Kreidler achieves settlement with health insurers - approves 10 more Exchange plans

Insurance Commissioner Mike Kreidler has reached settlements with Community Health Plan of Washington and Kaiser Foundation Health Plan of the Northwest and approved their 10 plans for sale in Washington’s Health Benefit Exchange, the Washington Healthplanfinder.

 Consumers in Washington will now have 41 choices in the Exchange when open enrollment begins Oct. 1. Community Health Plan of Washington (CHPW) will have three plans available in 26 counties.

 Kaiser will offer an additional seven plans in Clark and Cowlitz counties.

 Kreidler said the additional 10 plans meet the same high standards held for the other approved companies. They also ensure continuity of care for Medicaid enrollees and create more competition in the marketplace.

 The Exchange set an initial July 31 deadline for the Insurance Commissioner’s review and approval of plans for inclusion in the Exchange, where subsidies for health coverage will be offered as part of the federal Affordable Care Act.

“We had 31 health plans approved by the Exchange’s deadline. Washington consumers now have an additional 10 quality plans to choose from,” Kreidler said.  “We took the initial deadline seriously, but we also followed our own legal process and it worked. The Exchange cannot delay any further. It must take action and approve these plans by Sept. 5.”

Plumber? Attorney? Government Flack!

I have a quick question for the business owners in the audience – How’s it going? Been busy? Terrific. I hate to bother you, but the U.S. Government has another job for you. You are going to help steer Americans to the new Health Insurance Exchanges. And by the way, the gig starts today.

The legislators and staff who gave us The Patient Protection and Affordable Care Act (PPACA) may not have known anything about health insurance, but they were experts in the federal bureaucracy. The PPACA’s home address may be the Department of Health and Human Services (HHS), but the Internal Revenue Service, the Department of Labor and other federal agencies are involved with the implementation. The law has metastasized and can now be found throughout the government, which makes the raw meat mantra of defunding “Obamacare” that much more cynical.

So Mr. or Ms. Business Owner, how are YOU involved? This next section is from the Department of Labor’s website. It is safer to print this exactly as it appears rather than to paraphrase the governmentese and miss something.

Background On The Notice to Inform Employees of Coverage Options Under the FLSA

Section 18B of the FLSA, as added by section 1512 of the Affordable Care Act, generally provides that, in accordance with regulations promulgated by the Secretary of Labor, an applicable employer must provide each employee at the time of hiring (or with respect to current employees, not later than March 1, 2013), a written notice:
  1. Informing the employee of the existence of the Marketplace (referred to in the statute as the Exchange) including a description of the services provided by the Marketplace, and the manner in which the employee may contact the Marketplace to request assistance;
  2. If the employer plan's share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, that the employee may be eligible for a premium tax credit under section 36B of the Internal Revenue Code (the Code) if the employee purchases a qualified health plan through the Marketplace; and
  3. If the employee purchases a qualified health plan through the Marketplace, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.
On January 24, 2013, the Department of Labor (the Department) issued guidance stating the Department’s conclusion that the notice requirement under FLSA section 18B will not take effect on March 1, 2013 for several reasons.(2) The Department explained that this notice should be coordinated with HHS's educational efforts and Internal Revenue Service (IRS) guidance on minimum value. The guidance also stated the Department’s commitment to a smooth implementation process including providing employers with sufficient time to comply and select an applicability date that ensures that employees receive the information at a meaningful time. The guidance further stated that the Department expects the timing for distribution of notices will be the late summer or fall of 2013, which will coordinate with the open enrollment period for the Marketplace.

The Department is issuing this temporary guidance and model notice in advance of the expected timeframe announced in the guidance because, since the issuance of the guidance, the Department has received several requests from employers for a model notice on an earlier timeframe so that they may be able to inform their employees now about the upcoming coverage options through the Marketplace. Therefore, employers are permitted to use the model notice and/or rely on this temporary guidance prior to the applicability date stated below(3) to inform their employees earlier.

OK. How about in English?

