Commissioner Kreidler to testify before U.S. House of Representatives

Washington Insurance Commissioner Mike Kreidler will testify before the U.S. House of Representatives Ways and Means Subcommittee on Health on Dec. 4  about the Affordable Care Act and how it’s working in Washington state.
The Affordable Care Act is the first major step toward making changes that will improve the lives of millions of Americans. For the first time, people have access to affordable, comprehensive medical insurance that doesn’t penalize them for their gender or for having existing medical conditions. Americans will not be subject to limits on their lifetime or annual medical benefits, which unfairly targets people with chronic medical conditions. 

Commissioner Kreidler, a board member of Washington’s Health Benefit Exchange, will touch on our state’s experience in enrolling more than 100,000 citizens through Washington Healthplanfinder.
The hearing starts at 7 a.m. Pacific time and will stream live online.  

Read more about the hearing from the Ways and Means Committee. 

R in Insurance Conference, London, 14 July 2014

Following the very positive feedback that Andreas and I have received from delegates of the first R in Insurance conference in July of this year, we are planning to repeat the event next year. We have already reserved a bigger auditorium.

The second conference on R in Insurance will be held on Monday 14 July 2014 at Cass Business School in London, UK.

This one-day conference will focus again on applications in insurance and actuarial science that use R, the lingua franca for statistical computation. Topics covered may include actuarial statistics, capital modelling, pricing, reserving, reinsurance and extreme events, portfolio allocation, advanced risk tools, high-performance computing, econometrics and more. All topics will be discussed within the context of using R as a primary tool for insurance risk management, analysis and modelling.

The intended audience of the conference includes both academics and practitioners who are active or interested in the applications of R in insurance.

Invited talks will be given by:
  • Arthur Charpentier, Département de mathématiques Université du Québec à Montréal
  • Montserrat Guillen, Dept. Econometrics University of Barcelona together with Leo Guelman, Royal Bank of Canada (RBC Insurance division)
The members of the scientific committee are: Katrien Antonio (University of Amsterdam and KU Leuven), Christophe Dutang (Université du Maine, France), Jens Nielsen (Cass), Andreas Tsanakas (Cass) and Markus Gesmann (ChainLadder project).

Details about the registration and abstract submission process will be published soon on

You can contact us via rinsuranceconference at gmail dot com.

The organisers, Andreas Tsanakas and Markus Gesmann, gratefully acknowledge the sponsorship of Mango Solutions, RStudio, Cybaea and PwC.

We're looking for a Deputy Commissioner of Operations

We're currently recruiting for a Deputy Commissioner of Operations. This in an executive level exempt position that manages 35 employees in the following areas: Human resources, budget and fiscal, facilities and telecommunications, information technology and public records.

The successful candidate will be an active member of the Executive Management Team (EMT), setting the strategic direction of the agency, developing legislative priorities, ensuring fiscal responsibility and creating an inclusive, performance-based work environment.

Here's the full job announcement. Please share with anyone you think could be interested.

The job is open until Dec. 9, 2014.

Not only verbs but also believes can be conjugated

Following on from last week, where I presented a simple example of a Bayesian network with discrete probabilities to predict the number of claims for a motor insurance customer, I will look at continuos probability distributions today. Here I follow example 16.17 in Loss Models: From Data to Decisions [1].

Suppose there is a class of risks that incurs random losses following an exponential distribution (density \(f(x) = \Theta {e}^{- \Theta x}\)) with mean \(1/\Theta\). Further, I believe that \(\Theta\) varies according to a gamma distribution (density \(f(x)= \frac{\beta^\alpha}{\Gamma(\alpha)} x^{\alpha \,-\, 1} e^{- \beta x } \)) with shape \(\alpha=4\) and rate \(\beta=1000\).

In the same way as I had good and bad driver in my previous post, here I have clients with different characteristics, reflected by the gamma distribution. I shall call the gamma distribution with the above parameters my prior parameter distribution and the exponential distribution the prior predictive distribution.

The textbook tells me that the unconditional mixed distribution of an exponential distribution with parameter \(\Theta\), whereby \(\Theta\) has a gamma distribution, is a Pareto II distribution (density \(f(x) = \frac{\alpha \beta^\alpha}{(x+\beta)^{\alpha+1}}\)) with parameters \(\alpha,\, \beta\). Its k-th moment is given in the general case by
E[X^k] = \frac{\beta^k\Gamma(k+1)\Gamma(\alpha - k)}{\Gamma(\alpha)},\; -1 < k < \alpha. \] Thus, I can calculate the prior expected loss (\(k=1\)) as \(\frac{\beta}{\alpha-1}=\,\)333.33.
Now suppose I have three independent observations, namely losses of $100, $950 and $450 over the last 3 years. The mean loss is $500, which is higher than the $333.33 of my model.

Question: How should I update my belief about the client's risk profile to predict the expected loss cost for year 4 given those 3 observations?

Visually I can regard this scenario as a graph, with evidence set for years 1 to 3 that I want to propagate through to year 4.

Read more »

The Defense Rests

It is exhausting.  This choice.  This job.  This desire to craft a non-ideological, pragmatic path is taking all of my energy.  Confronted daily by people who either cannot, or will not, see the full picture that is the Patient Protection and Affordable Care Act (PPACA or Obamacare), I find myself calming the fears of its detractors or clarifying the rules to its biggest supporters.  To the right, and the righter than right, I find myself defending the law, or at the very least, the need for change.  Defending the insurers from the left could be a full time job in of itself.

Randy (name changed) called Friday.  He wanted to know when they were going to cancel his group health insurance policy.

Why would Medical Mutual cancel your company’s insurance?

Because my policy doesn’t cover any women or children.

But you don’t have any female employees, right?

Yeah, but they’re gonna cancel me!

OY, Randy, you’ve been watching FOX again.

It took fifteen minutes to reassure Randy.  Now, no one on FOX really said that a small business would lose its health insurance if there weren't any women or children on the policy.  That’s silly.  But the daily barrage of negativity, conspiracy theories, and half-truths take their toll on the viewers.  One day you’re a concerned business owner.  The next you are trying to get one of your employees to get married so that you can retain your group coverage.

It doesn’t get any better on MSNBC.  With neither an ounce of irony nor embarrassment, the outpost of the left gives us Howard Dean, the former governor of Vermont.  I’m sure that an extensive GOOGLE search might find an instance when Gov. Dean knew what he was talking about.  I’m just positive that none of his pronouncements about health insurance or the PPACA have any basis in reality.

