EZ Short Term Medical Insurance ends

The health insurance market continues to evolve at a rapid pace. Insurance plans that have been popular in the past are being replaced with new insurance and non-insurance products. A range of the latest products are listed for each state at Freedom Benefits.

The Trump administration proposes expanding these limited benefit insurance plans so we expect that a range of new products will be available soon.

Exploring the phenomenon of increased early insurance terminations

An increasing number of consumers are terminating health coverage within days, weeks or months of buying health insurance online.

I’ve noticed a trend in online health insurance enrollment that seems to be accelerating. I don’t understand it yet; this post is primary a basis to seek additional information.

The observation: The incidence of early termination of benefits is accelerating. In a growing number of cases, the benefits are canceled within days of online enrollment.

Background: I’ve been involved in online health insurance enrollment since the early 1990s an ran a national enrollment service for about a decade. In those early days online insurance enrollees typically relied on professional advice and assistance via telephone that, in my observation, contributed to increased suitability and satisfaction. Today’s health insurance exchange enrollees typically do not use available human advisory services so there is less data available on the motivations, psychology or emotional influences of enrollees on the insurance enrollment process.

Possible explanations:

Lack of consumer information – I’ve long been suspicious that online health insurance enrollees do not have sufficient information to make appropriate decisions. I’ve noticed, for example, confusion between primary coverage and supplemental health insurance.

Confusion with the Affordable Care Act – The Trump administration’s push to promote lower cost insurance with lower level of benefits may be misunderstood by consumers. Consumers may not understand for example, that they may enroll in expensive coverage that covers pre-existing medical conditions without limits OR low cost coverage that limits those benefits, but that they can not enroll in low cost insurance that covers pre-existing medical conditions in the entirety.

General distrust – Formerly an online consumer typically felt they could trust advice from a telephone support. I’m not sure that is true anymore. The wave of ‘fake news’ and propaganda about heat care this year is unprecedented.

Short term use – It is possible that consumers are enrolling for coverage immediately before a schedule doctor visit, for example, and cancelling coverage immediately afterward. I have only  few anecdotal comments to indicate this might be true. No reliable base of information is available. Some commenters speculate this will be accelerated by the cancellation of the health insurance requirement known as the ‘individual mandate’ under the Tax Cuts and Jobs Act.

Solutions: One possibility is to include health insurance advisory services as part of an employer-provided employee benefit plan. Not coincidentally, this is the approach that Freedom Benefits has adopted for 2018.

Another possibility is restoration and expansion of the health insurance navigator program that was established in 2010. This does not seem politically likely under the current political leadership.

A third possibility is to use improvements in technology to screen applicants and communicate on suitability and policyholder satisfaction issues. Our partners are working on these issues that require a greater investment in Artificial Intelligence and technology.

Insurance for small businesses

Q: Do you offer plans for small business? We are a small business of 3 people. Or can they purchase health insurance through you individually?

A: All of these plans shown in links related to Freedom Benefits are available to small businesses on a list bill basis. The easiest thing is to allow individuals to enroll without entering payment data and then ask us to set up the list bill.

If the business plans to pay for Obamacare-type individual insurance then an additional step is required to set up a Qualified Small Employer Health Reimbursement Arrangement.

Small group major medical coverage may also be available however these are traditionally not purchased through online enrollment services. A local representative may be the best bet.

Interesting trends in individual health insurance

This past week the individual health insurance open enrollment period for 2018 closed in 39 states using the federally controlled insurance exchange called Healthcare.gov.  We think that the trends favor growth in services like Freedom Benefits. The U.S. Department of Health and Human Services is charged with reporting on the results of that enrollment period. Associated Press dug into the enrollment data further and published some surprise results. Taken together with other previously released information, these are the trends in individual health insurance:

Overall, enrollment was unexpectedly strong considering the actions that factions of the federal government took to sabotage its own program. Without enrollment support, without advertising and with a short enrollment period almost 9 million signed up for coverage.

This insurance exchange is exclusively for working people with a suitable income. In most states, those who do not meet minimum earnings levels are not allowed to enroll through Healthcare.gov but instead are referred to state Medicaid programs.

