Legislative Update

Last week, the House Health Care Committee passed H.559, a bill which, if passed by the House and Senate, will significantly change the way anyone employed in a business with fewer than 50 employees obtains his or her health care coverage.  This will affect approximately 120,000 Vermonters as of Jan 1, 2014.  I encourage you to read the report  and the Rutland Herald article below.  Here is a summary:

  • Group health plans will no longer exist for businesses with fewer than 50 employees.  Instead, your employees (and you) will purchase their insurance individually via a State-run insurance exchange.  The State will determine the rates, the plan designs, who can be covered and how much they will pay (it will be determined by personal income).  You will have three plans (gold, silver & bronze) to choose from.  It’s important to note that none of the essential ingredients (rates, coverage, etc) have yet been determined.
  • Initial estimates show that in comparison to current rates (ie via BCBS-VT or MVP), the rates through the exchange will increase by a minimum of 18%, and probably far more than that.  You may be able to qualify for federal tax credits depending on your income level and whether we actually receive those federal funds.

I encourage you to read about this legislation and get informed.  I was at the town hall meeting in Wells on Saturday and it is no exaggeration to say that its effect will be far-reaching to all of us.  Please call me to discuss any of this.

 

Weekly Legislative Report
For the Week Ending February 17, 2012 

The House Health Care Committee voted 8-2-1 late Thursday afternoon in favor of an amended version of H.559 after weeks of testimony and deliberation on the session’s most significant health care reform initiative. The amended bill contains legislative directives governing state-specific construction of the health insurance exchange required by federal law, including a requirement that all benefit plans for individuals and small groups employing less than 50 employees be purchased through the exchange, that the exchange benefit options include lower-cost bronze plans in addition to the more generous silver, gold and platinum, a merger of the individual and small group markets (including the safety-net pool) into one pool, and a decision that the state won’t pursue an off-exchange basic health plan option to cover Vermonters with incomes between 133 and 200 percent of the federal poverty level.

The final committee vote came after consideration of several members proposed attaching other bills to H.559. Controversial proposals or issues requiring testimony were passed over, but the committee agreed to add provisions expanding the duties of the Joint Legislative Health Access Oversight Committee, addressing protocols for school sports injuries, an amendment to an existing prescribed products law, and an extension for a work group on claims edit standards.

Passed over were proposals deemed too controversial for H.559 but worthy of further consideration, including a prohibition on health plan mental health carve-outs, a VPIRG-sponsored bill to require enhanced insurer reporting on public websites, a bill requiring parity for primary mental health services, and a bill requiring payment for telemedicine. A proposal to amend last year’s midwives mandate was also delayed.

Prior to the final afternoon mark-up, brokers were invited to react to a proposal by committee chairman Rep. Michael Fisher to require broker fees be a direct transaction between the employer and the broker rather than including those costs in health insurer premium bills. The committee determined the issue was too involved to include as part of H.559, but they agreed that it should be considered later.

H.559 was referred Friday to the House Appropriations Committee for its consideration of the fiscal impact on the state budget of a provision in the bill to limit prescription drug out-of-pocket costs in health benefit plans. The full House is scheduled to consider H.559 on Thursday and Friday of this week.

 

Doubts resound at health care forum
By Brent Curtis
STAFF WRITER – Published: February 19, 2012

WELLS — There was universal opposition from residents who spoke Saturday at a forum to consider the pros and cons of a single-payer health care system in Vermont.

Close to 100 people packed the cafeteria at Wells Village School on Saturday morning, where a panel of speakers including two doctors, Rutland City’s treasurer and the commissioner of the Vermont Department of Banking, Insurance, Securities and Health Care Administration weighed in on the state’s ongoing efforts to create a universal health care system — including proposed legislation to set up a new health insurance marketplace, known under the federal law that authorizes it as an “exchange.”

While BISCHA Commissioner Stephen Kimbell, whose agency is tasked with helping to create the exchange and implementing a single-payer system once it’s designed, talked about the potential benefits of the health care reform initiatives, the other speakers and the roughly dozen members of the public who spoke all opposed the plan.

Kimbell spoke first by laying out the potential financial benefits of the state’s plan, starting with the creation of the exchange, which he said could bring upward of $400 million in federal funds that would be used to provide refundable tax credits to consumers in the exchange.

The exchange, which must be created no later than Jan. 1, 2014, in accordance with federal law, would encompass individuals and businesses with 50 or fewer employees, according to legislation recently introduced in Montpelier.

By 2017, Kimbell said, the state hopes to receive Medicaid waivers that will allow it to create and govern its own health care system with the goal of slowing down escalating health care expenses.