For example, Governor Dean was recently discussing the disastrous roll-out and the policy cancellations.  He was on Morning Joe and several other shows.  He opined that all the President had to do was to hire a bunch of unemployed kids, put them in a call center, and have them ring up everyone whose policy had been cancelled.  The kids could enroll everyone into Obamacare!

I doubt that approach would be welcome in Vermont, a state with less than half the population of Greater Cleveland.  I know that wouldn’t fly here.  Who explains the policies to the “kids”?  Vermont may have only one or two insurers and only a few options, but Ohio, California, and any other state that has an actual city or two will have multiple insurers and dozens of choices.  But on one has ever explained insurance, or economics, or city life to Governor Dean.  And there is absolutely no reason to do so now.

40 vs. 5

The PPACA was sold to the American public as a universal win.  Everyone would get better, more comprehensive health insurance for a lower monthly premium.  This blog has repeatedly pointed out that that was not possible.  The airwaves are now filled with the horror stories of cancelled policies and jacked-up premiums.  The right emphasizes every problem, real or imagined.  The left has a new argument – Isn’t it OK to inconvenience five million people so that 40 MILLION AMERICANS can now get access to affordable health care?

What a bunch of hooey.  This wasn’t a Hobson’s choice.  It wasn’t remake our entire system or do nothing to help the uninsured and the under-insured in our country.  We could have accomplished much of that goal by expanding Medicaid.  You don’t score many points by minimizing someone else’s loss.

I have watched my words parsed in the comment sections of Facebook and the AOL Patch.  The attorneys and attorney wanna-be’s who troll for fights can’t tolerate civil discussions.  One guy was convinced that all insurers will cancel their clients at the first sign of a claim.  Another reader is positive that the PPACA is the harbinger of the Apocalypse.  The extremes are so extreme.  The middle is lonely and damn near empty.

For the record:
  • Insurers pay claims.  My clients have benefited from their coverage.
  • The status quo was not sustainable.
  • There is a kernel of truth in everything you see and hear on FOX and MSNBC.  You need more than kernels.  You need a meal.
Take a deep breath.  We will all get through this together.  But for the moment, the defense rests.


Predicting claims with a Bayesian network

Here is a little Bayesian Network to predict the claims for two different types of drivers over the next year, see also example 16.15 in [1].

Let's assume there are good and bad drivers. The probabilities that a good driver will have 0, 1 or 2 claims in any given year are set to 70%, 20% and 10%, while for bad drivers the probabilities are 50%, 30% and 20% respectively.

Further I assume that 75% of all drivers are good drivers and only 25% would be classified as bad drivers. Therefore the average number of claims per policyholder across the whole customer base would be:
0.75*(0*0.7 + 1*0.2 + 2*0.1) + 0.25*(0*0.5 + 1*0.3 + 2*0.2) = 0.475
Now a customer of two years asks for his renewal. Suppose he had no claims in the first year and one claim last year, how many claims should I predict for next year? Or in other words, how much credibility should I give him?

To answer the above question I present the data here as a Bayesian Network using the gRain package [2]. I start with the contingency probability tables for the driver type and the conditional probabilities for 0, 1 and 2 claims in year 1 and 2. As I assume independence between the years I set the same probabilities. I can now review my model as a mosaic plot (above) and as a graph (below) as well.

Next, I set the client's evidence (0 claims in year one and 1 claim in year two) and propagate these back through my network to estimate the probabilities that the customer is either a good (73.68%) or a bad (26.32%) driver. Knowing that a good driver has on overage 0.4 claims a year and a bad driver 0.7 claims I predict the number of claims for my customer with the given claims history as 0.4789.

Alternatively I could have added a third node for year 3 and queried the network for the probabilities of 0, 1 or 2 claims given that the customer had zero claims in year 1 and one claim in year 2. The sum product of the number of claims and probabilities gives me again an expected claims number of 0.4789.


[1] Klugman, S. A., Panjer, H. H. & Willmot, G. E. (2004), Loss Models: From Data to Decisions, Wiley Series in Proability and Statistics.

[2] Søren Højsgaard (2012). Graphical Independence Networks with the gRain Package for R. Journal of Statistical Software, 46(10), 1-26. URL

Session Info

R version 3.0.2 (2013-09-25)
Platform: x86_64-apple-darwin10.8.0 (64-bit)

[1] en_GB.UTF-8/en_GB.UTF-8/en_GB.UTF-8/C/en_GB.UTF-8/en_GB.UTF-8

attached base packages:
[1] grid stats graphics grDevices utils datasets methods
[8] base

other attached packages:
[1] Rgraphviz_2.6.0 gRain_1.2-2 gRbase_1.6-12 graph_1.40.0

loaded via a namespace (and not attached):
[1] BiocGenerics_0.8.0 igraph_0.6.6 lattice_0.20-24 Matrix_1.1-0
[5] parallel_3.0.2 RBGL_1.38.0 stats4_3.0.2 tools_3.0.2

Why the commissioner decided against allowing canceled policies back into Washington

President Obama’s announcement this week that previously canceled individual health-insurance policies for 2014 could be reinstated – at the discretion of insurance commissioners – drew a lot of attention.

Washington state Insurance Commissioner Mike Kreidler acted quickly, deciding against allowing the previously discontinued policies to be put back into effect. The reasons are straightforward: The proposal does not make sense for Washington because of the overall negative effect on the stability of the health-insurance market.

To learn more about Commissioner Kreidler’s decision, please check his statement.

You can also see what is really happening with those canceled policies and how many consumers can qualify for more comprehensive coverage at less cost.

Where Do They Bury The Survivors?

A plane crashes on the Mexican – United States border. On board were U.S. citizens, Mexicans, Brazilians, and three passengers from Argentina. Where so they bury the survivors?

It is a classic misdirect. A mental sleight of hand. You know the answer. We don’t bury survivors.

Sleight of hand is an art. The best practitioners can shake your hand while they lift your watch and wallet. The trick for us is to watch them at work without becoming a victim.

I recently received an urgent email. A client forwarded Newt Gingrich’s article, “Obamacare’s Marriage Penalty and Divorce Incentive.” Was this true? Is the President anti-marriage?

Newt Gingrich as the defender of the sanctity of marriage? Guard your wallet!

I won’t bore you with the numbers. The federal subsidies are based on the size of the family, the ages of the insured, and are factored on the federal poverty level. A married couple with one child doesn’t need 33% more income when they have a second child. Couples don’t need twice as much income as singles to pay for food and shelter.

Will a few people get divorced to get a bigger health insurance subsidy? Perhaps. Of course, that also means that these people will pay more state and federal income tax. These things have a way of balancing out in the end.

