DataRaptor Is Coming!!!!

DataRaptor Is Coming!!!!

Over the next few months, the Ez Life Sales platform will grow into the most revolutionary and robust insurance sales system in the world - DataRaptor. This evolution is more than a change of name; it is a change in the way insurance is sold. We have designed DataRaptor with you, the insurance professional, in mind. Along with the features of a typical CRM (Customer Relationship Management) system, we have included

Integrated insurance quoting

• Field underwriting and health screening tools
• Marketing and sales help
• Data transfer directly from CRM to application
• Automated e-mails based on lead status
• Nurture campaigns for leads and clients
• Integrated dialer (optional)
• Integrated texting (optional)
• Click to call (optional)
• Email clients directly from CRM
• Case status directly into CRM
• Detailed sales reports
• Plus so much more…

Sign Up for Ez Life and automatically receive the new DataRaptor platform when it is released.

The Ex Spouse Gets The Money

The Ex Spouse Gets The Money

WASHINGTON (AP) - The Supreme Court says a Virginia law can't override a federal employee's decision to make his ex-wife, not his wife, his beneficiary in a federal insurance program.

Warren Hillman made Judy Maretta beneficiary of his Federal Employees' Group Life Insurance policy before their divorce and his re-marriage to Jacqueline Hillman. He never changed his beneficiary designation, and Maretta got the money after his death.

The second wife sued, but the Virginia Supreme Court said the first wife gets the money since her name was on the form.

Virginia law revokes a beneficiary designation in favor of the current spouse. But Maretta argued it was pre-empted by federal law saying named beneficiaries get the money.

The high court agreed in a unanimous judgment.

 

This actually happens more than most people realize.  We see it with some regularity on group life insurance that is part of an employers benefit package.   An employee puts his wife as beneficiary and later divorces never thinking to notify his employer to change his life insurance policy.

 

 

Navigator Pay

Navigator Pay

 

As most of you are aware, in addition to brokers and agents selling though the insurance exchanges (if approved by your state), there will be a new group called Navigators that will assist individuals and groups when they chose a plan through the exchange.

Here are a couple of states that have announced the payments that will be made to their navigators:

 

California will pay Navigators $58 per successful enrollment. Assuming a California Navigator successfully enrolls 4 applications per day or 940 applications annually, California estimated that a full-time Navigator with supervision, overhead, and labor expenses will cost $54,500 annually, or $26.20 per hour. The actual rate of pay for a Navigators and Enrollment Assisters will depend on the entity that employs the Navigator or Enrollment Assister and the awarded block grants.

Arkansas estimates it would pay In Person Assisters (IPA) $12.00 per hour, excluding taxes, benefits or other employment costs. Nevada’s contract with Kelly Services uses an administrative fee of 35%. If this same formula was used in Arkansas, the estimated cost of Arkansas’s IPAs would actually be $16.20 per hour.

Mergers Will Impact Prices

Mergers Will Impact Prices

Merger activity among hospitals seems to be increasing in anticipation of the Affordable Health Care Act becoming the law of the land in 2014.

 

Two decades ago, there were on average about four rival hospital systems of roughly equal size in each metropolitan area, according to research done by Martin S. Gaynor of Carnegie Mellon University and Robert J. Town of the University of Pennsylvania. By 2006, the number of competitors was down to three. Consolidation has continued, in 2002 doctors owned about three in four physician practices. By 2008 more than half were owned by hospitals.

 

If there is one thing that we all know, it is that limited sources of care drive prices up while quality and innovation suffer. A report by Leemore S. Dafny of Northwestern University found that hospitals raise prices by about 40 percent after the merger of nearby rivals.

 

The rate of increase in health care spending has slowed. Since 2009 health care spending has been growing less than 4 percent per year, the slowest rate in more than half a century, according to information from the Office of the Actuary at the Centers for Medicare and Medicaid Services. But it is still outpacing inflation by a significant margin, despite a sharp slowdown in the use of medical services.

