Analysis Paralysis*

Back in April, an agency client (we'll call him Mark) inquired about Long Term Care insurance (LTCi). As usual, I forwarded the link to FoIB Herman Bruns' evergreen primer on purchasing this valuable coverage.

Yesterday, I received this in email:

"Hi,

Just wanted you to know I am still here, just sidetracked with other responsibilities.

I am back to reading about LTC. 

Also I am curious about the combination policies that link together LTC and universal life [ie hybrid plans]; not sure I understand the death benefit. If I don't use the LTCi funds my heirs would receive a death benefit i.e. life insurance?  But you put a lot of money in upfront? Not sure how that compares with annual premiums.

Lots of questions. and apparently one can decide on certain components of traditional LTC.

I am almost at the time where we need to talk."

So, rather than try to answer all that via email, I called him.

The conversation ran for almost an hour, but I took away a few key points that I thought would be helpful to our readers.

First, I told Mark that, while I certainly encourage my clients to be informed consumers, there's a point where that becomes "information overload," and one simply shuts down, unable to make an actual decision.

And that would be bad.

Why?

Well, to paraphrase a dear friend:

The best LTCi plan is the one that is in force on the day you enter the nursing home.

The worst plan is the one that you never bought, and so wasn't in force when you needed it.

So ultimately, it doesn't really matter which plan you buy, as long as you make the conscious decision to either pull the trigger or self-insure.

Now, one may quibble as to which plan design represents the "best bang for the buck," and I'm happy to have that convo, as well. But the bottom lime is that a well-designed plan, that fits one's budget (both current and projected) is the goal, and how one achieves that will determine which type of policy (or policies) will achieve it.

It really is that simple.

(* Thanks, Jeff M!)

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OffBeat BluesNews

■ First up, this item from our friends at GeoBlue (one of our travel medical plan vendors):

"The last thing you want is for one of your clients to be surprised by their coverage, or lack thereof, while living abroad ... it is important to understand options available and how pre-existing coverage may vary between competitors. Preexisting conditions may be covered from day one, pending proof of credible coverage."

This is indeed a critical point, and one that may get short shrift, especially when dealing with folks not just on a cruise or vacation, but especially those who have decided to move to a different country. Regular readers may recall the strange case of Courtney Wilson, for example.

The GeoBlue folks explain that their ex-pat plans "strive to cover as many pre-existing conditions as possible" (at a price, of course).

So, smothering to consider when contemplating that move abroad.

■ "Hey Alexa, what does 'co-insurance' mean?"

Yup, the hi-tech folks at Anthem are now offering a direct line from your Alexa device to a number of online services, including:

• Access to their health savings account (HSA) or health reimbursement account (HRA) balance

• Ability to check how close they are to their health plan’s deductible or out-of-pocket amounts

• Help finding definitions for more than 200 insurance terms

And more.

This can even include access to dental plan info (where applicable).

Caveat: Might want to avoid calling out "Hey Alexa, it hurts when I do this."

Just sayin'.

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Clickbait Uber Alles

I am often amused by the lengths to which clickbait sites will go to generate traffic. Recently, FoIB Holly R tagged my in a Facebook post with the scary tite:

"Coronavirus survival comes with a $1.1 million, 181-page price tag"

Scary!

Of course, the article itself eventually belies the headline (we'll circle back to that).

Regular readers may recall the 2018 story of the "the young lad, attending a wedding reception replete with expensive (and apparently fragile) art work, who (apparently accidentally) knocked over a priceless glass statue,"and whose parents were ostensibly sued for $132,000.Of course, that tuned out to be clickbait, too:

"All the city did was file an insurance claim," Overland Park communications manager Sean Reilly told CNET ... We are NOT seeking payment from the family"

And so it is with the Coronavirus patent mentioned aboive:

"The bill is technically an explanation of charges, and because Flor has insurance including Medicare, he won’t have to pay the vast majority of it."

Oh.

The reason I am so amused by these is the credulity demonstrated by my fellow citizens who immediate condemn these episodes as some sot of indictment of the American health care system (which, to be sure, is far from perfect). This is because we're reluctant to have the real discussion: how much should this treaTment cost? And who decides whether that patient is actually worth it?

And, of course, the post generated the usual "oh, you poor Americans, the Canadian government-run model is so much better and more efficient."

