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VCphoto2

I’m Victor Crain.

I am an independent agent representing Aflac, VSP Vision, Delta Dental and Mutual of Omaha insurance.  The purpose of these policies is to help consumers minimize costs associated with using medical services and to meet living expenses while ill or injured without draining savings or investments.  My scope of work includes disability and long term care.

I’m licensed in New Jersey, Pennsylvania, Missouri and Virginia.

You work hard for your money, and you’ll need it for education expenses or retirement.  Most people don’t have enough in savings for either.  Why spend more on healthcare than you need?

In learning this trade, I’ve acquired knowledge about the Affordable Care Act, the Healthcare Marketplace(s), and business reporting that I’m quite willing to share.

As a market research veteran, I have access to information from a variety of sources, and I’ll be sharing that on this site.  What the media promotes and what you really need to know aren’t necessarily the same thing.  I’m here to help.

Welcome on board.

If you need to reach me:

Cell:  609 510-3712

vic@craininsurancellc.com

The High Cost of Health Insurance: Talk v. Action

My background is research. Inquiring minds really do want to know, and with a few phone calls and quality time on the Internet, you can find out a lot.

In my work, I’ve run into three types of people:

  • Those who charge high prices for health insurance
  • Those who complain about the high prices for health insurance
  • Those who do something about it

Yes, really, the third category exists. Apart from the Marketplace, I know of at least two good ways to cut costs dramatically without skimping on coverage. These are solutions provided by established organizations, not something I’ve cooked up. However, most people don’t know about them.

Best of all, they don’t involve any political uncertainty. “Trump” is not part of the vocabulary for these solutions.

I’m not going to explain them here, because I might run afoul of regulators saying that I’m providing insurance advice in a state in which I haven’t paid for a license yet.  (I’m licensed in NJ, PA, MO and VA.) If I don’t handle your area, I will still tell you what the solutions are and provide a referral to someone who can help you.

So if you want more information, you’re going to have to call or email me.

609-510-3712

vic@craininsurancellc.com

This is my way of trying to be useful.

Vic Crain

Small Business Health Insurance: Missing the Point

The Centers for Medicare and Medicaid Services (CMS) issued a press release on 15 May, mark_twain_congress_quote-511892offering new ways for small businesses to enroll in health insurance in addition to the SHOP marketplace provided by the ACA. The release also took the opportunity to make some partisan jabs at the ACA and the low rate of participation by small businesses in SHOP.

As an agent certified in SHOP, the CMS press release shows a complete misunderstanding of the problem. Think of the choices businesses face:

  1. You can buy policies for your employees at full price through SHOP.
  2. You can reimburse employee costs for purchasing subsidized health insurance by using an HRA and or HSA  as revised in December.
  3. You can buy much lower  cost policies using a hybrid self-insured approach.

The first method provides no financial incentives — so why do it?

The new options offered by CMS provide no financial incentives — so why do them either?

However, for CMS now to say that the ACA has been ineffective in serving small business is unfounded. CMS doesn’t in fact know how many businesses have chose Option 2.

Of course, the virtue of Option 3 is that politicians have nothing to do with it.

The major barriers facing most business owners with options 2 or 3 is awareness — they don’t know these options have been available.  However, they are, and they could save a lot of money.

Only politicians could design a program with no value and then wonder why no one is using it.


Sources:  Centers for Medicare and Medicaid Services Offers New Health Coverage Enrollment Option for Small Business, Press release, 15 May 2017.   

Medicare: Rule Changes for SEPs

SEPs are “special enrollment periods” which allow people to enroll in Medicare supplement or Advantage policies outside of normal open enrollment periods.

SEPs are available for a variety of situations: relocations, loss of insurance through work, if an insurer drops a drug that you need from coverage, etc.

Example: Say you turn 65. You are automatically enrolled in Medicare Part A.  If you don’t enroll in Part B (doctors) or Part D (drug coverage) during that initial enrollment period, you will pay a higher premium for these parts when you go to enroll in the future.

If you have a job with health insurance that meets the Medicare standard when you turn 65, you still get Part A, but you can defer enrolling in Parts B and D. When you leave that job, you have a 60 day SEP to get that coverage without penalty.

