Download The Impact of Health Care Reform on Medicare Advantage Plans

Congress Eyes Annuities to Bolster
Retirements
June 18, 2010
Jesse A Hamilton
WASHINGTON
Annuities, which have been getting a lot of attention from lawmakers
and federal agencies hoping to strengthen Americans' retirement
plans, were the subject of a congressional hearing analyzing their
place in the employer-based retirement system. At that hearing of the
Senate's Special Committee on Aging, federal agencies who have been
seeking input on guaranteed income said the response has been
vigorous and they would soon host a public hearing on this topic.
"We need to provide employers with more guidance, more tools and
more protection to encourage them to offer a range of options to their
employees," the committee's chairman, Sen. Herb Kohl, D-Wis., said at
the Senate hearing. He said he's been "encouraged by the recent
innovations in the financial services industry to develop new products
that will help retirees manage their savings. This is a rapidly
developing area and we want to encourage employers to consider
offering such products to meet their workers' needs."
But he said he wanted to be clear that he opposes any kind of
mandatory use of annuities. "No one should be forced to purchase a
lifetime income product," he said. "I will not support any kind of
mandate for consumers, because we recognize there is a wide range
of circumstance and need."
At the same time, Kohl also sent a letter to the Government
Accountability Office to request a review of how current regulators
make sure that financial institutions that sell annuities will be able to
meet those financial commitments and how state guarantee funds
may figure into that.
"Annuities can certainly be a very good and appropriate part of many
individuals' retirement and financial planning," Brian Atchinson,
president and chief executive officer of the Insurance Marketplace
Standards Association, told BestWire. "The whole thing, I think, is
moving in the right direction," he said. But his organization's primary
focus is on making sure that "the necessary safeguards are in place,
and that there be very clear and high standards."
The American Council of Life Insurers has been excited to see such an
interest from lawmakers and the administration. "This is just great
that the Hill is engaged in this topic," Alane Dent, a vice president for
federal relations at ACLI, said in a telephone interview. She said the
organization is realistic about the difficulty in getting anything done in
this current, hectic congressional session as it winds down toward
elections, but she said this attention is a good signal for the future.
"The groundwork is getting laid for a very robust discussion next
year."
Sen. Susan Collins, R-Maine, pointed out the importance of the topic,
saying during the hearing that a "tidal wave of retiring baby boomers
will be imposing unprecedented burdens and challenges for both the
Social Security system and for private pensions."
Fourteen percent of employers offer annuities as a rollover or outside
option in retirement planning, according to a recent survey by Hewitt
Associates. Though Kohl cited that number in his remarks at the
hearing, suggesting it as a low number, he didn't mention the Hewitt
survey's additional statistic that -- in 2010 -- 28% of employers said
they were likely to add annuities as a retirement planning option.
However, the same survey showed that only 2% of employers offered
annuities as internal components to plans for current participants, and
few companies said they were likely to grow that percentage.
"Encouraging workers to consider guaranteed lifetime income options,
such as by facilitating the availability of longevity insurance and
partial annuitization, represents sound public policy as the baby boom
generation reaches retirement age," William Mullaney, president of the
U.S. business division of MetLife Inc., told the committee in his
testimony.
Kohl has already supported legislation that would encourage annuity
use. In December, he and other lawmakers introduced a bill that would
designate a new requirement for retirement plan statements, having
them outline the expected monthly income payment from each
account rather than just the overall value -- an idea to simplify
planning for how much money is needed to sustain a retirement
(BestWire, Dec. 4, 2009).
From: King, Andy
Sent: Thursday, July 01, 2010 10:53 AM
Subject: Why the 3% RFA available with HDF is attractive at 3% interest - Seniors Lose 20 Percent Of
Buying Power Since 2000
Importance: High
Seniors Lose 20 Percent
Of Buying Power Since
2000
Benefits of Social Security recipients lost 20 percent
of their buying power over the past ten years. During the
same period, Medicare Part B premiums more than doubled, rising
111.9%. The Senior Citizens League (TSCL) recently released the
updated findings of our annual Social Security Loss of Buying Power
study just as the Congressional Budget Office (CBO) forecast that there
would be no annual cost-of-living adjustment (COLA) from 2010 through
2012 although Medicare costs would continue to escalate over the same
period.
“With the prospect of no COLA for three years, we are highly
concerned that retirees could lose more than half the buying
power of their Social Security benefits over the course of an
average 20-year retirement,” states TSCL Executive Director,
Shannon Benton.
The annual Loss of Buying Power study examines the changes
in the cost of goods and services that a typical senior age 65 or
older is likely to have. Unlike the consumer price indexes
maintained by the government, no complicated mathematical
formulas are used. “Just straight forward price change
calculations,” says Benton. The following chart illustrates just
a few examples of how costs have increased over the past
decade.
How Costs Are Going Up
Expense
Cost in
2000
$1.25
Cost in
March
2009
$2.45
Percent
Increase, 20002009
96%
Home heating
oil (national
average per
gallon)
Regular gas
(gallon)
Medicare Part
B premiums
(monthly)
10 lbs. russet
potatoes
$1.26
$1.91
51.6%
$45.50
$96.40
111.9%
$2.98
$4.74
59.1%
1 lb. butter
Milk (gallon)
Eggs (dozen)
$2.52
$2.78
$0.93
$3.16
$3.58
$1.85
25.4%
28.8%
98.9%
Movie ticket
$5.39
$7.18
33.2%
Source: 2009 Loss of Buying Power Study, TSCL, April 2009.
The study found that a senior having average monthly benefits of $816 in
2000 would have a current monthly benefit of $1,072.30 in 2009. But in
order to keep pace with rising costs, that senior would require a Social
Security benefit of $1,288.60 in 2009 just to maintain his or her 2000
expenses.
Continued overwhelming grassroots support from seniors nationwide
recently helped convince two Members of Congress to re-introduce
legislation that would provide a more fair and adequate COLA by using a
senior’s index to calculate the annual increase. TSCL is working to build
support for enactment of the legislation. To learn more, see the
Legislative Update “COLA CPI-E Legislation Introduced in Congress!” by
Former Representative David Funderburk, TSCL Legislative Consultant.
Sources: Update of CBO’s Budget and Economic Outlook, Congressional
Budget Office, March 23, 2009.
From: King, Andy
Sent: Wednesday, June 30, 2010 11:07 AM
Subject: Health care reform aims to provide coverage for millions of uninsured people and will pay for
that in part with phased-in Medicare Advantage funding cuts.
Importance: High
A Few Insurers Control Medicare
Advantage
June 23, 2010 | Associated Press
INDIANAPOLIS -- A small number of insurers controls a big chunk of the market for
Medicare Advantage health plans, according to a new Kaiser Family Foundation
report.
The nonprofit foundation said three or fewer companies dominate the market in
every state except New York for the plans, which are privately run versions of the
government's Medicare program that provides coverage for people over age 65 and
the disabled.
Medicare Advantage plans are subsidized by the government and offer basic
Medicare coverage topped with extras or premiums lower than standard Medicare
rates.
In 14 states and the District of Columbia, one company enrolls more than half of all
Medicare Advantage customers, Kaiser said.
This means that as health care reform unfolds, decisions made by a small number of
companies will have a large impact on the type of plans and premiums available over
the next several years, said Tricia Neuman, a foundation vice president and director
of its Medicare Policy Project.
Health care reform aims to provide coverage for
millions of uninsured people and will pay for that in
part with phased-in Medicare Advantage funding
cuts. Medicare will freeze the maximum amount it
pays plans next year.
Kaiser, which released its report Tuesday, said two insurers _ UnitedHealth Group
Inc. and Humana Inc. _ control 33 percent of total Medicare Advantage enrollment
nationwide. That rose to 11.1 million people this year, up 6 percent from 2009.
While a few companies control most markets, they offer many choices for
customers. Kaiser found that the average enrollee has 33 plans available in his or
her area.
The average monthly premium paid for a
Medicare Advantage plan with prescription
drug coverage was $44 this year, up from $36
in 2009.
From: King, Andy
Sent: Monday, June 28, 2010 9:59 AM
Subject: "Hospital DELERIUM affects about 1/3rd of patients > 70 y. old." WHY BENEFICIAL TO
SENIORS TO HAVE: a) Standardized Med-Sup with Trad. Medicare & b) advantage of automatic claims in
ACF Importance: High
All BMs:
Here’s why it is a benefit to seniors to have:
a) The simplicity of a standardized Med-Sup with Traditional
Medicare – Traditional Medicare is simple and there aren’t
dozens of different plans, as with MAs.
b) The advantage of ACF Partners, enabling seniors to have Part B
claims filed on their behalf automatically on a nationwide basis,
regardless of whether they are at home or in another state
visiting children or vacationing – seniors are very mobile these
days.
Read this article and you’ll see the importance, as will your agents.
Andy
SIX QUESTIONS TO
PROTECT ELDERLY
PATIENTS
By PAM BELLUCK
CJ Gunther for The New York Times
June 24, 2010, 12:42 pm
Hospital delirium affects about a
third of patients over 70.
This week, Pam Belluck reported in The Times on the risk that elderly patients
may become confused and delirious while in the hospital. Here she
offers advice on how to prepare when an elderly patient is headed to surgery or a
hospital stay.
About a third of patients over age 70 experience hospital delirium, and
the consequences can be serious, delaying a patient’s recovery and
even leading to placement in a nursing home. Elderly patients who experience
delirium are also more likely to develop dementia later on, and more likely to die
sooner than patients who do not become delirious.
Many readers have asked me what family members can do to help lower an
elderly patient’s risk. To find out, I turned to three experts – Dr. Margaret Pisani
at the Yale University School of Medicine, Dr. Wes Ely at Vanderbilt University
School of Medicine and Dr. Sharon Inouye at Harvard Medical School. Based on
their advice, here are six questions family members should ask to lower an
elderly patient’s risk for hospital delirium.
1. Do the nurses and doctors routinely screen for delirium or identify
high-risk patients?
Older and younger patients who develop severe infections or heart, liver or
kidney problems are at higher risk for delirium. But about 75 percent of delirium
cases are missed when the hospital or its intensive care unit is not actively
screening for it. While delirium can cause patients to become aggressive,
disruptive or incoherent, it can also manifest itself in much less obvious ways,
making a patient seem withdrawn or disconnected. Even with regular screening,
family members are often the first to notice subtle changes. If you detect new
signs that could indicate delirium — like confusion, memory problems or
personality changes — it is important to discuss these with the nurses or
physicians as soon as you can.
2. How does the hospital deal with agitation or delirium in patients if it
develops?
The longer the duration of the delirium, the greater the chances of poor
consequences for the patient, so it should be addressed quickly. Experts say
hospitals can treat delirium by helping patients sleep, making sure patients are
hydrated, allowing family members to stay at patients’ bedsides to help them
become reoriented, and getting patients up and walking when it is safe to do so.
Family members should also inquire about hospital policies involving restraints
for confused patients. Removing restraints is often recommended because they
can cause patients to feel paranoid or trapped. Some hospitals use anti-psychotic
medications like haloperidol, but some experts caution that these should be used
in moderation and are not yet proven to work.
3. What does the hospital do to keep patients from becoming
disoriented?
Situations like being without one’s eyeglasses, being in a darkened room and
being unaware of the day and time can trigger delirium. Hospital rooms should
have clocks, calendars and adequate light, and nurses and doctors should
ensure that patients have their glasses, hearing aids and dentures. Family
members should make sure the hospital staff knows if the patient needs these
items. The family can also bring a few familiar objects from home to help a patient
stay oriented. Things like family photos, a favorite blanket for the bed, a beloved
book or relaxation tapes can be comforting for all patients. Family members can
also help by speaking in a calm, reassuring tone of voice and reminding the
patient where he or she is and why. Massage can be soothing for some patients,
and if it is all right with the medical staff, family members can walk with the
patient in the hallways. Families should limit the length of visits and number of
visitors to prevent patients from feeling overwhelmed, but they should also try to
make sure the patient is rarely alone. If the patient experiences an acute episode
of delirium, relatives should try to arrange shifts so someone can be present
around the clock.
4. What policies are in place to make sure patients get adequate
sleep?
Family members should find out if patients are able to sleep through the night or
if they will be awakened for medical tests. Find out how the hospital controls
noise and whether it offers any nondrug measures like back rubs or warm tea to
promote sleep.
5. If my family member needs a urinary catheter or other bedside
interventions, how does the hospital decide when to remove them?
A common procedure like a catheter insertion can spur anxiety in frail, vulnerable
patients. Experts say it’s important to remove catheters, intravenous lines and
other equipment whenever possible because they can make patients feel trapped,
leading to delirium.
6. Will the physicians and pharmacy staff review my family member’s
medications to identify medications that increase delirium risk?
Bring to the hospital a complete list of all medications and dose instructions, as
well as over-the-counter medicines. It may help to bring the medication bottles as
well. Prepare a “medical information sheet” listing all allergies, names and phone
numbers of physicians, the name of the patient’s usual pharmacy and all known
medical conditions. Also, be sure all pertinent medical records have been
forwarded to the doctors who will be caring for the patient.
From: King, Andy
Sent: Thursday, June 24, 2010 7:17 PM
Subject: HERE'S WHY MAs are being reformed: TRUE EXAMPLES of problems in MA plans are
numerous. Many people discover flaws only after they have joined plan—and most cannot switch until
following year.
Importance: High
The problems people have in Medicare private health plans (also
known as Medicare Advantage
plans) are numerous. Many people discover these flaws only after they
have joined the plan—
and most cannot switch until the following year.
Most of the cases fall into the following categories:
1. Care can cost more than it would under Original Medicare;
2. Private plans are not stable;
3. Difficulty getting emergency or urgent care;
4. Continuity of care is broken;
5. Members have to follow plan rules to get covered care;
6. Choice of doctor, hospital and other providers is restricted;
7. Difficulty getting care away from home;
8. Promised extra benefits can be very limited;
9. People with both Medicare and Medicaid can encounter higher
costs.
Although specific private health plans are named in the case examples
below, the problems they
highlight are in no way limited to the companies identified. These
cases illustrate problems
people experience in any of the hundreds of private health plans
offered across the country.
Medicare private health plans are required to offer a benefit “package”
that is at least as good as
Medicare’s, but they do not have to cover every benefit in the same
way. For example, while
Medicare covers 100 percent of the cost of care for the first 20 days a
person requires skilled
nursing facility care, a private plan can require members pay a
copayment each day they are in a
nursing home.
Because of this, some people can pay more in a private plan than they
would have
under Original Medicare.
True Story
Mr. M., who lives in XXXX, XX, enters a hospital every 14 days for three
days of chemotherapy treatments for colon cancer. His doctor has
ordered four such
rounds of treatment. Depending on how his cancer responds, he may
require more. His
private plan, XX-XX, charges him a copayment of $900 for each
hospital visit.
That means Mr. M. will have to pay $3,600 out of pocket just for his
first four rounds of chemotherapy treatments. If Mr. M. was in Original
Medicare, he
would only have to pay the hospital deductible once because Medicare
covers 100
percent of the cost for the first 60 days of hospital care in a benefit
period even if they
are not consecutive (a benefit period under Original Medicare ends
when the person has
been out of the hospital for more than 60 days in a row). (Neither of
these charges
includes doctor fees.)
If instead of joining the private health plan, Mr. M. had stayed in
Original Medicare and
bought a supplemental policy available in his area that covers all his
out-of-pocket
costs for doctor and hospital services, he would have saved nearly
$2,000 just in the
hospital charges for his first four chemotherapy treatments. And he
would have little
or no additional out-of-pocket costs for medical care he receives the
rest of the year.
Unlike Medicare, which has offered guaranteed health care coverage
since 1966, private health
insurance companies come and go. Companies merge or go out of
business. They change the
benefits package from one year to the next, including what benefits
they cover and what the
benefits cost.
All of these changes are outside the control of plan members, but they
can affect
their access to the care they need.
True Story
Ever since Ms. T. had polio, she has relied on a wheelchair to get
around. The one she
uses now is nine years old, broken and beyond repair. In 2006, XXXXX
initially
refused to pay for a new wheelchair and only relented after she
appealed.
The plan’s benefits covered the full cost of the wheelchair without any
copayment. In December 2006, the wheelchair supplier told Ms. T. her
new wheelchair
would not be ready until January 2007. Because the chair would be
delivered in 2007,
the plan told her its new benefit structure would apply so she would
have to pay 20
percent of the cost—or $1,065. She paid the supplier a $150 fee to
expedite delivery,
but the chair still did not arrive in December. Now she owes the
supplier money she
cannot afford.
No one knows when or where an accident or other medical emergency
will strike. That is why
Medicare law mandates that private plans cover emergency and
urgent care regardless of
whether the provider is in the plan’s network or within the plan’s
service area. (Urgent care is a
sudden illness or injury that needs immediate medical attention but is
not life threatening.)
However, many calls from private health plan members detail being
denied
payment for out-of-network and even in-network emergency care or
are being denied
authorization to get urgent care while away from home.
True Stories
Mr. R. of Tennessee is 80 years old. In May of 2006 he joined a private
health plan,
XXXXXXXXXXXX. In November, he suffered a heart attack and was
hospitalized. Mr. R.’s
plan denied all claims because he had not gotten prior authorization
from the plan to
enter the hospital. The hospital bill totals over $87,000.
Mr. S. was having chest pain and called for an ambulance to take him
to a hospital near
his New Jersey home. When he arrived, he was diagnosed as having
suffered a heart
attack and was transferred to a second hospital that was better
equipped to care for him.
He is a member of XXXXXX, which denied payment for the second
ambulance because
he did not obtain prior approval from the plan.
Health experts have long extolled the importance of continuity of care.
This generally means the
availability or constancy of the health care provider as the source of
care, keeping follow-up
appointments with the provider and planning seamlessness transitions
when care changes from
one setting to another. Knowledge of a patient’s medical and family
history and personal
preferences are among the important information lost when people
have to change their health
care provider. Changing in the midst of a treatment can be traumatic
and detrimental to the
patient’s health.
True Stories
Mr. A., who lives in Naples, Florida, had spinal cord surgery, which his
XXXXXX plan
covered even though the operation was performed by an out-ofnetwork surgeon.
However, when he needed to go back to the same surgeon for followup visits, XXXXXX
refused to pay and told Mr. A. he had to find another surgeon that is
part of the plan’s
network for his follow-up visits to be covered.
Mrs. S. lives in Miami, Florida, and is receiving cancer treatment at
XXXXXXX
Hospital, which her son says is one of the best in the area. But when
XXXXXXXX XXXX
ended its contract with the hospital earlier this year, she was told
she would have to go another hospital. When she attempted to switch
to a
different HMO that still includes XXXXXXX in its network, a
representative of the new
plan said she had missed the Open Enrollment Period and would have
to wait to
change plans until the end of the year.
Private health plans generally require that a member’s doctor get
permission from the plan (prior
authorization) before a member get certain procedures, tests or care
from a hospital or skilled
nursing facility. If a member gets the care without the plan’s
permission, the plan can refuse to
pay for it. If the plan denies prior authorization, the member needs to
enlist the doctor’s help in
appealing the plan’s decision in order to get the care.
True Stories
Ms. C. has both Medicare and Medicaid. She enrolled in a XXXXXX
Medicare
private health plan. She started getting bills from her doctors that had
previously
been completely covered by Medicare and Medicaid. She leaned that
her plan
was denying the claims because she had not gotten a referral from her
primary
care physician before going to see her specialist doctors.
Mr. G., who lives in North Carolina, has a brain tumor. His sister called
MRC
because he was getting denials for his care from his Medicare private
health
plan, XXXXX. Mr. G. is very ill and gets most of his treatment at XXXX
XXXXXXXXX
Hospital. An MRC counselor was able to ascertain that the care was
being
denied because Mr. G. had not requested authorization from the plan
before
getting treatment for his brain tumor.
Mr. A. went to his primary care physician, who told him that he could
see a
dermatologist without a referral, assuring him that his patients do that
all the time.
However, Mr. A.’s private health plan, XXXXXX, denied the
dermatologist’s bill
because he had not gotten prior authorization to see a dermatologist.
Unlike Original Medicare, most private health plans have a network of
health care providers—
doctors, hospitals, skilled nursing facilities and others—that members
must use in order to
receive full coverage (except in an emergency). Health Maintenance
Organization (HMOs)
generally will not pay for care members get from providers who are not
part of the plan’s
network. Preferred Provider Organizations (PPOs) usually allow
members to see providers
outside the network, but they have to pay more out of their own
pocket for the privilege.
Private-Fee-for-Service (PFFS) plans allow members to go to any
provider that will accept
the plan’s terms and fees, but many providers will not.
Plan members may find they cannot go to the specialist or hospital
recommended by their doctor,
the nursing home they stayed at last time they needed skilled nursing
facility care, or other
providers of their choice. Problems arise when the provider is not in
the plan’s network, has
dropped out of the network or is dropped from the network by the plan.
To add to the problem,
while health care providers can drop out of a plan’s network at any
time, members are usually
locked in to the plan for a year.
True Stories
Mr. and Mrs. W., who live near Buffalo, New York, joined XX-XX’s plan
late last year.
In February, Mr. W. called because none of his wife’s doctors
participated in the plan’s
provider network. A plan salesman neglected to mention that the
couple would not be
able to choose any doctor they wished to see, which was what they
were used to under
Original Medicare. A plan representative told Mr. W. that his wife could
not go to her
regular doctors. The couple wants to drop the plan and return to
Original
Medicare. But it is too late—they are locked into the plan for the rest
of the year.
Ms. H., who lives in Portland, Oregon - in December she needed knee
replacement surgery
and her private plan, XXXXXX XXXXXXXXX, told her she would have to
wait six months to get it.
She was limping and in pain and could not wait that long. She was told
the plan had a shortage
of orthopedic surgeons in her area. It was only after she filed a
complaint with Medicare and
the plan that she was able to get the care she needed—three months
later.
Many people with Medicare enjoy their retirement by spending time
with family in other parts of
the country or live part of the year in warmer/cooler climates. Original
Medicare allows them to
get covered health care anywhere in the country. Private health plans
generally only allow
members to get care within their service area (except in an
emergency).
True Story
Mr. and Mrs. B. are New York residents who spend their winters in
Florida. Mr. B. is
enrolled in a Medicare private health plan offered by XXX. When Mr. B.
needed medical
care in Florida, XXX wouldn’t pay for it because he got care outside
the plan’s service
area. If he had Original Medicare, his care in Florida would have been
covered.
People with Medicare who choose to enroll in a private plan often do
so to get coverage of some
benefits Medicare does not cover, like dental and vision care. These
benefits vary widely from
plan to plan. People sometimes find that the benefit they joined the
plan to get will not cover as
much as they thought it would.
True Story
Mr. R., who lives in a New York City suburb, was injured after he was
hit by a car. His
injuries included broken teeth and a broken jaw. Mr. R. could not eat
solid food for seven
years after the accident. He was unable to work and could not afford
to pay his medical
bills because his only income was his monthly Social Security
Disability Insurance
check. When Mr. R. became eligible for Medicare, he learned that
Medicare does not
cover dental care. Last year, he attended a meeting sponsored by
XXXXXX and met with
a sales representative who assured him that XXXXXX’s XXXXXX
XXXXXXXX plan would cover
the dental treatment he desperately needed. After he joined, he was
denied dental care
and was told that XXXXXX only pays for accident-related dental care
within a year of the
accident.
People with Medicare and Medicaid have virtually no out-of-pocket
costs. Medicaid helps pay
Medicare deductibles and coinsurance. However, if they join a
Medicare private health plan,
Medicaid may not help pay any of their out-of-pocket costs.
True Story
Ms. E., who lives in Cincinnati, Ohio, is enrolled in the Qualified
Medicare Beneficiary
(QMB) program. QMB is a low-income assistance program that has
slightly higher
income limits than Medicaid and also helps pay an individual’s
Medicare out-of-pocket
costs. Ms. E. signed up for a Medicare private health plan,
XXXXXXXXXXXXXXXX. She called
in February 2007 because she was being asked for a copayment for
doctor visits.
Since she has QMB, she should not have to pay anything out of pocket.
She has also
had two bills denied, for a mammogram and an ultrasound, because
her doctors did not
get prior authorization before performing the services. Her bills now
total over $800.
Medicare private health plans were brought into the Medicare program
with the promise that
competition and entrepreneurship would lead to better, more costeffective care.
All too often private health plans do not deliver what they promise.
Even with enhanced
payments, private health plans often fail to deliver coverage that a
patient could obtain from
Original Medicare. Medicare private health plans should not cost
taxpayers more than Original
Medicare. Congress should level the playing field by making private
health plan payments equal
100 percent of what it costs to insure people in the Original Medicare
program.
From: King, Andy
Sent: Thursday, June 24, 2010 6:16 PM
Subject: A Timeline of Implementation: Health Reform & Medicare:
Importance: High
Health Reform and Medicare:
A Timeline of Implementation
2010
Provides a $250 rebate to people with Medicare in the doughnut hole. (The doughnut
hole is the $3,600 gap in the drug benefit when consumers pay full price.)
• Authorizes the Food and Drug Administration to approve generic versions of biologics,
which treat diseases such as diabetes, and allows generic versions to enter the
market after 12 years. This means more affordable versions of biologics will be
available to consumers in the future.
• Improves care coordination for dual eligibles—people who are enrolled in both
Medicare and Medicaid—through the creation of the new Federal Coordinated Health
Care Office within the Centers for Medicare & Medicaid Services (CMS).
• Many provisions to reduce fraud within the Medicare program take effect, including
tighter restrictions on physician self-referrals and requirements for claims to be filed
within one year of service.
• Reduces updates to annual market baskets, which are used to determine annual
payment adjustments, for home health care, inpatient hospitals, skilled nursing
facilities, hospice and other Medicare providers, and adjusts market baskets to
account for provider productivity.
2011011
• Manufacturers will provide a 50 percent discount on brand-name drugs and biologics,
and the government will provide a 7 percent discount on generic drugs for consumers
in the gap in 2011. Discounts will increase each year until the consumer’s share of