The bottom line is that Newt Gingrich knows that this is irrelevant. Newt would be campaigning against government waste and another inefficient entitlement program if the subsidies were calculated differently. It is just a sleight of hand.

We should, by now, be used to this from our politicians. Sometimes it is a mental misdirect. Sometimes it is a misstatement. And there are other instances when the politician tells the truth, technically, but what he/she said and what we heard are not even closely the same.

Example? My favorite is “If you like your policy, you can keep it. Period”. Balderdash.

I wasn’t in the room when the President and his advisors crafted that perfect slogan. “If you like your policy, you can keep it. Period.” So clear. So emphatic. So wrong. Did the President and his advisors intentionally mislead the country, or more likely, did we have a room full of people who had no idea what they were talking about?
  • Over 80% of Americans get their insurance coverage through work. If you are one of them, you don’t choose your plan, your employer does. It is not up to you.
  • Only policies on the books prior to the passage of the law and unchanged since that day, March 23, 2010, are grandfathered.
  • How long can the insurers run two separate sets of books? Policies issued prior to March 2010 have one set of rules while new policies have another. Who pays the additional cost to maintain the old contracts and monitor compliance?
This blog has tackled the grandfather issue repeatedly since August 2, 2010’s, Don’t Cry Uncle, Stay Grandfathered. Retroactive rules. Contradictory edicts. Those of us who actually work in the insurance business knew that we would see very few individual or small group policies limp across the finish line on January 1, 2014.

The President is shocked that many Americans are now losing their current policies and being forced into new, more expensive contracts.

There are some awful policies on the market that will disappear on January 1st. There are some policies that have a $25,000 or $50,000 cap. Those plans were cheap, but they did not really cover a major illness. However, about 11 million Americans are covered by comprehensive policies that will be cancelled in the next twelve months. These plans don’t conform to the new rules.

My policy is scheduled to end a year from now. Why? Because it doesn’t cover me for maternity. If nothing changes in the next twelve months, my premium will more than double next December. Of course I like my policy. And no, I can’t keep it.

The Patient Protection and Affordable Care Act (PPACA) will, eventually, help many Americans. But it would be foolish to dismiss out of hand those people who are angry or upset. You can’t just bury their fears with the survivors.


Picture from the Passen Law Group

googleVis 0.4.7 with RStudio integration on CRAN

In my previous post, I presented a preview version of googleVis that provided an integration with RStudio's Viewer pane (introduced with version 0.98.441).

Over 80% in my little survey favoured the new default output mechanism of googleVis within RStudio. Hence, I uploaded googleVis 0.4.7 on CRAN over the weekend.

However, there were also some thoughtful comments, which suggested that the RStudio Viewer pane is not always the best option. Indeed, Flash charts and gvisMerge output will still be displayed in your default browser, but also if you work on larger charts and with smaller screen, then the browser might still be the better option compared to the Viewer pane - of course you can launch the browser from the Viewer pane as well.

Hence, googleVis gained a new option 'googleVis.viewer' that controls the default output of the googleVis plot method. On package load it is set to getOption("viewer") and if you use RStudio, then its viewer pane will be used for displaying non-Flash and un-merged charts. You can set options("googleVis.viewer" = NULL) and the googleVis plot function will open all output in the default browser again. Thanks to J.J. from RStudio for the tip.

The screen shot below shows a geo chart within the RStudio Viewer pane of the
devastating typhoon track of Haiyan that hit Southeast Asia last week.

Session Info

RStudio v0.98.456 and R version 3.0.2 (2013-09-25)
Platform: x86_64-apple-darwin10.8.0 (64-bit)

[1] en_GB.UTF-8/en_GB.UTF-8/en_GB.UTF-8/C/en_GB.UTF-8/en_GB.UTF-8

attached base packages:
[1] stats graphics grDevices utils datasets methods
[7] base

other attached packages:
[1] googleVis_0.4.7 XML_3.95-0.2

loaded via a namespace (and not attached):
[1] RJSONIO_1.0-3 tools_3.0.2

Canceled health plans? What's really happening.

There's been a lot of news lately about insurers cancelling some health plans and changing others. Consumers have been getting the word through  'discontinuation' notices.

So what's really going on? This is happening in the individual market - where people who don't get coverage from their employer - buy their own health plans.   Most likely, the existing plans being canceled or changed, failed to meet new federal standards for benefits.  The reality about most of these previous plans is that they provided extremely limited benefits - no maternity care or coverage for prescription drugs, for example.

Beginning Jan. 1, 2014, plans must provide everyone basic essential benefits, such as maternity care, prescription drug coverage and mental health services.  And no longer can insurance companies ask you about previous illnesses you may have had. They must accept everyone.

Premiums will change for some plans. But if you received a notice from your insurance company, it does not mean you have to stay with whatever they offer. You can shop around for plans, either in the new Exchange - or from insurers selling outside of the Exchange.

Here's a map of all individual plans available by county.

For more details about insurers cancelling policies, check out this piece by Kaiser Health News.

Display googleVis charts within RStudio

The preview version 0.98.441 of RStudio introduced a new viewer pane to render local web content and with that it allows me to display googleVis charts within RStudio rather than in a separate browser window.

I think this is a rather nice feature and hence I have updated the plot method in googleVis to use the RStudio viewer pane as the default output. If you use another editor, or if the plot is using one of the Flash based charts, then the browser is still the default display.

The behaviour can also be controlled via the option viewer. Set options("viewer"=NULL) and googleVis will plot all output in the browser again.

Of course shiny apps can also run in the viewer pane. Here is the example of the renderGvis help page of googleVis. For more information about the new viewer pane see the online RStudio documentation.

For the time being you can get the next version 0.4.6 of googleVis from our project site only. Please get in touch if you find any issues or bugs with this version, or add them to our issues list.

Is this a step in the right direction? Please use the voting buttons below.

Session Info

R Under development (unstable) (2013-10-25 r64109)
Platform: x86_64-apple-darwin10.8.0 (64-bit)

[1] en_GB.UTF-8/en_GB.UTF-8/en_GB.UTF-8/C/en_GB.UTF-8/en_GB.UTF-8

attached base packages:
[1] stats graphics grDevices utils datasets methods base

other attached packages:
[1] googleVis_0.4.6

loaded via a namespace (and not attached):
[1] RJSONIO_1.0-3 tools_3.1.0

"Where do I get a detailed review of my auto and homeowners premiums?"