On June 19th, CMS will impose new requirements for proving eligibility for an SEP. This may add up to two months for processing requests for new coverage. You may be paying out-of-pocket for any care that you need during that gap. Will Medicare reimburse you later? Probably, but you’ll need to front the money in any case.

There are exceptions to the SEP rules.  Nevada has changed the rules to permit year-round open enrollment for its residents. Congress gave Native Americans year-round enrollment privileges.

If the politicians you elect are so wonderful, why haven’t they done that for you? Perhaps you should ask.

If you need advice as to whether you are eligible for an SEP, call your agent. If you can’t find him, I’ll try to put you in touch with someone who can help you. There are a lot of rules and unless you want to become an expert on the law, this is not a time for DIY.

ACA Repeal: the next act

According to one report, VP Pence has offered three changes to the repeal bill to win Freedom Caucus support for the Trumpcare bill: Elimination of requirements for what insurers must cover Eliminating coverage for pre-existing medical conditions Eliminating limits on what insurers can charge people with medical conditions Whether the bill can retain any support […]

via ACA Repeal: Here we go again — CRAIN’S COMMENTS

Dust and cancer

A new report from Duke University finds an explanation for increases in the frequency of thyroid cancer in household dust. “Thyroid cancer is the fastest increasing cancer in the U.S., with most of the increase in new cases being papillary thyroid cancer” [PTC], said the study’s lead investigator, Julie Ann Sosa, M.D., MA, professor of […]

via Flame retardants, household dust, and thyroid cancer — CRAIN’S COMMENTS

Anyone want to move to Hawaii?

United Benefit Advisors has produced this chart showing group health insurance costs by state.

It should come as no surprise that the Northeastern US is the most expensive area of the country for group health insurance.  However, the amount of difference in cost might be a shock.

These are 2016 figures.  The numbers for 2017 are a little  higher, and we expect the numbers for 2018 to increase by more than 15%.  These are costs under group heath insurance policies.  The cost for individual policies will be slightly higher (before the ACA subsidy is applied).

2016 Monthly Premium by state Chart.jpg

The Economy: Back to the Future

Have you heard the advertising mantra, “Perception is reality”? It’s not. Reality is based on data that isn’t subject to twisting by political pundits — for example, a rapid growth in inventory of unsold cars and trucks at US dealers. The election brought about a rally in consumer confidence and in the stock market without […]

via The Economy: Back to the Future — CRAIN’S COMMENTS

Treating Colds and Flu

I was helping a friend yesterday whose child was ill. At one point the child came to the mother because she was feeling poorly, and admitted taking some medication on her own while the mother was busy. That’s the prompt for this post. Acetaminophen is perhaps the most common active ingredient in cold and flu […]

via Your Health: Warning for Colds and Flu — CRAIN’S COMMENTS

Trump’s Actions on Healthcare to Date

Medscape offered a good review of Trump’s initial executive orders regarding healthcare.  ben_franklinI’m not going to repeat the article word-for-word here — just recap the basic points and what they might mean for you:

  • They are largely non-specific recommendations, leaving actual implementation to each agency.  Since most of the new Cabinet heads aren’t confirmed as yet, this is going to play out over time.
  • The executive order could end penalties for not having health insurance.  That sounds good until you realize that it will drive up the cost of health insurance for everyone else.  The notion of risk pool is that healthy people balance out the ill.  If you allow people who don’t use much health services to withdraw from the pool, the cost burden is born by the smaller number of people remaining.  It’s simple math.
    • On notion starting to be discussed is the idea of a “high risk” insurance pool for people with chronic health conditions.  This was tried in a number of states in the past for both health and auto insurance and failed in both areas.  States discovered that they were on the hook for budget-breaking sums and the cost to individuals soared.  (See Politz article, in sources, below.)
  • States will be given greater latitude to determine who qualifies for Medicare and CHIP assistance and what assistance these programs actually provide.  That’s OK if you live in the Northeast or West Coast, and not so good elsewhere.
  • Health insurance will be sold across state lines.  That’s a questionable benefit:
    • It reduces the power of state insurance commissioners, which could be a good thing.
    • The impact on the actual cost of insurance is questionable.  Take New Jersey, for example.  Residents will have more policy choices available, but those policies now sold in Pennsylvania and New York have higher prices than New Jersey allows.  It seems unlikely that a carrier that sells in both NJ and PA will bring a lower priced policy from NJ to consumers in PA.
  • It will repeal taxes imposed on pharmaceutical companies and insurance carriers.

