Georgia Health Insurance 411

Archive for March, 2009

Washington’s idea of a stimulus package seems to be springing leaks. They want to spend taxpayer money to create jobs and stimulate the economy.

So why are they buying condoms from China?

the U.S. Agency for International Development, which has distributed an estimated 10 billion U.S.-made AIDS-preventing condoms in poor countries around the world.

But not anymore.

They will still be handing out condoms, just not ones made in the United States.

In a move expected to cost 300 American jobs, the government is switching to cheaper off-shore condoms, including some made in China.

Outsourcing condoms. What is the world coming to?

“Of course, we considered how many U.S. jobs would be affected by this move,” said a USAID official who spoke on the condition that he would not be named. But he said the reasons for the change included lower prices (2 cents versus more than 5 cents for U.S.-made condoms) and the fact that Congress dropped “buy American language” in a recent appropriations bill.

Makes you wonder how effective is a 2 cent condom?

Or a nickel one for that matter.

Besides, he said, the sole U.S. supplier — an Alabama company called Alatech — had previous delivery problems under the program.

Delivery problems. Probably a joke in there somewhere but this is serious business.

It’s clear that Alatech’s problems over the years, which apparently have been resolved, may have driven U.S. officials to seek much less expensive foreign-made condoms in the first place.

But that’s cold comfort to Fannie Thomas, who has been making AIDS-preventing condoms in southeastern Alabama for nearly 40 years in the small town of Eufaula.

When the company loses this contract the plant will have no choice but to shut down, putting some 300 people, including Fannie Thomas, out of work.

Many residents in Georgia are losing their job and their health insurance. Sometimes COBRA is an option, sometimes not. There are many low cost alternatives available including short term medical, high deductible catastrophic health insurance as well as traditional health insurance plans.

Little Miss Muffet sat on a tuffet eating her curds and whey. Along came a spider who sat down beside her and frightened Miss Muffet away.

We don’t know what kind of spider spooked Miss Muffet but it probably wasn’t a Brazilian Wandering Spider.

Banana’s are good for you but don’t eat the spider.

A Brazilian Wandering Spider was found on a stalk of banana’s at Whole Foods in Tulsa, Oklahoma. Fortunately a worker spotted the spider and trapped it before it could do any harm.

The spider was given to University of Tulsa Animal Facilities director Terry Childs who said this type of spider kills more people than any other.

Childs said a bite will kill a person in about 25 minutes and while there is an antidote he doesn’t know of any in the Tulsa area.

Most bite related trips to the Emergency Room in the U.S. are for dog bites, but they also get their share of insect bites. Read the rest of this entry »

So what the heck is post issue underwriting?

Glad you asked.

That’s when you apply for coverage, the policy is issued. Then at some point in the future, usually following a claim, you get a letter from the health insurance carrier. They want to know all doctors you have seen in the last 5 years and all medications you have taken.

The envelope has a form you are to sign, allowing them to contact the doctors and obtain medical records.

Welcome to post issue underwriting.

You submitted an application. Probably went through a recorded telephone interview. They pulled your medical records (such as they are) from MIB and may have checked your prescription drug history with someone like Milliman Intelliscript.

You passed with flying colors.

Or did you?

Your claim may have been for a persistent cough or a nagging pain in your back. Or it may have been something as simple as your annual exam.

The next thing you know, they’re baaacckk . . .

What are they looking for?

Something you purposely, or even carelessly omitted in your medical history. Something so minor to you, it was probably dismissed or forgotten.

They are looking for a reason to deny your claim or even rescind your policy retroactively to the effective date.

Can they do that?

You bet.

If they can prove you withheld material information about your health you are out of luck.

That’s the bad news.

But here is the good news.

If you used an agent who knows the business. Understands how carriers think and what they look for, then (her comes the shameless plug) you are in good hands. I have worked with carriers for over 30 years. Who knows better how they think and what they will do than someone who has actually been on the inside and walked the halls of the home office?

I do a lot of things to diminish the possibility of post issue underwriting. Things like anonymous pre-screening a clients health history with potential carriers before submitting an application. We also do a trial run on every application. Even though all carriers accept (and prefer) electronic apps, we do a practice run on a paper app before ever submitting to the carrier. I review each application with my client, alerting them to potential issues and tell them what to expect during the phone interview.

I don’t like surprises and I assume my clients don’t either. Clients are never alone when I am hired to be their agent and advisor.

If you need your claim paid, would you rather fight the carrier’s on your own or have a professional “hit man” on your side?

The choice is yours.