We recommend that you get a policy-specific premium breakdown directly from your agent (or insurer, if you buy direct). Specifically, you might want to ask for a rate worksheet comparison between your last year's premium and your current annual premium. That's a good way to get an apples-to-apples comparison of what your rates are doing.

While you're at it, it's a good idea to make sure that the type and level of coverage is what you want. If you're driving a new car, you'll likely want comprehensive and collision coverage as well as liability (the latter is required by law.) If you're driving a $1,000 car, on the other hand, maybe liability coverage is enough. These are good things to discuss with your agent or company, particularly if you have changes in your life (new car, change in household members, moving, etc.)


Frank (name changed) is a successful attorney in his early 40’s. He lives in Greater Cleveland. On Friday he completed his health insurance application, hit the submit button, and watched the website crash. This message, in bold red and blue, flashed onto his screen:
Application Wizard
  • We apologize but there was an issue with our system when submitting your application. If we were able to process your application, we will send you an email within the next hour and you will not need to do anything else. If you do not receive an email from us within the next hour, then please return to this site and submit the application to us again.
Yes, purchasing a health insurance policy in 2013 can, at times, appear daunting. But Frank wasn’t dealing with the federal exchange. The computer issue had nothing to do with the Patient Protection and Affordable Care Act (PPACA). Frank was submitting an application for a 2013 policy with Anthem Blue Cross.

Alert the media! Contact Rush! Websites crash or are shut down for routine maintenance. No one died and no one got fired.

Anthem’s producer/applicant portal was down for about six hours. Frank’s application has been accepted and by the time you read this, he may have been approved.

The exchange roll out has been a mess. Even insurance agents, professionals long familiar with the complexity of working with insurers, the government, and the public, were surprised at how unprepared the government was for this vast undertaking. We even had advance warning. Agents have had eight years of Medicare Part D (Rx) and Medicare Advantage training, seven to nine wasted hours each August. And this year we were treated to the special training classes and tests to sell on the federally run exchange as detailed in You Put Your Left Foot In. CMM (Centers for Medicare and Medicaid Services), the agency administering the agent authorization process, is still having website issues.

This is a program designed by bureaucrats who know how to make things complicated but may have no idea how to make things work.

What has been lost in this P.R. disaster is just how irrelevant all of this has been. The most important thing to remember is that the new policies don’t start until January 1, 2014. Applications accepted on October 1st or December 10th still have the same effective date. Anthem Blue Cross is not going to run out of policies. You don’t need to be the first in line.

Of course, everyone with an ax to grind has jumped into the discussion. Online insurance marketers have “volunteered” to save the day and take over the process. If the federal government would only suspend common sense and a myriad of state and federal laws, an e-marketer could corner the market and restore order. Those offers have landed with a thud.

Equally self-serving have been the Republican members of Congress who have complained about the problems their constituents are having with the roll out. You can’t spend three and a half years actively trying to sabotage a program and then complain when it doesn’t work perfectly. And please, don’t shed tears for the sick and uninsured who are having difficulty enrolling in the now available coverage. There isn’t a Republican plan to cover any of these people.

There is a bi-partisan support to bump back the “Individual Mandate” for another year. Why force people to purchase insurance if the website is difficult to access? I’m surprised that this hasn’t already happened. Everybody wins.
  • The Republicans score a moral victory. Being against anything President Obama favors enhances their campaign donations. Winning a meaningless battle shows activity.
  • The Democrats show flexibility and are allowed, once again, to play the part of the martyr.
  • Big business, the unions, and the insurers see this as one step closer to a Single Payer system. By now you are sick of hearing TV commentators talking about the Young Invincibles, the young, healthy Americans who must be forced into the system for it to work. If healthy people don’t sign up, the system devolves into a Death Spiral and implodes under its own weight.
Delaying, or worse, eliminating the Individual Mandate hastens the conversion to a Single Payer system.

The exchange website and all of its attendant issues aren’t our biggest challenge as a country. It is our lack of intellectual honesty that will be our undoing. Disorganized and unprepared, we are heading for a crash.


Our home was damaged by a windstorm. We're worried. What's next?

We get this question a lot. It's very important that you try to safeguard your home from further damage. Depending on the type of damage, you may be able to safely do this yourself or you may need to hire someone - especially if you need to get a tarp on the roof if you're dealing with utilities or damaged and unstable structures.
You'll also want to contact your insurance agent or your insurer directly to let them know what’s going on, and to get any necessary instructions from them. They can also tell you how your coverage will apply. Most importantly, stay safe!


High resolution graphics with R

For most purposes PDF or other vector graphic formats such as windows metafile and SVG work just fine. However, if I plot lots of points, say 100k, then those files can get quite large and bitmap formats like PNG can be the better option. I just have to be mindful of the resolution.

As an example I create the following plot:
x <- rnorm(100000)
plot(x, main="100,000 points", col=adjustcolor("black", alpha=0.2))
Saving the plot as a PDF creates a 5.2 MB big file on my computer, while the PNG output is only 62 KB instead. Of course, the PNG doesn't look as crisp as the PDF file.
png("100kPoints72dpi.png", units = "px", width=400, height=400)
plot(x, main="100,000 points", col=adjustcolor("black", alpha=0.2))

Hence, I increase the resolution to 150 dots per pixel.
png("100kHighRes150dpi.png", units="px", width=400, height=400, res=150)
plot(x, main="100,000 points", col=adjustcolor("black", alpha=0.2))

This looks a bit odd. The file size is only 29 KB but the annotations look too big. Well, the file has only 400 x 400 pixels and the size of a pixel is fixed. Thus, I have to provide more pixels, or in other words increase the plot size. Doubling the width and height as I double the resolution makes sense.
png("100kHighRes150dpi2.png", units="px", width=800, height=800, res=150)
plot(x, main="100,000 points", col=adjustcolor("black", alpha=0.2))

Next I increase the resolution further to 300 dpi and the graphic size to 1600 x 1600 pixels. The file is still very crisp. Of course the file size increased. Now it is 654 KB in size, yet sill only about 1/8 of the PDF and I can embed it in LaTeX as well.
png("100kHighRes300dpi.png", units="px", width=1600, height=1600, res=300)
plot(x, main="100,000 points", col=adjustcolor("black", alpha=0.2))

Note, you can click on the charts to access the original files of this post.

"The insurance company came out and looked at my car. Doesn't that commit them to paying the claim?"

No. Insurers are required to investigate claims, but the fact that they start an investigation doesn't obligate them to pay a claim that they wouldn't otherwise pay. Once the facts are gathered and reviewed, the insurer can then make a coverage decision.