 

According to the Health Care Cost Institute, the rising health care spending of Americans under 65 in the last two years has been driven entirely by rising prices; not by more use. From 2009 though 2011 the fee for an outpatient visit to the emergency room rose 17 percent. The price of a routine office visit to a primary care doctor rose 8 percent. The price of radiology services rose 12 percent.

 

There are provisions of the health care law such as accountable care organizations that lend themselves to limiting competition. “Hospitals want to maintain their revenue streams and enhance their bargaining leverage,” said Professor Gaynor. “This is a way to do so.”

SKINNY" Plans Avoid Penalties For Larger Groups

"SKINNY" Plans Avoid Penalties For Larger Groups

US employers will be able to largely avoid penalties under the Obama-backed health care legislation, while offering very limited plans to their workforces. An article in Monday’s Wall Street Journal notes that these bare-bones plans may lack key benefits such as hospital coverage.

The WSJ article indicates that some benefits advisers and insurance brokers are offering these limited benefit plans to large employers. While these plans would cover minimal requirements such a preventive services, they do not offer full comprehensive coverage.

Government officials admit that these ‘skinny” plans appear to qualify as acceptable minimum coverage under the health care law. Companies offering these plans would dodge $2,000 per worker penalties for not offering health coverage. Although they might face other penalties if employees opt-out of the plans and choose to purchase subsidized coverage on the insurance exchanges, these fines would be far less costly.

The ACA act requires employers with 50 or more workers to offer health care coverage or face penalties. The Department of Health and Human Services (HHS) has promoted these plans as if they would cover benefits such as mental health treatment, hospitalizations and other vital services.

The WSJ however, points to a largely undetected loophole in the rules indicating that such mandates only apply to plans sponsored by insurers that are sold to small businesses and individuals. These cover only about 30 million of the 160 million people with private insurance. This leaves 130 million people—more than 40 percent of the US population—with private insurance that is not governed by these coverage mandates.

In general, larger employers, those with more than 50 workers, will only be required to cover preventive services without a lifetime or annual cost limit. Such low-benefit plans would constitute “health coverage” at a cost to employers that could be as little as $40 to $100 a month per employee—all while avoiding the ACA’s penalties for not providing coverage.

Government health officials are not pleased with the news that employers would seize on these business-friendly loopholes in the health care law. “We wouldn’t have anticipated that there’d be demand for these types of band-aid plans in 2014,” Robert Kocher, a former White House health adviser, told the Journal. “Our expectation was that employers would offer high quality insurance.”

Self Insured Plans For Small Groups

Self Insured Plans For Small Groups

For small businesses, being self-insured would let them avoid new requirements under the law that call for traditional small group plans to include richer benefits, such as mental-health and maternity care. Self-insured companies can also avoid changes to pricing rules that could increase costs for groups of healthy workers.

It comes with risks: A car accident or cancer case can leave small businesses on the hook for big medical bills. That is why most large insurers have generally offered such services to companies that have 100 or more workers and can spread the costs around.

Now, the health law is changing the risk-benefit calculation for smaller businesses. The approach is part of a growing playbook of strategies to minimize the effects—and potential costs—of the health law. Insurers are also letting small companies renew their yearlong health-benefit plans early, before the end of 2013. That would delay the impact of health-law provisions that broadly kick in on Jan. 1, but would only affect plans once they renew after that date.

There is some indication that UnitedHealth Group Inc. and Humana Inc. will begin offering smaller employers—including firms with as few as 10 members in UnitedHealth's case the option of a form of self-insurance in some markets later this year.

Officials in several states are seeking to stem the strategy by limiting so-called stop-loss insurance, which covers unexpected, large health-care bills for self-insured companies. Lawmakers in California and Rhode Island are considering bills that would impose new rules on such coverage when offered to small employers, who otherwise would find self-insurance too risky. Some states, including New York, bar stop-loss insurers from covering small groups.

Still, self-insurance by small companies "is growing because of its ability to circumvent some of the" federal health law's provisions, said Tanji Northrup, assistant insurance commissioner in the Utah Insurance Department.