Employers must provide a notice to each employee about the new Exchanges. There is no clear exemption for small businesses. Some parts of the health care laws apply to businesses with over 50 employees. There are rules for businesses with 20 employees. This regulation applies to businesses with as few as ONE employee.

The Department of Labor has, thankfully, created a pair of model documents. This link takes you to the form to use if you provide health insurance for any of your employees. This link is to the form for those employers who don’t.

Both forms advise the employee that he/she may save money by purchasing health insurance on the Exchange. Both direct the employee to the government’s website (the home of the internet’s largest collection of pictures of happy people). Both forms ask who at this business may be contacted to confirm information should the employee choose to apply for coverage on the Exchange. And if the employer provides coverage, there is a third page that asks the business to voluntarily provide additional information. Don’t volunteer.

What are the penalties for failing to comply? I have no idea. I gave up looking for that. I am preparing the forms for my clients. Some businesses are sending out blank forms. That would not appear to comply with the law.

How does a small business that doesn’t offer health insurance, and thus doesn’t have an agent, know to provide this form to its employees? You’re reading it. Click on the link and access the form. And how many of your people will sign up for coverage through the new Exchanges? We’ll set sales goals next week.


Visit the website -

googleVis 0.4.4 released with new formatting options for tables

Over the weekend googleVis 0.4.4 found its way to CRAN. The function gvisTable gained a new argument formats that allow users to define the formats numbers displayed in tables. Thanks to J. Buros, who contributed the code.


Session Info

R version 3.0.1 (2013-05-16)
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_0.4.4

loaded via a namespace (and not attached):
[1] RJSONIO_1.0-3 tools_3.0.1

New online tool shows you what individual health insurance costs next year in WA

We've built a new online tool to help you find out what health care plans will cost next year. Simply click on the map -- premiums vary by where you live -- and it will tell you which insurance carriers are offering coverage in your area. You can click on each company to see its rates, which vary based on your age.

A couple of caveats: These rates are mainly for the individual market, meaning people who have to buy insurance for themselves, and don't get it through an employer, Medicare, etc.

Also, the rates do factor in the subsidies that will be available to some people. Those subsidies will reduce the cost of coverage substantially for many people. You can estimate how much you'll pay, with subsidies taken into account, by using this online calculator from the Washington HealthPlanFinder.

Lastly, the list of health plans is likely to grow over the next couple of months. We are still reviewing plans, for example, for multiple insurance carriers that have filed to sell coverage outside the state exchange. And some plans that were rejected for the Exchange have filed appeals. So stay tuned.

An open letter from Mike Kreidler about insurance plans filed for Washington's exchange

An open letter from Insurance Commissioner Mike Kreidler

In January, the biggest changes under health care reform – or “Obamacare” – will take effect. Many health plans, which now have to comply with federal standards, will be significantly better. And hundreds of thousands of low- and middle-income Washingtonians will qualify for subsidies to help pay for coverage.

This fall, Washington’s new Health Benefit Exchange will open for business, giving consumers an easy way to compare health plans, sign up, and see if they qualify for the subsidies.

Many kinds of insurance policies, before they can be sold, must be reviewed and approved by my office. This is a very important consumer protection, designed to ensure that prices are fair and that insurers can deliver on their promises.

I’m pleased to report that based on state and federal law, we were able to approve 31 health insurance plans, from four carriers, for the Exchange. People shopping on the Exchange will have broad choice and significantly better coverage, starting Jan. 1, 2014.

Unfortunately, we had to reject applications from five other insurance carriers. These were not decisions I made lightly. I am a strong supporter of competition and consumer choice, and a longtime supporter of health care reform.

As the state’s insurance regulator, however, I have a duty to protect consumers and to hold all insurers to the same standards. There were substantial problems in the plans we rejected.

Health insurers must have adequate networks of doctors and other health care providers. And there were major problems with the networks of most of the rejected plans. One didn’t offer any pediatric hospital.

Another had no approved retail pharmacy. Certain plans didn’t have adequate access to transplant surgeons, or to HIV/AIDS specialists.