That said, if you feel your claim has been wrongly denied, is delayed, isn't fair, etc., our consumer advocacy staff may be able to help you. (We're the state agency that regulates insurance in Washington state.) Email us at or call us at 1-800-562-6900.

Not in Washington state? Here's a handy map to help you contact your own state's insurance regulator.

Why does my insurer ask such tough questions about my claim?

We get this question a lot. The insurance industry experiences millions of dollars of claims regularly, year after year. Many of the claims are legitimate, but unfortunately, many involve fraud.
Whether or not a claim is legitimate or fraudulent, it is important that insurance companies perform complete investigations and gather all supportive documentation to be able to evaluate a claim.
Of course, the claim process is not a fun thing to experience, but it is necessary that you cooperate with the insurer to help facilitate your claim. Expect them to want supporting documentation and to ask questions - it may take a bit of time. But, after you've answered their questions and provided the necessary information, you should expect a timely decision and a clear explanation of their decision. If you don't that you've been treated fairly, call us at 1-800-562-6900 or file a complaint. Maybe we can help!

Review: Kölner R Meeting 18 October 2013

The Cologne R user group met last Friday for two talks on split apply combine in R and XLConnect by Bernd Weiß and Günter Faes respectively, before the usual Schnitzel and Kölsch at the Lux.

Split apply combine in R

The apply family of functions in R is incredible powerful, yet for newcomers often somewhat mysterious. Thus, Bernd gave an overview of the different apply functions and their cousins. The various functions differ in their object inputs, e.g. vectors, arrays, data frames or lists, and their outputs. Other related functions are by, aggregate and ave. While functions like aggregate reduce the output size, others like ave will return as many rows as the input object and repeat the results where necessary.

Alternatively to the base R function Bernd touched also on the **ply functions of the plyr package. The function names are certainly easier to remember, but their syntax can be a little awkward (.()). Bernd's slides, in German, are already available from our Meetup site.


When dealing with data stored in spreadsheets most member of the group rely on read.csv and write.csv in R. However, if you have a spreadsheet with multiple tabs and formatted numbers, read.csv becomes clumsy, as you would have to save each tab without any formatting in separate files.

Günter presented the XLConnect as an alternative to read.csv or indeed RODBC for reading spreadsheet data. It uses the Apache POI API as the underlying interface. XLConnect requires a Java runtime environment on your computer, but no installation of Excel. That makes it a true platform independent solution to exchange data with spreadsheets and R. Not only can you read defined rows and columns from Excel into R, or indeed named ranges, but in the same way data can be stored in Excel files again and to top it all - also graphic output from R.

Next Kölner R meeting

The next meeting is scheduled for 13 December 2013. A discussion of the data.table package is already on the agenda.

Please get in touch if you would like to present and share your experience, or indeed if you have a request for a topic you would like to hear more about. For more details see also our Meetup page.

Thanks again to Bernd Weiß for hosting the event and Revolution Analytics for their sponsorship.

Having trouble reaching the Exchange's call center?

We know Washington's Exchange, is still experiencing high call volumes at most times of the day. If you need help getting started, consider calling a navigator or an insurance broker. You can find both in your area by entering your zip code. Here's the info. for finding a navigator and the broker information.

"I've invented a new medical treatment. How can I get insurers to cover this?"

Our consumer hotline gets this question periodically. Someone will have come up with a new way of treating some ailment, only to find that insurance companies don't want to cover it.

Insurance companies are far more likely to cover a treatment is it's "evidence-based. Typically, a treatment is deemed evidence-based after extensive clinical trials, for which the inventor (or inventor's company, actually) usually pays. In the scientific community, evidence-based treatments are considered more reliable, and therefor a better value for insurance companies' money -- and more likely to lead to success for the patient.

That said, insurance companies can pay for any treatment, so there's nothing stopping them from covering a treatment that's not evidence-based. However, with many health conditions, there are already numerous treatments available.

If you're a patient, and your insurer is refusing to pay for a particular treatment that you think would be effective, see our "How to appeal a health insurance denial" guide. You can win an appeal, but it takes some work.

Also, here in Washington state, the health plans we regulate -- which are about 37 percent of them -- must, by law, must include access to every type of licensed medical provider. Meaning that if you want to see a naturopathic physician, chiropractor, physician, acupuncturist, etc. for treatment, the choice is yours, so long as the treatment is within the scope of their practice. The law doesn't change what health conditions are covered by your plan, but it gives you more choice in who -- i.e. which kind of provider -- will treat you.

The New Normal

Under the old rules, the underwriting rules we’ve lived by for decades, health insurance premiums were determined by risk.  Healthy people paid less than those that weren’t.  We asked questions such as:

Do you smoke?
What is your height and weight?
What medications do you take and why?

The new rules under the Patient Protection and Affordable Care Act (PPACA) eliminate underwriting.  The new rules have us charging everyone the same premium regardless of health.  The only questions now are:

Do you smoke? (old habits die hard)
How old are you?
Where do you live?

How is that working?

Angie (name changed) is a 55 year old owner of a successful home-based business here in Greater Cleveland.  She purchases her own health insurance.  Angie is not a preferred risk.  Her $4,000 deductible HSA (Health Savings Account) policy was not rated Tier 1.  Nor Tier 2.  Tier 3.  Tier 4.  She wasn’t rated Tier 5.  Nor Tier 6.  Tier 7.  Tier 8.  Not even Tier 9.  Angie, a few years post-surgery, was issued, after intense negotiations, at TIER 10.  Her current premium is $482 per month.
How much will her premium be under the new system, a system that doesn’t ask health questions and doesn’t factor in previous illnesses?

