Fiduciary Double Speak, Owners Watch Out; Rules Change 4-8-2017

I’m that guy who loves details and actually reads things like the Fiduciary rule changes coming in April 2017. But, the 70 pages I just read have just been put on hold by President Trump (the article was written in election season). But, the industry leaders and bankers have acknowledged they may impose the spirit of the regulations.

I write my notes below knowing much of this or all of it may be deleted. So, stay tuned for more.

Breaking Fiduciary rules puts people in jail. Cool? Well, not so much. The rules have been revised, here’s the DOL statement about the new rules coming April 2017: Continue reading “Fiduciary Double Speak, Owners Watch Out; Rules Change 4-8-2017”

Our Modern World Can Learn From Old World Truths

I hear the words “modern world” and wonder, for all our advancements, why hasn’t human behavior changed? Think about the 5th century church writer who comments upon todays reading, Luke 9:7-9.

“John aroused Herod by his moral admonitions, not by any formal accusation. He wanted to correct, not to suppress. Herod, however, preferred to suppress rather than be reconciled. To those who are held captive, the freedom of the one innocent of wrongdoing becomes hateful. Virtue is undesirable to those who are immoral; holiness is abhorrent to those who are impious; chastity is an enemy to those who are impure; integrity is a hardship for those who are corrupt; frugality runs counter to those who are self-indulgent; mercy is intolerable to those who are cruel, as is loving-kindness to those who are pitiless and justice to those who are unjust. The Evangelist indicates this when he says, “John said to him, ‘It is not lawful for you to have the wife of your brother Philip.'” This is where John runs into trouble. He who admonishes those who are evil gives offense. He who repudiates wrongdoers runs into trouble. John was saying what was proper of the law, what was proper of justice, what was proper of salvation and what was proper certainly not of hatred but of love. And look at the reward he received from the ungodly for his loving concern!”

Integrity is a hardship for the morally corrupt, by Peter Chrysologus (400-450 AD)

[Peter Chrysologus, 400-450 AD, was a renowned preacher and bishop of Ravena in the 5th century]

excerpt taken from copyright (c) 2015 Servants of the Word, source:  www.dailyscripture.net, author Don Schwager

As a student of people and how they spend money on healthcare, I find the phrase from 1500 years ago very applicable today, “frugality runs counter to those who are self-indulgent.”  It’s interesting that as we consider ourselves more and more enlightened or modern that we shun the realities of humanity as though what’s been taught by Judaism and Christianity for many centuries is irrelevant.

Our economic system today depends upon individual borrowing, banks and many financial institutions provide easy access to a culture that loves self-indulgence. The 2008 economic depression was largely the result of Fannie Mae and Freddie Mac lending practice (Federal Reserve Report, 2015) permitting, and even promoting, individuals to over extend by borrowing much more than they could repay. This isn’t unlike how our Cities like Detroit (Bankruptcy approved-WSJ 2014) have borrowed upon our future and obviously, how our Country has borrowed $116,000 from each working persons future.

The fact is our age, our modern age, borrows to be self-indulgent and as a result our children aren’t learning the lessons taught more than 1500 years ago. Maybe we should give our youth a better example. Embracing the truths of centuries old might help our youth, simple truths about human behavior when ignored, promote our repeating the mistakes the old days arned a long time ago.

Joy is to hear his word.

It’s morbid to compare: GM 124; Hospitals 400,000

Outraged over auto deaths?

Mary Barra in front of congress.
Mary Barra in front of congress.

All human life matters and to my way of thinking it’s good the autos and government have a way to track responsibility. I live in Detroit so that makes me a car guy. I feel attached to the auto industry. It’s good the cars we drive are safe.

Outrage over car deaths, of course, makes sense. And, the autos have taken responsibility because the government has a good method to enforce the autos to be accountable to the public.

General Motors will pay $900 million to settle criminal charges related to its flawed ignition switch that has been tied to at least 124 deaths.

CNNMoney (New York) September 17, 2015: 2:46 PM ET;  “GM CEO: ‘People died in our cars’ ” Poppy Harlow

http://money.cnn.com/2015/09/17/news/companies/gm-recall-ignition-switch/

Let’s compare; outrage over 124 auto related deaths compared to more than 400,000 preventable deaths at hospitals? Where’s the outrage? Where’s accountability?

Screen Shot 2015-09-18 at 5.52.25 AM
Healthcare IT news aritcle,

 

In this article, congress talks about possible solutions but isn’t demanding accountability from our medical system.

“The tragedy that we’re talking about here (is) deaths taking place that should not be taking place,” said subcommittee Chair Sen. Bernie Sanders, I-Vt., in his opening remarks.