costs while in the gap is 25 percent for both brand-name drugs and generics in 2020.
(For a full explanation and chart of the phase-out see Health Reform and Medicare:
Closing the Doughnut Hole.)
• Eliminates deductibles and coinsurance for preventive services recommended by the
U.S. Preventive Services Task Force.
• Provides coverage of annual wellness visit and personalized prevention plan at no
charge.
• Provides 10 percent bonus payments to primary care doctors.
• Creates a CMS Innovation Center that will explore effective ways to create efficient
payment systems that are patient-centered, that preserve and incentivize high-quality
care.
• Reduces market basket updates for Medicare providers beginning in 2011.
• Prohibits private “Medicare Advantage” plans from charging enrollees more
than
Original Medicare for certain medical services, including chemotherapy
administration
and skilled nursing care.2011
(continued)
• Freezes “Medicare Advantage” payment rates at 2010 levels. In subsequent
years,
continues to phase in private “Medicare Advantage” payment reforms, which
reduce
government subsidies to insurance companies. The reforms aim to better
match
coverage costs in the private Medicare insurance market to those in the
Original
Medicare program.
• Allows “Medicare Advantage” enrollees to switch to Original Medicare
during the first
45 days of the new year.
• Freezes inflation indexing for Medicare-related Part B premiums for people with high
incomes.
• Raises drug plan premiums for individuals earning over $85,000 and couples earning
over $170,000.
• Creates a new voluntary national insurance program for long-term care services
(Community Living Assistance Services and Supports [CLASS] Program), financed
through voluntary payroll deductions. After five years of contributing to the program,
should a person require services in the future, the fund would provide a lifetime benefit
averaging $50 a day, depending on the needs of the person.
• Creates a single Annual Enrollment Period (AEP) for drug and health plan
changes,
which begins on October 15 and ends on December 7. (This new AEP will
begin in fall
2011 for enrollments for the 2012 plan year.)
20122012
• Eliminates prescription drug copayments for certain dual eligibles receiving home- or
community-based long-term care.
• Creates a new Medicare Independence at Home demonstration program for
chronically ill Medicare beneficiaries to receive primary care services in their homes
and to incentivize better coordination of care.
• Reduces payments to hospitals with high rates of preventable hospital readmissions in
order to promote higher-quality outcomes.
• Provides incentives for physicians and other providers to form Accountable Care
Organizations (ACOs) to encourage better communication among providers across
care settings, reduce costs and provide higher-quality care. ACOs are networks of
health providers that work together to provide a range of health care services for
patients. Providers who participate in ACOs that meet quality targets and achieve
savings to Medicare may share in those cost-savings. ACOs must meet specific
consumer-centered criteria, such as the creation of individualized care plans for
patients.
• Establishes a “value-based” purchasing system for hospitals. Medicare would link
payments to hospitals to their performance on quality measures. In addition, requires
development of value-based purchasing programs in other areas, including home
health agencies and skilled nursing facilities. The purpose is to create a more efficient
system that will reduce costs while also providing patients with higher-quality care and
better health outcomes.
• Provides bonus payments to high-performing private “Medicare Advantage” plans.
20132013
• Establishes a pilot program to evaluate bundled payments for inpatient hospital
services, outpatient hospital services, physician services, and post-care services,
including follow-up care after release from a hospital. The program will test if such
payment reforms lead to better care coordination, higher-quality care for patients and
lower costs. Under a bundled payment system, Medicare pays one payment for a
group of services offered in a single episode of care, whether administered under Part
A or Part B, instead of paying for each individual service separately.
• Increases the Medicare Part A payroll tax by 0.9% for individuals earning over
$200,000 and couples earning over $250,000. In addition, adds a 3.8% tax on certain
unearned investment income for individuals earning over $200,000 and couples
earning over $250,000.
20142014
• Reduces the out-of-pocket amount consumers in the doughnut hole must pay in order
to qualify for catastrophic drug coverage under Part D.
• Limits “Medicare Advantage” plan profits and administrative expenses to
15 percent of
Medicare payments.
• Establishes an Independent Payment Advisory Board with mandate to implement
Medicare provider payment changes to meet savings targets. Congress’s ability to
overturn or amend payment changes will be limited. However, the Board cannot
change Medicare eligibility or reduce benefits or premium subsidies, but is allowed to
make limited changes to how drug plan premium subsidies are calculated.
• Creates a national health exchange that includes standardized health packages that
meet minimum coverage requirements. Individuals and small businesses with less
than 100 employees will be able to purchase insurance through the exchange. The
exchange administers tax credits to help lower-income people obtain coverage.
• Implements general insurance reforms for the non-Medicare population, including
people in the two-year waiting period for Medicare. These reforms include guaranteed
issue of plans, prohibition on coverage exclusions based on a pre-existing condition,
and limiting age rating of premiums to three to one.
• Requires all U.S. citizens and legal residents to obtain qualifying health coverage.
Those without coverage will be assessed a tax penalty.
-------------------------------------------------------------------------------------------------------------From: Branch1P
Sent: Tuesday, June 22, 2010 9:14 PM
To: Andy King
Cc: John Gore
BE PREPARED for MA
DISENROLLMENTS
Subject:
Andy,
Very important dates here... I would suggest
any Branch Managers who want to make A LOT
of MONEY and build huge renewals over the
next 6 to 9 months pay close attention and BE
PREPARED!!!
I would also suggest
of it, but
clicking on the link BELOW
and reading all
especially pages 61 to 71.
Medicare Advantage can only enroll from 11/15/2010 to 12/31/2010 for the
2011 selling season, but
disenroll.
enrollees will now have 45 days to
(I will be very busy during this time too). CMS has even given
this time period a name, guess what it is...MA
Annual 45 Day
Disenrollment Period, they even gave this period it's own acronym...
ADP, that is too funny...
There are actually as many days set aside to Disenroll as there are to Enroll,
especially funny when it takes literally hours for a
MA AGENT to enroll
someone into a MA plan with lead generation, appointment booking,
confirmation of appointment booking, scope of appointment, telephonic
verification call, compared to about 1 minute on the phone to disenroll.
OMG and LOL come to mind as pretty good
acronyms in my opinion!!!
January 1 – February 15, 2011
MA Annual 45 Day Disenrollment Period
(ADP).
And let's back up a little....
August 1st has always been a great day for me because it is my birthday, but
this year CMS has my attention and I believe will send many of us a Birthday
Gift in early August...
August 2, 2010
Deadline for CMS to inform currently
contracted organizations of CMS’
decision not to authorize a renewal of a
contract for 2011.
I think many Medicare Advantage Companies think they may "just get
by", but whether or not they've notice, CMS nor the President of the United
States are fans of Medicare Advantage! No one will "just get by"!
There are many more important dates, so keep your eyes and ears open,
because I will!
And pass the word...BE
PREPARED!!!!
It will take many more agents than
normal to handle the a) nonrenewals of the PFFS, b) the non
renewing MAs that CMS doesn't
authorize a renewal contact for
2011, and the c) 45 days of ADP.
Annual Disenrollment Period!!!! I must
recruit 300 agents to
stay on top of this because we
all know 1 in 10 become
producers. 10 Recruits per
week won't quite get me there,
so I must step it up, and
hopefully others will too!
Here is the link...
http://www.ritterim.com/Resources/CM
S_Call_Letter_2011_Final.pdf
Here are the dates....
1. April 5th – Call Letter Released and Final MA Payment Rates issued
(Page 61).
2. May 3rd – CMS asks MA and PDP sponsors to notify them of voluntary
plan terminations (whether this is for an entire product or for a service
area reduction. (Page 62)
3. June 7th – Bids for 2011 plan year are due. Deadline for notifying CMS
of voluntary plan terminations, although most plans will have notified
CMS on or around May 3rd. (Page 63)
4. Late June/Early July – Plans file 2011 Broker Compensation. (Page 64)
5. Late August/Early September – CMS finalizes approval for 2011 bids.
(Page 65)
6. October 1st – Plans can begin Marketing for 2011 plans (Page 66)
7. October 2nd – Non-Renewed members should get their notice of
termination (Page 67)
8. Mid to Late October – CMS mails Medicare and You for 2011. (Page 67)
9.
October 31st – Members should receive their Annual Notice of
Change Letters (ANOC). (Page 68)
10.
November 15th – Annual Coordinated Enrollment Period begins
for 2011 (Page 69)
11.
December 31st – Annual Coordinated Enrollment Period ends for
2011 (Page 69)
12.
January 1st, 2011 – Open DISENROLLMENT Period (ODP) begins.
This allows Medicare Beneficiaries to disenroll from an MA plan (return
to Original Medicare) or disenroll from a MAPD plan (return to Original
Medicare and enroll in a PDP). (Page 70)
13.
February 15th, 2011 – ODP ends and members are “locked in”
(page 70)
BE PREPARED,
Lance Taylor
Branch Manager
Savannah 1P
United American
From: King, Andy
Sent: Wednesday, June 23, 2010 1:52 PM
Subject: MUST READ - YET ANOTHER MA LEAVING MARKET (Cigna) - impact approximately 92,000
members in 27 states - RECRUIT, RECRUIT, RECRUIT - 16 HOURS PER DAY, 6 DAYS PER WK, FOR 6
MOS
Importance: High
LANCE IS RIGHT - ALL BMS NEED 300
AGENTS RECRUITED TO TAKE
ADVANTAGE OF THESE
DISENROLLMENTS – MORE TO COME,
THEY ARE ANNOUNCING NOW!!!
16-6-6 – RECRUIT 16 HOURS PER
DAY, 6 DAYS PER WEEK FOR 6
MONTHS – AND AS BEFORE,
WRITE MILLIONS IN
AP!!!
ANDY
From: Branch1P Savannah GA [mailto:[email protected]]
Sent: Tuesday, June 22, 2010 7:50 PM
To: Andy King
Cc: John Gore
Subject: Cigna MA Pffs
Andy,
I don't know if you got this one or
not, good stuff!
P.S. I highlight the important
words in GREEN BOLD to remind us
of MONEY!
Lance Taylor
---------------------------------------------------
Cigna to exit national
Medicare Advantage
private FFS market in
2011
June 21, 2010 — 3:31pm ET | By Caralyn Davis
Cigna Corp. has chosen not to renew its national Medicare Advantage private feefor-service (PFFS) contract for 2011. Analysts have expected some Medicare
Advantage companies to leave the market due to changes that CMS is making
regarding provider networks.
CIGNA's decision will impact
92,000
members in 27 states,
approximately
spokeswoman Lindsay
Shearer tells
FierceHealthPayer. The goal is "to allow CIGNA
to provide greater focus on those core government businesses that provide the
most value for customers--that can be delivered on a sustainable basis, in
alignment with our strategy to improve the health, well-being and a sense of
security of customers through our industry-leading service and clinical
programs," she says.
CIGNA will continue to offer its Medicare Part D pharmacy plan and the Arizona
Medicare Advantage HMO plans. "The Medicare Advantage HMO in Arizona has
been a market leader for over 15 years. Our Part D plan has over half a million
members. Both plans have demonstrated an ability to deliver sustained value to
our customers," says Shearer. "In addition CIGNA offers a comprehensive suite
of group-sponsored retiree solutions including early retiree products, Medicare
Part D pharmacy benefits, CIGNA Medicare Advantage Alliance products with
Humana, Medicare Supplemental benefits and Medicare Advantage HMO group
plans in Arizona."
From: King, Andy
Sent: Wednesday, June 23, 2010 1:41 PM
Subject: "Thank You - so excited - We did our first Senior Seminar group today following outline - also
produced two more senior groups for us - we will get this snowball rolling. "
Importance: High
You are welcome, Ken. It certainly works!
Congratulations to your T.E.A.M in beginning Senior
Seminars!
Andy
-----Original Message----From: BM171 - Fort Worth North
Sent: Tuesday, June 22, 2010 7:50 PM
To: King, Andy
Subject: Thank You
We (my UM and Agents) did our first
Senior Seminar group today following
the outline below. You will get an
update from Matt sometime this
evening.
The event also produced two more
senior groups for us. I am so excited
and so are my agents and managers
but it was due to the phone call and
the email that you sent out that made
us realize how easy this could be for
us.
Again thanks and we will get this
snowball rolling.
Ken
Branch #171
"If hard work is the key to success, most people would rather pick the lock."
-Claude McDonald
Medicare Supplement
Seminar Marketing:
STEP BY STEP HOW-TO GUIDE ON
GENERATING THOUSANDS OF SENIOR
SEMINAR SALES
Here’s how it works, STEP BY
STEP:
1. APPROACHING SENIORS WITH A SURVEY: Have every
agent in your office fill out the form below with EVERY SENIOR
with whom they speak, using the following script:
“Mrs./Mr. Jones, many new changes in Medicare supplemental
plans have been recently announced by the Federal
Government. Many seniors are very concerned as to how their
coverage might be impacted from these new changes. As you
may know, the Federal Government and Medicare (CMS) have
recently introduced a new set of Standardized Plans – many
seniors do not understand these, and worse yet, some may not
have even heard of these important new changes yet.
As a part of my company’s public services, they have assigned
me the task to complete a survey with every senior who belongs
to a Senior Citizen Group, to offer a free educational program on
how the government’s new changes might affect them. We DO
NOT sell any of our products at our meeting, EVEN IF ASKED – it
is simply informational to answer everyone’s questions. We
keep it light and also provide everyone attending with several
gifts of their choice. The benefit we hope we gain will be that
your members will value our knowledge. We want to meet new
friends and hope they’ll keep us in mind later for any future
needs.
Please assist me with this survey so I can contact the leadership
of your local senior group.”
You can cut and paste this survey form (create a form with four
of these data-sets on each page):
SURVEY FORM – for Senior Citizen Group Member
Referring Senior Member’s Name_________________________
a) Do you belong to a Senior Citizens Group? YES____ NO____
b) Do your members need questions answered on the recent standardized
plan changes and whether healthcare reform will impact seniors?
c) Do your members need information on higher potential interest rates on
their savings, rather than the low rates currently seen?
d) What is the name of your group?____________________________
e) What date does your group meet?__________________________
f) Where does your group meet?_____________________________
g) Who are the leaders of your Senior Citizens Group:
- President’s name?_______________________
Phone___-_______
Secretary’s name?_______________________
Phone ___-_______
- Treasurer’s name?_______________________
Phone ___-_______
How many members are there in your group? _______
How many members attend each meeting on average?_______
How much are your dues? $______Monthly or annual? _______
Do they provide a meal at the meeting or is it pot-luck (members bring a
covered dish)? ____________
-
h)
i)
j)
k)
Have each agent bring you 20 or more completed surveys
each week for you to show them how to conduct calls to the
leaders of the Senior Citizen Group. Your objective is to begin
calling each group’s President, Secretary or Treasurer to offer
the informational meeting, fill in gaps in the survey and secure a
meeting date. YOU MUST SHOW YOUR AGENTS HOW TO
DO THIS.
2. CALLING THE PRESIDENT, SECRETARY OR
TREASURER: the following things are extremely important to
make clear:
a) USE THE REFERRING MEMBER’S NAME WHEN YOU
INTRODUCE YOURSELF
b) NO SELLING: There will be no offering of our products at the
meeting (you will hear an audible sigh of relief, because they
don’t want a ‘sales presentation’) – they will not agree to
allow you in if you don’t make this clear.
c) INFORMATIONAL ONLY: Only an overview of factors
influencing Medicare’s changes and current benefits will be
reviewed (these are found on CMS’ website and their ‘Guide
to Health Insurance for People with Medicare’). At the end of
the meeting, there will be a Q&A for those with questions. You
cannot discuss Medicare Advantage benefits under any
circumstances, since MA regulations require government
certification, which is complicated.
d) SENIOR OFFER PACK: We will keep the meeting light and
informational – every member in attendance will receive a nocost gift (everyone gets their choice of: LNL MedFacts kit for
those with heath concerns, LNL Memorial Guide, ChildSafe ID
Kit for their grandchildren and/or an ADP. There will also be a
door prize drawing for 3 primary prizes as well.
e) WE CAN HELP THEM GROW: Would they like to increase the
size of their membership, in order to increase their duepaying base? If so, would they be willing to allow you to set
up TV, Radio, Newspaper and Senior Publication ads for their
meeting date, at no cost to their group?
3. NO COST ADVERTIZING FOR YOUR EVENT THROUGH
PUBLIC SERVICE ANNOUNCEMENTS: arrange a time to
stop by and pick up a Senior Citizen Group officer’s permission
in writing to use their group’s name in your ads. Once secured,
you may call EVERY TYPE of media outlet to place the Public
Service Announcements – TV, RADIO, NEWSPAPERS. YOU
MUST SHOW YOUR AGENTS HOW TO DO THIS.
4. DOOR PRIZE DRAWING – purchase items that ‘wrap big’ (at a
local department store that also has a gift-wrap department),
such as coffee-pump servers or silver-plate bowls or dishes, for
@ $10 - $15 each. Spare no expense on professional gift
wrapping – you’ll position these in the meeting room and refer to
them throughout the meeting (“the door prize drawing is coming
up soon and everyone’s will be a winner”) - they’ll stay until the
end of the meeting in order to participate in the drawing. These 3
primary gifts get them to fill out the form for the other Senior Gift
Pack items – for you to send these to them, you’ll need their
address using the form below (note: the form does not say
‘mail’, it says ‘send by special delivery’ (to be personally
delivered). Your agents will later ‘special delivery’ the gifts that
everyone wins.
5. DOOR PRIZE DRAWING FORM: the form for the door prize
drawing is set up as follows – note it does not ask for a phone #
- seniors will not complete it if you do, and we don’t want calls
made anyway – the prizes will be sent by special delivery (your
agent – or I suppose they could mail it first class or overnight,
but how could they help the senior fill out the no-cost offers,
which allows a trusted relationship to form?). BE SURE TO
HAVE PLENTY OF PENCILS ON HAND, ONE FOR EACH
MEMBER – IT WILL SAVE TIME (You’ll need to FULLY flesh out
the value of each no-cost item – using your Laptop
Presentations and a projector would be easiest). You can cut
and paste this form:
DOOR PRIZE REGISTRATION
FORM
Door Prize Drawing and Senior Pack*
EVERYONE RECEIVES one or more items
listed below!
- WITH MORE LUCKY WINNERS FOR OUR GRAND
PRIZE DRAWING.
Any items in the Senior Gift Pack checked will be sent directly
by special delivery:
Physical Address (not PO Box):
Name
_____________________
Spouse’s Name (if
applicable) _____________________
Address ____________________ City___________________
State____________ Zip________
Please check one or more of the following no-cost promotional
gifts you would like to have sent directly to you:
1. MedFacts Kit (provides critical Medical info to EMS
services)
_____
2. Memorial Guide Kit (provides survivors your final
wishes)
_____
3. ChildSafe ID Kit (aids location of grandchildren, if ever
missing)
_____
4. Accidental Death Plan** (need date(s) of birth to see if
qualified)
_____
Your Date of Birth__-__-____
Spouse’s Date of Birth__-__-____
*no obligation – promotional offer(s) on behalf of Liberty National will be
sent directly to you.
**no premiums are due until the end of the first policy year.
If you know friends or relatives who would like to sponsor for a
promotional gift, please list their names below:
1. Name _______________________ Offer you would like to
sponsor_________________
2. Name _______________________ Offer you would like to
sponsor_________________
3. Name _______________________ Offer you would like to
sponsor_________________
4. Name _______________________ Offer you would like to
sponsor_________________
5. Name _______________________ Offer you would like to
sponsor_________________
From: King, Andy
Sent: Monday, June 21, 2010 5:06 PM
Subject: TOP 10 SENIOR ANNUITY CONCERNS: Overcoming objections to RFA - Annuity adoption:
Importance: High
Overcoming Objections to
Annuity Adoption:
1. FLEXIBILTY: This is why the Reserve Fund Annuity with
the HDF plan meets the #1 concern on annuities from
Seniors. SEE REASON # 1 BELOW, ADRESSED BY THE
RFA’s ‘NO LOCK, NO LOAD’ – WITHDRAWALS CAN BE
MADE WITHOUT A SURRENDER CHARGE.
2. GROWTH: 3% MINIMUM RATE
3. CONTROL: WITH NO LOCK-IN TIME ON HDF’S RFA, THE
CUSTOMER IS IN CONTROL
4. REVERSIBLE: SENIORS ARE NOT LOCKED IN
5. TOUCHING SAVINGS: ONLY DEDUCTIBLES ARE
WITHDRAWN
6. ALREADY HAVE REGULAR INCOME: CAN GET MORE
THAN MOST AVAILABLE PASSBOOK OR CD RATES
7. INFLATION: MINIMUM 3% INTEREST RATE ASSISTS
CONCERN
8. RISK: SOLID, A.M. BEST RATED COMPANY
9. KNOWLEDGE: AGENT IS THERE TO EXPLAIN
10. TRUST: DEPENDENT ON UNDERSTANDING
From: King, Andy
Sent: Monday, June 21, 2010 2:35 PM
Subject: Report Predicts Medicare Advantage to be Cut in Half - Medicare Advantage has certainly been
most affected by the recent health care reform bill
Importance: High
Report Predicts
Medicare Advantage to
be Cut in Half
In a report detailing how recently passed health care reforms would
impact different categories of health insurance, The Centers for
Medicare & Medicaid Services (CMS) predicted that Medicare
Advantage enrollment will be cut in half due to the new laws.
forecast that reductions in
Medicare Advantage payments—which
will lead to less generous benefits for
enrollees—will reduce total MA enrollees
to 7.4 million—roughly half the number of
enrollees today.
The report
This CMS analysis also detailed the pending Medicare Advantage
bonuses and rebates for plan quality rankings. In a five-star rating
system, a plan receiving four stars or higher would receive bonuses
gradually increasing from 1.5% in 2012 to 5% in 2014. The amount of
the "benchmark minus bid" rebates—which have been at 75%--will also
be based on quality rankings in the future, ranging from 50% to 70%,
depending on the stars earned by each plan.
Of the three types of private Medicare plans—Medicare Advantage,
Medicare Advantage
Medicare Supplement and Part D—
has certainly been most affected by the
recent health care reform bill.
From: King, Andy
Sent: Monday, June 21, 2010 2:12 PM
Subject: MA Shakeup Coming Soon - about to change under health care overhaul - Medicare's analysts
predict exodus from MA back to traditional program
Importance: High
Medicare Advantage
Shakeup Coming Soon
By Phil Daigle
For years, private Medicare Advantage plans have enjoyed generous payments from
the government, currently averaging 9 percent more than the cost of care in
traditional Medicare. The government's benevolence enabled Medicare Advantage
plans to offer lower out-of-pocket costs and extra insurance benefits compared with
traditional Medicare - like dental, vision, and prescription drug coverage. About 11
million seniors are signed up, nearly one-fourth of Medicare recipients.
That's about to change under the health care
overhaul. Payments are being trimmed back starting next year for all plans, to
correct what Obama says is wasteful overspending. However, beginning in 2012, the
law directs Medicare to award bonuses to high performing plans - plans that score
four stars or better on a 5-star rating system. The payment shift means that highquality plans will find it a lot easier to keep offering extra benefits, while
others will struggle. Indeed, Medicare's
own analysts predict an exodus from
Medicare Advantage back to the
traditional program after the cutbacks
begin.
The government's rating system evaluates health plans according to several
measures, including customer service, prevention and medical care for people with
chronic health problems. The ratings, already available on medicare.gov, assign one
to five stars for quality, with one signifying poor performance and five excellent.
How the private plans score on the quality rating
system set up by the government is about to have a
direct impact on insurers' finances -- not to mention
seniors' benefits and premiums. President Barack Obama's health
care law ties what the plans get paid by the government to the quality they provide,
for the first time. These ratings are about to become much more important. When
you start linking quality to payment, you can bet the plans are going to be very
motivated to bring the scores up.
Millions of seniors signed up for
popular Medicare Advantage
insurance plans don't get the best
quality, an independent study found.
There seems to be plenty of room for improvement. The study being released in April
2010 by looked at the health plans that seniors pick, according to the plans' scores
on a government rating system designed for consumers. Overall, senior have proven
The analysis
found that 47 percent of Medicare
beneficiaries are in plans that rate
three stars or two -- medium to fair
quality. Just 23 percent were signed
to be poor shoppers of Medicare Advantage plans.
up in plans that rate four or five stars - very good to excellent quality. Many
of the rest were in plans not yet rated.
If the new system of rewarding the
best plans and culling out the poor
performers works, seniors will be
more likely to be gravitate to the
better plans.
From: King, Andy
Sent: Monday, June 21, 2010 2:06 PM
Subject: Majority of Those in Medicare Advantage Not Enrolled in Top Ranked Plans - The government
clearly intends ...aggressively... weed out those that are not meeting certain measures
Importance: High
“The government clearly intends to use
the star rating program more
aggressively to reward plans
focused on quality and
weed out
those that are not meeting
certain measures.”
Majority of Those in Medicare
Advantage Not Enrolled in Top
Ranked Plans
Only 0.3% of MA enrollees are in a ‘5’ star, or top-rated, plan
April 29, 2010 - The majority of people in the Medicare Advantage (MA) program are
currently not enrolled in the highest-quality plans, despite the existence of a star
rating system that assesses quality for MA plans, says a new analysis released by
Avalere Health.
The star rating system is run by the Centers for Medicare and Medicaid Services
(CMS), and was put in place as part of an effort to help educate consumers on quality
and make quality data more transparent. Its summary ratings are based on five major
domains:
● staying healthy via preventive services such as screenings and
vaccines;
● managing chronic conditions;
● ratings of plan responsiveness and care;
● complaints, appeals, and voluntary disenrollment; and
● telephone customer service.
Avalere analyzed the CMS 2010 Part C Report Card, released in November 2009, and
enrollment data released in April 2010 to see whether beneficiaries’ plan selections
correspond with 5-star quality ratings assigned by the government.
According to Avalere’s analysis, 47.2% of MA enrollees are in plans with a ‘3’
or below rating, while 38.7% are in plans rated ‘3.5’ and up.
Only 0.3% of MA enrollees are in a ‘5’ star, or top-rated, plan.
Another 14.1% are unaccounted for, due to a plan being too new to measure or having
insufficient data to calculate the contract score.
Currently star rating scores are assessed and routinely published on CMS’s website
and Plan Finder, a web tool designed to help beneficiaries select MA plans. The
scores will continue to be published annually.
Coming with Health Care Reform
However, new starting in 2012, plans’ payments will be tied to their scores. Plans
receiving 4 or more stars will be eligible for quality bonuses of up to 5 percent of local
fee-for-service costs when fully phased in; higher-rated plans will also be able to keep
a larger percentage of the rebate dollars plans use to reduce beneficiaries’ cost
sharing and enhance benefits.
Together, these incentives may blunt some of the estimated $200 billion in cuts to MA
plan payments for the highest-quality plans, and may
prompt shifts in
enrollment as plan benefit designs become increasingly
reliant on their performance.
“The government clearly intends to use the star
rating program more aggressively to reward plans
focused on quality and weed out those that are not
meeting certain measures,” said Bonnie Washington, a vice
president at Avalere Health.
“Many plans are likely to be focused on improving their scores as payment becomes
increasingly tied to quality. In the short term, that may mean more attention on
dealing with complaints or their customer service. Long-term, we’ll likely see more
focus in areas such as outcomes, improving beneficiary experience, and disease
management, which may ultimately benefit consumers.”
From: King, Andy
Sent: Monday, June 21, 2010 1:58 PM
Subject: MUST READ - The Impact of Health Care Reform on Medicare Advantage Plans and Medicare
Prescription Drug Plans
Importance: High
The Impact of Health Care Reform
on Medicare Advantage Plans and
Medicare Prescription Drug Plans
by Michael A. Dowell
May 21, 2010
Previously published on May 18, 2010
The Patient Protection and Affordable Care Act (PPACA) makes significant changes
that will directly or indirectly impact Medicare Advantage Plans and
Medicare Part D Prescription Drug Plans.
Following is a summary of these modifications.
Medicare Advantage Plans
Medicare Advantage Payment Benchmarks. The recent health care reform will
gradually phase down Medicare payments to Medicare Advantage Plans, to bring
payments closer to the average fee-for-service costs of Medicare beneficiaries. In 2011,
benchmarks for Medicare Advantage Plans will remain the same as they are in 2010.
Between 2012 and 2013, Medicare Advantage Plan benchmarks will gradually be reduced
to levels closer to the costs of fee-for-service Medicare enrollees in each county, with lower
benchmarks (95 percent of fee-for-service costs) in counties with high fee-for-service