HSA Qualified Policy                                        Premium

  $3,000 deductible                                           $518.41

  $6,000 deductible                                           $369.63

Those numbers are real.  Tier 10 is the new normal.
The new 2014 policies would provide Angie coverage for maternity, though at 55 she’s willing to accept that risk.  Her current policy, issued in 2013, already has preventive care and an unlimited maximum benefit.
Much to the chagrin of some of the bureaucrats in Washington and the advocates around the country, the insurance companies, billion dollar corporations, understood who will be applying for health insurance in the next few months.  The doors are being thrown open (well, the exchanges will work eventually) and these are the first applicants:

Our currently insured who have been highly rated
High risk clients covered by  state mandated guaranteed issue contracts
Very unhealthy Americans who can't afford those guaranteed issue policies
These people need affordable health insurance.  More importantly, they need access to health care, but the PPACA does not necessarily meet that need.  Many of the very people this law was meant to serve were surprised when I told them the price.  Some were expecting free.  Almost everyone thought for sure that the premium would be less.
The insurers have no interest in losing their existing clients. For some reason the people pushing the PPACA, the government and the advocates, thought that the insurance companies would dump their entire book of business into the new insurance pools.  Sure this might allow the new clients to pay less initially, right up until all of the young and/or healthy dropped their coverage.  Then what?
Local insurers – Medical Mutual of Ohio, Anthem Blue Cross, UnitedHealth One, etc… - are offering their existing clients an opportunity to renew their policies as of December 1, 2013.  Sign a form and you get to keep your current policy until next December.  What happens in December 2014?  G-d only knows.
This is survival.  The insurers are stocking the pond.  In an effort to attract more 2013 business, major insurers have adjusted their underwriting.  Anthem blue Cross has suddenly decided that maybe smoking isn’t that bad.  Other companies have made similar short term changes.
Are you paying attention?  If you are going to qualify for a major subsidy, if you are suffering from a serious, expensive to treat illness, or if you have had a debilitating accident, you may be significantly better off thanks to the PPACA.  But if none of the above apply to you, then there is still a little time left to get in under the old system, to play by the old rules, to pay premiums based on your risk.
You have a small window before you become a part of the new normal.


Medicare open enrollment started this week and ends Dec. 7

Medicare's open enrollment period for prescription drug plans (Part D) and Medicare Advantage plans is Oct. 15 - Dec. 7. This is the time when you can enroll in a new plan or sign up for coverage.

If you need assistance understanding your options, we have trained volunteers in your community. Our Statewide Health Insurance Benefits Advisors (SHIBA) program offers free help to people with Medicare questions and can help you search for plans online. We even have free Medicare workshops across the state.

Remember, if you want to enroll in  new plan, you must contact Medicare. You cannot sign up through the state's new health benefit exchange,

If you have limited income and need help paying prescription drugs, check out Medicare's "Extra Help" program. To see if you qualify, contact the Social Security Administration at 1-800-772-1213 or go to

For more help, contact a local SHIBA office in your area.

Job seekers - We're looking for a legislative liaison and a policy/rules manager

Two jobs at the Insurance Commissioner's office just posted this week - a Legislative Liaison and a Policy and Rules Manager. Both positions are exempt, open until filled and salary depends on experience.

The Legislative Liaison is responsible for developing and managing our legislative and policy strategy, including developing our legislative agenda, legislative testimony, bill analysis, and stakeholder management. They're also the principal policy advisor to the executive management team on legislative and budget proposals impacting the agency.

The Policy and Rules Manager supervises staff in our Policy and Legislative Affairs division, prepares position briefs, decision memos, reports, coordinates rule-making for the agency, and drafts and adopts rules on behalf of the agency.

If you're interested or know someone who might be, encourage them to apply soon!


See most recent earthquakes in our area - are you ready for the big one?

We're getting ready for tomorrow's Great ShakeOut Earthquake Drill by cleaning out all the stuff under our desk - how about you? It's been a long time since the Nisqually Quake, but if you lived in Washington state then, you probably remember where you were and what it felt like. 
Some of us here in Olympia - only miles from the epicenter - heard what sounded like a freight train. Others saw the ground move like water. Are you ready for the next one? 
Check out the earthquake tracker on KIRO's It'll show you the most recent quake, how big it was and where it occurred.  

And don't forget about earthquake insurance - here's what you need to know.

Next Kölner R User Meeting: 18 Oktober 2013

Quick reminder: The next Cologne R user group meeting is scheduled for this Friday, 18 October 2013. We will discuss and hear about the apply family of functions and the XLConnect package. Further details and the agenda are available on our KölnRUG Meetup site. Please sign up if you would like to come along. Notes from past meetings are available here.

Thanks to Revolution Analytics, who sponsors the Cologne R user group as part of their vector programme.

How to report insurance fraud in Washington state

Our agency -- Washington state's insurance regulator -- handles a wide variety of complaints about insurance fraud by individuals and by businesses.

To report insurance fraud or scams, please see our online reporting form.

We also offer tips to avoid insurance scams, starting with the old-but-true advice that if it sounds too good to be true, it probably is.

We also have some tips on how to identify and report Medicare fraud and abuse, such as being billed for services you didn't receive.

I know the new health subsidies are based on your household income, but how do they define 'household'?

“Household” only includes you, your spouse, and anyone you can legally claim as a dependent on your tax return.

 It generally wouldn’t include a non-marital relationship (such as a boyfriend or girlfriend), except under very limited circumstances.

To get more details, see page 16 of the IRS instructions for filling out Form 1040 or call the IRS (after the government shutdown ends) at 1-800-829-1040.

When your insurance renews, remember to look at the statement

When you get a new insurance policy or your current policy renews, be sure to review the statement. You need to be sure that you're getting the type and level of coverage you asked for. 

Most people simply file away the information -- or toss it. But take a few minutes to look it over first. You really don't want to find out after the fact that a) you were paying for coverage you didn't want or need, or b) worse, that you didn't have coverage for something important.

If you see something that doesn't look correct, contact your agent or insurer immediately, before a loss occurs. If you wait until afterward, you'll likely be stuck with whatever coverage was in force at the time of the loss.

It's also a good idea to periodically review your coverage with your agent or insurer. You may want to add or eliminate coverage as changes occur in your life situation.

Why models need a certain culture to flourish

About half a year ago Ian Branagan, Chief Risk Officer of Renaissance Re - a Bermudian reinsurance company with a focus on property catastrophe insurance, gave a talk about the usage of models in risk management and how they evolved over the last twenty years. Ian's presentation, titled with the famous quote of George E.P. Box: "All models are wrong, but some are useful", was part of the lunch time lecture series of talks at Lloyd's, organised by the Insurance Institute of London.

I re-discovered the talk online over the weekend and found it most enlightening again.

So, what makes models useful? And here I mean models that estimate extreme outcomes / percentiles. Three factors are critical, according to Ian, to embed models successfully in risk management and decision making processes.
  1. Need - A clear defined need for the model.
  2. Capabilities - The skills and resources to build and maintain the model.
  3. Culture - An organisational culture that embraces, understands and challenges the model.
The need, if not driven internally, is often imposed by external requirements, such as regulation, e.g. banks and insurers have to use models to estimate the risk of insolvency in many countries. Building capabilities can largely be achieved by investing in people, technology and data. However, the last factor culture, so Ian, is often the most challenging one. Changing business processes, particularly in decision making at senior level requires people to change.

