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Qualified Health Plan committee date changed

Thursday, May 31, 2012

The exchange’s Qualified Health Plan advisory committee will meet Friday, June 8th from 10:30 am to noon replacing the June 13th meeting.

Upcoming Exchange meetings

Friday, May 25, 2012

The CT Health Insurance Exchange Board’s next meetings are June 21, July 19 and August 16 all from 9am to noon. The SHOP Advisory Committee will meet June 12th from 9 to 11am, July 11th from 1 to 3pm, and August 8th from 1 to 3pm. The Navigators Advisory Committee will meet June 12, July 10, and August 7 all from 1 to 3pm. The Qualified Health Plans and Benefits Committee will meet June 13, July 11, and August 8 all from 9 to 11am The Consumer Committee will meet June 13th from 1 to 3pm, July 10th from 9 to 11am, and August 7th from 9 to 11am.

Taking the pulse of CT’s Health Insurance Exchange

Tuesday, May 22, 2012

As health insurance reform begins to take shape here in Connecticut there are many important elements of implementation that the Health Insurance Exchange Board, their staff and advocate/stakeholders need to focus on. But nothing is more important than educating health care consumers. Securing reasonably priced, quality health insurance is hard enough; how health care reform, and the Exchange, will help consumers is complex. The educational message needs to reach all segments of our population, bridging age, race, gender and geography. One of those critical groups is entry level employees of small businesses that do not provide health care. Recently, the Exchange board hired a marketing firm, which has been reaching out to groups and individuals to collect and mine data, with the goal of educating the public. But sometimes feedback from a "boots on the ground" approach to data collecting is as helpful, or even more helpful, in bringing clarity. I run such a business, providing commercial maintenance services. To that end, a member of my staff and I spent two weeks talking to two people each day as we did our business at area big box home improvement stores. We asked 3 questions: 1. Are you an employer yes / no? 2. Do you have health insurance ? 3. Do you know what the Health Insurance Exchange is? Of the 40 individuals we interviewed, 31 were employees; 9 were small business owners. Not one of the 40 individuals had ever heard of the Connecticut Health Insurance Exchange. Not one of the 31 employees knew about health care reform. Seven of the 9 employers believe that health care reform will increase their costs; 2 employers (interestingly enough) believed that health insurance would be FREE under reform. One individual confused the CT Health Insurance Exchange with the NY Stock Exchange. Our survey wasn’t scientific, to be sure. But it does provide a very telling indication of just how much work needs to be done on brand development and awareness of the Exchange. And we haven’t even touched yet on the complexities of what it is the Exchange will do. Our informal survey highlights just one of the many challenges the Connecticut Health Insurance Exchange is facing. I am hopeful that the new marketing firm, and the Exchange board will make good use of the wealth of knowledge of the many health care advocates. Where small business owners and employees buy their wares might be a good place to get the message out. Kevin Galvin, owner, CT Commercial Maintenance

Insurance Exchange Board meeting notes

Monday, May 21, 2012

The CT Health Insurance Exchange Board met last week – not much happened. Small business owner, Kevin Galvin, and a consumer who has struggled with health care and insurance access gave very moving public comment to start the meeting. There were lots of updates but no actual substantive information. The committee reports were interesting – somewhat different than reports from advocates who attended them. There was an acknowledgement from the SHOP committee that they need to engage small business owners on the committee; they are going to work on that. They also recognize that the measure of their success should be whether more CT small businesses offer benefits rather than enrollment in the SHOP exchange. MA found that while small business enrollment in their Connector has lagged, more small businesses are finding affordable, decent coverage options and offering benefits to their employees. The SHOP exchange could serve as a competitive catalyst to improve offerings in the entire market. There was discussion about having CBIA run the SHOP exchange as well. The Qualified Health Plan Committee is struggling with defining the essential health benefit package and whether to include all the state mandates. There was discussion about the health benefits offered to employees of the exchange; Board members felt strongly that, as soon as the exchange is operational, employees should get their health benefits there, as will members of Congress. Mintz & Hoke continues their efforts to solicit the best ways to sell the exchange to consumers and small business. They are not collecting input for the exchange to use in designing their system but were asked for the feedback they have gotten so far. Their answers were 1) consumers are confused and uncertain, 2) benefit choices must be kept simple, choosing insurance is intimidating, and 3) they are targeting two populations – families (with mainly women making health decisions) and young invincibles. Upon questioning, they agreed with Vicki Veltri’s experience, matching ours, that the most salient fact about consumers is that they are very distrustful of both insurance and of government. The Exchange crosses both issue areas.