Most applicants (about 4 out of 5) qualify for a reduced premium based on their earnings that keeps their total expense at or below 16% of household income.

The total enrolled is far less than the projections made by the Department of Human Services before the Trump administration took actions to sabotage the insurance program.

The Trump administration shortened the enrollment period and cut off advertising funding so that fewer people would sign up for their benefits. The strategy worked to some extent. Fewer people enrolled for health insurance in 2018.

Most Healthcare.gov enrollees (about 7.3 million of the total 8.8 million enrolled) live in rural working class areas that voted for Trump and Republicans in 2016. Political observers predict that the government’s efforts to cut the health benefits of the working class will hurt their chances in future elections.

Yesterday President Trump said that he hopes and expects that his party’s success in eliminating the tax penalty known as the ‘individual mandate’ will ultimately result in a collapse of these federally funded health benefits for working-class Americans.

The number of people in the U.S. without health insurance is rising again. This was the impetus that pushed us into health care reform from the 1960s through 2010.  It’s difficult to believe that the problem will fester for another 50 years before the government takes action again.


The takeaways that are important for us at Freedom Benefits:

There is opportunity for year-round enrollment outside of the exchange open enrollment period.

The elimination of the individual mandate penalty means that it is no longer important that insurance meet federal legal requirements. Consumers are free to pick the insurance they want.

There will be demand for the lower priced insurance called skinny plans, short term medical, supplemental plans and limited benefit medical insurance.

The Trump executive order to promote the sale of insurance across state lines means that citizens in locations without low priced insurance may soon have other options.


I predict that most of the individual health insurance market will return to the private sector enrollment within a year.

ID cards not issued to dependents

I received this question from a health plan member today regarding ID cards for covered dependents. The information may be worth sharing because this is a common question:

MEMBER QUESTION:  I got two I.D card both have my name, i want to ask where is my daughter’s I.D card

MY RESPONSE: I am responding as the independent adviser and not as a representative of your insurance company.

To the best of my knowledge, ID cards are always issued in the name of the policyholder. I am not aware of any legal authority which allows and insurance company to issue an ID card in the name of a covered dependent. Duplicate ID cards may be issued and these may, include the names of covered dependents. The actual content of printing on the ID card varies among plan administrators.

For more information, you may wish to contact the members services office by telephone as listed on your insurance ID card.


The point is that:

  1. ID cards are typically not issued in the names of dependents.
  2. Some, but not all, health plan administrators list the names of covered dependents of the card.
  3. ID card printing and issuance practices vary between insurers but this practice of issuing cards only to the policyholder is consistent.

VBA Accident Insurance Summary of Benefits

This content is provided for educational purposes only and is not an offer of coverage and is not intended to represent a communication from an insurer.


2The Benefit Amounts shown above for Dental, Physical Therapy, Orthopedic Appliance, and Transportation are part of, and not in addition to, the Maximum
Benefit Amount for Accident Medical Expense. Payment of these Benefit Amounts reduces and does not increase the Benefit Amount for Accident Medical Expense.

If an insured person has multiple losses as the result of one accident, the policy will only pay the single largest benefit amount applicable.

24-Hour AD&D Insurance:
covers you 24 hours a day, 365 days a year, anywhere in the world while at work or at play.

Accident Medical Expense:
This benefit will reimburse up to the maximum amount if accidental bodily injury causes you to first incur medical expenses for care and treatment within 90 days after an accident. The benefit amount for accident medical expense is payable only for medical expenses incurred within 52 weeks after the date of the accident causing the accidental bodily injury. The benefit amount is subject to the deductible and the maximum benefit amount. Payment of the benefit amount for accident medical expense is subject to the sub-limits for dental, physical therapy, orthopedic appliances and transportation expenses shown. In no event will total payments for your dental care and treatment, physical therapy, orthopedic appliances, transportation and medical expense exceed the benefit amount for Accident Medical Expense. For residents of CT, ID, IN, MD, NJ, NY, and SD, this benefit is payable on a primary basis. For residents in all other jurisdictions, this benefit is payable on an excess basis; we will determine the reasonable and customary charge for the covered medical expense. We will then reduce that amount by amounts already paid or
payable by any other plan and will pay the resulting amount less the deductible. In no event will we pay more than the maximum benefit amount. The deductible will be deducted from any benefit amount for Accident Medical Expense that is paid. This Deductible applies separately to each Insured Person and each Accident.