One network would have required people to drive more than 45 miles to see a cardiologist, and more than 120 miles to see a gastroenterologist. That would be like living in Tacoma but having to see a doctor in Bellingham.

These were not minor technicalities. They were major problems.

Some people have pointed out that three of the carriers whose plans were rejected are currently serving people on Medicaid. They worry that people whose incomes rise, making them ineligible for Medicaid, will have difficulty moving to a regular commercial plan, or would lose important continuity of care offered by the community clinics. Many of these community clinics offer important services, such as language assistance or transportation.

Rest assured: The plans I approved for the Exchange include a substantial number of community clinics throughout the state. In many cases, Medicaid patients who want to remain with the same clinic will be able to.

The Affordable Care Act requires all carriers participating in the Exchange to contract with an adequate number of “Essential Community Providers,” or ECPs. These are defined as health care providers that serve high-risk, special needs and underserved individuals. Many Sea Mar clinics, for example, have contracts with the commercial carriers who were approved for the Exchange.

My staff and I worked very hard to try to get all carriers and all plans across the finish line in time. We had dozens of meetings, and 14 webinars to try to walk them through the process. I called one CEO after another, laying out the key issues and timelines. On the final night, July 31, we had staff waiting at their desks until midnight, in order to give the companies every possible minute to succeed.

But some carriers – particularly those new to the commercial insurance market -- simply couldn’t meet the standards this time.

We knew this first big year of health reform implementation would be a bumpy ride, and it has been. But I remain optimistic about the future. We will continue to work with all carriers to help them get ready for the next year, when I fully expect more insurers to succeed.

In the meantime, consumers have a broad number of choices. The insurance is meaningful, the networks robust, the subsidies significant. Again, the process has been bumpy. But it’s a very promising start.

Mike Kreidler
Insurance Commissioner

ChainLadder 0.1.6 released with chain-ladder factor models

Version 0.1.6 of the ChainLadder package has been released and is already available from CRAN.

The new version adds the function CLFMdelta. CLFMdelta finds consistent weighting parameters delta for a vector of selected age-to-age chain-ladder factors for a given run-off triangle.

The added functionality was implemented by Dan Murphy, who is the co-author of the paper A Family of Chain-Ladder Factor Models for Selected Link Ratios by Bardis, Majidi, Murphy. You find a more detailed explanation with R code examples on Dan's blog and see also his slides from the CAS spring meeting.

Slides by Dan Murphy

You Put Your Left Foot In

It was Chicken Cordon Bleu prepared by a lifelong vegetarian. It was a doctoral thesis that had been assigned to an illiterate. It was how I spent four hours and ten minutes Saturday evening. It was the federal government’s online classes for agents and brokers. People who have never purchased nor sold a health policy created these three courses:
  • Affordable Care Act and Marketplace Basics
  • Individual Marketplace Course
  • SHOP Marketplace Course
I read. I passed the quizzes. I aced the tests. I am now qualified to sell policies that are still waiting for approval on a platform that has yet to be created. Welcome to health insurance August 2013.

The Patient Protection and Affordable Care Act (PPACA) mandates that individual health policies will be available through Exchanges. Because you can never find an insurance agent when you need one, Exchanges were to be created by every state as a way for Americans to efficiently shop for health insurance. If a state balked at the potential cost or hassle (or at, G-d forbid, appearing to in any way help implement “Obamacare”) the federal government was empowered to create its own Exchange or a state / federal hybrid. Ohio has opted for the hybrid.

The PPACA mandates Exchanges, but in a widely misunderstood and disliked law, the concept of Exchanges ranks near the bottom of consumer and employer acceptance. So the marketers at the U.S. Department of Health and Human Services (HHS) have given us a new term – Marketplace.

What is a Marketplace? Think Exchange.

Today I learned how we in Ohio, which once had hundreds of choices for small group health insurance, will now have more choices even if the actual number of options is way less. Go ahead and re-read that sentence as many times as necessary until it makes sense. I also learned that there are only nine easy steps for a small employer (2-50 employees) to purchase health insurance coverage for his/her employees through the SHOP Exchange.