Bottom line:  The initial actions favor insurers and pharmaceutical companies at the expense of consumers. Health insurance prices will increase this year.  The Congressional Budget Office estimated that Trump’s actions would double the cost of health insurance over the next 10 years.  That may be an underestimate.

However, I don’t suggest running out to buy stock in these companies.  The theme over the last decade is that draining consumer wallets is a good way to bring the economy to a halt and, eventually, crash the stock markets.  It’s been done before.

It’s time to cut your expenses and save as much as you can.


Sources:

What you can do to improve your healthcare

Have you ever left a doctor’s office somewhat disappointed with your visit? Maybe you just spoke to a physician, but instead of having all your concerns addressed, you find yourself with even more questions? Do you ever wonder what doctors secretly wished patients would do that would make caring for you a smoother process? My purpose in writing this post is to do two things: to provide practical tips that you can use today that will 1) help prepare you for encounters you might have with the health care system in the future…whether it’s a routine doctor’s visit or an unexpected trip to the ER, and 2) help you make the most out of your interactions with your physicians. Therefore, without further ado…

via 5 Things Doctors Wish You Knew (that will empower you) — Musings of PuppyDoc

ACA Reform: the newest wrinkle

OK, it’s widely understood that “ethical Congressman” is an oxymoron if not an entirely extinct species.

Georgia Representative Tom Price is a Congressman.  He also invests iskunksn medical technology and pharmaceutical companies to the tune of about $300,000.  He also introduces bills and writes letters to regulators to help the companies whose stock he owns — boosting the value of  his own investment.   In turn, the companies donate to his re-election campaigns. (The Wall Street Journal first broke this story in December; CNN added new information today.)

Basically Tom Price is a poster child for “conflict-of-interest.”  Government is supposed to be “for the people”, not for your own wallet.

Price is also Trumps nominee for Health and Human Services Secretary and Trump’s designated leader on ACA reform.

If he’s leading the charge, just who is the real beneficiary of ACA reform going to be? 

In fairness, Price says that if he gets this new job, he will get rid of all of his stocks within 90 days.  However, he’s been in Congress for 11 years, with a consistent pattern of behavior.  That’s going to change overnight?? Plus ACA repeal reportedly will occur before he has liquidated his stocks, if it happens as promised.

Of course, the voters of Georgia share the blame for this mess. You elected someone five times who has consistently violated ethics rules.  How exactly does that work?   

Price’s original proposals for ACA repeal included the following five elements (quoted from NPR article cited below):

  1. Price’s plan offers fixed tax credits so people can buy their own insurance on the private market. The credit starts at $1,200 a year and rises with age, but isn’t adjusted for income. Everyone receives the same credit whether they are rich or poor. People on Medicaid, Medicare, the military health plan known as Tricare, or the Veterans Affairs’ health plan could opt instead for the tax credit to buy private insurance.
  2. Price advocates for expansion of health savings accounts, which allow people to save money before taxes to pay for health care. This includes allowing people who are covered by government health programs including Medicare and the VA to contribute to health savings accounts to pay for premiums and copayments. These proposals are included in Ryan’s plan.
  3. People with existing medical conditions couldn’t be denied coverage under Price’s plan as long as they had continuous insurance for 18 months prior to selecting a new policy. If they didn’t, then they could be denied coverage for that condition for up to 18 months after buying a new plan.
  4. The Price proposal limits the amount of money companies can deduct from their taxes for employee health insurance expenses. Companies can deduct up to $20,000 for a family health insurance plan and $8,000 for an individual. The goal is to discourage companies from offering overly generous insurance benefits to their workers. Ryan’s plan proposes a cap on the employer tax deduction but doesn’t specify the level of the cap.
  5. States would get federal money to create so-called high-risk pools under Price’s plan. These are government-run health plans for people with existing medical conditions who can’t get affordable health insurance on the private market. Critics say high-risk pools have been tried in as many as 34 states and largely failed because they were routinely underfunded.