Georgia health insurance can be tricky. Finding the right plan is only part of the battle. The real challenge comes the first time you file a claim.

A test of a policy is not in the obvious benefits, but rather what it does NOT pay.

Much has been said about the bonuses paid out to AIG employees. My take is, so what?

The bonus dollars represent less than 1/10 of 1% of the taxpayer money funneled to AIG.

Compare this to the recent omnibus spending bill which contained 9,287 earmarks totaling $12.8 billion out of $480 billion to keep Congress going until October.

Where is the outrage over that abuse of the taxpayer trust?

AIG bonuses represent taxable income. Money that will flow back (in part) to the Treasury.

How much of the $12.8 billion or $480 billion (in the omnibus bill) will return to the Treasury? Who knows?

The folks in Washington have no shame when it comes to pointing fingers.

The bonuses may outrage some, but the bigger issue is . . . what did AIG do with the $180 billion we gave them? Read the rest of this entry »

Georgia health insurance recently posted on a rumored plan to save taxpayer dollars by requiring Vet’s to pay for their own health care. We were incredulous but somewhat comforted by the thought this plan will never get off the ground.

Perhaps we were a bit hasty . . .

“It became apparent during our discussion today that the President intends to move forward with this unreasonable plan,” said Commander David K. Rehbein of The American Legion. “He says he is looking to generate $540-million by this method, but refused to hear arguments about the moral and government-avowed obligations that would be compromised by it.”

I said it before. I will say it again.

You’re kidding, right? Read the rest of this entry »

AIG, a recipient of some $170 billion in taxpayer money (courtesy of the U.S. Treasury and Federal Reserve) is drawing fire over announced bonuses to top executives. While this has nothing to do with Georgia health insurance, we still feel it is noteworthy.

The bonuses will total about $165 million according to the New York Times.

Reports that everyone in Washington is fuming over misuse of taxpayer money are not exaggerated. Barney Frank was so mad he was tongue tied. He said in essence, “we may not be able to override the bonus payouts but we own 80% of the company and can fire people.”

So misuse of taxpayer money is grounds for firing, huh?

Does that include the pork in the Spendulus bill? Or how about the 9,000 or so earmarks in the omnibus spending bill signed by El Prezo last week.

Seems to me this is the pot calling the kettle black. Read the rest of this entry »

This is a bit long, but well worth the read . . .

Earlier we looked at trauma centers and how they impact Georgia residents, health care and health insurance in Georgia. As a follow up to that post we want to look at Georgia PeachCare funding and quality of care. PeachCare is under-funded, even with Santa Claus delivering bags of money via the Spendulus bill. So how do we fix that problem? Impose a sin tax.

“A one-dollar-a-pack increase in state cigarette tax would reduce teen smoking, help fund the state’s tobacco-prevention-and-cessation program to the level recommended by the Centers for Disease Control and Prevention, protect children on PeachCare and Georgians who rely on Medicaid.”

Read the rest of this entry »

Marie Antoinette declared, “Let them eat cake”.

Apparently the new regime in Washington is taking their cue from the headless wonder. CNN reports that “the Obama administration is considering a controversial plan to make veterans pay for treatment of service-related injuries with private insurance.”

Like a lot of other things in the news lately, my initial reaction is, “they are kidding, right?”.

No official proposal to create such a program has been announced publicly, but veterans groups wrote a pre-emptive letter last week to President Obama voicing their opposition to the idea after hearing the plan was under consideration.

The groups also cited an increase in “third-party collections” estimated in the 2010 budget proposal — something they said could be achieved only if the Veterans Administration started billing for service-related injuries

Let me see if I understand.

We have an all volunteer army. Everyone who enlists does so willingly because of a desire to serve their country. They knowingly put themselves in harm’s way. Their reward is . . . pay for your own damn health care.

Asked about the proposal, (VA Affairs Secretary) Shinseki said it was under “consideration.”

“A final decision hasn’t been made yet,” he said.

Under consideration. So this is one way Obamaman wants to save money and pull us out of a nosediving economy?

Incredible!

Funding for Georgia health care is about to change. Money is tight. Every where. Especially at the state and federal level although you would not know Washington has gone beyond their last dime based on how they have spent money they don’t have over the last 6 months or so.

But that is another story.

Let’s talk about Georgia.

Even with Santa Claus handing out bags full of money from Washington via the Spendulus bill, Georgia is still coming up short on funding for PeachCare. And eventually even the idiots in Washington will realize they can’t keep funding projects when they can’t balance their checkbook. So Georgia is going to have to address funding for all programs, including entitlement’s, on their own. Read the rest of this entry »