CT’s insurance exchange keeps its solid C grade

Friday, May 18, 2012

Again this month Connecticut health care thought leaders gave our state’s health insurance exchange a C on health reform. Fifteen percent of thoughtleaders gave CT’s exchange a Failing grade; the exchange received no A’s. Several suggestions to improve health reform in CT focused on the exchange including “Speed up progress on the exchange”, “Add consumers and small business owners to [the] exchange board”, “Study what Maryland is doing for their exchange”, and “Get a more representative Exchange Board.” The survey list was collected from membership of health-related state councils, board and committees and leadership of health-related organizations. Respondents represented community organizations, foundations, providers, payers, consumer advocates, labor, business people, insurance brokers, and academics. To ensure independent responses, state officials responsible for reform functions were not surveyed. For more, go to the CT Health Reform Dashboard at www.cthealthreform.org.

Life Insurance Basics

Thursday, May 10, 2012

Many of us buy life insurance because we want to make sure that our loved ones, especially dependents, remain financially secure after we die. Income replacement is the No. 1 reason people buy life insurance. Non-earning caregivers also have an important - and often overlooked - economic value that should be covered by life insurance. Life insurance is also purchased by those interested in achieving specific business or estate-transfer goals. There are many types of life insurance policies depending on your goals, and there are huge price differences among different companies offering identical coverage. Policies are available from hundreds of life insurance companies in the United States. Most financial planners recommend that each family income provider carry no less than 10 times their annual income in life insurance. Here's an orderly way to go about shopping for life insurance: 1) Assess your needed life insurance amount.. 2) Decide on the most appropriate policy type for your goals. 3) Choose possible companies by setting high standards for financial stability ratings. 4) Shop until you find the best price. 5) Look at ways to get the best possible life insurance rate. Life insurance is a long-term proposition, so you should pay particular attention, at time of purchase and throughout the life of the policy, to the financial stability ratings of your life insurance company. Ratings indicate a company's ability to pay claims. Assessing your life insurance needs The first step in life insurance planning is to analyze your life insurance needs - meaning the economic needs of dependents left behind. A great way to determine your coverage needs is to use an online calculator like Insure.com's Life Insurance Needs Estimator Tool. Before purchasing a life insurance policy, consider your financial situation and the standard of living you want to maintain for your dependents or survivors. For example, who will be responsible for your final medical bills and funeral costs? Would your family have to relocate or otherwise change their standard of living after losing your income? The assumption of immediate death is necessary to determine the current life insurance needs for a family or individual. Add in the longer term financial needs of the remaining family members, such as: children's expenses, income for the surviving spouse, mortgage and other debt payoffs, college education funds and an additional emergency fund. Because life insurance needs change over time, your life insurance amount should be reevaluated periodically. We recommend a review at least once every five years or whenever you experience a major life event such as a change in income or assets, marriage, divorce, the birth or adoption of a child, or a major purchase such as a house or business. In theory, you should have a declining need for life insurance as you age because fewer people remain dependent upon you for income support. Exceptions would be protecting a business entity or paying taxes on a large estate for heirs. If the purpose of buying life insurance is to pay estate taxes, then you'll need permanent life insurance, which is in-force as long as you live and pay premiums. Policy choices Life insurance policies [http://www.insure.com/quotesmith/controller?REF=99998&reqid=qstermindex&redirx=x] are divided into two main types: Term life insurance, which provides only death protection without any side funds or "cash values" (offering the least expensive cost per $1,000 of death coverage purchased). Permanent life insurance, which has "cash value" accounts in which a return-on-investment component becomes an often complex and expensive part of the policy (most expensive cost per $1,000 of coverage). Term life insurance The simplest of all life insurance to understand and the cheapest to buy: Term life insurance provides death benefit protection without any savings, investment or "cash value" components for the term of the coverage period. Term life insurance is available for set periods of time such as 10, 15, 25 or 30 years. With "annual renewable term life," your policy automatically renews each year and premiums increase as you get older. Choose "level term insurance" if you want your premium to stay the same for the duration of the policy. Also available is "decreasing term insurance," where premiums remain level but your death benefit declines over time. This is good if you want to cover only a specific debt that decreases, such as a mortgage or business loan. As long as you pay