The individual Exchange is one way someone can purchase personal health insurance coverage. Why bother with the Exchange? $$$$ Individuals and families earning between 100% to 400% of the federal poverty level will qualify for subsidies. You have to go through the Exchange to qualify for the subsidy. Well over 50% of all applicants will get some premium assistance.

You can almost hear the border collies herding everyone to the pens.

We have been promised a single, streamlined form that could be completed by an individual, done over the phone with a government employee, or prepared online. The online version sounds like it will be the easiest option. The insurance shopper will be able to do this alone, with a qualified agent, with the yet to be fully defined Navigator, or with a volunteer.

The form will ask:
  • Your name
  • Your date of birth
  • Your address
  • Your citizenship / residency status
  • Your marital status
  • Do you smoke
  • Are you incarcerated
  • Your Social Security Number
  • Your income
  • Do you have access to a qualified, affordable health plan at work
Are you eligible for government provided health care
And of course, if they are covering any of your family they will need all of the above for them. The form has yet to be released. There may be more questions on the actual form.

The government will verify your answers through the appropriate agencies and determine your eligibility. Once you are advised of the amount of your subsidy, you may begin to shop for insurance.

A large portion of today’s classes dealt with how to safeguard the PII, Personally Identifiable Information. We have been protecting our clients personal information for years. My office is safe. My records are private. The government should do so well. What has yet to be determined is how the Navigators and volunteer organizations will protect the taxpayer information that will be routinely collected.

Four hours of this silly dance. I suspect that I’ve got another hour with the feds next week. The State of Ohio will have its own class sometime in September. If this is a war of attrition, they’ve picked a fight with the wrong guys. Thirty-five years in the business, I’m ready for the marathon. But I am frustrated with the Hokey-Pokey.


Installing a SSD drive into a mid-2007 iMac

I have a mid-2007 iMac with a 2.4 GHz Core2Duo processor and despite the fact that it is already six years old, it still does a good job. However, compared to a friend's recent MacBook Air with a solid state disk (SSD) it feels sluggish when opening programmes and loading larger documents.

So, I thought it would be worthwhile to replace the old spinning hard disk drive with an SSD, instead of buying a new computer. I still like the display of the iMac. Hence, I got myself a Samsung 840 SATA drive, as it came with a USB cable and bracket hard drive holder.

It actually wasn't that difficult to replace the hard drive in my iMac. Of course I can give no guarantee that this works for you as well. Here are the steps I took:
So far I am really happy with the new SSD. Applications are opening much faster and overall the computer feels much snappier. It looks like it can serve me quite a little longer.

Here are a few pictures of the surgery:

iMac with glass panel and bezel removed
Display and hard drive removed
New SSD and old HDD

Screen shot of the new system preferences

How Do You Spell "Knife"?

There was a time when children would ask a parent or a teacher how to spell a particular word. The adult would inevitably send us to the dictionary. This would often prove to be a lesson in self-reliance, problem solving, and phonetics. But English being English, a dictionary search could also be a frustrating waste of time.

Senator Sherrod Brown invited me to a seminar. The invitation stated that he was bringing the U.S. Department of Health and Human Services to Cleveland on August 8, 2013 to answer questions about the Marketplaces or Exchanges. I emailed my RSVP within minutes of receiving the invitation.

We have all seen a young cheerleader whoop it up after her side’s quarterback has thrown an interception, totally unaware of the gravity of the situation. Well, in the last few weeks I have been on two phone conference / webinars with the Centers for Medicare and Medicaid Services (CMS). As previously noted, the government employees hosting the meetings were woefully unprepared. Cheerleading permeated each seminar. After a basic slide show presentation high on platitudes but almost bereft of facts, questions were thrown to the hosts, who, like the Browns’ receivers, quickly dropped them. These meetings were frustrating wastes of time.

