What's up Doc, DI-style

DI being, of course, disability income insurance. My industry isn't well-known for frequent innovations, so when I saw this in email, my curiosity was piqued:

"Guardian challenges Individual Disability Income Insurance industry with unique features for physicians"

Physicians, like most of us, depend on their wages to pay for things like food and shelter, cars and clothes, and all the rest. And it's not like this niche has gone under-served: along with lawyers and accountants, white collar-focused carriers have long since targeted these typically high-end clients.

So what could Guardian have possibly come up with to merit such a breathless headline?

I looked through the email, and a couple items caught my eye:

■ Enhanced True Own-Occupation Protection means more ways to qualify for benefits

Own-occ has long been the gold standard for high-end DI plans. Briefly, it means the inability to perform the majority of the duties that they one's been trained to perform. Now, this is just a baseline definition, and carriers usually tweak them to make their product more attractive. Any wording that makes it easier to access benefits, as this rider purports to do, has to be a plus.

■ Option to protect student loan debt payments.

This is truly cool, and exclusive to Guardian. I really like programs like this; when carriers think "outside-the-bun" (as with MassMutual's RetireGuard) it makes me smile. Think about it: if your income stream is cut off, how are you paying off your student loan(s)? If you're a doctor or lawyer (for example), you're likely paying off both undergraduate and graduate schools.

There are other interesting provisions, as well, including coverage for hospice care.

Kudos to Guardian.

[Hat Tip: Adrianna Webster]

New York, New Jersey and Your Insurance

On Twitter, a friend of mine asked if damage from bombings such as the one in Chelsea would be covered by one's homeowners or auto insurance. We've blogged before on how commercial (business) insurance policies handle terror-related claims, but this is a very different question.

For example, in this latest incident, condo and car windows were shattered, and it seems possible (likely) that there was damage to nearby residences and vehicles from the tremendous heat and flying debris. So, would these claims be covered?

As I do any time auto or homeowners insurance comes up, I turned to my P&C guru Bill M, who tells me that:

Homeowners and auto policies will include an exclusion for "war or acts of war, declared or undeclared" and the like. But terrorism isn't war, so it's likely covered by both, absent some (unusual) specific exclusion.

Which makes sense. So I asked him if that was something that we'd be seeing soon. Bill doesn't think so, as it would be against public policy, and there's also the question of "frequency of occurrence;" that is, we have a lot more tornadoes and hailstorms (for example) than bona fide terrorist actions [ed: knock wood].

As always, consult your own policy and agent for specific answers about your policy.

[Hat Tip: tsrblke]

Stupid Prospect Tricks

So for several months, I've been following up on a referral. Susie is a friend-of-a-friend, and came to me for some life insurance quotes. We discussed her needs, did a pre-screen, and I got her some quotes. This was by no means a remarkable case - no huge numbers or unusual underwriting challenges - but the outcome illustrates why we have things like Life Insurance Awareness Month.

After sending her a few monthly follow-up nags reminders, I got this in email this morning:

"Thanks for all your follow ups Henry.  We have decided not to get life insurance for me per our financial advisor."

Because I'm terrible at high pressure tactics, and out of respect for my friend (the referrer), I elected not to send this response:

Hi Susie!

Thanks for your reply. I think it's remarkably generous that your Financial Planner has offered to replace your income, pay off your mortgage, and finance your kids' education when you shuffle off this mortal coil.

You did get his signed promise to do so, right?

After all, he has a fiduciary responsibility (even further enhanced by recent DOL reg's) to you, and advising you to self-insure instead of shifting that risk off to an insurance company, it's only right that he accept responsibility for that advice.

Be well.

Tar Heel State Blues: The Saga Continues

So it appears that my prediction that North Carolina's Blue Cross affiliate would skate on that penny-ante huge fine may have been premature. FoIB Jeff M tips us that:

"The N.C. Department of Insurance has levied a record $3.6 million fine against Blue Cross and Blue Shield of North Carolina for widespread problems that led to billing and enrollment errors"

Which seems significant, until we translate it to real-world terminology:

"The N.C. Department of Insurance has levied a record $3.6 million tax on Blue Cross and Blue Shield of North Carolina insureds."

That's because, as long-time readers know, companies don't pay these fines: their policyholders do. Every penny of that fine will now be passed along to the Blues' insureds in the form of higher rates.

Jeff also points out that the carrier will have no problem fronting the cash, "since they've not paid commissions since April, the money is there to pay the fine...and a whole lot more."

Heh.

Oy, Canada (Part 2,740)

It's been a while since we've checked in on the health "care" system of our Neighbors to the North©. It appears that things haven't improved. Take, for instance, the case of Stefan Molyneux:

"Canadians know how awful socialized medicine is, and Canada is plagued with immense wait times and a strained system, which Stefan’s recent experience illustrates."

Here's his story:



"Average wait time for MRI in Canada is 101 days. I got one the next business day."

Coming here soon (the 101 day wait, that is).

Gaming O'Care in the news

Co-blogger Patrick has written quite a bit about the challenges that carriers face regarding the overly generous 90 day grace period enjoyed by folks who buy their ObamaPlans on the Exchange.

Now, some 4 years since they first opened for business on that platform, carriers are beginning to realize just how dangerous that game of chicken has been.

For them:

"They are using [health insurance] until they need it and then when they don't need it, they get rid of it"

That's Patrick, as quoted in this morning's US News online edition, where he and FoIB Louise Norris share some interesting, disturbing insights.

Recommended.

Hey Senator Rubio, Give Credit Where It's Due

Obamacare supporters need to stop giving Marco Rubio credit for the splinter he wedged into Obamacare's fingertip. The splinter is the language Rubio inserted into the 2014 CRomnibus that made Obamacare risk corridor payments budget neutral.

When Obamacare passed, the risk corridor provision - which is a temporary program - was written with very vague language. The program existed but didn't specify where funding was coming from. Theoretically it was going to come from a combination of the profitable insurers and the federal government sending payments to insurers who suffered losses.

Because there was a chance of government funding, the GOP called out risk corridors as a bailout for insurers. To combat the political gamesmanship, the Obama Administration pushed a narrative that the program would pay for itself and pointed to an April 2014 CBO document stating the budget neutrality position.

Based on the CBO numbers, Senator Rubio's risk corridor language shouldn't have been an issue. But like many CBO reports, the actual results are a far cry from their rosy projections. In 2014, risk corridors paid out roughly 13% of what they were supposed to. CMS just released preliminary data for 2015 and have made it clear that they will have another shortfall this year. All of this is resulting in pundits and politicians calling the GOP the devil or heroes.

Unfortunately they've got it all wrong. Marco Rubio inserting language into a budget amendment didn't make the legislation pass. That would come from all of the brains in DC who vote on the bills. It also comes from a Presidential signature making the bill become a law.

In CRomnibus, its not about what Rubio did. It's about the bipartisan approval (57 Democrats in the house and 25 Democrats in the senate) that voted in favor of the bill. And let's not forget President Obama who signed it into law.

These are the elected officials who put risk corridors in jeopardy. They are the ones who should be given credit.

Sorry Marco.