Medicare costs, and higher benchmarks (115 percent of fee-for-service costs) in counties
with lower fee-for-service Medicare costs. The new rates will be phased in over three to six
years depending on geographic locations.
Risk Adjustment. Medicare Advantage Plan payments to private plans will be further
reduced through changes in the method used to compensate plans for the health status of
enrollees (risk adjustment). In 2011, risk scores will be reduced by 3.41
percent. Beginning in 2014, CMS will have the authority to further
reduce risk scores, with a reduction of at least 5.7 percent in 2019
and in future years.
Quality Based Payments. Medicare Advantage will provide bonuses to plans
receiving four or more stars, based on the current five-star quality rating system
for Medicare Advantage Plans, beginning in 2012; qualifying plans in qualifying areas will
receive double bonuses. The recent health care reform also modifies the rebate system, with
rebates allocated based on a plan’s quality rating. There will also be phased-in adjustments
to plan payments for coding practices related to the health status of enrollees, with
adjustments equaling 5.7 percent by 2019.
Minimum Loss Ratio Requirements. Starting in 2014, if the United
States Secretary of Health and Human Services (the Secretary)
determines that a Medicare Advantage Plan does not maintain a
medical loss ratio (MLR) of 85 percent (meaning that 85 percent of
plan revenues do not go towards benefits), the plan must remit a
specified sum to the Secretary. If a plan fails to have an MLR of 85
percent for three consecutive years, the Secretary will preclude new
enrollment in that plan. If a plan fails to have an MLR of 85 percent for
five consecutive years, its contract must be terminated.
Benefit Protections and Simplifications. Starting in January 2011, Medicare
Advantage Plans cannot impose cost-sharing for chemotherapy administration services,
renal dialysis services, and skilled nursing care services that exceed the cost-sharing for
those services under original Medicare. The Secretary has discretion to require that costsharing for other services also does not exceed original Medicare cost-sharing. Starting in
January 2012, plans that receive rebates and/or performance bonuses and that offer
supplemental benefits must: (1) apply the most significant share to reductions in costsharing for benefits available under Medicare Parts A, B and D; with reductions in out-ofpocket expenses applying to all benefits under Parts A and B; (2) apply the second most
significant share to meaningful coverage of preventive and wellness benefits that are not
benefits under traditional Medicare; and (3) use the remaining share to meaningfully
provide coverage for benefits that are not covered under traditional Medicare, such as eye
examinations and dental coverage.
Special Needs Plans (SNPs). SNPs are required to be National Committee for
Quality Assurance (NCQA)-certified for 2012 and later years. CMS authority to
restrict the types of members enrolling in SNPs has been extended
through 2013.
Medicare Part D Drug Benefit Plans
Elimination of Exclusion of Coverage of Certain Drugs. Starting in 2014,
Medicaid programs will no longer be able to exclude smoking cessation agents,
barbiturates and benzodiazepines from coverage under Medicaid. Because Medicare Part
D-covered drugs are defined generally as those drugs that are covered under Medicaid, this
new provision will result in a small expansion of Medicare Part D coverage of barbiturates.
Starting in 2013, Medicare Part D will cover benzodiazepines and barbiturates used in the
treatment of epilepsy, cancer or a chronic mental disorder.
Closing the Medicare Prescription Drug "Donut Hole." The recent health care
reform creates a multi-part process for closing the Medicare Part D coverage gap, or
“donut hole.” In 2010, certain beneficiaries who reach the “donut hole” will receive a $250
rebate. In 2011 and later years the coverage gap will decrease each year until 2020 by
decreasing beneficiaries’ costs through decreases in drug costs and member cost sharing.
In 2020 the “donut hole” will be eliminated and beneficiaries will pay 25 percent coinsurance for prescriptions.
Formulary Requirements. Starting in 2011, drug plan sponsors must include in their
plans' formularies all covered Medicare Part D drugs in a category or class identified by
the Secretary. The Secretary has discretion to establish exceptions that allow a plan
sponsor to exclude or attach utilization management requirements to a drug within a
protected category or class. The criteria for determining drugs to be included under this
section, and the exceptions described above, are to be established through notice and
comment rulemaking. The current six protected classes of drugs remain protected until
such time as the Secretary establishes new criteria.
Part D Premium Subsidies for High-Income Beneficiaries. Starting in
January 2011, beneficiaries with higher incomes who pay the Medicare Part B incomerelated premium will also be subject to a Medicare Part D income-related premium. The
increased premium amount will be based on a percentage of the base beneficiary premium
for that year as determined by the Secretary. The Secretary will inform the Commissioner
of Social Security (the Commissioner) of the base beneficiary premium amount by
September 15 of each year and inform the Commissioner of the income threshold by
October 15. The Commissioner will make determinations to carry out the income-related
premium and will collect the amount through withholding from Social Security checks.
Long-Term Care Facility Outpatient Prescription Drugs. Starting in 2012,
plans must use specific, uniform dispensing techniques for Medicare Part D-covered drugs
provided to residents of long-term care facilities whose prescriptions are paid for under
Medicare Part D. They may include weekly, daily or automated dose dispensing of Part Dcovered drugs. The techniques are to be determined by the Secretary through consultation
with relevant stakeholders, including both residents and their representatives.
Medicare Prescription Drug Plan and Medicare Advantage-PD Plan
Complaint System. The Secretary is required to develop an easy-to-use complaint
system that will allow for the collection and maintenance of complaints received through
any source and by any mechanism against Prescription Drug Plan (PDPs) and Medicare
Advantage-PD plans. The system must be able to report and initiate appropriate
interventions and monitoring and to guide quality improvement. A model electronic
complaint form is to be developed and maintained on www.medicare.gov and the Office of
Medicare Ombudsman's websites. The Secretary is also required to report to Congress
annually on the number and types of complaints, geographic variations in complaints,
timeliness of responses to complaints, and resolution of complaints.
Uniform Exceptions and Appeals Process for PDPs and Medicare
Advantage-PD Plans. For exceptions and appeals filed on or after January 1, 2012,
prescription drug plan sponsors must use a single, uniform exceptions and appeals process
and provide access to it through a toll-free telephone number and a website.
AIDS Drug Assistance Programs and Indian Health Service. Starting in
2011, prescription drug costs reimbursed by AIDS Drug Assistance Programs (ADAPs)
and the Indian Health Service will count towards true-out-of-pocket (TROOP) costs when
calculating eligibility for catastrophic drug coverage under Medicare Part D.
Deduction for Expenses Allocable to Medicare Part D Subsidy. Employers
that continued to provide creditable drug coverage for their retirees after Medicare Part D
was enacted are entitled to a 28 percent rebate from Medicare towards the cost of that drug
coverage. They pay no tax on the rebate amount, and may deduct from their taxes the full
amount of the cost of the retiree coverage as if they received no rebate. The recent health
care reform eliminates employers’ ability to deduct the 28 percent rebate from their taxes,
effective 2012.
Medicare Advantage and Medicare Part D Drug Benefit Plans
Annual Beneficiary Election Period. The open enrollment period, during which a
beneficiary may enroll in or disenroll from a Medicare Advantage Plan during the first
three months of the year, is eliminated. Starting in 2011, an individual who enrolls in a
Medicare Advantage Plan may return to original Medicare and a Medicare Part D plan
during the first 45 days of the year. Starting in the fall of 2011, the annual coordinated
election period for Medicare Part C and Part D plans will run from October 15 through
December 7 of each year, rather than from November 15 to December 31.
Authority to Deny Plan Bids. The Secretary now has discretion to deny a bid that
proposes significant increases in cost-sharing or decreases in benefits offered by the
Medicare Advantage Plan or Prescription Drug Plan (PDP) sponsor. The provision applies
to bids submitted for contract years beginning on or after January 1, 2011.
From: King, Andy
Sent: Monday, June 21, 2010 1:21 PM
Subject: Big changes to Medicare are coming, beginning with Medicare Advantage - beneficiaries will
have access to fewer plans, some to none at all
Importance: High
Medicare Advantage: You Get
What You Pay For
‘Big changes to Medicare are coming, beginning with
Medicare Advantage, the program that provides private
insurance alternatives to traditional fee-for-service
Medicare’
By Austin Frakt, Assistant Professor of Health Policy and Management
Boston University’s School of Public Health
June 15, 2010 - The Obama administration seems worried. In an election
year, any change to Medicare that adversely affects beneficiaries is a
political liability for incumbents. And
big changes to Medicare are
coming, beginning with Medicare Advantage,
the program that
provides private insurance alternatives to traditional fee-for-service
Medicare, the program’s public option.
Last Monday, private insurers that offer Advantage plans submitted their
2011 bids, estimates of the cost of providing a fixed set of basic Medicare
benefits next year. It is through this annual bidding process that the
generosity of coverage and level of cost-sharing for each plan is
established. With 2011 government payments to plans fixed at 2010 levels
by the new health overhaul law,
it is likely that beneficiaries
will pay more to get less from Advantage plans
next year. The bids will reveal how much.
According to the Wall Street Journal, in advance of the bid deadline,
Department of Health and Human Services Secretary Kathleen Sebelius
sent a letter to insurance companies warning them not to dramatically
increase premiums or cost-sharing of Advantage plans. If they do, they run
the risk that Sebelius will reject their proposals.
Despite the secretary’s threat,
it’s inevitable that Advantage
plans will adjust their premiums and cost-sharing
upward in the long run, if not in the short run.
Over
the next few years, the new health law gradually reduces Advantage
payments from today’s generous levels that are about 15% above fee-forservice costs. The lower levels will depend on local costs and plan quality.
That’s good news for taxpayers, even if
it isn’t welcome news
to Medicare beneficiaries. According to the Congressional
Budget Office, the reduction in plan payments is expected to save over
$100 billion in the next decade. The lower spending on Advantage plans
inevitably will lead to reductions in plan availability. Some
beneficiaries will have access to fewer plans,
some to none at all,
a fact illustrated by a Health Care Financing
Review paper I co-authored.
Our earlier paper in the International Journal of Health Care Finance and
Economicsindicates that even where plans continue to be offered, their
benefits will be less generous as government
payments decrease. Though beneficiaries will object to the loss
of benefits, they actually don’t value those benefits anywhere near their
full cost to taxpayers. In a study published last year, also in
the International Journal of Health Care Finance and Economics, we found
that
for the benefits provided by each additional
dollar paid to Advantage HMOs since 2003,
beneficiaries would have paid just $0.14 out of
their own pocket. In monetized terms, a dollar saved makes a
Medicare beneficiary worse off, but by
This
far less than one dollar.
relatively poor return of value on taxpayer
dollars is why I support reductions in Advantage
payments. The administration and congressional Democrats have
chosen the right path for Advantage payment policy. Having done so, they
are now faced with a political problem. How can they avoid the potential
ire of disgruntled Medicare beneficiaries? It will be hard, if not impossible.
Sebelius’ letter is a good try. It’s an attempt to bully plans into selfsubsidizing their products or finding creative ways to hide the reduction in
generosity this year. If she succeeds, then she’ll have achieved a shortterm political victory. But she’s facing an uphill battle.
In the long run,
there’s no getting around the fact that
Advantage plans will shrink in generosity and
availability. Anything else would defy a fundamental law of
economics that also happens to be a fundamental law of politics: you get
what you pay for.
From: King, Andy
Sent: Monday, June 21, 2010 1:14 PM
Subject: Medicare News - Rating System For MA Plans to become more significant- Under new health
law, star system will be used - chart shows % senior citizens in each state
Importance: High
Medicare News
Rating System For Medicare
Advantage Plans Slated For
Upgrade as Stars Grow in
Importance
Under the new health law, the star system
will be used to award bonuses
- chart shows % senior citizens in each state
in star-rated plans
By Susan Jaffe
Percentage of beneficiaries enrolled in
Medicare Advantage plans by rating:
Note: Categories include plans with half stars. For example, the
two-star category includes plans with 2.5 stars.
Chart Source: Avalere Health
June 15, 2010
For consumers looking for bargains on refrigerators or restaurants,
ratings can be helpful. But a score card doesn't work as well for
selecting a Medicare private health plan.
About 47 million people are in Medicare, the federal health program
for the elderly and disabled; nearly a quarter of them are enrolled in
Medicare Advantage plans, offered by insurance companies as
alternatives to the traditional program.
The plans, which receive federal subsidies, offer Medicare's
standard benefits plus extra benefits, often including prescription
drug coverage. A few years ago, federal officials began rating these
plans - using a scale of one to five stars - but seniors' advocates,
policy analysts, insurers and some top Medicare officials agree the
ratings are flawed.
Even so, the star system is about to become more
significant.
Under the new health-care overhaul law, the ratings will be used for
the first time to award bonuses potentially worth hundreds of
millions of dollars to the best plans. If the bonuses had been in
effect last year, the top-rated plans would have received a total of
$1.3 billion, estimates Dr. Brian Biles, a health policy professor at
George Washington University.
But many seniors don't have much choice: Biles found that only
15 percent of Medicare Advantage members live in
counties where four- or five-star plans are offered.
In a new study, Avalere Health, a consulting firm, found that only 5
percent of Medicare Advantage members in Virginia are in four-star
plans. That compares with 33 percent in Maryland and 68 percent in
the District. And no one in the Washington area is enrolled in a fivestar plan, for a good reason: None of the plans offered here has
earned the top grade.
Although the scores are updated every fall, some are based on
information that is almost two years old. More than 40 percent of
plans have no rating because they are too new or too small,
according to studies by the Kaiser Family Foundation and Avalere.
(KHN is a part of the Foundation.)
To fix some of the ratings' shortcomings, CMS will propose
changes this summer, says Blum. "We will start off with the system
we have," he says. "But I fully expect that it will change over time."
The ratings' flaws were underscored in April, when
Medicare ordered Aetna, one of the nation's top health
insurers, to suspend enrollment in its Medicare Advantage
and stand-alone Medicare prescription-drug plans.
Medicare's compliance officer told Aetna that a delay in
the plans' approval of the filling of prescriptions
"potentially puts Aetna's current and future enrollees'
heath at risk."
Yet when the decision was announced, Aetna's most
expensive Medicare Advantage plan in Northern Virginia
was rated at 3.5 stars - between "good" and "very good."
An Aetna official said the rating makes sense because drugcoverage performance is only one of many criteria used to
determine rankings.
Under the Medicare Advantage program, the government pays the
plans a set amount for each beneficiary - an average of 13 percent,
or about $1,140 in 2009 - above what the original Medicare program
spends on a similar individual. Some plans use the money to offer
extra benefits such as dental care, eyeglasses and gym
memberships, often at no additional expense to the beneficiary.
The health-care law phases out these extra
payments beginning in 2011. That change, which
would probably force many Advantage plans to trim
their extra benefits, may make the plans less
attractive to many people.
Medicare Advantage ratings are currently based on 33 criteria,
including members' satisfaction, customer service and how often
members get screenings and tests. Plans that also offer drug
coverage are graded in 19 additional areas.
A summary or average of the results for each plan appears on the
"Medicare Options Compare" website (go to www.medicare.gov and
click on "health and drug plans"). Most beneficiaries can enroll in a
plan only during the last six weeks of the year, unless they move or
have just become eligible for Medicare. Under the new law, plans
earning four or five stars will get a 1.5 percent bonus in Medicare
payments starting in 2012 , rising to 5 percent by 2014.
Some of the top plans may get even bigger bonuses.
Improving the rating system could help consumers such as Elaine
Collins, a 69-year-old Arlington resident who works for a military
contractor and is thinking of retiring and enrolling in a Medicare
Advantage plan. When she checked the Medicare website recently,
almost half of the 26 plans in Northern Virginia lacked ratings. "It's
so complex, it boggles the mind," she says. "Part of me
says I should just keep working, and that's the way I'm
headed."
The ratings system and the new bonuses draw complaints from
both the industry and consumer advocates.
Robert Zirkelbach, a spokesman for America's Health Insurance
Plans, says that some plans may never get four or five stars even if
they improve, because he says much of the assessment is relative
and "the plans are compared against each other and then graded
on a curve."
Vicki Gottlich, a senior attorney at the Center for Medicare
Advocacy, a consumer group, says she dislikes the use of an
average score because it can mask the fact that a plan might be
good in one area but lousy in another. To get the complete
view, seniors would need to look on the Medicare website for the
plan's complete score card.
From: King, Andy
Sent: Friday, June 18, 2010 5:02 PM
Subject: Is ObamaCare using savings from Medicare's 21% doctor cut being to increase the TOTAL
number of doctors?
Importance: High
HHS to spend $250 million to
increase number of primary-care
providers
By Darryl Fears
Thursday, June 17, 2010
In an attempt to address a national shortage of health-care workers,
Health and Human Services Secretary Kathleen Sebelius said
Wednesday that the federal government will spend $250 million in
programs to increase the number of doctors, nurses and other care
providers.
The money is the first allotment from the Prevention and Public Health
Fund,
created by the new health-care law, the
Obama administration said in a statement. It includes $168 million
to train 500 new primary-care physicians over the next five
years, $30 million to encourage 600 nursing students to
attend school full-time and complete their education, and
$32 million to create 600 new physician assistants.
As the health law inches toward full implementation in 2014, the
nation faces a major shortage of primary-care doctors and nurses "due
to the needs of an aging population and a decline in the number of
medical students choosing primary care," the announcement said. In
addition, thousands of aging baby boomers who are doctors and
nurses are eyeing retirement.
From: King, Andy
Sent: Friday, June 18, 2010 4:51 PM
Subject: SEMINAR TIME! Doctors 21 percent pay cut this week - Congress failed to defer the cuts by
two more years - made the 21 percent cut the law of the land"
Importance: High
Doctors face 21 percent cut in
Medicare payments
By Ed O'Keefe
Washington Post Staff Writer
Monday, June 14, 2010
Doctors with Medicare patients will start seeing a 21
percent pay cut
this week after Congress failed
to defer the cuts by two more years.
"The Senate's failure to act before
June 1 made the 21 percent cut the
law of the land,"
AMA President J. James Rohack said in a statement.
"Physicians will start seeing a 21 percent cut in
Medicare payments this week that will hurt seniors'
health care as physicians are forced to make
practice changes to keep their practice doors open."
Medicare Supplement
Seminar Marketing:
STEP BY STEP HOW-TO GUIDE ON
GENERATING THOUSANDS OF SENIOR
SEMINAR SALES
Here’s how it works, STEP BY
STEP:
6. APPROACHING SENIORS WITH A SURVEY: Have every
agent in your office fill out the form below with EVERY SENIOR
with whom they speak, using the following script:
“Mrs./Mr. Jones, many new changes in Medicare supplemental
plans have been recently announced by the Federal
Government. Many seniors are very concerned as to how their
coverage might be impacted from these new changes. As you
may know, the Federal Government and Medicare (CMS) have
recently introduced a new set of Standardized Plans – many
seniors do not understand these, and worse yet, some may not
have even heard of these important new changes yet.
As a part of my company’s public services, they have assigned
me the task to complete a survey with every senior who belongs
to a Senior Citizen Group, to offer a free educational program on
how the government’s new changes might affect them. We DO
NOT sell any of our products at our meeting, EVEN IF ASKED – it
is simply informational to answer everyone’s questions. We
keep it light and also provide everyone attending with several
gifts of their choice. The benefit we hope we gain will be that
your members will value our knowledge. We want to meet new
friends and hope they’ll keep us in mind later for any future
needs.
Please assist me with this survey so I can contact the leadership
of your local senior group.”
You can cut and paste this survey form (create a form with four
of these data-sets on each page):
SURVEY FORM – for Senior Citizen Group Member
Referring Senior Member’s Name_________________________
l) Do you belong to a Senior Citizens Group? YES____ NO____
m) Do your members need questions answered on the recent standardized
plan changes and whether healthcare reform will impact seniors?
n) Do your members need information on higher potential interest rates on
their savings, rather than the low rates currently seen?
o) What is the name of your group?____________________________
p) What date does your group meet?__________________________
q) Where does your group meet?_____________________________
r) Who are the leaders of your Senior Citizens Group:
- President’s name?_______________________
Phone___-_______
- Secretary’s name?_______________________
Phone ___-_______
Treasurer’s name?_______________________
Phone ___-_______
How many members are there in your group? _______
How many members attend each meeting on average?_______
How much are your dues? $______Monthly or annual? _______
Do they provide a meal at the meeting or is it pot-luck (members bring a
covered dish)? ____________
-
s)
t)
u)
v)
Have each agent bring you 20 or more completed surveys
each week for you to show them how to conduct calls to the
leaders of the Senior Citizen Group. Your objective is to begin
calling each group’s President, Secretary or Treasurer to offer
the informational meeting, fill in gaps in the survey and secure a
meeting date. YOU MUST SHOW YOUR AGENTS HOW TO
DO THIS.
7. CALLING THE PRESIDENT, SECRETARY OR
TREASURER: the following things are extremely important to
make clear:
f) USE THE REFERRING MEMBER’S NAME WHEN YOU
INTRODUCE YOURSELF
g) NO SELLING: There will be no offering of our products at the
meeting (you will hear an audible sigh of relief, because they
don’t want a ‘sales presentation’) – they will not agree to
allow you in if you don’t make this clear.
h) INFORMATIONAL ONLY: Only an overview of factors
influencing Medicare’s changes and current benefits will be
reviewed (these are found on CMS’ website and their ‘Guide
to Health Insurance for People with Medicare’). At the end of
the meeting, there will be a Q&A for those with questions. You
cannot discuss Medicare Advantage benefits under any
circumstances, since MA regulations require government
certification, which is complicated.
i) SENIOR OFFER PACK: We will keep the meeting light and
informational – every member in attendance will receive a nocost gift (everyone gets their choice of: LNL MedFacts kit for
those with heath concerns, LNL Memorial Guide, ChildSafe ID
Kit for their grandchildren and/or an ADP. There will also be a
door prize drawing for 3 primary prizes as well.
j) WE CAN HELP THEM GROW: Would they like to increase the
size of their membership, in order to increase their duepaying base? If so, would they be willing to allow you to set
up TV, Radio, Newspaper and Senior Publication ads for their
meeting date, at no cost to their group?
8. NO COST ADVERTIZING FOR YOUR EVENT THROUGH
PUBLIC SERVICE ANNOUNCEMENTS: arrange a time to
stop by and pick up a Senior Citizen Group officer’s permission
in writing to use their group’s name in your ads. Once secured,
you may call EVERY TYPE of media outlet to place the Public
Service Announcements – TV, RADIO, NEWSPAPERS. YOU
MUST SHOW YOUR AGENTS HOW TO DO THIS.
9. DOOR PRIZE DRAWING – purchase items that ‘wrap big’ (at a
local department store that also has a gift-wrap department),
such as coffee-pump servers or silver-plate bowls or dishes, for
@ $10 - $15 each. Spare no expense on professional gift
wrapping – you’ll position these in the meeting room and refer to
them throughout the meeting (“the door prize drawing is coming
up soon and everyone’s will be a winner”) - they’ll stay until the
end of the meeting in order to participate in the drawing. These 3
primary gifts get them to fill out the form for the other Senior Gift
Pack items – for you to send these to them, you’ll need their
address using the form below (note: the form does not say
‘mail’, it says ‘send by special delivery’ (to be personally
delivered). Your agents will later ‘special delivery’ the gifts that
everyone wins.
10.
DOOR PRIZE DRAWING FORM: the form for the door
prize drawing is set up as follows – note it does not ask for a
phone # - seniors will not complete it if you do, and we don’t
want calls made anyway – the prizes will be sent by special
delivery (your agent – or I suppose they could mail it first class
or overnight, but how could they help the senior fill out the nocost offers, which allows a trusted relationship to form?). BE
SURE TO HAVE PLENTY OF PENCILS ON HAND, ONE FOR
EACH MEMBER – IT WILL SAVE TIME (You’ll need to FULLY
flesh out the value of each no-cost item – using your Laptop
Presentations and a projector would be easiest). You can cut
and paste this form:
DOOR PRIZE REGISTRATION
FORM
Door Prize Drawing and Senior Pack*
EVERYONE RECEIVES one or more items
listed below!
- WITH MORE LUCKY WINNERS FOR OUR GRAND
PRIZE DRAWING.
Any items in the Senior Gift Pack checked will be sent directly
by special delivery:
Physical Address (not PO Box):
Name
_____________________
Spouse’s Name (if
applicable) _____________________
Address ____________________ City___________________
State____________ Zip________
Please check one or more of the following no-cost promotional
gifts you would like to have sent directly to you:
1. MedFacts Kit (provides critical Medical info to EMS
services)
_____
2. Memorial Guide Kit (provides survivors your final
wishes)
_____
3. ChildSafe ID Kit (aids location of grandchildren, if ever
missing)
_____
4. Accidental Death Plan** (need date(s) of birth to see if
qualified)
_____
Your Date of Birth__-__-____
Spouse’s Date of Birth__-__-____
*no obligation – promotional offer(s) on behalf of Liberty National will be
sent directly to you.
**no premiums are due until the end of the first policy year.
If you know friends or relatives who would like to sponsor for a
promotional gift, please list their names below:
1. Name _______________________ Offer you would like to
sponsor_________________
2. Name _______________________ Offer you would like to
sponsor_________________
3. Name _______________________ Offer you would like to
sponsor_________________
4. Name _______________________ Offer you would like to
sponsor_________________
5. Name _______________________ Offer you would like to
sponsor_________________
What’s old, is again new! And the Federal Government is AGAIN providing us
with the reasons for HUGE seminar selling success!!!
Seniors want and appreciate information, especially in times of turmoil – and
with the new cutbacks in Medicare Advantage Plans, coming MA
disenrollments, new Standardized Plans, low interest rates on savings,
scheduled Part B doctor pay cutbacks and many other new senior challenges,
the time is now ripe. Senior Group Seminars allow you an opportunity to
answer many questions and alleviate brand-new, pressing Senior concerns.
In the very early 1980s, I was one of the company’s leading Med-Sup Unit
Managers and a leading Producing Agent as well. My agents began asking for
something called ‘Direct Response Leads’, but this was before I had ever heard
of them – however, I was smart enough to know that my agents were being
recruited by someone for them to ask me such questions. I told them: “As a
matter of fact, I am beginning to work on developing a new program.” While I
WAS beginning, in reality I initially had no idea what that might be.
When I met with my agents the following Monday, I told them I had developed
a plan but that I needed their help to start it. I told them I would begin
approaching Senior Citizen Groups to offer training on ‘Medicare’s New
Changes’ – at that time, the DRG program had just been announced. Part A’s
Diagnostic Related Group changes, initiated by President Reagan under the
Omnibus Reconciliation Act, were causing much consternation - to concerned
seniors, this equated to potential Medicare cutbacks and they had many
questions.
Sound familiar? Today Seniors’ concerns are also revolving around new
‘cutbacks’ and ‘changes’ – simply choose the area of concern currently being