Where in the past senior management may have relied on advisors' expert judgement to guide them in their decision makings, they have to use models in a similar way now as well. I suppose, in the same way as it takes time and effort to build effective relationships with people, it is true for models as well. And equally, decisions should never rely purely on either other people's opinion or indeed model output. As Ian put it, outsourcing all modelling/thinking, and with that the decision making to vendors of models, such as catastrophe modelling companies or rating agencies, who both aim to provide probabilities for extreme events (catastrophes and companies failures) may be sufficient to tick a risk management box, but can ultimately put the company at risk, if model assumptions and limitations are not well understood.

Perhaps we are at the dawn of another enlightenment? Recall Kant's first sentence of his essay What is enlightenment?: "Enlightenment is man's emergence from his self-incurred immaturity." Indeed, it doesn't matter if we use experts' opinions or the output of models, relying blindly on them is dangerous and foolish. Don't stop thinking for yourself. Be critical! Remember, all models are wrong, but some are useful.

Plotting Your Escape From The PPACA

William was damned near ecstatic. My client had a right to be. William is a 57 year old self-employed Republican pragmatist. He is also very unhealthy. There are no imminent threats. He just suffers from the kinds of things that causes health insurance companies to run away. William’s current health insurance, a $5,000 deductible HSA qualified contract, is $1,055 per month. On January 1, 2014 his premium plummets to $404.

William is now a huge fan of the Patient Protection and Affordable Care Act (PPACA). And if you, like Bill, are paying a lot of money for your health insurance due to your significant health problems, then the new law may save you a lot of money, too. Today’s blog is not for you.

Today’s blog is for those Americans who are reasonably healthy, do not need maternity coverage, and have an income above 400% of the federal poverty level. This is also a post for those people who will not qualify for a federal subsidy for a number of other reasons. The following will actually be relevant for a lot more people than you might think.
Today’s blog post includes numbers. Lots and lots of numbers. Stay with me. This is your money.

The exchanges opened October 1st. There have been, predictably, significant computer issues that will be resolved in time. Some of our insurers are still trying to get their policies and applications approved. I have been advising my clients to ignore the new system until November 1st.

I finally received Medical Mutual of Ohio’s 2014 rates. We don’t have applications, just rates. Here is how the PPACA affects a healthy 58 year old who happens to be fond of a good cigar (ME!).

Current Policy - $5,000 deductible HSA qualified contract - $310 per month

New 2014 Policy - $6,000 deductible HSA qualified contract - $633 per month

If you will bear with me, I will give you a more complete look at some real numbers. The following is a Medical Mutual of Ohio policy, $6,000 HSA qualified contract, for a non-smoker. The 2013 rates assume the insured is healthy. We no longer care in 2014 as we begin to utilize community rating.

                     2013                                                                        2014
            Male          Female                                                  Male and Female
22     $ 55.21         $ 75.43                                                        $166.75
42        92.68          135.67                                                          219.62
62      244.92          254.09                                                          476.20

Community rating is great if you are the sickest guy on your street.
All of these policies, new in 2013 and new for 2014, cover preventive care at 100%. The 2014 policies also cover maternity the same as any other medical condition. But if you don’t have a serious pre-existing condition and you don’t need maternity, you don’t need one of the new 2014 policies.

How do you escape the PPACA if it isn’t going to help you? Get coverage now! A policy purchased now, effective now, eludes the PPACA till the end of 2014. What will we do a year from now? I don’t know, but I would rather save $3,600 over the next year and see what develops.

The Department of Health and Human Services (HHS) has been forced to create this on the fly. Let’s give them an extra year to get this right. If you allow yourself to be victimized by the PPACA, it is your own damn fault.


Hole-in-one insurer pleads guilty to three felonies

Kevin Kolenda, a Connecticut businessman who insurers golf tournament hole-in-one prizes but has a history of not paying, pleaded guilty today in King County Superior Court to two counts of selling insurance without a license and one count of first-degree theft.

Kolenda started Golf Marketing in 1995 and sold hole-in-one insurance coverage to charity golf tournaments across the country including in Washington state. He repeatedly failed to pay winning golfers, leaving charities to come up with the prize money. To skirt prosecution, he also changed the name of his business several times.

Other states where Kolenda sold bogus insurance including: Montana, Ohio, Georgia, California, New York, Hawaii, Alabama, Massachusetts, Florida, Connecticut and North Carolina.

Kolenda paid $10,000 in restitution today. He will pay another $5,000 in four months, when he returns to Seattle for sentencing.

What to do if your Medicare Advantage plan is going away

Medicare open enrollment starts Oct. 15. Some people may have already received a notice saying their Medicare Advantage plan is going away. If you or someone you know has received a notice, here's some steps to take:

  • Check with your medical providers and find out what Medicare Advantage plans they accept in 2014.
  • Read about your rights
  • Avoid a gap in coverage by selecting a new plan before Dec. 31
  • If you can't decide between a Medicare Advantage plan or returning to Original Medicare, see page 59 of the Medicare and You 2014 booklet for help

Need more help? Contact our free Statewide Health Insurance Benefits Advisors (SHIBA), They can  help your evaluate and compare plans. 

WAhealthplanfinder will be down tonight for system improvements

Washington's Exchange - the - is up and running, but some people are still experiencing slow loading times and difficulty submitting their applications. The Exchange is taking the website down tonight starting at 10 p.m. until 6 a.m. tomorrow morning to work on system improvements. Want an update on their progress? Check often.

I hear new health plans must meet 'actuarial value' standards - what's that mean?

All individual and small employer health plans sold inside and outside the new Health Benefit Exchange - - must have an actuarial value of at least 60 percent.

This means the plan must pay for least 60 percent of your medical costs for essential health benefits. Sixty percent is the standard for the new 'bronze level' plans. You also can choose from a silver level or gold metal level plan. Silver plans pay for 70 percent of your costs and gold pay for 80 percent.

Here's answers to additional questions about how the new 'actuarial value' works:

If my plan has an actuarial value of 70 percent  does that mean I will not have to pay more than 30 percent of my entire insurance costs?
No, the actuarial value is only based on the level of coverage the plan provides for essential health benefits.  If your plan has an actuarial value of 60 percent, for example, that means that the plan will pay 60 percent of your covered expenses for essential health benefits and you pay 40 percent of the covered expenses for essential health benefits. 
Although the actuarial value of your covered expenses for essential health benefits will be covered, you may have other costs such as deductibles, copays and coinsurance, as well as costs for services that are excluded or are not covered benefits.