your premiums, the company cannot cancel you. Term life insurance is a popular choice because of the long rate-guarantee periods and because of the ability to get a low cost life insurance policy. However, if you get to the end of your policy term and still need life insurance, you'll need to shop for a new policy, which will then be priced based on your older age and health status. Choosing an initial rate-guarantee period is easy: Match the period of time your dependents need your income to the available rate-guarantee periods. For example, if your children are young and you have decades to go on your mortgage, try 30-year term life. If your children are leaving the nest and your home is paid off or nearly paid off, 10-year term might fit the bill. Other policy provisions that drive the popularity of term life insurance are guaranteed renewal and guaranteed convertibility. Guaranteed Renewal. Before you buy a term life policy, ask the agent or company to confirm to you that the policy contains a guaranteed renewable option, which grants you the right to continue coverage beyond the initial rate-guarantee period without a medical exam. This feature, found in most term life policies sold today, is extremely important should you become sick and uninsurable toward the end of your rate-guarantee period. For example, say that you've been paying $800 per year on a $500,000, 20-year level term life policy and develop cancer near the end of the 20-year period, thus making you uninsurable. Assuming that you want to continue the coverage, a guaranteed renewable clause would allow you to continue the coverage beyond 20 years on an annual renewable basis without an exam, albeit at a much higher annual premium of, say, $8,000 in year 21, $11,000 in year 22, and so on. You may have sticker shock right now but these premiums don't look so high when you are very sick and uninsurable but still in need of coverage. Guaranteed Convertible. Another built-in feature of most term life policies is the right to convert your coverage to any cash value policy that the company might offer at current rates without having to take another physical exam. This feature may be of use in the future if you decide you want cash value life insurance. If you'd like term insurance to cover you for a certain period of time but you're confident you'll outlive the policy, consider a "return of premium" (ROP) term life insurance policy. Under this type of policy, if no death benefit has been paid by the end of your insurance term, you receive all your premiums back (tax-free). Return of premium term life insurance generally costs 50 to 150 percent more than a comparable term policy but it provides a way to hedge your bets no matter what happens. Term life insurance is widely available on the Internet, from direct-to-consumer life insurance companies and from insurance agents and brokers. Cash value life insurance If you want more than a death benefit from your life insurance policy and like the idea of a long-term savings account (not insured by any federal agency) or stock market investment, you might consider cash value life insurance such as whole life, universal life or variable life. But be prepared to pay much higher premiums per $1,000 of coverage precisely because you are now funding a cash value account and paying fees and expenses. In many cash value policies, the annual premium does not increase from year to year. Universal life policies allow you to fluctuate or even skip premium payments, which in turn adjusts your death benefit amounts. Unlike term life insurance, which is easily compared online, cash value insurance is often marketed by agents and brokers in a face-to-face setting, where needs and strategies can be discussed. Because of the complexity and dizzying array of possible outcomes for permanent life insurance, regulators insist that cash value insurance be sold using pre-approved illustration formats. These illustrations can run to 15 or more pages. Cash value life insurance illustrations are divided into two major sections: guaranteed values and projected or "illustrated, non-guaranteed" amounts. Illustrations can be complex and hard to compare in an apples-to-apples way. Pay particular attention to the guaranteed death benefit and premium-payment sections because these columns contain the actual company promises. If you don't like what you see there, walk away. Another caveat: Many cash value policies contain harsh penalties for surrendering the policies in the early years. Changing your mind within the first few years is an expensive decision. Whole life insurance Ordinary whole life insurance offers "permanent protection" with a cash value account that grows over time. Whole life provides a level death benefit and level premiums throughout your life and for as long as you continue to pay the premiums. For example, a healthy 40 year-old female might pay $4,200 per year for a $500,000 whole life policy. The premium remains level at $4,200 per year for the rest of her life and, in the event of death at any age, the policy will pay $500,000 to her beneficiary. Whole life also contains a cash value account that builds over time, slowly at first and gaining steam after several years. You can withdraw your cash value or take out a loan against it, but remember, if you die before you pay back the loan, the death benefit paid to your beneficiaries will be reduced. For example: Susan has a $500,000 whole life policy in force and, over the years, has borrowed continually from the cash value. Her total loan amount and accrued interest totals $300,000. When Susan dies, her