blasted in the news: ObamaCare, Medicare Advantage cutbacks, new 5-star MA
rating systems, new 85% MA Medical Loss Ratios (MLR), Part B’s new
SCHEDULED 21% physician pay cutbacks, new 2010 Med-sup plan changes etc.
But now, we can add low interest rates on savings as yet another senior
concern.
Seniors are concerned and want information – that’s where Seminar Selling
comes in.
In only my FIRST senior group meeting, we had 297 seniors show up –
double their normal turnout, using my special ‘secret’ methods below. And best
of all, we got MANY MORE than 297 leads out of it – in fact, my agents
worked the results of this first meeting for nearly 2 years –
AND THEY STILL DID EVEN MORE MEETINGS IN OTHER CITIES TOO, as they
learned how to do it themselves.
Seminar Selling not only solved my agent’s concerns, it took my unit’s
production to the stratosphere and got me promoted. I continued using this
method in my Branch Office and again got promoted again to a Director’s
position.
You can do the same thing I did – TODAY, HDFs with RFAs and ancillary products
are superb low-cost products for disenrollees and we have some of the lowest
HDF rates in the nation – especially favorable against the Plan Fs others sell.
There’s never been a better time to do this –the Federal Government’s new
changes are confusing to seniors and you can help educate them.
You can quickly and easily write hundreds of thousands of
dollars of Medicare Supplement premium (or LIKE SOME
MANAGERS, even MILLIONS IN A QUARTER, as was the
case in the last HMO disenrollments in the late 1990s – IF
YOU HAVE ENOUGH AGENTS RECRUITED IN ADVANCE).
GOOD
SELLING!!!
From: King, Andy
Sent: Wednesday, June 16, 2010 10:45 AM
Subject: "16-6 & 6" - NOW'S THE TIME - RECRUIT 16 HOURS PER DAY, SIX DAYS PER WEEK, FOR 6
MONTHS AND YOU TOO CAN WRITE MILLIONS OF $$$ OF PREMIUM IN DISENROLLMENTS
Importance: High
HERE’S WHY YOUR UA RECRUITNG IS SO
IMPORTANT – YOU MUST PREPARE NOW FOR
COMING DISENROLLMENTS – LAST TIME
DISENROLLMENTS OCCURRED, INDIVIDUAL BMS
WROTE MILLIONS OF DOLLARS OF PREMIUM IN
A FEW MONTHS. BUT TO DO THAT, YOU NEED TO
RECRUIT READY AGENT DISTRIBUTION NOW –
YOU HAVE ONLY ABOUT 8 WEEKS TO GET A
HUGE SALES FORCE TRAINED AND READY –
THEN YOU HAVE TO KEEP ADDING MORE FOR
THE REST OF THIS YEAR, ABOUT 6 MONTHS.
DUE TO RECENT MA CHANGES, THE SELLING
SEASON WILL ONLY BE ABOUT 6 WEEKS THIS
YEAR – WITHOUT A LARGE SALES FORCE, YOU
WILL NOT BE ABLE TO KEEP UP WITH THE APPS
YOU COULD WRITE.
LANCE TAYLOR, WHO RECENTLY RE-JOINED US
FROM THE MA MARKET, RECOUNTED THAT HE
WROTE 2,500 APPS IN HIS OFFICE DURING
THE LAST SELLING SEASON – BUT HE
RECRUITED HARD TO GET A MASSIVE SALES
FORCE IN PLACE. NOW, MANY OF THESE SAME
PEOPLE ARE DISENROLLING FROM MAS. HE
SAYS THAT OUR HDF&RFA IS THE PERFECT
PRODUCT FOR MANY OF THESE CUSTOMERS,
DUE TO HOW LOW THE PREMIUMS ARE RELATIVE
TO THE MAS THEY CURRENTLY HAVE. IF YOU
DON’T GET A SALES FORCE IN PLACE NOW,
YOU’LL NEVER BE ABLE TO TRAIN THEM SOON
ENOUGH TO TAKE ADVANTAGE OF THESE
MASSIVE OPPORTUNITIES. HE SAYS EVERYONE
NEEDS TO WAKE UP NOW AND RECRUIT TO THIS
– “THE CLOCK IS TICKING AND WE ARE
RUNNING OUT OF TIME.”
LAST WEEK AT THE ATLANTA SEMINAR A BM
WHO PARTICIPATED IN THE LAST
DISENROLLMENT WAVE LAMENTED. PER
MICHAEL KAISER:
“I HEARD ALL OF ANDY’S WARNINGS ABOUT
RECRUTING, WITH HIS RALLYING CRY OF “”166-6” – SIXTEEN HOURS PER DAY, SIX DAYS PER
WEEK, FOR SIX MONTHS. BUT I GOT A LATE
START AND ONLY GREW TO 20 AGENTS. I
WATCHED EVERYONE AROUND ME WHO
RECRUITED 50-60 AGENTS DOUBLE THEIR
INCOMES – FIVE OF THESE BMS MADE A
MILLION DOLLARS IN ONE YEAR BECAUSE THEY
GOT READY. I DID NOT GET ACTIVE SOON
ENOUGH AND BY THE TIME I REALIZED IT, IT
WAS TOO LATE. ANDY IS RIGHT – IF YOU DON’T
START NOW, YOU WILL MISS THE MILLION
DOLLAR BOAT LIKE I DID.
THIS TIME, I INTEND TO GET READY WITH THE
HEAVIEST RECRUITING POSSIBLE. I NEED 60
AGENTS
NO W ”
SEE THE ARTICLE
BELOW
From: King, Andy
Sent: Wednesday, June 16, 2010 10:41 AM
Subject: MILLIONS IN BM EARNINGS AT STAKE: Farewell, Medicare Advantage : Democrats strike up
the funeral parade for private insurance options - CMS is also reshuffling staff so Advantage is run by
actively hostile bureaucrats.
Importance: High
FRIDAY, JUNE 11, 2010
Farewell, Medicare Advantage : Democrats
strike up the funeral parade for private
insurance options.
The Wall Street Journal reports:
The White House is launching its latest Willy Loman campaign to
resell ObamaCare, helped by $125 million that unions and other
interest groups say they'll spend to make Americans love their
new entitlement. Seniors in particular should curb their
enthusiasm.
"First and foremost," President Obama told seniors on Tuesday in
Wheaton, Maryland, "what you need to know is that the
guaranteed Medicare benefits that you've earned will not change,
regardless of whether you receive them through Medicare or
Medicare Advantage." First and foremost, nothing about that
sentence is true.
Advantage gives almost one of four seniors private insurance
options, and Democrats are about to cut its funding by some
$136 billion as health costs rise. The Congressional Budget
Office says these cuts will cause enrollment to drop by 35%, the
Administration's own
50%,
Medicare actuaries predict
and both outfits take for granted that benefits will also
decline.
The President knows this, so he and his fellow Democrats are
gearing up to blame these cuts on . . . insurers, rather than on
their own policies. In a letter last week, Democratic
Congressional leaders Henry Waxman, Pete Stark, Max Baucus
and Jay Rockefeller demanded that the Health and Human
Services Department reject "any effort" by insurers to "reduce
benefits next year."
Secretary Kathleen Sebelius followed up by warning
insurers to "focus on price and quality rather than
asking seniors who need health care the most to pay
more for it." The Medicare regulator, CMS, is also
reshuffling staff so Advantage is run by actively
hostile bureaucrats.
From: King, Andy
Sent: Wednesday, June 16, 2010 10:16 AM
Subject: 21% MEDICARE DOCTOR PAY CUT ARTICLE - WHY SENIORS CITIZEN GROUPS ARE
CONCERNED AND WANT MORE INFORMATION ON MANY ISSUES
Importance: High
CONGRESS TAKES RECESS, 21%
MEDICARE CUT DUE JUNE 15
PUBLISHED 06/12/2010 - 8:49 A.M. CDT
Medpagetoday.com REPORTS HERE that "The Senate left Friday on a
long weekend, which means that no changes will be made to Medicare
reimbursement rates until sometime next week at the earliest. When
senators returned to their home states for a Memorial Day break at the
end of May, they left a major piece of unfinished business in the
hopper: a bill to extend a number of expired federal programs.
The bill would also give physicians who treat Medicare patients a 19month reprieve, during which their reimbursement rates would not be
cut. The House passed the bill on May 28."
"Because the Senate failed to pass the House version of the bill, a
21% pay cut for doctors who treat
Medicare patients technically went into effect June 1.
However -- as it has done twice already this year -- the Centers for
Medicare and Medicaid Services (CMS) announced that contractors
would not process any claims for medical services delivered on the
first 10 business days of the month. That grace period ends on
Monday. So starting June 15, CMS will begin processing claims for
services provided on June 1 and later at the new, much lower rate."
That is, unless the Senate passes a bill before then. Senate leaders
had said the tax extenders bill -- with the 19-month "doc fix" -- would
likely come up for a vote early next week, but with the Senate out until
the middle of Monday afternoon, it now looks as if the vote won't come
until next Tuesday, the 15th, at the earliest."
"As for whether CMS will extend the amount of time that claims are
being held, an agency spokeswoman said she had no updated
information on the subject."
In a related story the Associated Press REPORTS HERE that "President
Barack Obama is asking Republican lawmakers to approve billions of
dollars in new spending to avert a scheduled 21 percent cut in
payments to doctors who treat Medicare patients. If GOP senators
don't allow the stalled proposal to pass, some doctors will stop
treating Medicare recipients, Obama said in his weekly radio and
Internet address Saturday."
"The Senate's top Republican, Mitch McConnell of Kentucky, said his
party wants to avoid reducing physicians' fees, but do it without
adding to the deficit — meaning spending cuts elsewhere."
"The doc fix is part of a large, Democratic-drafted bill that would
extend several popular tax breaks while greatly increasing the tax
that oil companies pay into a spill liability fund. Republican senators
have focused their objections on the bill's tax increases, not the
doctors' pay matter."
President Obama said: "I am committed to permanently reforming this
Medicare formula in a way that balances fiscal responsibility with the
responsibility we have to doctors and seniors."
"The president said he is 'absolutely willing to take the difficult steps
necessary to lower the cost of Medicare and put our budget on a more
fiscally sustainable path. But I'm not willing to do that by punishing
hardworking physicians or the millions of Americans who count on
Medicare. That's just wrong. And that's why in the short-term,
Congress must act to prevent this pay cut to doctors'."
From: King, Andy
Sent: Monday, June 14, 2010 12:59 PM
Subject: MUST READ - THIS WILL LIKELY CAUSE MORE DISENROLLMENTS - U.S. warns insurers over
Medicare Advantage costs - * Sebelius sends letters to Cigna, WellPoint - HHS also offers states funding
to review insurance rates
Importance: High
U.S. warns insurers
over
Medicare Advantage
costs
Mon Jun 7, 2010 4:48pm EDT
HHS tells companies to watch Medicare Advantage
costs
* Sebelius sends letters to Cigna, WellPoint
* HHS also offers states funding to review insurance
rates
WASHINGTON, June 7 (Reuters) - Health insurance companies that offer
alternative Medicare plans for seniors must keep their costs in check
or risk being denied the ability to market them next year, the top U.S.
health official warned in letters released on Monday.
Health Secretary Kathleen Sebelius, in a letter to the chief executives of
WellPoint Inc and Cigna Corp, among others, told companies the federal
government would deny their bid to sell such insurance plans,
called Medicare Advantage, "if they appear to include
excessive increases."
The Obama administration's warning comes amid growing pressure on health
insurance companies to keep premium and co-payment costs low as U.S. officials
work to enact new healthcare reforms passed in to law earlier this year.
The letters, also sent to the Blue Cross Blue Shield Association and
Health Care Service Corp, called on health insurers to "focus on
competing on price and quality" when submitting proposals to sell the
plans in 2011 and not to raise costs for older Americans.
While UnitedHealth Group Inc and Humana Inc are the top private insurers in the
Medicare Advantage market, the letters were sent to insurer CEOs who had met
Sebelius last month, including WellPoint's Angela Braly and Cigna's David
Cordani.
Bids to sell 2011 Medicare Advantage plans are due today. The plans
often offer additional benefits beyond traditional fee-for-service
Medicare, but also cost more, having sparked controversy for years
amid larger efforts to rein in healthcare spending.
The healthcare reforms passed earlier this year after a prolonged congressional
battle strengthen the Department of Health and Human Services' (HHS) ability to
intervene in insurers rates, but stops short of allowing direct federal oversight of
what insurers charge.
Instead, it leaves it mostly to the states, but allows HHS to intervene under some
circumstances. Health insurance is currently regulated on a state-by-state basis
with some more closely overseeing health insurers than others. Some
congressional Democrats are backing proposed legislation to allow federal
review.
Separately on Monday, HHS began offering states millions of dollars to
beef up their oversight of how much health insurers plan to charge. The
funds could also be used to start such reviews if their state currently does not
conduct them.
Ensuring companies do not raise insurance costs is
key for Democrats implementing the controversial
reforms ahead of the November mid-term elections.
"These grants will help states protect consumers
and protect small employers by holding insurers
accountable for unreasonable insurance rate
increases that make coverage unaffordable," Jay Angoff,
who heads HHS' Office of Consumer Information and Insurance Oversight.
As part of a 5-year, $250 million program ordered by the heath reform law, states
could win $1 million in 2010 to take a closer look at insurers' rates, as well as give
HHS data on their findings.
From: King, Andy
Sent: Monday, June 14, 2010 11:01 AM
Subject: CIGNA'S MEDICARE ADVANTAGE FILING STATUS WITH THE CENTERS FOR MEDICARE &
MEDICAID SERVICES
Importance: High
CIGNA'S MEDICARE ADVANTAGE FILING
STATUS WITH
THE CENTERS FOR MEDICARE & MEDICAID
SERVICES
Hartford, Conn. – June 10, 2010
CIGNA (NYSE:CI) announced today that it filed to renew its CIGNA
HealthCare of Arizona Medicare Advantage HMO and national
Medicare Part D contracts with the Centers for Medicare & Medicaid
Services (CMS) for plan year 2011.
The company did not file to renew its national Medicare Advantage
Private Fee-For-Service (PFFS) contract.
CIGNA Individual PFFS customers along with all individuals joining the plan
through the end of 2010 will experience no changes this year. CIGNA will
continue to serve its clients, brokers, health care professionals and contractors
into 2011 for 2010 claims and other needs.
CIGNA will also continue to offer its comprehensive suite of employer retiree and
pre-retiree solutions
including group medical plans that supplement Medicare and the CIGNA Humana Medicare Alliance.
From: King, Andy
Sent: Monday, June 14, 2010 9:40 AM
Subject: MUST READ - CIGNA WITHDRAWS MAs - Another One Bites the Dust - 109,000 Medicare
Advantage enrollees - CIGNA will not offer CIGNA Medicare Access (PFFS), private fee-for-service medical
plan, in 2011.
Importance: High
CIGNA To Withdraw From Medicare
Private FFS Market
A large carrier has decided to stop selling Medicare Advantage private
fee-for-service plans in 2011.
CIGNA Corp., Philadelphia (NYSE:CI), says it will continue to offer CIGNA
HealthCare of Arizona Medicare Advantage HMO and national Medicare Part D
coverage in the 2011 plan year.
The company’s CIGNA HealthCare unit has decided not to renew a national
Medicare Advantage Private Fee-For-Service contract.
109,000 Medicare Advantage
private FFS plan enrollees, according to the Ritter
CIGNA has about
Insurance Marketing blog.
Enrollees who now have CIGNA individual Medicare private FFS coverage can
keep the coverage in 2011, and Medicare enrollees can buy the individual private
FFS coverage until the end of the year, CIGNA says.
Medicare
Advantage Plans:
Another One Bites
the Dust
In another sign that Medicare
Advantage is falling by the wayside,
yesterday CIGNA announced it will not
offer CIGNA Medicare Access (PFFS),
its individual private fee-for-service
medical plan, in 2011.
From: King, Andy
Sent: Thursday, May 27, 2010 4:53 PM
Subject: HAVE YOU CONSIDERED THE BENEFIT OF NEW PLAN N TO YOUR RENEWALS AND SALES?
Importance: High
To: All Branch Managers
We all realize that if a customer has an insurance plan that
pays 100% of the bill, with no out-of-pocket costs, the senior
has little incentive to control costs, which in turn causes
larger premium increases.
Over 10 years ago, our retired Chairman CB Hudson and our
present Chairman Mark McAndrew suggested that two
important things must hold true for our agents to maximize
our potential:
1. Premium increases must be minimized by having the
customer participate in a portion of the bill as a
disincentive to over-utilization. To accomplish this, they
felt that the standardized plans would have to be
modified by CMS – and not surprisingly, if you know
these gentlemen, their proposed benefit structures
closely emulate our present HDF and Plan N.
2. Long-term renewals must be preserved for our Agents
and Managers. This is a critical component as our basic
TMK core belief: “Whatever we do must be good for the
agent and manager, must be good for the customer and
must be good for nthe shareholder – if one of these 3
things is missing, we won’t do it.”
Mark and CB were obviously ahead of their time – unlike
most other companies (most have no long-term renewals,
which leave out one of our “three core belief legs”), we
now have plans that meet these two objectives. To
illustrate what I mean about the impact of customer
participation in claims as a disincentive for over-use of a
policy, yesterday I forwarded your own state’s rate
increase history on HDF from 2005-2010, sent to both you
and your Director. You would certainly agree that HDF
increases were negligible over the 5 years since we
introduced it.
So what’s the impact of what we learned from HDF for
your future Med-Sup marketing?
1. The persistency on plans that require customer
participation (like HDF) is EXCELLENT. WHY?
Due to the low need for HDF rate increases, HDF’s
cost becomes more favorable over time when
compared to Plan F rate increases - as Plan F’s over-
utilization makes premiums rise faster than HDF’s
lower-utilization premium, relative persistency on
HDF is very good – and because the relative HDF
premium difference can become better and larger
over time, it makes a great argument for increased
HDF affordability in a customer’s eyes, the longer
they keep it.
2. For the same reasons, we predict our New Plan N will
also have good persistency. Since the most common
claims are generated under Part B of Medicare, Plan N’s
small out-of-pocket cost should also bring big returns in
controlling premium increases, just as HDF did.
So consider these facts in piquing your interest in our
NEW Plan N and familiarize your agents with the small
benefit differences from Plan F –with potentially big
premium savings now, and especially over time. Plan N is
yet another very affordable plan option, like HDF – WITH
GREAT PERSISTENCY FROM PLAN N (like HDF), AND AS
IMPORTANTLY, WITH LONG-TERM RENEWALS:
LNL’s Plan N
Pays 100% of Medical Expenses (Part B Coinsurance) except
for a copayment of up to $20 for an office visit and up to $50
for an emergency room visit.
The emergency room copayment is waived if the insured is
admitted to any hospital, and the emergency visit is covered
as a Medicare Part A expense.
From: King, Andy
Sent: Thursday, May 27, 2010 3:27 PM
Subject: Another Press Release - "LIBERTY NATIONAL LIFE INSURANCE COMPANY NOW IN MEDICARE
SUPPLEMENT MARKET"
Importance: High
NEWS RELEASE
FOR IMMEDIATE RELEASE
Andrew W. King, President and Chief Marketing Officer
972-569-3607
[email protected]
LIBERTY NATIONAL LIFE INSURANCE COMPANY NOW IN
MEDICARE SUPPLEMENT MARKET
May 27, 2010
McKinney, Texas — The passage of final healthcare reform will seriously reduce insurance
producers’ sales incomes due to the federal government’s imposition of much higher medical loss
ratios on underage health insurance products at the end of 2010. It has already begun to impact
thousands of insurance professionals nationwide as companies have been forced to announce
cuts to Agents’ advance loan commissions. Companies nationwide are considering withdrawing
products altogether.
The traditional Medicare Supplement market is one of the most stable insurance markets in
America and will virtually be untouched by healthcare reform, providing a safe haven for those Agents
adversely impacted by healthcare reform. Liberty National Life Insurance Company is pleased to
announce that it has added Platinum PLUS™ Medicare Supplements to its outstanding product
portfolio. Liberty National Agents can now offer these 2010 standardized plans: A, B, F, HDF, and N.
In general, our pricing methodology is attained-age, gender-distinct, smoker/nonsmoker, and
geographic area rated.
With Platinum PLUS, Liberty National has joined its sister company, United American
Insurance Company, in the Medicare Supplement marketplace and is benefiting from UA’s vast
experience. United American has been selling Medicare Supplements since Medicare began in 1966,
and is a longtime leader in individual Medicare Supplement sales*. Visit www.lnlcareers-pr.com to
learn about the opportunities our Sales Agents enjoy.
Andrew W. King, President and Chief Marketing Officer of Liberty National Life Insurance
Company says, “I have been in the Medicare Supplement business for nearly 30 years and this is the
most exciting time I have ever seen for our Agents in the Medicare Supplement market. Here’s why.
The Centers for Medicare and Medicaid Services estimates that in 2017, when the Medicare
Advantage provisions will be fully phased in, some projections indicate enrollment in Medicare
Advantage plans may be lower by about 50%. With more than 10 million Seniors aging into Medicare,
this is the best time for Agents to be in the Medicare Supplement market. To learn more about our
2010 marketing strategy as well as sales and management opportunities, visit www.lnlcareers-pr.com
and let us show you how you can make a meaningful difference for Seniors, yourself, your family, and
your future.”
Since 1900, Liberty National has been providing individual life and supplemental health
insurance. For more than 30 consecutive years, Liberty National has earned the A+ (Superior)
Financial Strength Rating from A.M. Best Company (as of 6/09). We are also rated AA- “Very Strong”
for Financial Strength by Standard & Poor’s (as of 12/08), A1 for Insurer Financial Strength by Moody’s
(as of 1/09), and A+ “Strong” for Insurer Financial Strength by Fitch (as of 6/09). Every year since
1995, Liberty National has been named to the Ward’s 50 Life-Health List (as of 7/09). The Ward Group
is a consulting and analytical firm specializing in the insurance industry. The Ward’s 50 analysis is
based on financial performance over a five-year period. More than 800 insurance companies were
included in this past year’s analysis.
*NAIC Medicare Supplement Loss Ratios in 2008, Medicare Experience Report By Direct Premiums Earned For Total Individual Policies, August 2009.
From: King, Andy
Sent: Tuesday, May 25, 2010 7:35 PM
Subject: Medigap on the comeback - Seniors are into seminars - MA client contribution to their health
care will rise as high as 70% in 2010. This is just the beginning, folks.
Importance: High
Seniors are into
seminars
Medigap on the
comeback
2/2/2010
Be active in the seminar world. Seniors
are attending informative
seminars at a record rate right now. They are confused and
scared of the changes they are constantly hearing about. You
can be a wonderful source of peace and reassurance in their lives.
Currently there are over 10 million Americans on Medicare Advantage, most of
which are on a no-premium plan. Most of these consumers will be forced
to re-enroll in traditional Medicare. For those of you who believe that
traditional Medicare with a Medigap policy is the best protection for our clients,
this is good news! The $130 billion cut to Medicare Advantage beginning in 2013
will be the straw that broke the camel’s back. The federal government has clearly
stated that the expense for a senior on Medicare Advantage is 14% higher than an
individual enrolled in original Medicare with a Medigap policy. They have also
clearly stated that it is simply unaffordable, resulting in drastic increases in
premium, co-pays and coinsurance to our clients.
In speaking with several major HMO carriers, I was informed that the average
will
rise as high as 70% in 2010. This is just
the beginning, folks. Once the $130 billion in cuts prove not to
premium plan will now have client contribution to their health care
have the desired impact, there will be larger cuts, eventually leading to the
elimination of Medicare Advantage as we know it. As premiums and out-of-pocket
expenses match or exceed the exposure of traditional Medicare with a Medigap
policy, our clients will demand that we take action. Now in 2010, I can tell you that
after countless hours of research, Medicare Advantage will soon be a thing of the
past and will be remembered as one of the largest mistakes in American health
care history.
Our prospects want the knowledge and services that we provide. Seminars are so
highly attended because of the safety the consumer feels. In a group setting,
seniors feel safe and assume that there will be no sales process. They are
correct. There should never be a sale in a seminar atmosphere. Seminars are for
information, education and for the consumer to establish if they need your
services. Use your seminars to create interest and show needs. If you do so
successfully, the appointments will present themselves.
From: King, Andy
Sent: Tuesday, May 25, 2010 5:57 PM
Subject: LNL Med-Sup Comparison: Advantage of HDF & RFA, vs. Plan F, where suitable
The following comparison between Plan F and HDF/RFA is not to be
used for sales presentations. Please refer to published, detailed
company sales brochures for all presentation information.
As before, these two illustrations for TX and FL premium rates are only
meant to allow you to consider the potential advantages of HDF, with
a Reserve Fund Annuity that has a “no lock/no load” period for
deposits – as compared with a Plan F. This illustration uses a
maximum allowable annual deposit of $4,000 per year, at the
beginning of each period – interest accumulates daily and is
compounded on an annual yield (the maximum allowable balance for
the RFA is $70,000).
Liberty National Life Insurance
HDF & RFA vs. Plan F
How many annual HDF deductibles would someone have to incur over a 10
year time period before using all premium savings and/or interest on $4,000
annual RFA deposits, versus Plan F?
Texas standard comparison of Plans F, N and HDF:
Mo. Prems for T-65, F, NS, Attained Age, Area 3
Plan F
173
Plan N
137
Plan HDF
54
Savings for HDF with 3% RFA (Reserve Fund Annuity, no lock-in period, no commission load):
TX Plan F versus Plan HDF
Plan F = 173 x 12 = 2,076 x 10 years = $20,760*
HDF = 54 x 12 = 648 x 10 years = $6,480*
Premium Difference = $14,280*
Premium savings: $14,280 divided by $2000 annual deductible =
7.14 times*
a) If previous health has been good, it may be suitable to allow a part of the premium
difference for the purchase of another product, such as life insurance).
b) If a customer wishes to deposit more than $4,000 per year, other annuities are
available from the company.
$4,000 per year into RFA x 10 years = $40,000
Approximate interest compounded annually at 3% = $12,606.85**
Total 10 yr compounded interest: $12,606.85 divided by $2,000 Ann. deductible =
6.3 times***
Add premium savings ($14,280*) + 3% interest ($12,607**) = $26,887
Divided by $2,000 Ann. deductible =
13.4 times***
* Not to be used for sales presentations – for illustrative purposes only – example does not include
differential premium rate increases over time.
** Not to be used for sales presentations – approximate interest based on annual additions of
$4,000 at the beginning of each year: interest accumulates daily and is compounded on an annual
yield.
*** Not to be used for sales presentations; division in this illustration based on HDF’s current annual
deductible; the annual deductible has been increased by CMS yearly.
To calculate approximate annual yield on compounded interest, click on the following link:
http://www.moneychimp.com/calculator/compound_interest_calculator.htm
Compound Interest Calculator
Inputs
Current Principal:
$
Annual Addition:
$
Years to grow:
Interest Rate:
Compound interest time(s) annually
Make additions at start end of each compounding period
Results
Future Value:
$
%
Florida standard comparison of Plans F, N and HDF:
Mo. Prems for T-65, F, NS, Issue Age, Area 1
Plan F Plan N Plan HDF
203
163
69
Savings for HDF with 3% RFA (Reserve Fund Annuity, no lock-in period, no commission load):
FL Plan F versus Plan HDF
Plan F = 203 x 12 = 2,436 x 10 years = $24,360*
HDF = 69 x 12 = 828 x 10 years =
$8,280*
Premium difference = $16,080*
Premium savings: $16,080 divided by $2000 annual deductible =
8.04 times*
a) If previous health has been good, it may be suitable to allow a part of the premium
difference for the purchase of another product, such as life insurance).
b) If a customer wishes to deposit more than $4,000 per year, other annuities are
available from the company.
$4,000 per year deposited into RFA x 10 years = $40,000
Approximate interest compounded annually at 3% = $12,606.85**
Total 10 yr compounded interest: $12,606.85 divided by $2,000 Ann. deductible =
6.3 times***
Add premium savings ($16,080*) + 3% interest ($12,607**) = $28,687
Divided by $2,000 Ann. deductible =
14.3 times***
* Not to be used for sales presentations – for illustrative purposes only – example does not include
differential premium rate increases over time.
** Not to be used for sales presentations – approximate interest based on annual additions of
$4,000 at the beginning of each year: interest accumulates daily and is compounded on an annual
yield.
*** Not to be used for sales presentations; division in this illustration based on HDF’s current annual
deductible; the annual deductible has been increased by CMS yearly.
From: King, Andy
Sent: Tuesday, May 25, 2010 1:13 PM
Subject: "New Med Supp Opportunities" - excerpt says "vast opportunities for agents serving the senior
market - MA beneficiaries just as frustrated by MA marketing restrictions as their agents."
Importance: High
New Med Supp
Opportunities
Published 4/28/2010
R PHILLIPS
Now that Medicare has modernized Medicare supplement plans at the same time as the
vast
opportunities for agents serving the senior market.
first of 78.2 million baby boomers begin turning 65, there are
MIPPA, the 2008 Medicare Improvements for Patients and Providers Act, made significant
changes to the Medicare Advantage (MA) program. Most of the changes, such as the
prohibition on cold calling, were largely viewed as negative by agents and brokers.
These MA changes overshadowed the positive effects the law has on Medicare
supplement products. In fact, MIPPA has created an opportunity
for agents to
reenergize their Med supp sales.
Med supp has a very high satisfaction rate among
policyholders – 9 out of 10 are likely to recommend Med supp
products to others. A 2009 survey from America’s Health Insurance
Plans and the BlueCross BlueShield Association found that 88
percent of policyholders are satisfied with their coverage, and 62
percent are very satisfied. Additionally, the price differential between
Med supp and Medicare Advantage is continuing to narrow, making
Med supp an attractive alternative. Most importantly for agents, Med
Supp has no annual enrollment period and can be sold year-round.
Selling strategies
Reputation, customer satisfaction, and best practices in customer service and claims
processing play an important role in the purchase decision. The reasons for buying Med
supp are the same as they have always been. The agent’s job will be to remind clients
what those reasons are:
There is no annual enrollment period