Healthcare IT News, Erin McCann “Deaths by medical mistakes hit records, the way IT is designed remains part of the problem.” WASHINGTON | July 18, 2014

http://www.healthcareitnews.com/news/deaths-by-medical-mistakes-hit-records

When I talk about our medical system is broken, it’s clear that if the auto tracking method were applied to hospitals we’d have accountability.

Here’s a quote from the same article;

In the hearing’s closing questions, when Sanders inquired as to why this crisis was not constantly splashed across front page news, he was met with this: “When people go to the hospital, they are sick. It is very easy to confuse the fact that somebody might have died because of a fatal consequence of their disease, versus they died from a complication from a medical error,” Jha said. “It has taken a lot to prove to all of us that many of these deaths are not a natural consequence of the underlying disease. They are purely failures of the system.”

In our premiums and in our government run healthcare we pay for these services.

But, our system requires more fixes than just this. The white paper is breaking apart many pieces of the medical system apparatus in order to demonstrate the areas where the system is broken. Follow the white paper for what’s wrong, then we’ll be publishing the fixes in 1qtr 2016.

Let Us Be Your Claim Negotiator

Have you received a large unexpected hospital, physician, or pharmacy bill? Give us your latest Explanation of Benefit (EOB) and we’ll provide you with a negotiation point! We search and compare the cost of services and will find the lowest and most common cost.

In the ever changing environment of the ACA, deductibles and copays are much higher than ever before. Did you know doctors and hospitals will negotiate? As your advocate, we find information that will help lower how much you pay.

If you are interested in this service, head on over to benstaff.com to learn more about it, and like BenStaff on Facebook to let us know you are interested!

A Real Life Story of Accepting ACA Changes for a Small Business; Part II

Part II – a Small Business Looking to Do Better

The story starts with a business who engaged us for our Decoder because they asked the simple question, “we know it’s different than it use to be, and we perceive we could do better but we don’t know how to make the right decision.” In the first post, a couple days ago, you learned about the background a little bit. Feel free to review that post below.

Today, we’ll begin to cover details about who is being covered and who is not. It’s very common to have employers who cover individuals that should not be covered. Would you be surprised to know that employers have been known to cover deceased employees, or family members? When we visit with employers we never expect problems but we’re never surprised to find them either.

Job One, Research

Our first job is to research the details about all those covered and all those who are, or were, working for a company. We ask for lists that would show us this information. For instance, tax statements that provide lists of employees and payroll reports that show hours worked plus HR rosters of employees and former employees and other data. The research starts almost immediately and it usually entails asking questions about documentation that’s available that an insurance company would ask to prove the status of an employee or dependent. Identifying problems can be as easy as doing this research.

Our research immediately draws our attention to questions about a former board president who is still covered. In asking questions, it’s obvious there is no current relationship with the former executive. They had been involved and were made promises by the company. As we discuss this with current ownership, no one wants to address the issue with the board or the former executive. We helped solve the problem by including a proper commentary about the liability to both parties for covering someone who should not be covered.

But the former executive had an agreement?

Insurance companies can audit large claims any time, that’s in the small print. If they audit a claim on a former executive, like in our story, and they discover this person is covered it would be bad for both the employer and former employee. Coverage for groups means employees of the group must be covered and individuals who are not employees can not be covered. This is why it’s called group coverage.

So what actually would happen?

If an audit were to occur by the insurance company they would deny the claim of the former employee stating they’re not an employee of the company and not eligible for “group” coverage.  This is bad because the former employee and covered individual could use promises by the government to impose upon the employer the need to pay the claim. To keep the story simple, I’ve eliminated all the details and possibilities for how this could happen. The point is, there’s a chance the employer would be stuck paying the claims of the employee without insurance coverage. This is bad for everyone.

When we arrived the former employee had been on the plan more than 10 years. Why this had been left to linger is anyone’s guess.

What was the outcome?

The employer and former employee understood the risk to both employer and former employee. We introduced an agent who could help with individual coverage. We directed them to seek individual coverage immediately. This was completed within a week. As a note about how this worked, ACA makes transition from group to individual possible because it eliminated pre-existing conditions and medical underwriting. In the old days, these two rules made doing what we did much more difficult.

This small adjustment to the rules gave us the understanding to help the employer. Because the Decoder puts all of these facts in writing, it made it much easier for the employer to make the change with confidence. They just had to see it in writing and be able to show the former employee as well. This is the purpose of the Decoder.

If you enjoyed the story, or learned something from it, please let me know in the comment below. Do you have your own insurance story?