The cognitive dissonance is truly a sight to behold:

The article explicitly (if belatedly) explains that this actually ocuured under a government-run system, and one which certain policitcos have expressly advocated that we should apply to every American: Medicare.

Sheesh.

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Alphabet Soup & CV-19: The Latest

From our friends at FlexBank:

"The COVID-19 relief measures and benefit plan compliance changes keep coming at a rapid pace. Recently, the IRS issued additional notices (beyond the provisions of the CARES Act and the DOL guidance released on April 29th) that further relax rules related to group health coverage and Section 125/FSA benefits."

Specifically, this news applies to an employer's POP (Premium Only Plan), also frequently (and not quite accurately) called a Section 125 Pan.

Briefly, a POP plan is what enables an employer to deduct the employees' portion of the group health insurance premium pre-tax, which generally result in decent savings for both the employer and the emnployee. The plan document is the magic wand that allows this to be considered legit by the IRS.

Oh, and what are those changes?

For example:

"Employees may make a new election to enroll in employer-sponsored health coverage on a prospective basis if the employee initially declined to elect employer-sponsored health coverage."

And there's more - click here for the whole picture.

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Outstanding Vendor Service

My better half has a rather long commute to and from work, most of which is highway miles. As one might imagine, this has resulted in quite a few little chips and dings on her car's hood; last year some gravel really did quite the number on it, and we finally got around this year to having that fixed.

(We went the self-pay route on this, since it was fairly minor and it didn't seem prudent to file an insurance claim)

After getting a couple estimates from local body shops, we selected the Collision Center of Dayton.

Why them?

Well, primarily because Marty (the manager, who also did the estimate) just struck me as a genuinely honest and helpful person. He stressed how important it was that the newly-painted hood match up with the fenders (which were *not* being re-painted), and he spoke about how his "paint guy" was one of the best in the business at this sort of thing.

It also didn't hurt that his estimate was about 20% lower than the other fellows (for the same exact job).

And I also liked that he made a point at the initial appointment that, no matter who did the work, we should follow up in a month or so with a plastic shield (from another vendor altogether) to prevent this sort of thing from happening again.

We drooped off her car on Tuesday, assuming it'd be available for pickup this afternoon. Bit they actually called yesterday about noon to let me know that the car was done. Wow!

So we drove over, and the car looked beautiful, there was literally no indication that it had ever been damaged. Which was what we were promise, and they delivered. But what really stood out was something very small, but tells you everything you need to know about the provide they take in making their customers feel special: they had also cleaned the inside of her car.

We would never have expected that, and it just underscores the value they place in providing excellent customer service.

Recommended!

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Can I Have Medicare Advantage AND a Medicare Supplement?

Yes, but why would you want both?

If you have an MA plan and apply for a Medigap, one of the caveats on the app states "You don't need both an MA and Medigap plan".

Of course no one ever reads those things.

That includes some agents . . .

If you have an MA plan and enroll in a PDP (Prescription Drug Plan), you are automatically disenrolled from your MA plan. But if you only buy the Medigap and forgo the drug plan, your MA plan will continue without missing a beat until YOU cancel the plan.

If you keep the MA plan your Medigap carrier will never see or pay a claim.

Essentially you are paying for worthless coverage.

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Riddle Me This: A Health Insurance Premium Update

So, a few weeks ago, we noted this challenge:

"I’ve gotten $100 back from my auto insurance company because of the decrease in traffic. With health care utilization down as much as 70%, where’s my check from my health insurance company?"

At the time, we posited a few answers, and were even provided a credible rebuttal:

"Only 3% of our April claims were COVID related. And no guarantee the avoided elective procedures won’t skyrocket now. Not the same thing."

But that was then, and this is now.

A small group client just received this from Anthem:

"We continue to look for ways to provide support and financial relief to you and your employees during the COVID-19 emergency.

Shelter-in-place orders across the country have caused significant disruptions to traditional patterns of care. As a response to these challenges, we are supporting our customers by issuing you a premium credit based on your April 2020 invoice."

That is, a credit on their August premium representing 10% of what they paid in April. Is this too little too late, or simply a nice gesture acknowledging the pain we've all been experiencing? I'm in the "don't look gift horses in the mouth camp," and grateful.

#YouMakeTheCall

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