Plans are guaranteed renewable
Benefits don’t change year to year
Plans can’t cancel coverage as long as premiums are paid
Clients can change plans any time during the year (subject to
underwriting)
Generally, there are no provider networks
Between the MIPPA changes and health care reform, some Medicare Advantage
enrollees may be taking a fresh look at Med supp. Some Medicare beneficiaries
are just as frustrated by the Medicare Advantage marketing
restrictions as their agents. And now, health care reform will further
shorten the annual enrollment period by eliminating the January through March open
enrollment.
The sales opportunities with Medicare supplement
insurance are stronger than ever. Millions of new
clients are aging-in each year and will undoubtedly
find the modernized, lower premium plans very
attractive.
From: BM130
Sent: Tuesday, May 25, 2010 9:15 AM
To: King, Andy
Subject: Re: Estimated annual cost for people on Medicare Advantage, according to CMS, is shocking!
WOW!!!
OHIO – 43235 (Columbus)
Good Health - $3,350/yr –
$5,600/yr: $279/mo - $466/mo
Poor Health - $5,200/yr $10,000/yr: $433/mo –
$833.00/mo
When compared to our HDF the
potential cost is amazing:
Just under those in good health THE
489%.
COST could be as much as
Combine that with the ever-shrinking
list of providers that will even accept
some of these plans.
Truly a “No Brainer”.
Mike
In addition to comparing HDF to traditional Plan F, agents and
managers should also look at what www.medicare.gov say’s
about “estimated annual cost for people like you” 65-69
in good and in poor health.
Based on my experience, most seniors buy insurance to provide
financial protection from the costs associated with major health
problems.
Most MEDICARE ADVANTAGE plan prices are relatively low but
when you look at the cost estimates for Medicare “Advantage”
plans, they are shockingly high!
As seen below, agents can access the CMS website and see
for themselves - but in our Zip code 75070, here are the
“estimated annual costs for ages - 65-69:
Good health cost –$2,800 to $6,100 per
year.
Convert good health estimated annual cost to a
monthly cost
of $233 – $509. Did I mention that this is the estimated
annual cost for people in “good health”, WOW!
Poor health cost - $3,950 to $9,350 per
year.
Convert poor health estimated annual cost to a
monthly cost
of $329 – $779.
Note: of the 59 available plans, 19 provide no drug coverage. These
plans are not standardized and can be complex and confusing.
In addition, with proposed federal payment cuts this year,
plans are likely to do one of three things:
1.
Continue to increase premiums
2.
Lower benefits further
3. Or Non-renew their contract with the Centers for
Medicare and Medicaid Services (CMS)
With nearly 10M beneficiaries on MA Plans
and 10M prospects T-65 over the next five
years, we are positioned better than ever
to catch the wave of humanity by
EXECUTING OUR HDF MARKETING
STARTEGY!
TO SEE FOR YOURSELF, CLICK ON THE
WEBSITE BELOW:
http://www.medicare.gov/default.aspx
1.
Click “health and drug plans”
2.
Click “compare health plans and Medicare policies”
3.
Click “find and compare health plans”
4.
Step 1 – Select a search option
a.
5.
Click “ begin general plan search”
Step 2 – Zip code and current coverage
a.
Enter your Zip Code “12345”
b.
Select age range “65-69”
c.
Your health status – “poor”
d.
What type of coverage do you have – “I don’t know”
e.
Did you get a letter from Medicare or SSA…. “ Select no”
f.
Click “continue”
6.
Step 3 – Review Current coverage and consider options
a.
b.
c.
7.
a.
Click “Continue”
Find and Compare Plans
Click “ continue to plan list”
Step 4 – choose a plan to compare
Scroll down and see for yourself…
YOU ARE IN!
Jim Campbell
From: King, Andy
Sent: Tuesday, May 25, 2010 11:16 AM
Subject: The outlook for Medicare supplement in particular has never been stronger.
Importance: High
As the Health care debate raged on over
the last 18 months, many opponents of the
legislation used sky-is-falling scenarios to
describe how it would affect the private
insurance market.
We’re predicting nothing of the sort in the
senior market. In fact, the outlook for
Medicare supplement in particular has
never been stronger.
From: King, Andy
Sent: Tuesday, May 25, 2010 10:58 AM
Subject: How the Health Reform Will Affect Medicare – And the Agents Who Sell It
Importance: High
How the Health Reform Will Affect Medicare –
And the Agents Who Sell It
Published 4/20/2010
Medicare supplement
Medicare supplement agents may be the big
winners in all this — here’s why:
1. Modernized plans, including the new Plans M and N, create new
opportunities for agents to sell coverage with lower rates than traditional
Plans F and G. These new plan designs also compete with Medicare
Advantage on one important point: They pay benefits above and beyond
original Medicare.
2. Taxation of the Retiree Drug Subsidy (RDS) for employer-sponsored plans
has many groups reconsidering if, or for how long, they should continue to
offer group coverage for their retired workers. Recently, large companies
reported the bottom-line impact of the new taxes in the tens and hundreds
of millions. Many large employers have already moved to transition from
group to individual coverage using a Medicare Coordinator model of call
center or online enrollments. The
taxation of the RDS will
only speed the process and increase the size of
the individual market. The elimination of the RDS tax deduction
is effective Jan. 1, 2013.
Our Take: The minimum 80 percent loss ratio for individual products affects the
under-65 market and Medicare Advantage market, but will not apply to
plans that supplement original Medicare. We predict the doctor fix
is in—whether temporary or permanent. Congress will make sure the
reimbursement rates are increased after the health care reform dust settles.
From: King, Andy
Sent: Tuesday, May 25, 2010 10:45 AM
Subject: CMS Tells Health Insurer To Suspend Medicare Advantage with Prescription Plan Sales
Importance: High
CMS Tells Health Insurer To Suspend
Medicare Plan Sales
By ALLISON BELL
Published 4/9/2010
The Centers for Medicare & Medicaid Services says a large health insurer will have to sit
on the Medicare drug plan market sidelines until it resolves CMS compliance concerns.
CMS intends to make XXXXX suspend new sales of Medicare Advantage plans with drug
coverage and stand-alone Medicare Part D prescription drug plan coverage starting April
21, officials say.
XXXXX has about 400,000 enrollees in Medicare Advantage plans with prescription
benefits and
600,000 in prescription drug plans.
CMS has accused XXXXX of changing its Medicare plan drug formulary, or approved
drug list, to a closed list, from an open list, and then failing to provide the
required level of continued access to the drugs taken off the
formulary.
XXXXX also violated coverage determination processing rules and appeal rules, and it
applied prior authorization and step therapy drug requirements that had not been
approved by Medicare, officials say.
Some violations of appeals rules occurred as recently as late March, Brenda Tranchida,
director of the CMS program compliance and oversight group, writes in a letter to
XXXXX.
Tranchida notes that XXXXX has until April 16 to file a written rebuttal and until April 21
to request a hearing.
The marketing suspension “will remain in effect until XXXXX demonstrates to CMS that it
has corrected its deficiencies and they are not likely to recur," officials say.
“XXXXX is cooperating fully with CMS on its review, and is working to resolve the issues
CMS has raised as soon as possible,” XXXXX says.
“Compliance problems are unacceptable to XXXXX,” XXXXX President XXXX XXXXXXX
says in a statement. “The issues raised to us by CMS have our utmost attention. XXXXX
takes our obligations to our Medicare beneficiaries seriously, and our priority is to help
ensure they have access to high-quality care, excellent service and needed medications.
We are working with CMS to resolve these matters, and we also will be doing proactive
outreach to impacted members to resolve these issues.”
(AS PREVIOUSLY STATED REPEATEDLY, ABSOLUTELY
NONE OF THIS EMAIL STRING IS TO BE USED FOR SALES
PRESENTATIONS – IT SIMPLY HELPS YOU UNDERSTAND
WHAT FACTORS ARE AFFECTING THE MARKET)
From: King, Andy
Sent: Tuesday, May 25, 2010 8:27 AM
Subject: WHY RFA w/ HDF AT 3% MIGHT BE even more ATTRACTIVE - 775 U.S. banks NOW on FDIC
'problem' list - list was 702 as of 12/09 - Are Seniors getting more concerned?
Importance: High
775 U.S. banks on FDIC
'problem' list
FDIC chair Sheila Bair says the pace of U.S. bank
failures is likely to quicken in 2010.
Last Updated: Thursday, May 20, 2010 | 1:57 PM ET
CBC News
A total of 775 U.S. banks are now on the Federal Deposit Insurance
Corporation's dubious "problem list" of banks in danger of default, the
agency said Thursday.
The agency that guarantees U.S. loans keeps a running tally of lenders
December 2009,
there were 702 banks on its "problem list," up
from 552 on Sept. 30, 2009.
it insures on a quarterly basis. At the end of
At the end of February, that figure jumped to
775.
At the same time, the total number of assets held by those institutions
increased during the first quarter, from $403 billion to $431 billion US.
That's the highest level since June 30, 1993, when the "problem list"
was 793 names long and they held $467 billion in assets.
The 775 figure is almost 10 per cent of the roughly 8,000 chartered
U.S. banks that fall under the FDIC's purview.
"The banking system still has many problems to work through, and we
cannot ignore the possibility of more financial market volatility," FDIC
chair Sheila Bair said. "But the trends continue to move in the right
direction."
Some 140 banks failed in fiscal 2009, the highest total since 1992
during the height of the savings and loan crisis. So far in 2010, 76 U.S.
banks have gone into default
"There will be more failures, to be sure," Bair said, although she added
that the vast majority of "problem" institutions never end up going into
default.
Profits up
Indeed, the FDIC's report Thursday was not all bleak. American banks
earned $18 billion in profit during the first quarter of 2010, up from
$5.6 billion a year earlier.
Commercial real estate is one of the culprits, the agency said,
especially true at smaller and mid-sized banks because they're more
heavily dependent on local conditions.
And a further decline in home prices, expected by many analysts,
would cause more losses for banks.
"Another leg down in housing could extend the period for which the
credit distress persists," said Richard Brown, the FDIC's top
economist. "That's a legitimate concern."
A recent report by the Congressional Oversight Panel found that U.S.
banks face up to $300 billion in losses on loans made for commercial
property and development.
That report also said that on nearly half of all commercial real estate
loans, the borrowers owe more than the property is worth, and the
biggest loan losses are expected for 2011 and beyond.
'There will be more failures, to be sure.'—FDIC chair Sheila Bair
In another sign of health, the FDIC's deposit insurance fund, which fell
into the red last fall, posted its first improvement in two years. Its
deficit shrank by $145 million to $20.7 billion.
The FDIC expects U.S. bank failures to cost the insurance fund around
$100 billion through 2013. The agency mandated last year that banks
prepay about $45 billion in extra premiums, for 2010 through 2012, to
help replenish the fund.
Loan loss provisions — the amount of money banks set aside to cover
bad loans — dipped nearly 17 per cent from a year earlier.
From: Jim Campbell
Sent: Monday, May 17, 2010 2:57 PM
Subject: Estimated annual cost for people on Medicare Advantage, according to CMS, is shocking!
In addition to comparing HDF to traditional Plan F, agents and managers
should also look at what www.medicare.gov say’s about
“estimated annual cost for people like you” 65-69
in good and in poor health.
Based on my experience, most seniors buy insurance to provide financial
protection from the costs associated with major health problems.
Most MEDICARE ADVANTAGE plan prices are relatively low but when you look at
the cost estimates for Medicare “Advantage” plans, they are shockingly high!
As seen below, agents can access the CMS website and
see for themselves - but in our Zip code 75070, here are
the “estimated annual costs for ages - 65-69:
Good health cost –$2,800 to $6,100 per
year.
Convert good health estimated annual cost to a monthly
cost of
$233 – $509. Did I mention that this is the estimated annual cost
for people in “good health”, WOW!
Poor health cost - $3,950 to $9,350
per year.
Convert poor health estimated annual cost to a monthly
cost
of $329 – $779.
Note: of the 59 available plans, 19 provide no drug coverage. These plans are not
standardized and can be complex and confusing.
In addition, with proposed federal payment cuts this year, plans are likely to do
one of three things:
1. Continue to increase premiums
2. Lower benefits further
3. Or Non-renew their contract with the Centers for Medicare and
Medicaid Services (CMS)
With nearly 10M beneficiaries on MA Plans
and 10M prospects T-65 over the next five
years, we are positioned better than ever
to catch the wave of humanity by
EXECUTING OUR HDF MARKETING
STARTEGY!
TO SEE FOR YOURSELF, CLICK ON THE
WEBSITE BELOW:
http://www.medicare.gov/default.aspx
Click “health and drug plans”
Click “compare health plans and Medicare policies”
Click “find and compare health plans”
Step 1 – Select a search option
a. Click “ begin general plan search”
5. Step 2 – Zip code and current coverage
a. Enter your Zip Code “12345”
b. Select age range “65-69”
c. Your health status – “poor”
d. What type of coverage do you have – “I don’t know”
e. Did you get a letter from Medicare or SSA…. “ Select no”
f. Click “continue”
6. Step 3 – Review Current coverage and consider options
a. Click “Continue”
b. Find and Compare Plans
c. Click “ continue to plan list”
7. Step 4 – choose a plan to compare
a. Scroll down and see for yourself…
1.
2.
3.
4.
YOU ARE IN!
Jim Campbell
From: King, Andy
Sent: Sunday, May 16, 2010 4:15 PM
Subject: "I’m HORRIFIED at how my Medicare Advantage plan will change for next year."
Importance: High
Q. I’m horrified at how my Medicare Advantage plan will change for
next year. It will no longer cover routine vision, hearing and dental care
and instead of low copays I must pay 20 percent of the full cost. How can I
find another plan that will give me a better deal?
A. Many people are shopping around for a new Medicare Advantage (MA)
especially people with plans that are
raising their prices, reducing benefits or, in
some cases, pulling out of Medicare altogether
for next year—during open enrollment from Nov. 15 to Dec. 31.
health plan—
You may find a better deal—or you may not. But you do have options, and
it’s important to know how to assess them.
From: King, Andy
Sent: Sunday, May 16, 2010 4:05 PM
Subject: Disadvantages of Medicare Advantage Plans - PROTECT YOURSELF FROM FRAUD
Importance: High
Excerpts per DOI:
Disadvantages of Medicare
Advantage Plans