Make sure you read your policy to see what services are excluded services.  Benefits that are not covered would be subject to the terms of your insurance policy, so it is important to read your policy before getting the service or treatment. 
What are essential health benefits? As of Jan. 1, 2014, all individual and small employer health plans must cover these 10 benefits:

  1. ambulatory patient services
  2. emergency services
  3. hospitalization
  4. maternity and newborn car
  5. mental health and substance use disorder services including behavioral health treatment
  6. prescription drugs
  7. rehabilitative and habilitative services and devices
  8. laboratory services
  9. preventive and wellness services, chronic disease management
  10. pediatric services ‐ including oral and vision care


Washington's Healthplanfinder now up and running

After a few hours of technical difficulties earlier today, is now up and running. There may be a few more glitches as additional issues are fixed, so if you're filling out an application, be sure to save your information. Also, the website will be down temporarily tonight at 8 p.m.

Eight health insurers have been approved to sell 46 different plans inside the Exchange. Remember, the Exchange is the only place you can go to receive federal tax subsidies to help lower your monthly premium - and there's only one official Exchange for our state -

If you earn more than the cut-off for a subsidy (about $46,000 for an individual and $94,200 for a family of four), you also can shop for insurance outside the Exchange. To see all of the plans available in your county - both inside and outside the new Exchange - check out this map.

Creating a matrix from a long data.frame

There can never be too many examples for transforming data with R. So, here is another example of reshaping a data.frame into a matrix.

Here I have a data frame that shows incremental claim payments over time for different loss occurrence (origin) years.

The format of the data frame above is how this kind of data is usually stored in a data base. However, I would like to see the payments of the different origin years in rows of a matrix.

The first idea might be to use the reshape function, but that would return a data.frame. Yet, it is actually much easier with the matrix function itself. Most of the code below is about formatting the dimension names of the matrix. Note that I use the with function to save me a bit of typing.

An elegant alternative to matrix provides the acast function of the reshape2 package. It has a nice formula argument and allows me not only to specify the aggregation function, but also to add the margin totals.

Five things you should know about flood insurance

1) Your homeowners policy doesn't cover floods. Flood damage is not a covered peril on standard homeowners policies and most commercial policies, although many people assume that it is. That can be a costly assumption.

2) You can get an estimate of your property's flood risk online with a "one-step flood risk profile."

3) You may have to have flood coverage. Mortgage lenders often require flood coverage if a home is located in a flood-prone area (also known as a "special flood hazard area.")

4) Most people buy flood coverage through the government. Flood insurance is widely available through the National Flood Insurance Program, which is run by the Federal Emergency Management Agency, or FEMA. There are limits, however, on how much damage they'll cover. Many local agents sell NFIP policies.

5) Rates may be going up. In July 2012, Congress passed the Biggert-Waters Flood Insurance Reform Act, which will change the way the National Flood Insurance Program is run. Among those changes: premiums will increase for some policyholders. That's being done to make the program more financially stable.

Why Are You Afraid?

This is a blog. You, Dear Readers, are viewing this online either on the blog’s home site or on the AOL Patch System. You are comfortable online and this is probably only one of several blogs that you read on a regular basis. We know how to research issues. We know how to find the information we need to help us form our opinions or to confirm our long held beliefs.

Our comfort with the internet allows us to laugh at the television reports that paint an issue in strictly solid black or solid white. We can, if we wish, quickly go online and find the shades of gray.

But what if you don’t have internet access? What if you not only don’t have a computer, but you really don’t know how to use one? Then you are at the mercy of your news sources – TV, the newspaper, the radio, and your friends. And many of your news sources like to keep you nervous. Scared to death. Many, but not all.

Monica Robbins is the Senior Health Correspondent at WKYC, Channel 3. Ms. Robbins has been covering health issues in the Greater Cleveland market for over ten years. She and her station have worked diligently to demystify the Patient Protection and Affordable Care Act (PPACA) from its inception. The WKYC website and her on air reports have attempted to answer viewers’ questions in a straight-forward, non-political fashion.

In an effort to build on a mission of providing information instead of fear, Monica Robbins invited the local chapter of the National Association of Health Underwriters (NAHU) to spend three hours last night fielding viewers’ questions. Channel 3 set up a phone bank, brought in snacks and sandwiches, and promoted our availability online, during Dr. Phil, and on the evening news broadcast.

We received nearly 300 phone calls!

There was a common thread that ran through the vast majority of the calls that I received, FEAR. The people who called were afraid of “Obamacare”. How was the new law going to affect them? Would they lose their coverage? Will they be able to afford their new policies?

A third of my calls were from people on Medicare. Aside from the improvements in the Medicare Part D (Rx) benefits, Medicare is pretty much untouched by the PPACA. But my 11th caller was a nervous 68 year old. His buddy told him that the premium for his Medicare Supplement was going to be four times higher next year due to Obamacare. Some friend. There was the 66 year old who was concerned about her vitamin D prescription. And there was the woman in her mid-fifties, still recovering from the surgeries to remove brain tumors, who had been told that the new policies would not cover liver transplants for anyone over 60. There is nothing in the law that prohibits liver transplants for 61 year olds, and she doesn’t need a transplant, but she has heard the reports and she is worried.

There wasn’t a single call, not one, from someone who will be hurt by the new law. My fifth call was a grandmother inquiring about coverage for her 22 year old granddaughter. The young woman is an uninsured college student. I had several calls from people who had lost their jobs, could not afford to exercise their COBRA option, and were now uninsured. Most had dependent children. The PPACA doesn't benefit everyone. What law could? But the concern and fear fueling these calls was a direct result of negative, often fact-less, political messaging.

Two of my calls came from people who were paying a lot of money for their or their spouse’s employer sponsored group health insurance plans. I couldn’t promise that the new health plans would be cheaper. I could reassure them that they will have choices and the opportunity to shop for alternate coverage.

Many of our callers just needed a safe website that could answer their questions. This one, created by the Ohio Association of Health Underwriters, even has a subsidy calculator. I patiently repeated the actual web address for them as they wrote it down before heading to the public library to access the internet.

We were supposed to start at 5 PM, but the phones started to ring before that. After an hour I turned to Ms. Robbins and Ingrid Martin, our Board Member who had helped to organize this, and asked when we were going to do this again. They had already agreed to the need. They appreciated our mutual commitment to helping Greater Clevelanders in making this transition. I’m sure we will be back again in a few weeks.

I, of course, am looking forward to doing this again. A veteran of numerous charity telethons, I love answering the phone on TV. That and we were too busy to meet Russ Mitchell when he came down to say hello. He and I share a real appreciation of Gino Vannelli.