted: 12:20 pm, 02.13.2014
Wendy Keneipp, who writes a blog on q4intel.com, a website dedicated to performance consultation for insurance and benefits agencies, posted the following recently:
“An article in Inc. Magazine talks about the difference between overachievers and high performers. I see how this plays out in insurance agencies with great consistency. These personalities are well developed, and I have come to believe that an underlying theme separating the overachievers from the high performers is confidence.”
Her blog post about confidence and how it impacts producers and agency owners was informative and helpful. Read the rest of Wendy’s blog post here.
Posted: 9:35 am, 01.20.2014
Petula Dvorak, columnist for the arguably left-leaning Washington Post, has written a scathing commentary lambasting not only the debacle of the Maryland health insurance exchange launch, but, if one were to take it to its logical extension, the rollout of the Affordable Care Act.
Dvorak uses words such as, “epic bungling,” “disaster” and “incompetence” to describe the efforts of one state to conform to President Obama‘s landmark legislation.
Read Dvorak’s column here: Maryland’s health Web site debacle: A scandal of incompetence
Posted: 10:01 am, 12.20.2013
Out2Enroll, a program created to encourage the lesbian, bisexual, gay and transgender communities to enroll in Obamacare, was launched Sept. 12 with an event at the White House hosted by HHS Secretary Kathleen Sebelius and President Obama’s senior advisor, Valerie Jarrett. Read this entry »
Posted: 10:04 am, 12.12.2013
Robert McCartney, writing in the proudly liberal and Democrat-supporting Washington Post, concisely explains why Md. Lt. Gov. Anthony Brown (D) will be the state’s next governor, despite his oversight of the state’s mega-bungled online health exchange rollout.
Read Robert McCartney’s column here.
It pointless to discuss the problems with the Obamacare rollout or whether or not President Obama lied about Americans keeping their insurance policies when nearly 4 million have already received cancelation letters. Turn on any cable news program – conservative or liberal – or any major newspaper, and the headlines are the same: Obamacare is in a free fall and the Obama administration appears unable to stop it.
There are some truths, however, of which many are apparently unaware or refused to acknowledge as they have been expressed over the past three-and-a-half years.
Here are some truths, with brief explanations or observations. Read this entry »
Posted: 7:21 pm, 11.13.2013
The White House announced Wednesday that the federal health insurance exchange, healthcare.gov, and the state exchanges combined enrolled slightly more than 106,000 individuals during its first month.
The Obama administration said during the ramp-up of the Obamacare website that it was confident it would reach its goal of enrolling 7 million individuals before open enrollment ends on March 31.
The Washington Post reported that in response to the administration’s announcement about the dismal enrollment numbers for October, HHS Secretary Kathleen Sebelius said: “The marketplace is working; people are enrolling. The promise of affordable health-care coverage is increasingly becoming a reality to more and more Americans.”
Doing the math, it looks as if the goal of 7 million will be missed by a hair. Maybe by about 6.5 million hairs based on the current sign-up rate.
Taking my elementary math skills a step further, if we were to use HHS stats for per-month enrollment, the site should reach full enrollment in April 2019.
Only five and one half years too late.
That’s my take.
Posted: 11:10 am, 11.07.2013
We all know people who are irritatingly good at something. People for whom certain skills just come naturally, with little or no effort. At school, they were the guys who always made the team but never showed up for practice. As an adult it’s the guy who plays one round of golf every six months and can still play off scratch. If you’re not picturing someone in particular right now, you’re probably one of those people.
You probably also know about the dark side of that kind of natural talent. It’s never enough. Sooner or later, you need to make the effort. That’s why many lesser sports people often beat out their more talented rivals; they know the value of hard work. No matter how good you are, you can’t avoid it. Think about that kid at school; are they a pro sports player now? I didn’t think so.
Insurance agency owners
We have encountered many insurance agency owners who fall into a similar category. Many of them were very effective producers before they took over. Many became owners through an internal perpetuation. One thing they all have in common is that they need to change their ways before they come to sell the agency. Read this entry »