“We don’t think we can lower that $5 billion cost, we just want to slow the rate of growth,” he said. “Just increasing at a more modest rate would be good.”

But the other speakers said that not only did they doubt that the single-payer plan would lower health care costs, but they said it could damage the quality of health care provided in the state while ruining the economy as well.

From the projections Rutland Treasurer Wendy Wilton assembled using expense and revenue estimates from a number of sources, the state would find itself deep in debt if it pursued a single-payer plan.

“What I found scared me so badly about the future of the fiscal state of Vermont that I decided I had to tell people,” Wilton, a former state legislator, said.

According to her estimates, Vermont would find itself $2 billion in the hole five years into a single-payer plan.

That dire prediction is based largely on a pair of assumptions — that the $400 million in federal dollars coming to Vermont to support the system would dry up and that the state’s economic growth wouldn’t be as robust as predicted.

But she said given the economic realities both in the state and nationwide, she believed both scenarios could come to pass.

“The revenue sources are a house of cards,” she said. “What happens if we’re not out of the global recession when we implement the system? … We need to think of ourselves as investors. Do you feel good about this process? I know I don’t.”

And even if the economy improves and the federal money continues, Wilton said her calculations show the state only “breaking even” with what it’s spending on health care now.

The doctors who spoke also offered poor prognoses.

Jerry Stein, a retired doctor of obstetrics and gynecology living in Wells, said a large portion of Vermonters and small businesses would lose out under the single-payer system and the exchange.

While a single-payer system could be years away, Stein said the detriments he foresees from it could have an effect far sooner if the legislation for creating the exchange is approved

While the exchange would be a benefit for some individuals due to an income sensitivity system built into it, Stein predicted that small businesses, particularly those that are now part of association health care plans, and the self-insured would suffer.

Stein also doubted a statement made earlier in the meeting by Kimbell, who said that Vermont’s single-payer coverage would be accepted at hospitals and health care providers in other states.

“For Mr. Kimbell to assume Vermont will be entering into contracts with every provider around the country is an interesting notion,” he said. “I don’t know how they’re going to do that.”

Dan McCauliffe, a Rutland dermatologist, listed 10 reasons why he believes access to providers and services would be more difficult under a universal plan.

McCauliffe’s reasons for delays included more people seeking health care services, a departure of doctors who he believes will leave the state, difficulties recruiting new doctors, the possible immigration to Vermont of the medically needy in neighboring states, and global budgets that he predicted will lead to HMO-style rationing of services.

“Cost overruns are going to be borne by hospitals and other health care providers under a global budget,” he said. “The system is going to force me to ration care. That’s not what I went into medicine for.”

 

Credit Based Insurance Scoring

Most insurance companies now include your credit score as one of the factors they evaluate, along with other factors like claims history and driving record.  Evaluating these factors helps insurers determine if you qualify for their underwriting programs and at what rate.  Your credit score is VERY important to an insurance company and helps determine your insurance premium.

Your insurance score is a snapshot of your insurance risk at a particular point in time.  It is a number based on the information in your credit report that shows whether you are more or less likely to have claims in the near future that will result in losses for the insurance company.  The higher your score, the less risk you represent.  The insurance company is also looking for your payment history and your ability to pay your bills on time.  If they have to chase you every month for payment, this costs them money and it will affect your rate.

Insurers use insurance scores along with other risk information, such a motor vehicle records, loss history reports, property inspections and application information to evaluate new and renewal auto and homeowner insurance policies.  It helps them decide “If we accept this applicant or renew this policy, will we likely be exposed to more losses than our collected premiums will allow us to handle?”

Call us today for more information on how your credit score affects your insurance premiums.

Small Business Health Insurance In Vermont

This is a busy time of year for a health insurance professional. Most (though not all) employer plans renew each January. Deductibles are usually calendar year and insurance company rates are filed and approved by the Banking and Insurance Department (BISCHA) on a calendar year basis.

Currently, there are three health insurers marketing to small businesses in the state of Vermont. “Small” is defined in Vermont as having between 1 – 50 full-time, benefit-eligible employees. The three insurers are:

• Blue Cross Blue Shield of Vermont, based in Montpelier and non profit
• MVP Health Care, based in Schenectady NY and also non profit
• Cigna Health Care is offered strictly through the Vermont Chamber of Commerce Association and is a publicly traded international company

The Vermont Chamber of Commerce Association (VACE) has been with Cigna for over a decade and this year the Vermont Chamber sent their business out to bid.  BCBS and MVP offered competitive quotes and BCBS won. So as of January 2012, the Cigna business with the Chamber will be moving to BCBS. The plans will be the same or very similar and the rates will be level. BCBS also guaranteed to cap the renewal increase in 2013 at 10% and hopefully less, depending on claims and the medical loss ratio. I have over 300 accounts with Cigna through VACE and they are thrilled about not having a rate increase in 2012. After receiving 18% last year, this is very good news!