Limitation on Accident Medical Expense: This benefit does not apply to charges and services 1) for which you have no obligation to pay; 2) for any injury where worker’s compensation benefits or occupational injury benefits are payable; 3) for any injury occurring while fighting, except in self-defense; 4) for treatment that is educational, experimental or investigational in nature or that does not constitute accepted medical practice; 5) for treatment by a person employed or retained by the Policyholder; or 6) for treatment involving conditions caused by repetitive motion injuries, or cumulative trauma and not as the result of an accidental bodily injury. This insurance applies only to medically necessary charges and services.

Extensions of Insurance: Exposure
– If an accident causes you to be unavoidably exposed to the elements and as a result of such exposure you have a loss, then such loss will be insured under the policy.

Disappearance
– If you have not been found within 1 year of a disappearance, stranding, sinking, or wrecking of any conveyance in which you were an occupant at the
time of the accident, then it will be assumed, that you have suffered loss of life insured under the policy.

Exclusions:
Insurance does not apply to any Accident, Accidental Bodily Injury or Loss when the United States of America has imposed any trade sanctions or there is another legal prohibition to providing the insurance, or when caused or resulting from:

1) an Insured Person acting/training as a pilot or crew member. (unless temporarily performing duties in a life threatening emergency.);

2)an Insured Person’s emotional trauma, mental or physical illness, disease, pregnancy, childbirth or miscarriage, bacterial or viral infection (unless the bacterial infection is caused by an Accident or by Accidental consumption of a substance contaminated by bacteria.), bodily malfunctions or medical or surgical treatment thereof. ;

3) an Insured Person’s commission or attempted commission of any illegal act, including but not limited to any felony;

4) an Insured Person being incarcerated after conviction;

5) an Insured Person being intoxicated, at the time of an Accident.;

6) an Insured Person being under the influence of any narcotic or other controlled substance at the time of an Accident. (unless taken and used as prescribed by a Physician.);

7) an Insured Person’s participation in active military service (except for the first 60 consecutive days of active military service);

8) an Insured Person’s suicide or intentionally self-inflicted injury;

9) a declared or undeclared War.

Description of Coverage: Once you are enrolled in the plan, you will receive a description of coverage.

WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant.

Insurance is underwritten by Federal Insurance Company, a member insurer of the Chubb Group of Insurance Companies. The coverages described in this literature may not be available in all jurisdictions. This literature is descriptive only. Actual coverage is subject to the language of the policies as issued
(Policy # 9907-05-81 & 9907-05-82). Exclusions Apply. This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. The expected benefit ratio for this policy is 85%. This ratio is the portion of future premiums which the company expects to return as benefits, when averaged over all people with this policy.

IMPORTANT NOTICE—THIS POLICY DOES NOT PROVIDE COVERAGE FOR
SICKNESS.

Chubb, Box 1615, Warren, N.J. 07061-1615

Highlights of coverage are listed here. 

The source of this content is the product brochure.

 

Value Benefits of America Terms and Conditions

This content is provided for educational purposes only and is not an offer of coverage and is not intended to represent a communication from an insurer.

1. Member understands that VBA is not an insurance company or program. Accident Benefit Payments are made by the insurance company issuing the blanket coverage to Members.

2. VBA provides savings to its members on services through a number of sources. The current list of benefits may be modified through additions or deletions. A quarterly newsletter, posted on our web site or sent via e-mail, will keep Members up to date on benefits and other pertinent information.

3. Payments for the VBA Program are due in advance. Payments will be drafted on or about 15 days before the due date. If you choose to cancel your program, it is your responsibility to make sure that your membership card and a written request for cancellation are sent to VBA at least 15 days prior to the anniversary of your effective date in order for your account not to be
charged for additional fees.