I was counting on Senator Brown to host an informative meeting. Based on the email address, I could tell that this invitation was sent to his supporters, people who had worked on the campaigns and maybe even donated to his campaigns in the past. This was going to be a friendly crowd.

The seminar was scheduled for 5:30 – 7:00 PM at The City Club. That lack of awareness should have been a tip-off. His staff didn’t know that the Browns were playing their first preseason game that night or that the Indians were hosting a Dollar Dog Night game against the Detroit Tigers. Both a few blocks away.

By the way, it shouldn’t be necessary to note this, but the Patient Protection and Affordable Care Act (PPACA) lives at the U.S. Department of Health and Human Services (HHS). Senator Brown bringing in HHS should be the equivalent of having a Supreme Court Justice explain the Constitution.

Wrong Again

Arriving at 5 PM, I knew I had wasted my time the moment I walked into the empty room. Instead of the Senator and an advance team, I saw a couple of staffers and Sherrod on a screen in the front of the room. All they had to do is hit play and we would be treated to a quick canned intro from the Senator. If this presentation wasn’t going to be good enough for him to show, I already knew that I had blown $20 on parking.

The room was eventually filled with leaders of various not-for-profits, Democratic activists, and the terminally confused. There were only three insurance agents in the room. The vibe was positive right up until the presentation started.

Our young presenter was from Chicago. We knew this because she mentioned it, and her need to catch a plane, frequently. Being from out of state was a double liability for her. She was not prepared to discuss the new regulations and she was often wrong about the Ohio health insurance marketplace. Worse, the audience quickly sensed her numerous shortcomings.

Ms. Chicago may have left her pom poms at home, but she was a determined, if not talented, cheerleader. She begged the audience to remember Begged is not an exaggeration. She told us that the government’s website is the answer to every question you could possibly have about health care and the solution to ANY problem you may ever encounter.

I was sitting next to the executive director of one of the dread disease foundations. My tablemate, a young woman in her early thirties, quickly grew frustrated with our presenter’s mistakes, inability to answer the most basic of questions, and repetition of the website address.

If someone representing the U.S. Department of Health and Human Services can’t answer a basic question, who can? I asked a question about the Personal Responsibility Fee, which is the new Orwellian way to say the Individual Mandate. I won’t bore you with the question. She couldn’t answer it. Worse, she said that the answer would have to come from the Internal Revenue Service. THAT IS WRONG. The IRS may have a hand in administering the PPACA, but HHS is writing the rules.

But we still have the website. Good luck finding the answer to your questions there. And we still have dictionaries. The huge Webster’s Encyclopedic Unabridged Dictionary of the English Language sitting on my bookshelf may have almost every word in the English language, but it is still a challenge to find the correct spelling of some words. Sometimes it’s darn near impossible. Don’t believe me? Have your child look up "knife".


Auto insurance and pizza delivery

We get a lot of calls from parents -- and usually those calls are after the fact, unfortunately -- about whether their child delivering pizzas needs additional auto coverage.

Sorry, but the answer's usually yes. Most personal auto insurance policies won't cover you if you're getting paid to use your own car to transport people or property for business purposes.

In general, you'll need to buy a business or commercial auto insurance policy if you are a health care worker who occasionally uses your own car to take clients to appointments. The same is true if you use your own car to deliver flowers, newspapers, pizzas, etc.

If you have questions about your coverage -- and policies do differ -- contact your agent or insurance company directly.