beneficiary will receive $200,000 because the life insurance company will first pay itself back from the death benefit. Understand what your beneficiaries will receive upon your death. If you have a traditional whole life policy, your beneficiaries receive only the death benefit no matter how much cash value you've built up. Other payout options available for higher premiums are: Death benefit plus cash value Death benefit plus return of premium Whole life policies can be issued as "participating" or "nonparticipating." Participating policies typically cost more but may return annual dividends if the insurer has a good financial year. Dividends are never guaranteed. Nonparticipating whole life insurance offers no dividends. Buyers of whole life insurance like the certainty of fixed premiums with a known death benefit for life. They also appreciate the "forced savings" component and watching their cash value account build up. Universal life insurance This kind of policy offers greater flexibility than whole or term life. Universal life has many moving parts to understand before you buy. After your initial premium payment, you can reduce or increase the amount of your death benefit. Also, after your initial payment, you can pay premiums any time and in any amount, as long as you don't miss a minimum payment level. In some cases, there are limits to how much extra you can pay in advance. If you choose to increase your death benefit, you may have to provide medical proof that your health has not deteriorated. You will need to manage these policies to maintain sufficient funding, especially because the insurance company can increase charges. Some new universal life policies perform like term life insurance: They can be configured at the time of purchase to provide both level death benefits and level premiums that are guaranteed for life as long as you pay the scheduled premium. Variable life insurance Variable life offers a death benefit with a side fund that operates like an investment account. It shifts the uncertainties of investment gains and losses to the policyholder. The insurance company invests your premiums and offers you a choice of funds in which your money will be invested. Returns are not guaranteed. The amount of money your beneficiaries will receive and the cash value of your policy depend on how well the underlying accounts perform. Theoretically, the cash value can go down to zero and, if so, the policy will terminate. Some variable life policies will guarantee a minimum death benefit. Other permanent life insurance considerations When your cash value account grows large enough, it can be used by the insurer to pay your premiums for the rest of your life. This is known as being "paid up." You can still withdraw your cash value, but you'll have to resume premium payments to keep the policy in force or settle for a reduced benefit that the remaining cash value can support. Your policy illustration will show you how long it may take for your whole life policy to be "paid up." If you no longer want your whole life policy, you can surrender it to receive the current cash surrender value or convert it into an annuity, but keep in mind that cashing in a permanent policy after only a couple of years is an expensive way to get insurance protection for a short time. Riders add benefits You can add riders to your life insurance policy that guard against a number of unpleasant situations. Your insurer will have its own list of available riders, but here are a few: Accelerated death benefit rider (aka living benefits rider): Pays the benefit early if you become terminally ill. Accidental death benefit rider: Pays an extra benefit if you die as the result of an accident. Long term care rider: Pays for long term care expenses should you not be able to do some of the "activities of daily living," such as dressing or toileting. Waiver of premium rider: Waives premium payments should you become totally disabled. How life insurance is priced Your life insurance rate is based on your life expectancy, the face amount you request and the length of the policy, whether it's the duration of your life (whole life) or a specific period (term life). Obtaining a low cost life insurance policy depends, in large part, on your current and past health. Because your current and past health conditions impact your life expectancy, insurers want to know as much as possible about your health condition. Common conditions such as high blood pressure, heart disease, obesity, cancer and depression can all raise your life insurance rate or even result in a declination. Based on your medical history, you'll be grouped into a category such as "preferred plus," "preferred," "standard" and "substandard." Your category ultimately determines your premiums. Insurance buyers with severe health conditions or a combination of conditions can find it hard or impossible to find life insurance. They are known as "impaired risks." Local agents may not be experienced enough to find a company that specializes in insuring people with certain medical conditions. Fortunately, impaired-risk specialists have expertise in knowing where to direct applications for folks with medical conditions. The life insurance buying process The life insurance applications process is paper-intensive, can take weeks and often seems intrusive for people who value their privacy. A face-to-face paramedical examination is generally required for policies in excess of $100,000, which means, at minimum, giving of both blood and urine samples to the paramedical professional. Expect questions in detail regarding your