Given that a Silver level ACA plan in NJ can cost upwards of $900 per month, a $1,200 annual credit doesn’t amount to much. And why should the credit be the same for a millionaire as for someone making minimum wage?  The pre-existing condition rule means that some people with long term health issues will be excluded from coverage. 

Finally, do Price’s ethics issues have anything to do with GOP efforts earlier this month to reduce or eliminate the independent Congressional Ethics Office? 

The Affordable Care Act (aka Obamacare) repeal is turning into a circus.  I’m sure there are more acts to follow.


Sources:

  • http://www.cnn.com/2017/01/16/politics/tom-price-bill-aiding-company/index.html
  • http://www.npr.org/sections/health-shots/2016/11/29/503720671/5-things-to-know-about-rep-tom-prices-health-care-ideas
  • http://ktla.com/2017/01/16/trumps-hhs-nominee-introduced-legislation-to-help-company-soon-after-investing-in-it-house-records/
  • http://www.msnbc.com/rachel-maddow/watch/ethics-questions-loom-over-trump-hhs-pick-rep-tom-price-839983683992
  • http://www.wsj.com/articles/donald-trumps-pick-for-health-secretary-traded-medical-stocks-while-in-house-1482451061

Healthcare: what you do need to do now

Donald Trump promised today that there will be “healthcare for everyone” after repeal of the ACA. He can actually do that very easily and cheaply, by cutting back the healthcare provided to “catastrophic” coverage. This category of plan exists today, but almost no one actively sells it because if provides very little value to the […]

via Healthcare: what you do need to do — CRAIN’S COMMENTS

ACA Reform

If you have insurance coverage through the Marketplace, the key advice right now is —

DON’T PANIC.logo@2x.png

While, to paraphrase Mark Twain, the word “congressman” is a synonym for “idiot”, it’s unlikely that we’ll see sweeping changes in the near future.

  • Congress is using a special procedure to “repeal” the Affordable Care Act (also known as Obamacare).  In fact, using that procedure, they can only repeal a portion of the law — the portion that involved direct Federal spending and tax penalties for individuals and businesses.
  • Many smaller hospitals are just as upset as consumes about losing Federal subsidies for healthcare.  The can’t afford returning to the burden of treating the uninsured.  Since the medical community is such a huge donor to Congress, they will want their say in hearings before Congress acts. So will insurers, the AARP and other groups.  That takes time.
  • Several analysts have speculated that there will be some kind of “bridge” legislation to keep the current system running until they can come up with a revised system.  That would be sensible.  But then again, this is Congress.

The bottom line is that we need to know what the facts are before we can figure out what is best to do.  Until the dust settles, we just don’t know.

Any replacement system will require legislation that will be subject to filibuster.  For that reason, it will require support from both parties to put it in place.  That’s simply going to take time.  I’d be modestly surprised if we actually had a replacement system before 2018, and if passed then, it wouldn’t take effect until 2019.  But we’ll see.

However, panic over the law could trigger a pull back in spending by consumers.  Another recession?  We’ll see.

By the way, if you haven’t read Mark Twain — particularly his cynical “Letters from the Earth” — you really should.  Most of what he said about people and  especially politicians is still true.  He’s just a lot more humorous in how he says it.

 

Discrimination in Healthcare — CRAIN’S COMMENTS

45% of patients with advanced rectal cancer don’t receive the recommended treatment for this disease. Rectal cancer is a problem. Forecasts call for 39,000 new cases of this type of cancer in the US by the end of this year. Rectal cancer is the largest subcategory of colorectal cancer, and is the second leading cause […]

via Discrimination in Healthcare — CRAIN’S COMMENTS

Older Men and the Women Who Love Them, More — CRAIN’S COMMENTS

Cleaning out my mailbox, there was an article on this in Science Daily from earlier this year that’s important for older men and the women who love them to know. Low testosterone levels complicate recovery from hospital stays, according to a study from the University of Texas. Testosterone levels fall in men after age 40 […]

via Older Men and the Women Who Love Them, More — CRAIN’S COMMENTS

Medicare Supplement and Medicare Advantage — Do You Know the Difference?

Do you know anyone turning 65?  Do you know anyone 65 or older who would like help figuring out which insurance options make the most financial sense for them?

Supplements cover medical expenses that basic Medicare doesn’t.  Advantage plans replace the basic Medicare plan and add additional coverage features.