You must follow the rules of the plan you joined to receive the
services. Plans are required to provide you with information about their rules
and how to receive services. Plans can legally deny payment for covered
services if you did not follow their rules.

Except for emergency care, HMOs require that you use their doctors
and providers. In a PPO, you can visit providers outside the network, but
you’ll have to pay more. A private fee-for-service plan allows you to see any
doctor or provider you choose, but it might be hard to find providers
willing to work with private fee-for-service plans.

A Medicare Advantage plan may not be the best option if you see
providers frequently. Use the “Compare” tool on the Medicare website to
estimate your out-of-pocket costs for various Medicare Advantage plans
based on your health status.

Medicare Advantage plans negotiate contracts on an annual
basis. Your plan could decide to leave Medicare or change
its benefits, premiums, and copayments at the end of each
year.

Medicare Advantage and Medicare Part D plans don’t have a “free
look” period when you enroll. This means if you enroll in a plan and are
out of an annual enrollment period, you may not be able to drop the plan. If
you dropped a Medigap policy to enroll in a Medicare Advantage
plan, you might not be able to get your old policy back.
PR O TE C T Y O UR SELF FR O M
FR A U D
While Medicare Advantage plans may be a good option for some people,
they’re not right for everyone . Consider carefully before making any
changes to your Medicare coverage and beware of deceptive and fraudulent
Medicare sales practices.
Here are some tips to help you protect yourself:

Before joining a plan, always personally confirm with your doctor
and other providers that they will accept the plan. Your choice of
providers in a Medicare Advantage plan may be restricted. Don’t
take a salesperson’s word for it!

Don’t buy anything from a salesperson who comes to your home
uninvited. It is illegal to sell Medicare Advantage plans door-to-door
or to make unsolicited telephone calls. Plans may market by direct
mail or through radio, TV, and print advertisements.

Don’t be fooled if a salesperson claims to be with Medicare or Social
Security, even if he or she shows you an official-looking
identification card. Medicare and Social Security do not make home
visits or unsolicited phone calls. An agent may not enroll you in a
Medicare Advantage plan over the phone unless you made the call.

Be careful about giving out your Medicare number or other personal
information. An unethical salesperson can use this information to
remove you from original Medicare and enroll you in a Medicare
Advantage plan without your knowledge.

Don’t sign anything you haven’t read and don’t fully understand .
Agents are required to disclose in advance the product they are
selling. Ask questions about things you don’t understand. Take
notes. Write down the salesperson’s name, address, pho ne number,
and what he or she told you. It’s a good idea to have a trusted friend
or family member with you when you talk to the salesperson.

Don’t believe a salesperson or agent who tells you that a Medicare
Advantage plan won’t affect your original Medicare coverage. If you
enroll in a Medicare Advantage plan, it will provide your health
coverage instead of original Medicare. Some salespeople may try to
tell you that Medicare Advantage plans are Medicare supplement
insurance. They’re not. Medicare supplement insurance fills in the
“gaps” in original Medicare by paying some of the costs that original
Medicare won’t pay. Medicare Advantage, however, entirely replaces
your original Medicare coverage. Your Medigap policy will not pay
benefits if you join a Medicare Advantage plan.
Seniors worry about
Medicare Advantage
cuts
Associated Press
Tens of billions of Medicare dollars funneled through insurers also pay for extras
that never reach beneficiaries: multimillion-dollar salaries, executive retreats in
Hawaii, Scotland and Cancun, and massive expenditures on marketing to lure
more customers to the privately administered Advantage plans that serve as an
alternative to government-provided Medicare.
Medicare Advantage subsidies are on
the chopping block to pay for the
overhaul, lowering payments to private Medicare Advantage plans,
which on average cost the government 14 percent more than
traditional Medicare.
The harshest critics of the Advantage program say patients are exchanging
hassle-free coverage for a plan with cheap perks that may ultimately deny them
necessary treatment.
"I get too upset over it," said 71-year-old Charlotte Casey of Miramar, Fla., who is
on an Advantage plan through Coventry Health Care. "The seniors are
going to get the worst of it."
Casey first enrolled in a Humana plan, but she dropped it over problems with its
prescription drug coverage. She plans to switch from her current plan, too,
because her primary care doctor will no longer be covered and she'd have to
travel farther for nonemergency hospital services.
"Regular Medicare is the best one, but you have to pay for a supplement," she
"With this (MAs), sometimes you
want something and they don't want
to give it to you."
said.
Despite the belief that Advantage plans offer broad savings for seniors, a
Government Accountability Office report last year found wide differences
depending on the plan, including home health service costs that could be up to
84 percent more than traditional Medicare.
A half-million Advantage enrollees were in plans with no co-pay for hospital
stays. But
a roughly equal number were in plans with high
hospital co-pays and no limits on
out-of-pocket inpatient expenses,
potentially costing patients
thousands more.
The disparity was greatest for some of
the sickest seniors, those who return to
the hospital within 60 days of discharge, the
GAO found. Under traditional Medicare, those
patients would not pay any deductible. Under
many Advantage plans, the deductibles can be
steep.
Many of the perks offered by Advantage plans are relatively cheap. Vision
coverage cost insurers $3.37 a person each month, on average, according to 2007
filings with the government. Hearing coverage cost less than a dollar.
"The little stuff, the nickle-and-dime stuff, it's good," said John Arline, who was
faced with a huge bill for his 84-year-old grandfather Mervyn Urquhart earlier this
people don't need coverage for
the nickle-and-dime stuff."
year. "But
Urquhart, though suffering from Alzheimer's disease, is a reasonably healthy
After treatment
for a stomach virus and deep vein
thrombosis in January, he was so weak
engineering retiree living in Wheatley Heights, N.Y.
from time in a hospital bed that doctors
agreed he needed rehabilitation and
physical and occupational therapy.
His Advantage plan turned him down,
even though Medicare covers such
treatment. Arline and other
relatives footed the
roughly $12,000 bill for
rehab. With it, Urquhart is now able
to walk, to feed himself and to live a
fairly normal life.
"They violated this patient's
rights," Arline said. "They did that
because it was
cheaper."
Insurers participating in the Advantage program responded to inquiries by Senate
spending more
than 15 percent of premium revenues on
profits, marketing and corporate expenses,
Democrats. The companies reported, on average,
nearly 10 times the rate of
traditional Medicare.
Meanwhile, Advantage companies were paying for multimillion-dollar corporate
retreats in exotic locales and hundreds of their executives were being paid more
than $500,000 annually. Government reports have shown Medicare Advantage
providers continually outpace profit projections. The congressional review
released this month showed 34 Advantage companies devoted $27 billion in
government subsidies from 2005 through 2008 to profits, marketing cost and
other corporate expenses.
Advantage
enrollees remain in danger."Seniors are going to lose
many of the benefits that seniors like and rely on
today," said Robert Zirkelbach, a spokesman for
America's Health Insurance Plans, an industry group.
"And in some parts of the country, seniors will lose
access to their Medicare Advantage plan
altogether."
The insurance industry still contends the majority of
From: King, Andy
Sent: Sunday, May 16, 2010 2:09 PM
Subject: Seniors Often Choose Poor Quality MA Plans - NEW MA 5-Star RATING SYSTEM- 47% of
Medicare beneficiaries in plans w/ 2 or 3 star ratings. For 1st time, law ties what the plans get paid based
on # of stars
Importance: High
Seniors Often Don't Choose Best
Quality Medicare Advantage Plans,
Study Finds
Kaiser Health News
The Associated Press
April 29, 2010
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"Millions of seniors signed up for popular Medicare
Advantage insurance plans don't get the best quality,
an independent study found.
score on a quality rating
system set up by the government is about
to have a direct impact on insurers'
finances — not to mention seniors'
benefits and premiums.
How the private plans
health care
law ties what the plans get
paid by the government to the quality they
President Barack Obama's
provide,
for the first time. There seems to be
plenty of room for improvement.
The study being released Thursday by Avalere
Health, a major consulting firm, looked at the health
plans that seniors pick, according to the plans'
scores on a government rating system designed for
consumers. The ratings, available on Medicare's
website, assign one to five stars for quality.
The analysis found that
47% of Medicare
beneficiaries are in
plans that rate three
stars or two.
From: King, Andy
Sent: Wednesday, May 12, 2010 8:10 PM
Subject: SHOCKING FACT: SENIORS NEED HELP - largest jump in FOOD PRICES over 26 years - HDF
vs. Plan F - use some prem savings for 3% RFA, some for Life ins. OR EXTRA SAVINGS FOR FOOD,
where appropriate
Importance: High
U.S. Food Inflation
Spiraling Out of Control
National Inflation Association
04/22/2010
The Bureau of Labor Statistics (BLS) today released their Producer
Price Index (PPI) report for March 2010 and the latest numbers are
shocking. Food prices for the month rose
by 2.4%, its sixth consecutive monthly
largest jump in
over 26 years. NIA believes that a major breakout
increase and the
in food inflation could be imminent, similar to what is currently being
experienced in India.
From: King, Andy
Sent: Wednesday, May 12, 2010 7:58 PM
Subject: HDF WITH 3% RFA----Seniors taking a hit as returns plummet - Record-low interest rates are
hurting seniors who depend on bank account interest to supplement their incomes.
Importance: High
Seniors taking a hit as returns
plummet
For savers, low rates are matter of high
interest
Arthur Lowell, 80, played pool recently at the Hopkinton Senior
Center. Lowell pulled his investment income out of CDs when rates
began to decline and moved about $60,000 into the stock
market.
he said.
“We all know how that went,’’
(Photos By Joanne Rathe/Globe Staff)
By Megan Woolhouse
Globe Staff / February 6, 2010
E-mail this article
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Record-low interest rates that have been a boon for
hurting seniors who depend on bank
account interest to supplement their incomes.
borrowers are

PHOTOS Suze Orman's top money tips for 2010
Certificates of deposit, a popular savings option for
conservative investors, are paying an average of just
0.58 percent interest for a six-month term, according to
the Federal Deposit Insurance Corp. That is down from
more than 5 percent in 2006. Savings accounts are
yielding even less.
For those who put most or all of their money into CDs, the impact has been dramatic,
causing some to rethink their budgets. For example, a $100,000 six-month CD that earned
$5,233 four years ago generated $780 in interest last year, about $85 a week less.
Donna McGuire, 65, a recent retiree, said she and her husband were relying on interest from
savings to boost their retirement budget. With their savings income down, the Hopkinton
resident may have to look for a part-time job.
“These are supposed to be my golden years,’’ McGuire said, “and they’re
rusting.’’
With significant rate hikes probably a long way off, conservative
investors face a difficult choice: Cope with reduced income or
choose riskier options with potential for better gains.
It is the downside of a strategy designed to turn around the lagging economy by making it
cheaper to borrow money. Some savers complain they are being penalized for doing
precisely what the federal government has long advised Americans to do: save. They did not
purchase homes beyond their means, sign up for interest-only adjustable mortgages, or pile
extravagant purchases on credit cards.
“It takes money out of the pockets of savers and gives it to the borrowers who are up to their
eyeballs in debt,’’ said Greg McBride, a senior analyst at Bankrate.com. “You’ve got Aunt
Mildred putting money in [savings] and it goes to a guy with a new house and
two new cars.’’
Mark Zandi, chief economist at Moody’s Analytics, said while the decline in interest rates
has been a “net positive’’ for the overall economy because it costs less to take out a loan,
the accompanying low savings rates strain some households,
particularly those of middle-class seniors.
“It’s not a slam dunk positive,’’ Zandi said. “Many people think the people who rely on
interest are generally wealthy or well-to-do, but there are many middle-income seniors who
rely on it, and it does create a substantive hardship.’’
Certificates of deposit have been attractive to older investors or those saving to reach a
short-term goal, like a down payment on a home, because they are guaranteed by the FDIC.
In return for committing their money for set periods, investors are rewarded with an
interest rate that is higher than the rate offered by a traditional savings account. Money
market bank accounts also pay higher interest than regular savings but often require
minimum deposits and include restrictions, such as limits on the number of monthly
withdrawals.
From: King, Andy
Sent: Wednesday, May 12, 2010 7:45 PM
Subject: Why the 3% Reserve Fund Annuity rate associated with HDF Med-Sup is VERY helpful to
Seniors - Seniors Have Seen Earning Power from Savings Devastated
Importance: High
Seniors Have Seen Earning Power from
Savings Devastated
Seniors have seen the earning power from their savings devastated, which is pilling
on economic and health risks for one of the most vulnerable segments of our society
- - its grandparents and great grandparents.
Many are very, very scared.
Beginning in 2001, the Federal Reserve reduced short-term interest rates 13 times,
dropping the federal funds rate 84%.
These actions devastated interest income from savings upon
which seniors depend to pay their cost of living in food,
property taxes, prescription drugs, dental care, etc. Such
causes health and economic angst for many seniors.
If a politician would publicly propose a policy to reduce senior citizen incomes by
84% we know what would happen to him. But not a peep is heard when politicians
quietly allow and even encourage government (and its Federal Reserve) policies that
devastate senior citizen interest incomes from their savings by 84%. Why not?
Politicians even brag about 'the lowest interest rates in generations' as if they
personally created a free lunch for everybody - with zero losers. Why do they
brag about devastating senior incomes?
There is no doubt that many senior citizens feel a wave of 'financial terrorism' has
purposefully been launched against them by their government and the financial
sector. They feel their pockets are being picked, each and every day.
Interest income from their hard-earned savings has been
crushed to rates not seen in their adult life-times.
From: King, Andy
Sent: Monday, April 26, 2010 9:19 PM
Subject: NEW REPORT - projects reductions in payments to private MA plans would trigger exodus from
program. Enrollment would plummet by 50%, as plans reduce extra benefits
Importance: High
Govt report says health care overhaul
won't cut costs but will increase them
By: RICARDO ALONSO-ZALDIVAR
Associated Press
04/22/10 11:50 PM EDT
WASHINGTON — President Barack Obama's health care
overhaul law will increase the nation's health care tab
instead of bringing costs down, government economic
forecasters concluded Thursday in a sobering assessment
of the sweeping legislation.
A report by economic experts at the Health and Human
Services Department said the health care remake will
achieve Obama's aim of expanding health insurance —
adding 34 million Americans to the coverage rolls.
The report's most sober assessments concerned Medicare.
In addition to flagging the cuts to hospitals, nursing homes
and other providers as potentially unsustainable, it
projected that reductions in payments to private Medicare
Advantage plans would trigger an exodus from the popular
program. Enrollment would plummet by about 50 percent,
as the plans reduce extra benefits that they currently
offer. Seniors leaving the private plans would still have
health insurance under traditional Medicare, but many
might face higher out-of-pocket costs.
In another flashing yellow light, the report warned that a
new voluntary long-term care insurance program created
under the law faces "a very serious risk" of insolvency.
From: King, Andy
Sent: Monday, April 19, 2010 8:07 PM
Subject: One Medicare Advantage co paid its top exec $35 mil. Another co paid out $210 mil among 260
managers
Importance: High
WHY DEMOCRATS HATE MEDICARE
ADVANTAGE
February 2010:
A recent report from Congress highlighted the reasons Democrats hate Medicare Advantage. The
study of Medicare Advantage plans’ revenues and expenses from 2005 to 2008 found that the
average Medicare Advantage insurer spent over 15% of its revenues
on marketing, administrative costs, and profits. Most of these companies’
revenues come directly from Medicare (around $800 per month per enrollee in Arizona; $1,000
per month per enrollee in Florida) while the rest comes from premiums charged to people
enrolled in the plans.
Medicare spends less than 1.5% on administrative expenses and over 98% on health care costs
for seniors. Two-thirds of Medicare Advantage plans spent only 85% of their revenue on
enrollees’ health care costs. The study sited six plans that spent only 75% of revenues on their
enrollees.
The report concluded that total amounts spent on profits, marketing, and other expenses by
Medicare Advantage plans over the last four years was 27 billion dollars. This is money that
should have stayed in the Medicare Trust Fund, but instead went to private
insurance companies to be spent on things other than health care for seniors
and disabled citizens on Medicare. This is why Democrats have targeted
Medicare Advantage for big cuts.
The report notes that in 2007 one Medicare Advantage company paid its top
executive $35 million. Another company paid out a total of $210
million among 260 managers. The study also reported on expensive retreats,
which are typical rewards for top sales agents and employees in the insurance
industry. In 2007, one insurer spent over $3 million on retreats in Hawaii
while it spent only 83% of its revenue on health benefits for seniors enrolled in
its plans.
This is why Democrats hate Medicare Advantage plans. And this is why
Democrats will see to it that Medicare cuts payments to the insurance
companies that run the plans. Democrats in Congress don’t agree on much,
but I think this is the exception.
From: King, Andy
Sent: Monday, April 19, 2010 7:59 PM
Subject: Some seniors may lose Medicare benefits they now enjoy
Importance: High
Some seniors may lose Medicare benefits they
now enjoy
By Peter Grier, Staff writer / March 22, 2010
Washington
Many senior citizens worry about the effect that the health care reform bill may have on
them. After all, they generally use the health care system more than do younger people.
And those living on fixed incomes may have little leeway in their budgets to help if their
health costs rise.
Would healthcare reform legislation affect seniors in any direct
way?
The short answer is “yes.”
The longer answer is that some seniors may lose Medicare benefits they now enjoy. Many
others will gain from an enhancement of Medicare’s prescription-drug program.
Here are some specifics on these changes:
MEDICARE CUTS
Under the healthcare reform bill, government payments to
Medicare Advantage – plans that are run by private insurers such
as Humana and are an alternative to traditional Medicare – will be
cut by $132 billion over 10 years. (Those plans currently get
somewhat more per person from the government than traditional
Medicare does.)
Medicare Advantage plans often offer extra benefits that seniors in traditional Medicare
don’t get. It is possible that these extras will be dropped as Medicare Advantage plans feel
a budget squeeze.
In most areas of the United States, this reduction will be phased
in over three
years, beginning in 2011, although in some places it will take longer.
The bill does not contain cuts to traditional Medicare benefits.
However, Medicare payments for home healthcare would be reduced by $40 billion
between now and 2019. And certain payments to hospitals would be cut by $22 billion over
that same period.
From: King, Andy
Sent: Monday, April 19, 2010 7:51 PM
Subject: MEDICARE ADVANTAGE: Healthcare Reform Law also reduces MA's open-enrollment period for
enrollees to the first 45 days of the year beginning in CY 2011
Importance: High
Healthcare Reform Law Cuts Medicare Advantage
Payments
April 9, 2010
The Patient Protection and Affordable Care Act of 2010 as amended by the Health Care and
Education
Reconciliation Act of 2010 (Healthcare Reform Law) makes substantial changes to the Medicare
Part C
Medicare Advantage (MA). According to the Congressional Budget Office (CBO) combined
scoring estimate,
the MA payment changes in the Healthcare Reform Law will result
in an approximately $135 billion
reduction in direct federal spending over the next 10 years, one of
the largest spending reduction line items
in the Healthcare Reform Law.
Changes to the Medicare Advantage Program
Medical Loss Ratio
In addition to the new payment methodology, the Healthcare
Reform Law also
implements a medical
loss ratio (MLR) requirement for MA plans of at least 85%, beginning
in CY 2014. MA plans that fail to
meet this requirement will be required to rebate to CMS the percentage of the MA plan’s MA
revenue
equal to the difference between 85% and the MA plan’s actual MLR, which could mean further
reductions in MA plan payment. Furthermore, MA plans that do not meet the 85% MLR
requirement for
three consecutive years will not be permitted to accept new enrollees in the subsequent year. The
Healthcare Reform Law also requires that CMS terminate MA plans that do
not meet the 85% MLR
requirement for five consecutive years.
Cost-Sharing Limitations and Annual Election and Open Enrollment Periods
The Healthcare Reform Law restricts MA plans’ ability to impose enrollee cost sharing for
certain
services above the cost sharing required for those services under the Medicare FFS program.
Those
services include chemotherapy administration services, renal dialysis services, skilled nursing
care, and
such other services that the Secretary determines appropriate, “including services that the
Secretary
determines require a high level of predictability and transparency for beneficiaries.” Since many
of these
services are costly, they could result in further increases in MA plan costs, to the extent an MA
plan
currently has in place higher cost-sharing requirements for those services. This provision is
effective
beginning with CY 2011.
The Healthcare Reform Law also reduces the openenrollment period for enrollees to the first 45 days of the
year beginning in CY 2011 (instead of the current three-month period). MA plan
enrollees’ choice
will be limited to the Medicare FFS program; they will no longer be allowed to change their
election to
another MA plan. The Healthcare Reform Law also shortens the annual coordinated election
period by
approximately three weeks. Beginning in 2012, the annual coordinated election period will be
between
October 15 and December 7.
Special Needs Plan Extension
The Healthcare Reform Law extends the authorization for special needs plans (SNPs) to 2014.
The
Healthcare Reform Law provides the Secretary with the authority to adjust payments to SNPs to
reflect
the costs of treating high concentrations of frail individuals. Additionally, for CY 2012 and
subsequent
years, all SNPs must be accredited by the National Committee for Quality Assurance (NCQA)
based on
standards established by the Secretary.
Secretary’s Authority to Deny Bids
As an additional cost-cutting measure, the Healthcare Reform Law grants the Secretary
the specific
authority to deny a bid submitted by an MA organization for an MA plan if it proposes
significant
increases in cost-sharing or decreases in benefits offered under the plan.
From: King, Andy
Sent: Monday, April 19, 2010 6:59 PM
Subject: Obama calls Medicare Advantage as a "waste," -Congress agreed - MAs to drop 4.8 million
members - MAs preparing now to absorb reduced payment over the next few years."
Importance: High
Will Latest Medicare Advantage Cuts Kill
the Program?
Joe Cantlupe, for HealthLeaders Media, March 23, 2010
President Obama has described Medicare Advantage as a
"waste," and Congress has agreed, proposing $132 billion
worth of cuts to the program over 10 years in the health
reform package.
payment
reductions to private insurers involved in the program
may pave the way for seniors to move into traditional
Medicare or commercial individual plans. Under the
Medicare Advantage cuts planned in reform, the first
payment cuts would occur in 2011. Health insurer CEOs
are advised to begin now to "absorb reduced payments,"
While some senior citizens are worried about the cuts, experts say that
according to one health plan expert.
Private insurers involved in Medicare Advantage often offer extra healthcare that seniors in traditional
Medicare don't get, such as vision care or dental, or even gym memberships. But opponents say the
Medicare Advantage plans cost the government 14%
more than traditional Medicare.
private
The Congressional Budget Office has stated that the health reform measure passed by the House would
result in a deficit reduction of $118 billion, and an additional $20 billion would come from changes
included in the Senate version.
extra benefits not covered by
Medicare, would be cut $67 per member per month in
2019.
Nationwide, the average value of the
The Medicare Advantage reductions would cause "massive disruption for the 10 million senior citizens
enrolled in the program," says Karen Ignagni, president and CEO of America's Health Insurance Plans,
cuts are enacted, millions of seniors will
lose their coverage and face higher premiums." Senior
citizens are expected to be notified of the cuts sometime
this year.
the insurance lobby. "If these
Given the proposed cuts, health insurers may drop some
of these extras or insurers may cut benefits and/or
increase premiums, experts say.
These cuts could cost insurers to drop Medicare
Advantage and seniors to leave the program. In
fact, CBO estimates that Medicare Advantage
enrollment would drop by 4.8 million members by
2019.
Robert Moffit, director of the conservative Heritage Foundation's center for health policy studies, calls
Medicare Advantage cuts "terrible." "It's not a pleasant
situation for senior citizens. If you don't have Medicare
Advantage, you have to buy supplemental coverage,
employer or go into the individual market. Senior citizens
are going to be very unhappy."
the
"Medicare
Advantage plans should start preparing now to absorb
reduced payment over the next few years."
In a Gorman report issued earlier this year, LeMasurier stated that
From: King, Andy
Sent: Thursday, April 08, 2010 10:09 PM
Subject: MUST WATCH CBS NEWS VIDEO ON MAs !!!!!!!!! MEDICARE DIS-ADVANTAGE??????????? THIS
SAYS IT ALL!!! PROMOTES SIMPLICITY OF TRADITIONAL MEDICARE
Importance: High
AS JIM SAYS, “THIS SAYS IT ALL”
ON MEDICARE ADVANTAGE” –
WATCH ASTOUNDING VIDEO FROM
CBS NEWS FROM LAST SUMMER –
AND OBAMACARE HAS NOW
ACTED ON TOP OF
THIS!!!
HERE’S THE VIDEO LINK AND THE TEXT BELOW:
http://www.cbsnews.com/video/watch/?id=3064246n
&tag=related;photovideo
Medicare Disadvantage
PRIVATIZED HEALTH CARE
FOR SENIORS CAN LEAVE
THEM IN THE DARK AS
INSURANCE COMPANIES
REAP A WINDFALL
By Elizabeth Curlee
Play CBS Video Video Private Medicare Not Helping
More 8 million Americans are now getting Medicare through
private insurance companies. But are these private providers
really beneficial to senior citizens? Armen Keteyian investigates.
(CBS) It was the summer of 1965 when Medicare was created to provide
government-sponsored health care for seniors. Today some $381 billion tax
dollars a year are spent on Americans 65 and older.
But in recent years, more and more Americans — 8.3 million and rising — are
getting Medicare through private insurance companies. Tonight, CBS News
chief investigative correspondent Armen Keteyian takes a closer look at the
program critics charge has turned into a disadvantage for seniors, and a
windfall for the insurance industry.
It was the winter of 2003 when Congress, in the dead of night, overhauled
Medicare.
"This prescription drug benefit is a good deal for all seniors," said Rep.
Dennis Hastert, R-Ill.
But buried inside the bill was another deal — one that CBS News
investigation has discovered was not necessarily a benefit for seniors.
A large portion of one of the most successful public programs in history was
quietly placed in the hands of private insurance companies. The goal of
Medicare Advantage: to provide seniors with more benefits, like vision and
dental care, and control rising costs. But today, for seniors like Aaron Cohen,
it's become Medicare Dis-Advantage.
"I'd rather go back to the old-fashioned Medicare," Cohen told
Keteyian.
Cohen, an 86-year-old who lives in Connecticut, says he switched to an
advantage plan only after a salesman assured him he would be completely
covered while staying in Florida.
But after breaking his leg in that state, Cohen began to believe he had been
sold a bill of goods.
"There was something radically wrong," Cohen said. "They wouldn't give me
any home therapy, claiming that it wasn't covered."
But that's only part of the problem. With traditional Medicare, there's one
plan for everyone, everywhere. Private Medicare Advantage offers as many
as 50 different plans, causing untold confusion over coverage, premiums, copays, provider networks.
"These insurance benefit packages are very complicated. Almost nobody
without really technical sophistication can figure out exactly what they are
buying," said Robert Hayes, who runs the Medicare Rights Center.
Hayes said every year his staff fields thousands of calls from seniors scared
to death they've made the wrong choice.
Not only are private plans more confusing, they are more expensive to
taxpayers.
In fact, three independent reports found private insurance companies are
paid, on average, 12 percent more than what it cost the federal government
to run Medicare — in some cases, 50 percent more.
The head of Medicare insists private plans give you more for your money.
"I think there is a lot more that we could do in regular Medicare that we
aren't doing currently, that some of the Medicare Advantage plans are able to
do because of how the payment structure works," Leslie Norwalk told
Keteyian.
But how much of that money is going back into the pockets of the insurance
companies?
"Well, it's required by law: 25 percent goes back to the federal treasury, 75
percent goes back to the beneficiary," Norwalk said.
So the insurance companies are doing this, what, out of the kindness of their
hearts, asked Keteyian?
"There, there would be, I'm sure, some small amount to administer the
additional benefits," Norwalk said.
But CBS News has found that's not always the case. An independent report
found when it comes to the fastest-growing plans, known as private fee-forservice, half of that extra money goes back to the insurance companies. All
these private Medicare plans are expected to cost taxpayers an additional
$54 billion over the next five years.
"Taxpayers are losing; people in Medicare are losing," Hayes said. "And the
structure of Medicare as a national treasure that we need to rely on moving
forward, is being undermined."
So much so that key Congressional Democrats now want to cut payments to
private plans. The insurance industry is fighting back with a direct mail
campaign urging seniors to contact their representatives.
Ironically, Cohen got one of the letters. On the back, his very personal
feelings about his Medicare Advantage plan.
"This plan is worthless," he wrote.
From: King, Andy
Sent: Thursday, April 08, 2010 1:26 PM
Subject: MUST READ!!! NEW BM: EYE OPENER!!! $37,409 ap FOR WK-HUGE INCREASE in Med-Sups,
HDF& SR. LIFE for wk -21 M-S sales-HDF driving force - AGENTS CAN EARN $700-$1000/sale: $3.5K–$5K
per week.
Importance: High
Everyone should see the 2 emails below from New
BM Chris and SVP Jim Campbell. From Jim’s training on
OUR HDF being sold with our UNIQUE RESERVE FUND ANNUITY,
Chris took the ball and ran for a touchdown! His sales the week
BEFORE implementing this HDF Marketing with the RFA was only
$8,230 – THE FIRST WEEK WITH A FOCUS ON HDF-RFA, THEY
SOLD
$37,409
LAST WEEK – AGENTS SOLD HDF/RFA,
OTHER MED-SUPS AND LIFE –
much AP!!!
nearly 5 times as
FOLKS, AGAIN - CHRIS HAD NEARLY 5
TIMES AS MUCH IN SALES FROM
IMPLEMENTING HDF/RFA AND
GETTING PEOPLE EXCITED WITH A
CONTEST TO DO IT! Now, he’s on his
way!
NOW THAT’S MARKETING!
Jim and I sure am PROUD OF YOU,
CHRIS!!! Go for #1 – it will take
others very little time to catch on to
your new-found momentum… but
they will, so keep it growing, recruit
like the wind to it. As Jim says, with our
HDF strategy, agents will earn up to $700$1000 per sale or $3,500 – $5,000 per
week!!! And that’s FAN-TAS-TIC in
ANYBODY’S BOOK! It’s there for anyone
who wants it – and wait until Chris gets
the new LNL rates too – he doesn’t even
have the lower rates yet! LOOK OUT
WHEN HE GETS THOSE TOO!!!
ANDY
From: BM660
Sent: Friday, April 02, 2010 10:32 AM
To: Jim
Subject: Contest
I am
really proud of all the agents here at branch
660. We have had a
tremendous increase in
The HDF
plan was the driving force and
Medicare Supplement sales.
6 HDFs issued immediately.
Over the week we were able to sell
kicked us off with
MANY other Medicare supplements as
well for a
total of
21
Medicare supplement
sales – WITH life, for a
total of
$37,409
– and $27,471 has
already issued - to
show you the impact of
HDF on sales, the
previous week was
only $8,230!!!
I'm also
very proud of the push that has
started with offering final
expense coverage with the HDF
& other Medicare appointments.
After your visit the week of March 8th, I met with my agents
and explained to them the advantages of bringing up Final
Expense coverage to seniors.
The very next week, Tamberly sold a Final Expense Plan to a
senior.
Stewart also turned in a Final Expense Plan with a Medicare
sale.
The approach in the 2 sales were different, but both were
equally important and successful.
Tamberly's approach is using money saved on
premiums with an HDF/RFA to fund a Final
Expense Plan.
SOLD!!!!!
Stewart's approach was on a MSG plan where
the senior’s existing Term life plan was up for
renewal, to increase from a cost of $700
annually to $4,900 ANNUALLY. The senior
was going to go without life insurance because
of the cost. She was extremely happy that
Stewart simply asked her, "how are you
funding your final expenses?"
SOLD!!!!!
our dramatic increase in
Medicare sales is a result of better
understanding the advantages of
the HDF & Reserve Fund Annuity
I believe that
This truly is an
amazing policy!
benefits.
It has a
deductible "Stop Loss" less than
most Major Medical plans
and is less
confusing to seniors if explained correctly. The day to day
co-payments and deductibles that they have paid their entire
working career is what they expect. We are just showing
them that they can pay for these things from premium
savings, and also with an annuity that earns them 3%.
How much are they
earning in their savings
account? NOT 3%!!!
When a
senior fully funds the Reserve Fund Annuity at $4,000 they
can also earn $120 in interest.
We have great things happening here in branch 660 and
we're going to strive to get better every day for ourselves
and the customers.
it is an eye
opener!
Thank you Jim -
Chris
Branch Manager #660
From: Jim
Sent: Thursday, April 08, 2010 12:13 PM
To: King, Andy
Subject: FW: Medicare Contest
What a great opportunity we have with people turning 65!
 9.5M on Medicare Advantage – and shrinking
 10M T-65 over the next five years - and growing
During my travels over the past few weeks, I have spoken
with a number of managers and agents who have said the
best case scenario is… most T-65 prospects are paying
upwards of $350+ per month for their individual major
medical plan.
$350 + month plus
 $1,000- $1,500 deductable
 co-pays
 stop loss of $5,000 – 10,000
When you compare the cost of the HDF ~
$100/ mo,
the savings is significant.
With our HDF strategy, there is enough money left over to
set aside for deductibles and co-pays in our Reserve fund
annuity, cover the cost of a Part D plan and provide for a
final expense plan while showing retirees how to pocket the
balance of the savings.
With our HDF strategy,
agents will earn up to
$700-$1000 per sale or
$3,500 – $5,000 per
week.
Everyone win’s:
Client: better benefits and a more affordable price and cost
Agent: better up front income opportunity and longer term
renewals with two products in place
Company: client growth, agent retention and in a few years
more profits for investors…
From: King, Andy
Sent: Tuesday, April 06, 2010 9:12 PM
Subject: DESIGN MED-SUP LEADS FOR INCREASED LEAD RESPONSES!!! Here's YOUR OPPORTUNITY to
help seniors understand - "Seniors Fear Health Care Remake Will Hurt Medicare"
Importance: High
Seniors Fear Health Care Remake
Will Hurt Medicare
March 31, 2010
WASHINGTON -- Seniors aren't breaking out the champagne for President Barack
Obama's health care law, and for good reason.
While Democrats hail the overhaul as their greatest health care achievement
since Medicare, seniors fear it's a raid on that same giant health care program a bedrock of retirement security - in order to pay for covering younger, uninsured
workers and their families.
broad cuts in projected Medicare
payments to insurance plans, hospitals, nursing homes and other
There's no doubt that
service providers will sting. What hasn't sunk in yet is that the new law also
improves the lot of many Medicare beneficiaries. Obama is hoping that most will
eventually conclude the plusses outweigh the minuses.
Nonetheless,
seniors are anxious.
"I'm afraid from the little I've heard that it's not good for seniors," said Muriel
Couzon, 86, a retired supervisory social worker from New York City. A Democrat,
Couzon says the legislation could affect her vote this fall: " I have to see what
it will do to me and other seniors like me."
There will be winners and losers:
-
Gross cuts in projected payments to insurers,
hospitals and other providers total $533 billion over 10 years, according to
a preliminary analysis by the Kaiser Family Foundation. About $100 billion
will be plowed back into Medicare, leaving a net cut of $428 billion.
Medicare spending will continue to grow under the law, just not as fast. The
reductions are about 6 percent).
-
The law strengthens traditional
, which covers about three-fourths of seniors, by
Medicare
improving preventive care and increasing payments to frontline primary
care doctors and nurses serving as medical coordinators. But it reduces
generous government subsidies to private insurance plans,
Medicare alternatives that have lately gained popularity.
That could lead to an exodus
from the private plans.
-
The most significant new benefit - closing Medicare's prescription
coverage gap - won't be fully phased in until 2020. That's a long time if
you're old and frail. The coverage gap starts after the first $2,830 spent on
medications in a year. Seniors then pay entirely out of their pocket until
they have spent $4,550, when the government starts picking up 95 percent
of the tab. After the rebate this year, seniors in the gap will get a 50 percent
discount on brand name drugs in 2011, and a smaller break on generics.
The discounts gradually ramp up until the "doughnut hole" is closed.
-
One change has received little attention but could have major
consequences. The law authorizes a variety of experiments to provide
better care for seniors struggling with multiple chronic illnesses - about
half the program's beneficiaries. Prominent voices in the medical
community have been clamoring for the government to use Medicare as a
laboratory for change. If the approach succeeds, fewer people may end up
in the hospital for bad drug reactions and other common problems.
"It's going to be very important for
Medicare beneficiaries to
understand that on the whole, this
is not the disaster some people
said health economist Marilyn
have painted it to be,"
Moon, who as a former Medicare trustee helped oversee program finances from
1995 through 2000. "It is a bit of a mixed bag, but I think on balance it is going to
put the program in a better position, over a long period of time."
Her one major caveat: Many seniors in private
insurance plans under Medicare Advantage will
face higher premiums and reduced benefits as
subsidies are scaled back to bring the private
plans' costs in line with those of traditional
Medicare.
"Beneficiaries will notice that, and they're
going to be unhappy because it's a takeaway,"
said Moon, who directs the health care program at the American Institutes for
Research.
Government payments to the private plans _ about 10 percent richer than perperson spending for traditional Medicare _ have enabled them to offer
comprehensive coverage for less. Seniors flocked to sign up, boosting
enrollment to about one quarter of all Medicare beneficiaries.
The same cuts will benefit seniors in traditional Medicare, who have been paying
higher monthly premiums to support the government's generosity.
Such nuances got lost in an emotional debate that veered off into "death panels"
and "pulling the plug on grandma." Nothing that drastic was ever in the bill. Still,
Republicans accuse Obama of slashing Medicare, and polls show the message
has stuck.
An Associated Press-GfK survey in March found that 54 percent of seniors
opposed the legislation then taking final shape in Congress, compared with 36
percent of people age 18-50.
"We've got an education job to do with seniors," said Sen. Chris Dodd, D-Conn. "I
think they are probably the least open to seeing the benefits."
AARP and other major organizations representing seniors supported the law,
despite the polls. Now they're planning a sustained outreach campaign to call
attention to the legislation's benefits. It might not be an easy sale.
Sent: Tuesday, April 06, 2010 7:34 PM
To: Andy King
Subject: Re: CMS FACT SHEET: CMS ISSUES FINAL 2011 PAYMENT POLICIES FOR
MEDICARE ADVANTAGE AND PRESCRIPTION DRUG PLANS
What this means at 20,000 foot level is that:
MANY MAs WILL SIMPLY EXIT
THE MARKET.
The reimbursement rates won’t change from 2010, so the
1.4% increase plans were to receive in 2011 won’t happen
as Obamacare’s regs require that payments be frozen at
2010 levels.
This means that:



