Kind of Off-Topic, but...

This is pretty amazing:

"2nd baby is born from dead donor's transplanted womb at Cleveland Clinic"

Most of us are familiar with posthumous organ donation (heck, there's even a checkbox on drivers' licenses), but I daresay that likely includes corneas and kidneys, hearts and lungs, that kind of thing. I've even heard of harvesting sperm from a dying father.

But this one is new to me. And it gets even more interesting:

"It's the second child in the hospital system to be born from a dead donor's transplanted womb." [emphasis added]

Wow - And Mazel tov to Mom!

[Hat Tip: Holly R]

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From the folks in DC

Comes this helpful video on how to report federal pandemic unemployment compensation. Although it's geared for agents, seems perfectly suitable (and informative) for consumers, as well:

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This is Weird: Revisited

The other day, Hank posted on the difficulty he was having reconciling why a given person's group health insurance rate changed depending on whether they were the employee or the employee's spouse. That post, and some back-and-forth in the comments, sparked my curiosity. 

Hank said

"up until about age 40, the male spouse rate is actually lower than the male employee rate. And at age 35,female employees are actually more expensive than their(presumably) stay-at-home counterparts."

So I graphed the data based on the original post.

1.  Male employee vs male spouse
2.  Female employee vs female spouse

Graph #1 addresses the first reference above (click to enlarge):

The premium rates differ in specific amounts, but the differences are not material below age 50.  After age 50 the spouse rate rises above the employee rate.  This insurance company apparently has data that support the higher cost for older male spouses vs older male employees.  I’m guessing that older male spouses tend to have more health conditions that prevent them from working.  That would show up in the experience of the pool, and its effect would likely grow as the individuals age.

Graph #2 addresses the second reference:

The main difference in this graph vs. Graph #1, is seen in ages under 35.  My guess is that the female spouse rate is higher than the female employee rate through these younger ages because of marginally higher maternity liability.  That difference then closes rapidly.   After age 54 the female spouse again appears to be more costly.  Again, I don't dispute that the insurer’s cost data support the differences.  After taking maternity into account, the result observed in Graph #2 is consistent with the result observed in Graph #1.   It may well have the same origin i.e., that older female spouses tend to have more health conditions than older female employees, that prevent them from working.

Another possibility is that this insurance company’s pool includes marginally more male spouses who are employed (under age 50, anyway), and therefore represent a lesser liability to the female employee's plan because of COB (Coordination of Benefits).

Whatever, and aside from the actual dollars-and-cents differences in rates, the shapes of the lines on the graphs seem to me consistent.

I think the actuarial correspondent is correct about the beneficial effect of selection for employees vs spouses.  It’s visible in the premium rate relativities in all the other premium rate graphs I created (see PS, below).   I'm surprised he did not mention (or maybe he did?) the cost of maternity for younger females, regardless whether working or not.  That’s visible in the graphs, too.

In each of the questions you’ve raised. I’m not claiming I have a full explanation.  While I think my guesses may be a good part of the explanation, we’re still left with questions.

"We started with one question, and ended up with many questions."  One of my profs in college (philosophy, not mathematics) often made that remark at the end of his lectures - and then always concluded by saying "What a marvelous bargain!"    I still think that insight was worth the whole semester's tuition.  At least for his class.  (In 1965, the undergraduate tuition at my school for a 3-hour class was only about $150).

Which means - - this exercise was a bargain!

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A Win for Private Medical Practices

Math is hard

Especially in these difficult times. On the plus side, I recently received this news in email from the Feds:

"Helping consumers calculate their income can be challenging, especially for those who are self-employed or have income that is difficult to predict. The Centers for Medicare & Medicaid Services (CMS) has released a new tool to make this process easier!

The new income calculation tool allows consumers to add previous income, unemployment benefits (including federal pandemic unemployment compensation), and expected future income to calculate their income."

They've even supplied a helpful video:



Feeling frisky? Well then, click here to test drive the new tool itself.

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So this is weird

Working on a new group quote, finally noticed something I suppose I've know all along, but just never 'paid any attention to.

Take a look:

[click to embiggen]

It's never really "clicked" for me until the other day that at any given age, the rates are different for employees versus spouses. That is, a male employee's rate is always different than that same age male spouse, and same for females.

Why?

After all, that person is the same risk regardless of whether he or she is the employee or the spouse. Or is he (or she)?

So I reached out to FoIB (and actuary) Gregg Fann for his insights, and he replied that it likely has to do with the "actively at work" clause in group plans. That is, dependents (spouses) aren't necessarily that healthy.

And I can see that, but it still doesn't wash, because, well, up until about age 40, the male spouse rate is actually lower than the male employee rate. And at age 35, female employees are actually more expensive than their m(presumably) stay-at-home counterparts.

I realize that in the grand scheme of things this is really not a huge deal, but it's been bugging me for a few days now: why the difference?

Any thoughts on this?

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Another great idea

This reminds me somewhat of the Sesamecare site which "takes the reduced-fee, cash only model and expands it to include primary care and dental visits, eye exams and MRIs, and other services." So there's precedence:

"I’m building a network of cash friendly medical providers in the DC Metro area."

This is from FoIB Sheron Sidbury, an agent in Virginia, who's expanding her menu of client services in a very meaningful way. She's taken a clue from our friends in the DPC and cash-provider worlds, and then gone a step further:

"[M]y goal is to help people in our local area find cash pay and other non-insurance methods to take care of their healthcare needs."

I love this.

Why?

Well, as we've noted ad nauseum, coverage ≠ care, and with today's emphasis on both higher deductibles and health care pricing transparency, this seems like a wonderful opportunity to help her clients. This effort is still in the embryonic stages, but I expect that it will grow quickly as more and more providers learn about it and hop aboard. Hopefully, this can continue to expand to other markets, as well.

So, fingers crossed hopefully.

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