lifestyle, intended foreign travel destinations, your family health history and your personal health history. Do you intend to scuba dive? Have you had parents or siblings with heart disease or cancer before age 60? Have you ever taken any medicine for anxiety or depression? These, and more, are the kinds of questions to expect. Sometimes multiple interviews are required in order to verify your information. The paramed examiner typically asks these questions face-to-face and often insurance companies will conduct follow-up telephone interviews so that you can verify the first set of answers. Regardless of the type of life insurance you buy, most policies require you to meet certain guidelines regarding your lifestyle and health history. If it sounds tempting to shortcut this process by fudging on an answer or withholding information, don't do it. It's a crime in all 50 states to lie about or conceal information on a life insurance application. Besides, policies obtained through fraud can be voided at claim time. Insurers will likely report your medical exam results (reported as numbered codes) to the Medical Information Bureau (MIB), which maintains a database of those who have applied for life insurance in the last seven years. If you've given different answers to medical questions in the past, it will raise a red flag with the MIB. The goal of the MIB database is to reduce fraud. All standard life insurance policies generally cover death by any cause at any time in any place, except for death by suicide within the first two policy years (one year in some states). If you don't care to go through the underwriting process, you have two other, more expensive, options: Simplified issue life insurance can be purchased after answering only a few medical questions. There is no medical exam required. However, if you report health problems, you will likely be declined. Also, if you are healthy, or even if you have some negative medical history, an underwritten policy is still going to be your least expensive. Guaranteed issue life insurance is sold to anyone who applies (up to an age limit) and is by far the most expensive way to purchase life insurance. This should be considered only by those who are declined for everything else but still need life insurance. These policies have graded death benefits, meaning your beneficiaries won't receive the full death benefit until several years into the policy. In naming a beneficiary, keep in mind that the life insurance company will want to see only the names of those who are financially dependent upon you. An acquaintance, friend or relative, absent of a financial relationship, will not do. Working with an agent After reviewing the various life insurance policies available, you might still be unsure about which best meets your needs. The American Council of Life Insurers (ACLI) recommends consulting an insurance agent. ACLI spokesman Jack Dolan says an agent can recommend policies that will meet your needs. "Look at the recommended policy with care to be sure it fits your personal goals," Dolan says. Carefully study your agent's recommendations and ask for a point-by-point explanation. Make sure the agent explains items you don't understand. Because your policy is a legal document, it is important that you know what it provides. Insure.com offers these recommendations for deciding which type of life insurance to purchase: If your agent recommends a term life policy, ask: What is the Standard & Poor's, A.M. Best, Fitch, Moody's and Weiss ratings of this insurance company? What is the initial rate-guarantee period? Is this policy renewable past the initial rate-guarantee period without a physical exam? If so, what are the premiums? Is this policy convertible to permanent insurance without a physical exam? If so, for what period of time do I have the right to convert? If your agent recommends a cash value policy, ask: What is the Standard & Poor's, A.M. Best, Fitch, Moody's and Weiss ratings of this insurance company? Can you tell me, in writing, why you are recommending cash value insurance for me at this time? Why should I combine my life insurance protection needs with my investment objectives? Can you please prepare an analysis for me that shows the true cost of this cash value insurance policy over 5, 10, 15, 20, 25 and 30 years vs. buying term life and investing the difference in long term bonds over those same time periods? How much is your first-year commission on this proposed cash value policy vs. your commission on an equivalent term life insurance policy? Are these proposed annual premiums within my budget? Why do you think that I can commit to paying these premiums over the long term, perhaps decades? How much will I receive if I surrender the policy? Additional Resources Consumer Federation of America's Insurance "Rate of Return" Service Insurance Information Institute: Learn about life insurance Your state's department of insurance may also have life insurance buying guides online For a free life insurance quote or more information on the types of life insurance available, please visit Insure.com. Amy Danise is a staff writer for Insure.com. Visit Insure.com for a comprehensive array of comparative auto, life and health quotes, including a vast library of originally authored insurance articles and decision-making tools that are not available from any other single source. Insure.com is dedicated to providing impartial insurance information to consumers. Visitors can obtain instant quotes from more than 200 leading insurers, achieve maximum savings and have the freedom to buy from any company shown.