Plans will have to absorb or pass on the full cost of
Medical inflation for 2011 UP TO 5%.
The new regs extend CMS’s ability to coding intensity
adjustments that will further impact plan payment
another 1 to 2 points.
So it’s reasonable to think plans will be modeling 2011
benefits with the expectation of up to a 6 percent
reduction in revenue from CMS.
Restated, payments to MA plans will continue to
decrease over the next couple years, requiring MA
plans to again make choices between lower margins
(doubtful), increasing premiums, increasing cost
sharing (generally can’t be greater than original
Medicare) or reducing benefits.
MANY MAs WILL SIMPLY
EXIT THE MARKET – STRAT
RECRUITING TODAY- THEY
WILL STATE INTENT TO
CMS IN JUNE.
From: King, Andy
Sent: Tuesday, April 06, 2010 8:33 PM
Subject: I am pumped!!!!! It’s time to rally the troops!!!! Get on the phones!!!!! Get recruiting so we can
capitalize!!!!!!!!!!! LEAD FROM THE FRONT with loud messages like the one you’re sending
Importance: High
Yes Kyle, it is easy to get excited if you
read
ANY of the emails below – ESPECIALLY on OUR
UNIQUE HDF WITH OUR RFA – NO ONE ELSE HAS
IT!!!
WITH MAJ-MED COMMISSION AND ADVANCE CUTS
COMING IN DROVES – AND CUTBACKS TO MAs –
AND OUR NEW MED-SUP RATES – AND OUR
ENTIRELY UNIQUE HDF/RFA THAT ALLOWS A
SENIOR TO ALSO BUY LIFE INSURANCE WHILE
GETTING BETTER INTEREST ON THEIR SAVINGS,
WITH NO “LOCK AND LOAD” ON ACCESS -
RECRUITING COULD NOT BE
EASIER - RIGHT NOW!
ANDY
From: BM031
Sent: Tuesday, April 06, 2010 6:22 PM
To: King, Andy
Subject: RE: Disadvantages Of MA Plans, as you seeT-65 Seniors for HDF and Reserve Fund Annuity
You know Andy, I’m sitting here reading this and I
can’t help but wonder about how many other
individuals in the company are getting the message
you are sending loud and clear!!!! I’m wondering if
they are as pumped up as I am about what we are
Well I am
pumped!!!!!
looking at!
It’s time to rally the troops!!!!
Get on the phones!!!!!
Get recruiting so we can
capitalize!!!!!!!!!!! LEAD FROM
THE FRONT with loud
messages like the one you’re
sending, giving them CLEAR
direction to success!
Build it and they will
come!!!! Then show
them the way!!!!
Can you tell IM
EXCITED!!!!
--->If you can dream it, then you can achieve it. You will get all you want in life if you
help enough other people get what they want.
Kyle
From: UA Actuary
Sent: Monday, April 05, 2010 4:48 PM
To: Andy King
Subject: FW: CMS FACT SHEET: CMS ISSUES FINAL 2011 PAYMENT POLICIES FOR MEDICARE
ADVANTAGE AND PRESCRIPTION DRUG PLANS
Health Care Reform has taken AWAY “medical cost
trend” funding increases FOR INFLATION from Medicare
Advantage plans for next year – 2011 – even though
medical costs continue to rise dramatically. That
spells HUGE TROUBLE for MAs.
And that’s just the beginning of the “MA TRAIN
WRECK”
– BUT great opportunities IN
DISENROLLMENTS for UA LATER THIS
YEAR! JUNE IS WHEN MA’s WILL HAVE TO
DECIDE…RECRUIT & TRAIN YOUR
SALESFORCE NOW!
From: CMS PRESS RELEASES AND FACTS SHEETS
Sent: Monday, April 05, 2010 3:57 PM
Subject: CMS FACT SHEET: CMS ISSUES FINAL 2011 PAYMENT POLICIES FOR MEDICARE ADVANTAGE
AND PRESCRIPTION DRUG PLANS
FACT SHEET
For Immediate Release
April 5, 2010
Contact:
CMS Office of Media Affairs
(202) 690-6145
CMS ISSUES FINAL 2011 PAYMENT POLICIES FOR MEDICARE ADVANTAGE
AND PRESCRIPTION DRUG PLANS
Background: The Centers for Medicare & Medicaid Services (CMS) today announced the
capitation rates for Medicare Advantage plans for 2011. The 2011 Rate Announcement was
accompanied by the final 2011 Call Letter for Medicare Advantage (Part C) and Medicare
prescription drug (Part D) plans.
CMS stated in the 2011 Advance Notice that, if new legislation was enacted after the Advance
Notice was released, but before the Rate Announcement was published, changes would be
incorporated into the Announcement. As required by Section 1102 of the Health Care and
Education Reconciliation Act of 2010, the capitation rates for 2011 are the same as the capitation
rates for 2010.
In previous years’ Rate Announcements, CMS included final estimates of the National Per
Capita Growth Percentages (MA Growth Percentages) as well as tables summarizing the key
assumptions that were used to develop the MA Growth Percentages. The final estimates of the
MA Growth Percentages were used to trend the previous years’ capitation rates to the payment
year. Given that the capitation rates for 2011 are the same as the capitation rates for 2010, the
MA Growth Percentages have no relevance for the 2011 capitation rates. Therefore, this
Rate Announcement does not include final estimates of the MA growth percentages or the
associated key assumptions tables.
Disadvantages Of
Medicare Advantage
Plans
The disadvantages of choosing Medicare Advantage Plans or
Medicare Part C plans are discussed below:
Disadvantage of Medicate Advantage Plans:

Numerous Plans:

Excessive cost: These plans cost more than the Original Medicare plan.
Medicare Advantage offers as many as 50 different plans.
These many plans can give rise to confusion. People wanting to enroll in these plans
will have to seek the advice of an expert in Medicare Advantage Plans, who can
provide them with complete and accurate information. Without reliable and precise
information, the person is likely to be misled to choosing wrong and inappropriate
plans, resulting in payments for benefits that are not required.
Sometimes, they may cost more than 12 to 50 percent of the cost of Original
Medicare Plan.

Lack of flexibility: The Medicare Advantage provides coverage if the
insured obtains treatment from their network of health care providers. If the insured
wishes to see a doctor outside the network, then the insured needs to pay an extra
amount.

Limited coverage area:

Lack of stability: Medicare Advantage plans, being private insurance plans,
Many Medicare Advantage plans limit coverage
to certain geographic areas. This is a disadvantage for insured who are frequent
travelers. In case of any injury or illness, they may have to bear the expenses out of
their pocket, if they are outside the geographical limits specified by the plan at that
point of time.
are not very stable as the contracts can change annually.

Sudden termination of coverage: The private insurance company
can withdraw from a particular area, if it is not making expected profits in that
geographical are. This leaves the insured without any coverage.
Medicare Supplement Advantages

Protects you against many medical costs
not covered by Medicare.