Unfortunately, shortly after this decision, Cigna decided to no longer market in the small group market in Vermont. They are still a competitive option for employers with 51+ employees but they will not be an option if you have less than 50 employees. I think Cigna is a very good health insurance company and am sorry to see them go. They are a progressive and technologically savvy company. We need MORE competition in this state, not less.

If you have any questions or want to discuss your health insurance plan, please contact me at (802) 367-5217.

We Kept Pedaling and Loved It!

AKP Foundation
Angela, Phil, Chip, and Jonathan

AKP (Always Keep Pedaling) Foundation is a unique organization founded by a remarkable young man. Jon Wilson lost his leg to cancer in 2006, at the age of 24, and made his comeback by enjoying adaptive sports including cycling, skiing and whitewater kayaking. He started his foundation to provide resources to other young people going through similar situations and help them achieve the same type of comeback through sports.

The 2nd Annual Always Keep Pedaling Tour was held, September 18. Finn & Stone was proud to be a sponsor of this event and had a team of four cyclists. Team Finn & Stone was made up of Jonathan Ams, Chip Ams and Angela & Phil Arbolino. Jonathan rode 51 miles, including a very challenging ride up and over Rupert Mountain! Chip, Phil & I did the 25-mile route and loved every minute of the beautiful day. Most fun moment?: When Chip, who got a late start due to a forgotten helmet—he was actually the last person to start—came zooming past me and Phil (and everyone else, I think)! I almost fell off my bike, I was so startled to see him! It pays to stay in shape, I guess.

It was 40 degrees at the starting line but the sun was shining and it was a spectacular fall day in Vermont. A great time was had by all, and Finn & Stone is very proud to be supporting this very worthy cause. We are already training for next year’s ride!

For more information on this event and the AKP Foundation, check out their website at www.akpfoundation.org.

New Website!

Welcome to our new website! If you are a current Finn & Stone client, thank you! We appreciate your business very much. If you are not, please look around and see what you think. There is a lot of information here because we want to be a resource for you. We are going to offer lots of ideas to make the insurance process easier for you. Please check out our new Facebook and Linkedin page too. This is our 50th year and we are excited to be a growing, vibrant insurance agency in southern Vermont. If we can help you with anything or answer any questions, please contact us today. We look forward to working with you!

Supplemental Insurance with Aflac

I recently contracted with Aflac to represent them as a broker to my clients. A lot of my accounts already offer Aflac but I was never excited about them. I have always thought of supplemental insurance as “overinsurance”. I felt as long as you had a good health insurance product, you shouldn’t need to pay more money to supplement it. But that was back when most people had low deductibles and copays to cover office visits and prescriptions. There really wasn’t a need for more insurance.

But times have changed and most people now have large deductibles. I have a $3000 deductible and that is very common. Employers have had to increase deductibles in an effort to reduce costs. This is where Aflac can help. We offered an Aflac accident plan, a cancer plan and a hospital plan to all Finn & Stone employees. 60% of our employees bought something and with prices ranging from $14-$40 a month, I think it is money well spent. Call or email me today if you would like more information on Aflac products.

Roof Collapse

Someone once said that “winters in Vermont are like 10 pounds of ham for 2 people. It just goes on and on and on.” This past winter was especially long with an awful lot of snow. Vermont had a record amount of barn and roof collapses because of it. I have lived in Vermont for 15 years and this is the first winter we had to rake our roof. “Collapse” is not always a “covered peril” so make sure you know if your roofs are covered. If you have a barn with animals in it, collapse is a serious issue. Check with your agent to make sure you are adequately covered.

Basement Water Coverage

One of the most common claims we have is water in the basement. Most homeowner policies limit “water back up and sump pump overflow” coverage. If you have a finished basement, you might not have enough coverage. We finished our basement a few years ago and turned it into a gym. Now, along with our washer and dryer, we have three pieces of expensive gym equipment. If we had water in our basement, basic coverage would not be enough. At my last renewal, I increased my coverage to $25,000 and the additional annual premium was $55. Well worth it for the piece of mind to know I am adequately covered. Be sure and check with us if this a concern for you.