Everyone needs one of these options, and they need not cost a fortune.  However, the choices aren’t one-size-fits-all, and the prices vary between carriers.  It can be confusing.

I can help.  Have them call me.

OPEN ENROLLMENT FOR SMALL BUSINESS 2016

Companies with less than 25 employees and with employees who make less than $30,000 per year can earn a 50% tax credit if they sign up for health insurance through the Federal SHOP marketplace.  Until 25grinzFEARduckwatchingyou-viDecember 15th, there is no requirement that most employees participate.  If many employees get insurance through spouses or parents, and you have only a couple of workers who need health insurance, you can do it.  However, only until December 15th.

Example:  Say the monthly cost for a Silver level policy for a young single worker is $400 (list price).  You can pay $200.00 if that amount and get a tax credit for $100.00.  Or you can pay $300.00 and get $150.00 tax credit.  The employee pays what you don’t.

If you have a good worker you want to keep, this is a valuable and not-too-expensive way to show appreciation for what he or she does.

If you’re a worker, why isn’t your employer doing this?  You should ask.

If you have questions, call me.

Where I Want to Be

My goal is to be able to help anyone who comes to me with a problem regarding health insurance.  The US has an insanely inefficient health insurance system designed to make a few people rich and frustrate the many.  To have good coverage requires quilting together policies from various insurers that will provide what people need for the most reasonable cost possible.

I’m finally there in terms of having the pieces that I need to be able to do that. First, I’m licensed in New Jersey, Pennsylvania, Missouri, and Virginia, and will be shortly in Illinois.

Second, yes, I still represent Aflac, a company that I respect.  However, Aflac only provides policies in New Jersey for employee groups; the offerings for individuals are highly limited.  The product line is better in some other states, but not perfect.

Aflac really excels i25grinzFEARduckwatchingyou-vin four areas:

  • Short term disability
  • Accident
  • Cancer
  • Critical illness

150px-logo-mutualofomaha-svg

 

I’ve added Mutual of Omaha and RSLI for long term disability and long term care,  both riders on life insurance.

rsli

I’ve added Delta Dental for employee groups and Ameritas dental for individuals and families.  Delta only offers policies for employee groups in most states through agents and policies for individuals online.  Ameritas matches Delta benefits at a lower cost than Delta charges for individuals.delta

ameritas

I’ve added VSP for vision.

vsp

I’ve added United American for Medicare Supplement policies.

ua-logo

I can add to the array as needed, but what I have gives me the ability to pick and choose the best policies for each individual client.  That’s what I’ve always wanted.

I figure if I do well for each client, they’ll refer others to me.  I’ve never needed the DOL rule to guide my conduct — I’ve always put the client’s needs first.  It’s all about “Doing well by doing good” and “Givers gain”.

You are what you’re feeling, so feel happy!!! – The Effects of Negative Emotions on our Health — Be Like Water

Humans experience an array of emotions, anything from happiness, to sadness to extreme joy and depression. Each one of these emotions creates a different feeling within the body. After all, our body releases different chemicals when we experience various things that make us happy and each chemical works to create a different environment within the body. […]

via You are what you’re feeling, so feel happy!!! – The Effects of Negative Emotions on our Health — Be Like Water

Insurance for the disabled

This is a subject I’m working on now.

Insurers have no problem writing life and disability policies for healththlx3t6c8yy people.

However, getting insurance for someone who starts as disabled (e.g., autism, brain injury) is a challenge.  Certain states make that even more difficult.  For example (thank you Governor Christie), it’s illegal in NJ to write certain types of insurance for people on Medicaid.  If you’re poor, the state makes it harder to dig yourself out.

thzaeabdiqHowever, there are solutions.  As an agent, I have to dig to find them.  Most consumers wouldn’t know where to look.

Happily, I’ve always enjoyed doing research.  It’s my calling.

By the way, there are people who invest in life insurance at age 18, before there’s an opportunity for much to happen to them.  They’re smarter than I was.  If healthy, they have more options and policies are very low cost.

This is an insurance/health focused blog.  I have a related blog at “Crain’s Comments” (vlcrain17.wordpress.com) that addresses a range of additional topics in writing, finance, technology, science and medicine.