Exchange fix bill dies in Senate

The bill to bring the CT Health Insurance Exchange into compliance with federal regulations died on the Senate calendar last night as the session ended. The bill would have added two consumer and two small business representatives to the Board’s membership and given the State Health Care Advocate a vote. Currently there are no voting members representing consumers and three Board members have insurance industry backgrounds. The bill passed two committees and passed the House unanimously but was never called in the Senate. The administration has defended their appointments and the composition of the current Board. Board members are appointed by the Governor and legislative leadership. Thankfully one current member, appointed by House Republicans, is a small business owner.

CT Health Reform Dashboard – CT up to 12.1%

Friday, May 4, 2012

CT has jumped ahead in progress in health reform to 12.1% of the tasks completed, according to the May CT Health Reform Dashboard. This is up from 10.8% last month. While we are closing in on the major January 1, 2014 deadline for many reforms, much remains to be done. At this rate, it will take 5.6 years to achieve reform. The dashboard can be found at www.cthealthreform.org.

Upcoming insurance exchange meetings

Tuesday, May 1, 2012

The CT Health Insurance Exchange Board’s next meeting is May 17th 9am to noon. Upcoming advisory committee meetings include:
  • Qualified health plans committee May 14th 9am to 11am 
  •  SHOP exchange committee May 14th 1pm to 3pm 
  • Consumer committee May 15th 9am to 11am 
  • Navigator committee May 15th 1pm to 3pm
All meetings are at tentatively at the Legislative Office Building.
The Consumer committee will also be holding webinars – Stakeholder Discussions – led by Mintz & Hoke, the exchange’s communications firm. The webinars are scheduled for:
  • Small Employers May 9th 3pm to 5pm 
  • Consumer Session I May 10th 3pm to 5pm 
  • Consumer Session II May 16th 9am to 11am 
For information on how to participate, email Kathy Morelli at kathym@mintz-hoke.com
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