4. Member hereby appoints Value Benefits of America (VBA) President, or failing this person, a VBA Director, as proxy holder for and on behalf
of the member with the power of substitution to attend, act and vote for and on behalf of the member in respect of all matters that may properly come before the meeting of the members of VBA and at every adjournment thereof, to the same extent and with the same powers as if the undersigned member were present at the said meeting, or any adjournment thereof. Annual meetings are to be held in Arizona the second Tuesday of August.

5. VBA reserves the right to terminate any enrollment or deny eligibility in
the program for lack of payment to VBA. Returned checks, insufficient notices on bank drafts or denial by the member’s credit card company for payment of the membership fee is deemed to be evidence of non-payment by a member. There will be a $10.00 charge to be reinstated in the program after such denial. If reinstatement for non-payment happens more than once, a $20.00 reinstatement fee will apply.

6. In the event of any dispute, member agrees to resolve said dispute solely by binding arbitration that shall be governed by the laws of the state of Arizona and enforceable at Scottsdale, Maricopa County.

7. Membership canceled within the first 30 days of the enrollment date may be eligible for refund if the membership card and written cancellation request are sent to VBA. The administrative fee is not refundable. Approved refunds will be processed approximately 30 days after the cancellation.

8. Membership is effective on the 1st of the month following enrollment acceptance by VBA.

Member Agreement:
By signing your enrollment form, Member expresses desire to become a member of Value Benefits of America. Member acknowledges that the
discount plans ARE NOT INSURANCE, but membership includes certain limited supplemental insured coverage’s. Membership benefits are not a replacement for health insurance coverage nor are they intended as a substitute for health insurance coverage. Membership fees may change for all members, but not individually, with notification.

The source of this content is the product brochure.

Highlights of VBA Accident Medical Expense Insurance

This content is provided for educational purposes only and is not an offer of coverage and is not intended to represent a communication from an insurer.

 

Value Benefits America (VBA) Accident Medical Expense Plan Highlights:

VBA Including Accident Medical Expense
VBA Membership With Accident Medical Expense Plus AD&D
Accident Coverage – Best in Class – Great complement for High Deductibles
Issue ages 18-64 – Guarane Issue – Fast/Easy Issue
For: Individuals, Families or GROUPS (EFT or List Billing)
AME Benefit levels: $2,000 to $25,000
No social security number required
No Occupational, Activities Or Sports Excluded
VBA Association Group Membership includes: 24/7 Telemedicine (telephonic or video) – No Cost consultations with Board Certified Physicians,  Unlimited Use
$35/month for a Family – $2,000 AME benefit – each covered person, each accident

Who purchases this coverage?
Anyone that has a medical plan with high deductibles or can’t afford other coverage.

A summary of benefits is covered here.

The source of this content is the product brochure.

Caution about ‘skinny’ health plans

NBC News published a detailed investigative report on “skinny health plans” this past week. Their conclusion is that consumers are confused about health insurance and that the Trump administration is adding to the confusion. As a guy who has handled more than 50,000 consumer communications about health insurance over many years, I agree with the published report’s analysis and conclusion. Yet this this consumer confusion existed back in the years before the Affordable Care Act so we can’t blame it all on Trump just because he has pushed the ‘skinny’ health insurance approach by executive order.

I tend to react furiously to false advertisement claims by health insurance marketers, often untrained telephone sales boiler rooms that notoriously mislead consumers. Recent claims that insurance plans are “ACA compliant” or “promoted by President Trump” are the most confusing to consumers lately.

Yet these alternate health plans do have their place in the market. Whether we call them “skinny health plans”, “short term medical insurance”, “limited benefit health insurance” or “core health insurance”, my position has always been that some coverage is better than none at all.

Most people who pay for their own insurance are not adequately covered by any single health insurance  plan, including the ACA health insurance policies. Whether an ACA plan or another plan works better for a normally healthy person is a function of the type of medical bills they will incur in the future; something we can seldom predict in advance.

In a perfect world, we would be covered by a government-influenced basic coverage and a supplemental policy through our employer or purchased individually. Although we are far from a perfect world, Freedom Benefits can help small business employers redesign their health plans to maximize the benefits to employees that are offered through a combination of public and private health plans.