Health insurance questions: Preventive colonoscopies and polyps

Until fairly recently, when consumers had routine preventive colonoscopies, they often faced a substantial bill for surgery if a polyp was discovered and removed during the procedure. But current guidelines from the U.S. Department of Labor, under the Affordable Care Act, protect consumers from these extra charges for polyp removal.
Q5: If a colonoscopy is scheduled and performed as a screening procedure pursuant to the USPSTF recommendation, is it permissible for a plan or issuer to impose cost-sharing for the cost of a polyp removal during the colonoscopy? 
No. Based on clinical practice and comments received from the American College of Gastroenterology, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and the Society for Gastroenterology Nurses and Associates, polyp removal is an integral part of a colonoscopy. Accordingly, the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. On the other hand, a plan or issuer may impose cost-sharing for a treatment that is not a recommended preventive service, even if the treatment results from a recommended preventive service.
In addition, the federal guidelines help people with a family history that put them in a high risk group for certain diseases. They will now be able to get more frequent preventive care without additional costs.
Q7: Some USPSTF recommendations apply to certain populations identified as high-risk. Some individuals, for example, are at increased risk for certain diseases because they have a family or personal history of the disease. It is not clear, however, how a plan or issuer would identify individuals who belong to a high-risk population. How can a plan or issuer determine when a service should or should not be covered without cost-sharing? 
Identification of "high-risk" individuals is determined by clinical expertise. Decisions regarding whether an individual is part of a high-risk population, and should therefore receive a specific preventive item or service identified for those at high-risk, should be made by the attending provider. Therefore, if the attending provider determines that a patient belongs to a high-risk population and a USPSTF recommendation applies to that high-risk population, that service is required to be covered in accordance with the requirements of the interim final regulations (that is, without cost-sharing, subject to reasonable medical management).
If you're having problems with your health insurer over these sorts of issues and you live in Washington state, feel free to contact our consumer hotline at 1-800-562-6900 or email us

Setting axes limits with googleVis

I posted about the various googleVis axis options for base charts, such as line, bar and area charts earlier, but I somehow forgot to mention how to set the axes limits.

Unfortunately, there are no arguments such as ylim and xlim. Instead, the Google Charts axes options are set via hAxes and vAxes, with h and v indicating the horizontal and vertical axis. More precisely, I have to set viewWindowMode : 'explicit' and set the viewWindow to the desired min and max values. Additionally, I have to wrap all of this in [{}] brackets as those settings are sub-options of h/vAxes. There are also options minValue and maxValue, but they only allow you to extend the axes ranges.

Here is a minimal example, setting the y-axis limits from 0 to 10:

With more than one variable to plot I can use the series argument to decide which variables I want on the left and right axes and set the viewWindow accordingly. Again, here is a minimal example:

Session Info

R version 3.0.1 (2013-05-16)
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_0.4.3

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

Everybody's Happy!

A billion here, a billion there, and pretty soon you're talking real money.
Senator Everett McKinley Dirksen (1896-1969)

The new rates are out!  The new rates are out!  The Cleveland Plain Dealer reported today (won’t be able to say that much longer) that we finally have the new individual rates under the Patient Protection and Affordable Care Act (PPACA).  These are the prices that Ohioans will pay if they purchase coverage through the new exchanges.  And everyone is thrilled.  Positively giddy.

Mary Taylor, Lt. Governor and Insurance Commissioner, announced that our rates will be going up an average of 41%.  The Ohio Department of Insurance is projected our average adult premium will be $332.58 per month.  The Democrats were happy since they were worried that the number was going to be higher.  The Republicans were celebrating another opportunity to complain about escalating costs.  And average Ohioans, numb from way too many political ads last November and the recent budget shenanigans, chose to focus on the streaking Cleveland Indians.

Of course, loving the numbers wasn’t really good enough for either side.  Thankfully there are plenty of chances to evangelize their message and fight with the other side.  And everyone has a dog in this fight.

Approximately 80 – 90 percent of the people purchasing policies on the public exchange will qualify for a subsidy from the federal government.  As we have discussed previously, the federal government will help you pay your health insurance premium if you earn between 100% - 400% of the federal poverty rate.  That means if you earn less than $45,960 as a single or $94,200 as a family of four, you may qualify for assistance if your employer doesn’t provide adequate group health insurance.

The left is happily furious that Ms. Taylor reported the real number, $332.58, and not what someone might pay if he/she qualifies for a subsidy.  The Plain Dealer article notes that a 30 year old making $30,000 per year would have a premium of $285 per month, but that the federal government would cover $76 of that monthly fee.  Our hypothetical 30 year old would really have a premium of $209 per month.

At the risk of appearing to take sides – BALONEY!

1. The premium really is $285.  Some of it will be paid by the insured and the rest will be paid, in real dollars, to the insurance company.
2. That $76 is actually $912 in year one.
3. President Obama postponed the employer mandate, the tax that was scheduled to cover the cost of subsidizing the individual policies.
4. The uninsured 30 year old that was in my office yesterday was thrilled to acquire a health policy for $92.39 per month.  She would not have purchased a $209 policy.  And yes, coincidentally, she is a hairdresser making $30,000 a year.

The good news is that if my 30 year old hairdresser is forced to purchase a policy through the exchange next year, she will be acquiring maternity coverage at no additional cost.  She doesn’t think that she needs it, but it couldn’t hurt.  My healthy thirty year old male clients are looking at larger price bumps without a meaningful increase in benefits.

The Patient Protection and Affordable Care Act was supposed to be revenue neutral.  Sure there were costs associated with implementing the bill, but there were sources of revenue, too.  The first to disappear was the CLASS ACT, a program that was to pay for long term care eventually but front-load some early money for the PPACA.  That program ended almost two years ago.  The real money stream was to come from the employer mandate.

The nonpartisan Congressional Budget Office has estimated that delaying the employer mandate will cost us $12,000,000,000.  The Washington Post also reports that the CBO estimates that as many as 1 million fewer people will be insured due to the delay.

While the left denied the existence of mathematics, the right pretended that everyone in our country has access to comprehensive health care.  Blinders on and fully aware that their actions are equivalent to doing nothing, the Republicans of the U.S. House of Representatives voted today for the 40th time to repeal all or most of Obamacare (PPACA).  Then they went home for the summer recess.  This vote was so irrelevant that the major new outlets ignored it.

But back to Ohio.  Our rates are going up, but it could have been worse.  If you are unhealthy, pregnant, or earning less than 400% of the federal poverty level, the policies may prove to be a good deal.  And if you’re not, well the Indians are 60 – 48.


WA Supreme Court: Insurer can be held liable for agent's actions

In a case that’s been closely watched by the insurance industry, Washington’s State Supreme Court on Thursday affirmedthat insurers are liable for the illegal actions of their agents.

“The ruling is a big win for consumers,” said Insurance Commissioner Mike Kreidler, whose decision the case was challenging. “If you allow someone to do business on your behalf, it only stands to reason that you can be held responsible for what they do.”

The case involved violations of the state’s insurance laws in 2006 and 2007 by an insurance agency appointed by Chicago Title Insurance Company. That agency, Land Title Co. of Kitsap County, Inc. repeatedly offered illegal inducements to get business. The violations included illegally “wining and dining” real estate agents, builders and mortgage lenders with free meals, donations for a golf tournament, monthly advertising, and Seattle Seahawks playoff game tickets.

Although Land Title was Chicago Title’s exclusive agent in the Washington counties at issue in the case, Chicago Title argued that it was not responsible for its agent’s actions. In a consent order signed in 2009, the company agreed to pay a $48,334 fine if it did not prevail in court.

“Chicago Title’s arguments were contrary to a century of insurance law,” said Kreidler. “In order to effectively regulate insurers and protect consumers, it’s important to hold insurers responsible for the actions of their agents.”

Title insurance practices have long been a concern to Kreidler, whose office in 2005 scrutinized 18 months of employee expense reports and ledgers for the largest title companies in King, Pierce and Snohomish counties. The examination found many cases in which the companies were providing gifts, golf tournament sponsorships, parties, ski trips, sports tickets, meals and other inducements to get business.

“Few people shop for title insurance, although they certainly can,” said Kreidler. “It tends to be included in the large stack of documents that homeowners are handed to sign. So title companies and others in the industry are positioned to steer business to particular insurers.”

New rules took effect in March 2009, clearly outlining what can be given. There are limits on advertising, donations to trade associations, meals, training, leasing workspace and gifts.