Offers greatest freedom of choice in
coverage options.
Not limited to specific care providers.
Easiest to use, if you travel out of the
area frequently.
UPDATE
“Cuts to MA [Medicare Advantage]
should be a no brainer.”
By Monica Sanchez
In a previous post I asked “Who’s Getting the Advantage from Medicare Advantage? (See that post for background
on the Medicare Advantage program and the controversy over cutting overpayments to the private insurance
companies that operate them.)
The answer to my question continues to be answered from the pages of The Wall Street Journal, which proclaimed
this past August: ”Humana 2Q Profit Rises 34% On Medicare Business.”
But some still bemoan that people in Medicare Advantage plans will suffer horribly if the $149 billion we will give
these plans in overpayments over the next ten years are cut, like in this letter to the editor of the Palm Beach Post:
“Medicare Advantage is an option that serves 22 percent of the 45 million Medicare beneficiaries. The key is its
innovative and coordinated approach to health and wellness. These plans offer enhanced benefits and added value.”
Just what is this 'added value'? Austin Frakt, a health economist at Boston University, provides hard evidence that the
extra benefits to people in Medicare Advantage plans are highly overrated — and overpaid:
“My work (with Steve Pizer and Roger Feldman) shows that for each additional dollar spent by the federal
government (taxpayers) on the program since 2003, just $0.14 of it can be attributed to additional value (consumer
surplus) to beneficiaries (see also: findings brief).
How can anyone possibly claim that 14 cents on the dollar is a good deal?
These overpayments are particularly unfair to the majority of people who prefer the public Medicare program but must
help pay for those who enroll in the private plans. As the Center on Budget and Policy Priorities explains:
“Under Medicare Part B, beneficiaries are charged a monthly premium equal to 25
percent of the costs of Part B-related services, which include physician visits and
other types of outpatient care. Because private-plan overpayments increase
Medicare costs under both Part A (hospital and nursing home services) and Part
B, they increase the Part B premiums that beneficiaries must pay. According to
both MedPAC and the Chief Actuary at the Centers for Medicare and Medicaid
Services, the Medicare Advantage overpayments have raised the Part B
premiums by $2 per month per person, or $48 a year for a couple, in 2007.
“Cuts to MA [Medicare
Advantage] should be a no brainer.”
To quote Dr. Frakt,
Medicare Advantage Cuts: Once More with
Feeling
BY AUSTIN FRAKT
Abstracting from the economics wonkery a bit, let me put research findings on Medicare Advantage (MA) payments
plainly.
Payment to MA plans has gone way up since 2003. Did the payment increase largely benefit beneficiaries or not?
This is a current political and policy debate, about which much has been written in the media (both traditional and
blogospheric). It turns out the answer is known and quantifiable. My work (with Steve Pizer and Roger Feldman)
shows that for each additional dollar spent by the federal government (taxpayers) on the program since 2003, just
$0.14 of it can be attributed to additional value (consumer surplus) to beneficiaries (see also: findings brief).
What do we make of the other $0.86? That goes to the insurance companies but doesn’t come out “the other end” in
the form of value to beneficiaries. In part it is accounted for by the costs of the additional benefits and in part it is
captured as additional insurer profit.
The balance of the evidence is on Obama’s side. In fact, it is a landslide: for each dollar spent, 14% of the value
reaches beneficiaries and 86% of it goes elsewhere (profit or cost).
Cuts to MA should be a no brainer.
Medicare Disadvantage
POSTED BY BRUCE BARRY
Today's City Paper cover story on Nashville-based HealthSpring
shows how the firm's
core business model -- owning and operating Medicare Advantage
insurance plans -- is vulnerable to health care reform that could cut
or eliminate federal subsidies for those plans. Although CP writer Walker
Duncan's piece highlights an interesting local example of the tension between for-profit insurance
and health care cost control, it underplays the larger policy controversy surrounding Medicare
Advantage plans.
The story describes the subsidies that keep Advantage plans in business but neglects to emphasize
that these plans, and the companies (like HealthSpring) that peddle and profit from them, contribute
to the government's health care financing woes by taking taxpayer money to provide Medicare
benefits at higher costs than necessary. A new analysis of Medicare financing by the respected Kaiser
Family Foundation calls the upside of Medicare Advantage plans "a matter of dispute" but concludes
that "it is undisputed that Medicare Advantage payments have added to the cost of Medicare borne
by the government." Although the AARP doesn't support doing away with Advantage plans entirely,
the organization's head does agree that
Medicare Advantage insurers
"are being paid too much."
The CP story finds HealthSpring CEO Herb Fritch fretting that
reform "could put the
whole Medicate Advantage industry in peril." That sounds like a fine
idea.
G O OD RI D D AN CE TO
M ED I C AR E ( D IS - )A DV AN TA G E
By Marie Cocco
Good riddance to Medicare Advantage
disadvantage.
President Barack Obama’s bid to reduce the taxpayerfunded slush fund that flows to the managed-care
insurance industry through Medicare is an emphatic, if
overdue, effort to turn Washington around. So be ready for
insurance-industry propaganda masquerading as concern for the elderly—and
know that the facts belie the industry’s fantasies.
For years, public and private studies of Medicare HMOs—euphemistically called
“Medicare Advantage”—have shown that the program run by the insurance
industry costs the government more per patient than the very same patient would
have cost to treat under traditional Medicare. The most recent analysis by the
nonpartisan Medicare Payment Advisory Commission puts the overpayment at 14
percent per enrollee, a surcharge that taxpayers pay for those Medicare
beneficiaries who now get their coverage through private, managed-care plans
(more than a fifth of the people in the overall program). “This added cost
contributes to the worsening long-range financial sustainability of the Medicare
program,” the commission says.
You would think that private industry would welcome the competition—fair bidding for
government contracts is not an exotic idea, after all. But predictably, the industry has
resorted to scare tactics. Benefits would be cut! Patients would be harmed! Those
who choose to get Medicare through private insurance plans would bear the brunt
of cost reductions that are necessary to save Medicare as a whole!
The claims are about as accurate as the marketing pitch the insurance industry
made when it began heavily promoting health maintenance organizations during
the 1990s.
Remember when HMOs were the next big thing in health
care? Managed care was offered as an antidote to the Clinton administration’s
attempt at broad health care overhaul. It was to be a magic elixir that cured just
about everything that ailed the health care industry. Patients would have a limited
choice of doctors and hospitals, but in exchange they were supposed to get more
coordinated care that helped them stay healthier and avoid costly illnesses and
procedures. In Medicare, the savings were to be poured into extra benefits—
notably prescription drug coverage, at a time when there was no drug plan in
traditional Medicare. Those who paid for the insurance—Medicare, for example, or
private employers—would reap great savings, and the nation’s overall health
expenditures would begin to decline.
What happened on the way to this utopia?
The insurance industry figured out pretty quickly that it was easy
to make a buck by managing price, not care. “What happened in
the late 1990s is that patients perceived that managed care
plans were in business to keep them from seeing doctors, as
opposed to helping them get the right care,” says Stuart Guterman, a Medicare expert at
the nonpartisan Commonwealth Fund.
Soon came the invention of “drive-by deliveries” that pushed women and their newborns
out of hospitals within 24 hours, and “drive-by mastectomies” that sent cancer patients
home to care for their own surgical wounds. “The concept has gotten kind of contaminated,”
Guterman says.
The backlash was political, with Congress passing legislation to end the worst abuses,
and practical: In 1996, according to the Kaiser Family Foundation, 31 percent of workers
covered by employer plans were in HMOs. By 2008, the proportion had dropped to 20
percent. The vast majority of workers covered by an employer-based health plan now
choose more-flexible preferred-provider networks.
The Medicare Advantage experiment is not without
usefulness. But profit-making enterprises are motivated by
money, not altruism. Whenever the private insurance industry says it can do
something better than public insurance, be wary: Routing government money through
private industry so that it eventually gets to the intended beneficiaries is often inefficient.
Obama also plans to end the circuitous route that student loans now make from government
coffers through private lenders and then, finally, to students. Direct government loans to
students, studies have shown, cost taxpayers less.
This country needs to manage health care better, by reordering the system in a way that
rewards prevention and cuts down our reliance on costly procedures. This was supposed to
be what managed care achieved.
The greatest lesson of Medicare managed care isn’t that
we shouldn’t manage care. It’s that the management must
be done for public benefit, not private gain.
The unspoken disadvantages of
Medicare 'Advantage'
By Frank Kaiser, Special to the Times
It was doomed before it began.
Medicare Advantage program
is a shimmering mirage of cheap copays, cheaper hospital
stays and the quaint notion that it's free of some anonymous Washington bureaucrat pushing you
Like its predecessor, Medicare+Choice, the current
around.
At least that's what the pushers of this chimera told us. Various insurers touted big discounts on
dental, vision and hearing needs. Deals so good we found ourselves saying,
"What do
we have to lose?"
A lot, it turns out.
Patched together by drug and health insurance lobbyists, the 415-page 2003 Medicare Prescription
Drug, Improvement, and Modernization Act has indeed improved the lot of Medicare beneficiaries.
Today, thanks to Part D, only 8.5 percent of us lack drug coverage. Of the 8.7-million currently
enrolled in private Medicare Advantage MA plans (Part C), most say they are pleased with the
benefits formerly covered under traditional Medicare (Parts A and B)
- at least
until they get sick.
According to the Medicare Rights Center, the sickest of
those enrolled in MA pay far more for health care than they
would pay for traditional Medicare. That organization has
reported:
"People who receive chemotherapy, inpatient hospital
care, home health care and skilled nursing care through
private health plans incur greater out-of-pocket costs than
they would through the public Medicare program, and they
cannot insure themselves against these prohibitive costs."
What ObamaCare means for MajMed Agents - and what Med-Sup
opportunities YOU have in recruiting
them
Subject: RE:
I’M EXCITED!!!!!!
What a once in a lifetime opportunity to help both sides of the
fence.....recruiting these agents being affected by this, providing a
new secure position with a company that is moving in such a positive
direction in an extremely good position in the market AND offering
protection to seniors being affected by providing some of the best
protection money can buy! What a
WIN-WIN!
Thanks, Andy!
--->If you can dream it, then you can achieve it. You will
get all you want in life if you help enough other people get
what they want.
Kyle
Another Year with No Social Security COLA?
Based on current data, there will again be no cost of living adjustment (COLA) for Social Security
recipients in 2011, or at most a very small one.
Healthcare, electricity, housing costs and fuel -- the mainstays of the senior household budget -- are rising
furiously. But Congress didn’t even give us the one-time $250 COLA payment President Obama proposed.
Maybe they don’t think the situation is very urgent, since their COLA is calculated differently. Members of
Congress are expected to get $3,500 next year for their cost of living adjustment.
As you know, the COLA problem started because the law bases our cost of living on the consumer price
index (CPI), and the CPI isn’t rising. But the CPI, which is based on a “typical” urban worker’s basket of
goods, does not accurately track senior costs. Our budgets, which include more medical expenses,
prescription drugs, fuel oil, home repairs and groceries, aren’t at all like those of young, urban workers.
It’s time Congress heard from you on this issue.
We will not stop pushing until we know they’ve heard you. You worked hard all your life. You have a right to
a secure retirement.
Thank you.
Daniel O’Connell
Board Chairman
The Senior Citizens League
P.S. Although everyone’s situation varies, one study for TSCL found that a realistic COLA of 3% in 2010,
based on actual senior costs, is worth $10,000 to you over a 20-year retirement, when compounded
annually.
How Will Health Care Reform
Affect Medicare Advantage?
March 26, 2010
Mar. 26-- Jack prefers to receive his medical benefits through a private health plan.
federal government set to help pay for health care
reform by reducing its payments to insurers who offer those
private plans, called Medicare Advantage, the octogenarian
is worried.
And with the
"There's been a lot of rumors with the passing of 'Obamacare' ... that
we're eventually going to lose the advantage portion of
Medicare.".
Here's how the law affects Medicare:
Since there will be $400 billion in future cuts in Medicare
reimbursements, mainly to hospitals, will there be cuts in benefits?
Hospitals agreed to the reductions. In exchange, most Americans will
have to have health insurance instead of using the emergency room
for care and sticking hospitals with the bill.
What will happen to Medicare Advantage?
Today, Medicare
pays private insurers an average of 14 percent more
than it spends to care for people enrolled in traditional Medicare.
The overpayments help lower premiums and co-insurance costs, and provide extra benefits like
vision and dental coverage, even gym memberships.
The law would nearly eliminate the overpayments, saving $132
billion over the next decade.
Costs could increase and extras may be eliminated next
year, when payments to insurers are to be frozen at 2010
levels. The payments will start to drop in 2012.
Premiums will likely go up next year -- as they did this year.
From: King, Andy
Sent: Monday, April 05, 2010 9:39 PM
MUST READ ---A ONCE-IN-LIFETIME
CHANCE FOR YOU ---- What ObamaCare
means for Maj-Med Agents - and what
Med-Sup opportunities YOU have in
recruiting them
Subject:
A RARE
ONCE-IN-A-LIFETIME RECRUITING
OPPORTUNITY
FOR UA BMs:
RECRUITING SHOULD SKYROCKET DUE
TO EXTRORDINARY CIRCUMSTANCES:
Here’s why ObamaCare passed,
along with Maj-Med Administrative
Health Costs cuts (including Maj-Med
Agent Commissions):
And here’s why Medicare Advantage plans
are being cut by OBAMACARE so harshly:
MAs are so much more expensive
than Traditional Medicare – UP TO 118%
OF TRADITIONAL MEDICARE
- THAT’S WHY MA’S WILL BE CUT SO
DRAMATICALLY BY OBAMACARE – THE
GOV’T CAN’T FUND BOTH MAS AND
OBAMACARE!
And here’s the scope of the number of MA
disenrollees who will be affected (MA cuts = disenrollments)
- as a result OF FUNDING CUTS,
MA disenrollments will be
HUGE
– UP TO 10.8 MILLION SENIORS!
AND WE ARE INTRODUCING LOWER MEDSUP
PREMIUMS (especially HDF with our
market-unique Reserve Fund Annuity),
WITH LOTS OF LEADS TO GET THEM!
2011
Insurance
Reform
Medicare
Prohibit Medicare Advantage plans from imposing higher
cost-sharing requirements for some Medicare covered
benefits than is required under the traditional fee-forservice program.
----------------------------------------------------
And now, on to Maj-Med AGAIN:
UNDERAGE MEDICAL LOSS RATIO
REQUIREMENT (DOES NOT AFFECT
ANCILLARY HEALTH PLANS LIKE
CANCER, CRITICAL ILLNESS, ETC):
WHY MAJ-MED AGENTS ARE
SCRAMBLING TO FIND A HOME:
2010
Insurance
Reform
Require health plans to report the proportion of premium
dollars spent on clinical services, quality, and other costs
and provide rebates to consumers for the amount of the
premium spent on clinical services and quality that is less
than 85% for plans in the large group market and 80% for
plans in the individual and small group markets.
Requirement to report medical loss ratio effective plan
year 2010.
MAJ-MED Agent Concerns on HIGHER
MEDICAL LOSS RATIO FOR MAJ-MED
PLANS: While the bill does explicitly state that agents and brokers will be
allowed to enroll individuals and employers in qualified health benefits plans, both
inside and outside of the exchange, the legislation creates a new Small Business
Administration grant program that would award federal money to non-profits
for the purpose of providing small businesses with less than 100 employees
assistance with consumer information, outreach, counseling, and enrollment.
The new program will cut experienced and
educated agents out of the process in favor of
random non-profits with no prior health insurance background and give such
entities the authority to advise small businesses on their insurance decisions.
TUESDAY, MARCH 23, 2010
Impact - MLRs (Medical Loss Ratios)
Impact on the number of carriers selling individual and family plans either through
exchanges or privately, or both.
"MLR" is the ratio of premiums paid in to what is paid out for medical care and wellness.
The current reform will require in 2011 that all carriers selling individual and family plans
must meet 80% MLR in that market. That means every company selling health plans by
2011 must be spending at least 80 cents of every dollar received in premiums on
healthcare and related expenses.
Needless to say reduction in those expenses, including agent commissions, will occur.
How some carriers will be able to meet the new MLR: some carriers may choose to exit
the market instead of trying to achieve 80% MLR on individual & family health coverage.
It will be curious to see who is left standing.
---------------------------------------------------------------------------------------------------------Maj-Med Agent Blogs found on Internet:
Under HR 3590 (Senate Bill):
"Requirement to report medical loss
ratio effective plan year 2010;
requirement to provide rebates effective January 1, 2011."
This could have a huge impact on commission. We
(Maj-Med sales Agents) could be cut out of the
picture.”
--------------------------------------------------------------------------------------------------------------------------------
Survey: Most Agents Think Health
Moves Will Hurt

By ONLINE NEWS SERVICE
Published 3/26/2010
About 88% of health insurance agents are expecting the new Patient Protection
and Affordable Care Act to drive
up group health rates.
HSA Resources L.L.C., St. Cloud, Minn., says 92% of the agents it surveyed this
week said PPACA would increase insurance premiums in the individual market.
65% expect the role of the health
insurance agent to decrease because of the new
law, and 24% expect the role of the agent to
decrease significantly. About 58% of the agents
said they believe their overall sales will
decrease.
In addition,
2010
Insurance Reform
Require health plans to report the proportion of premium
dollars spent on clinical services, quality, and other costs
and provide rebates to consumers for the amount of the
premium spent on clinical services and quality that is less
than 85% for plans in the large group market and 80% for
plans in the individual and small group markets.
Requirement to report medical loss ratio effective plan
year 2010.
2011
Medicare
Prohibit Medicare Advantage plans from imposing higher
cost-sharing requirements for some Medicare covered
benefits than is required under the traditional fee-forservice program.
UA'S/LNL'S UNIQUE
HDF & YOU – HOW
AGENTS CAN MAKE
$2,250 PER WEEK – BY
SELLING MORE THAN
JUST HDFs!!!
Please see below some logic to understand
EXCEPTIONAL opportunities for making
OUTSTANDING money on HDF and other
products – this is simply an illustration to make
you think as a BM, not to use as a training
piece. DO NOT FORWARD TO OTHERS.
Earnings on HDF and LIFE INSURANCE versus
PLAN F ONLY
EXAMPLE: T-65, FEMALE, NON-SMOKER, (HEAD OF
HOUSEHOLD), TEXAS
HDF, T-65, PREF MO PREM ANNUALIZED ANN COMM @ 40% PROD BON
TOTAL EARNED
LNL Plan F
$158
$1,896
$228 x 2 apps/wk = $456
12% = $228
n/a
LNL HDF
$50
$598
5 apps/wk = $450 FOR HDF
DIFFERENCE =
$108
$1,298
$6/wk – if only HDFs were sold…
MIN/MO to RFA: - $50
$600
SAVED PREM:
$58/mo
$696/yr
15% = $90
n/a
$138
n/a
n/a
n/a
$10K LNL Life 5RT: -$33/mo
-$396/yr
5 apps/wk = $1,800 FOR LIFE
$ Senior’s savings: $25/mo
$300/yr
Total:
$83/mo
$996
= $2,250/wk TOTAL L&H PAY
65% = $257
n/a
$347
$90 x
-
40% = $103 $360 x
+
n/a
$103 X 5 sales
Q: How is the interest in UA’s Reserve Fund Annuity calculated compounded daily, monthly, or
yearly? (with no lock-in time for deposits, no surrender charges and no commission load);
A: The interest accumulates daily, but is compounded on an annual yield.
FACTS AS WE KNOW THEM, FOR YOU TO CONSIDER WHY HDF WITH THE
RESERVE FUND ANNUITY IS A GREAT MARKETING PLAN:
(NOT TO BE USED FOR PRESENTATIONS)
1.
WE KNOW OF NO OTHER COMPANY THAT HAS A RESERVE FUND
ANNUITY (RFA) ON HDF - RARE MARKETING ADVANTAGE USING THE RFA.
2.
TURNING-65 (T-65) SENIORS ARE HEALTHIEST BECAUSE THEY ARE
THE YOUNGEST. WHEN YOU DO A 5-YEAR LOOK BACK ON
HOSPITALIZATIONS AND DOCTORS VISITS TO DETERMINE HDF
SUITABILITY, MOST WILL SEE IT MAKES SENSE TO HAVE HDF INSTEAD OF
PLAN F, TO HAVE A CHANCE NOT TO SPEND EXTRA MED-SUP PREMIUMS
NEEDLESSLY.
3.
T-65 SENIORS ARE NOT AS CONCERNED WITH HIGHER
DEDUCTIBLES - THEY ARE MORE FAMILIAR WITH HIGH DEDUCTIBLES
NOW, DUE TO MAJ-MED DEDUCTIBLES MORE RECENTLY EXPERIENCED IN
THE LAST FEW YEARS. MANY DEDUCTIBLES AVERAGED UP TO $2,500 $5,000 - UNLIKE A FEW YEARS AGO. OVERALL, HDF IS PERFECT FOR
HEALTHY PROSPECTS.
4.
T-65 HDF RATES WITH UA/LNL ARE LOW (AND T-65 HDF HAS
HIGHER COMMISSION RATES THAN F).
5.
T-65 SENIORS ARE NOT YET LOCKED INTO MA’s (MEDICARE
ADVANTAGE) – THEREFORE, A HIGHER # OF ‘MEANINGFUL’
PRESENTATIONS WILL RESULT BY WORKING T-65s – THE NEW AGENT
WON’T GET TURNED DOWN AS OFTEN.
6.
T-65 SENIORS DO NOT HAVE A CURRENT MED-SUP - WITH ANY
COMPANY – NO ‘PRICE-SHOPPING’ PROBLEMS.
7.
WRITING T-65 COUPLES WITH DIFFERENT HEALTH HISTORIES
MAKES IT MUCH MORE DIFFICULT TO TEACH A NEW AGENT TO
MANUEVER THROUGH THIS POTENTIAL “PRESENTATION MINEFIELD” (I.E.
WHEN WE TRY TO SELL AN HDF TO ONE SPOUSE AND AN F TO THE
OTHER).
8.
THERE ARE MORE T-65 FEMALES PROSPECTS THAN T-65 MALES.
9.
T-65 FEMALES WHO ARE HEAD-OF-HOUSEHOLD HAVE ASSETS ON
TOP OF INCOME FOR MULTIPLE-PRODUCT PURCHASES, BY
VIRTUE OF:
A) ASSETS THEY SAVED OR
B) ASSETS THEY INHERITED FROM PARENTS OR
C) ASSETS THEY INHERITED FROM SPOUSE OR
D) ASSETS THEY RECEIVED THROUGH DIVORCE (AVG 50%
DIVORCE RATE NATIONALLY).
10.MULTIPLE-PRODUCT PURCHASES: HDF, WHEN COUPLED
WITH THE DFA, CAN FREE UP UNSPENT PREMIUM FOR THE CUSTOMER TO
BUY ADDITIONAL COVERAGE, AS WELL AS SENIOR AND
COMMISSIONS/BONUSES FOR THE AGENT/MGR. PRODUCT EXAMPLES:
HDF AT 15% COMMISSION, LIFE AT 65% COMMISSION & 40%
PRODUCTION BONUS
11.T-65 LIFE INSURANCE IS EASIER TO QUALIFY FOR, BASED ON YOUNGER,
HEALTHIER AGES ON AVERAGE.
12.T-65 PROSPECTING LIST: THEREFORE, FOCUSING ON T-65
FEMALES, ‘HEAD OF HOUSEHOLD’, >$20K ANNUAL
INCOME ALLOWS NEW AGENTS TO MORE EASILY LEARN HOW TO
PRESENT HDF AND SELL ADDITIONAL PRODUCTS, WITH MANY MORE
“VIABLE” PRESENTATIONS. GET THIS DRILL-DOWN LIST FROM
YOUR BRANCH’S SALES GENIE SITE.
13.
THE UA-HDF RESERVE FUND INTEREST RATE AT 3%
PAYS HIGHER INTEREST RATES THAN CURRENT SAVINGS
ACCOUNT RATES BEING PAID AT MANY, MANY BANKS- (NO
“LOCK & LOAD” – i.e. no lock-in time for deposits, no
surrender charges and no commission loads on the Reserve
Fund Annuity):
Q: How is the interest in UA’s Reserve Fund Annuity calculated (with no
lock-in time for deposits, no surrender charges and no commission load); is it
compounded daily, monthly, or yearly?
A: The interest accumulates daily, but is compounded on an annual yield.
For an idea, CALCULATE $4,000 PER YEAR, placed in RFA @ 3% INTEREST at the
beginning of each year:
(NOT TO BE USED FOR PRESENTATIONS)
http://www.moneychimp.com/calculator/compound_interest_calculator.htm
Inputs
Current Principal:
Annual Addition:
Years to grow:
Interest Rate:
Compound interest time(s) annually
Make additions at start end of each compounding period
Future Value:
$
$
%
$
COMPARE OUR HDF RESERVE FUND ANNUITY RATE OF 3% TO THE
SAVINGS ACCOUNT RATES SEEN BELOW.
SAVINGS/MMA ACCOUNT RATE EXAMPLES FROM
DALLAS MORNING NEWS AS OF 4/1/10:
(NOT TO BE USED FOR PRESENTATIONS)
Institution
Intro Rate
Savings Ally Bank
Posted: 04/01/10
MMA
MMA
MMA
MMA
MMA
Savings
MMA
Savings
Savings
Savings
MMA
Intro Mos
0.00
Ally Bank
Posted:
0.00
04/01/10
EverBank
Posted:
2.25
04/01/10
MetLife Bank,
NA
0.60
Posted:
04/01/10
Beal Bank, SSB
Posted:
0.00
04/01/10
Colonial
Savings, FA
0.00
Posted:
04/01/10
ViewPoint Bank
Posted:
0.00
04/01/10
OmniAmerican
Bank
0.00
Posted:
04/01/10
Beal Bank, SSB
Posted:
0.00
04/01/10
Colonial
Savings, FA
0.00
Posted:
04/01/10
Southwest
Securities, FSB
0.00
Posted:
04/01/10
Bank of America0.00
Rate Post
Intro
0
CM APY
1.28
D
Min Bal
Open
1.29
Min Bal Avoid
Fees
$0
Mthly
Fees
0.00
0.00
0
1.28
D
1.29 $0
0.00
0.00
3
1.25
D
1.26 $1,500
5000.00
8.95
0
0.60
D
0.60 $5,000
0.00
0.00
0
0.50
M 0.50 $1,000
1000.00
10.00
0
0.50
D
0.50 $2,500
2500.00
10.00
0
0.30
D
0.30 $250
250.00
3.00
0
0.25
M 0.25 $1,000
2500.00
10.00
0
0.25
Q
0.25 $500
500.00
3.00
0
0.25
D
0.25 $50
300.00
3.00
0
0.15
Q
0.15 $200
200.00
5.00
0
0.15
D
0.15 $25
5000.00
10.00
Institution
MMA
MMA
Savings
MMA
Savings
Savings
Savings
Savings
MMA
MMA
MMA
Savings
Intro Rate
Intro Mos
Posted:
04/01/10
BBVA Compass
Posted:
0.00
04/01/10
Southwest
Securities, FSB
0.00
Posted:
04/01/10
BBVA Compass
Posted:
0.00
04/01/10
ViewPoint Bank
Posted:
0.00
04/01/10
Bank of America
Posted:
0.00
04/01/10
OmniAmerican
Bank
0.00
Posted:
04/01/10
Frost National
Bank
0.00
Posted:
04/01/10
Wells Fargo
Bank
0.00
Posted:
04/01/10
Frost National
Bank
0.00
Posted:
04/01/10
Wells Fargo
Bank
0.00
Posted:
04/01/10
Chase Bank
Posted:
0.00
04/01/10
Chase Bank
Posted:
0.00
04/01/10
Rate Post
Intro
CM APY
Min Bal
Open
Min Bal Avoid
Fees
Mthly
Fees
0
0.10
M 0.10 $25
10000.00
15.00
0
0.10
M 0.10 $600
1500.00
15.00
0
0.10
Q
0.10 $25
500.00
12.00
0
0.10
D
0.10 $2,500
2500.00
5.00
0
0.10
D
0.10 $25
300.00
5.00
0
0.10
Q
0.10 $100
250.00
3.00
0
0.05
Q
0.05 $50
500.00
3.50
0
0.05
D
0.05 $100
300.00
3.00
0
0.05
D
0.05 $50
2500.00
12.00
0
0.05
D
0.05 $100
3500.00
10.00
0
0.01
M 0.01 $25
1500.00
12.00
0
0.01
D
300.00
4.00
0.01 $25
BESIDES LOW INTEREST RATES, SAVINGS
ACCOUNTS ARE FDIC INSURED UP TO A
MINIMUM OF $100,000 - BUT COULD IT
TAKE TIME TO WITHDRAW, DEPENDING
ON THE SCOPE OF A PARTICULAR SET OF
CIRCUMSTANCES???
(NOT TO BE USED FOR PRESENTATIONS)
LOOK AT WHAT CNN-MONEY SAYS:
Banks at risk of going bust
tops 700
The number of lenders on the FDIC's watch list continued to mount as
banks grapple with loan troubles.
By David Ellis, staff writer
February 23, 2010: 11:36 AM ET
NEW YORK (CNNMoney.com) -- More than 700 banks, or nearly one out of every 11, are at
risk of going under, according to a government report published Tuesday.
The Federal Deposit Insurance Corp. said that the number of banks on its so-called "problem
list" climbed to 702, its highest level since June 1993.
The number of banks under scrutiny by regulators has moved steadily higher since the
recession began. Just 76 financial institutions were on the list in the fourth quarter of 2007.
Banks that end up on the problem list are considered the most likely to fail because of
difficulties with their finances, operations or management.
Still, few of the lenders that are on the list actually reach the point of failure. In fact, just 13%
of banks on the list have been seized and shuttered by regulators.
The names of the banks on the list are never made available to the
general public by regulators out of fear that depositors at those
institutions may prompt a so-called "run on the bank."
Banks have been hit hard by the troubles in the broader economy. Nearly a third of the more
than 8,000 lenders across the country reported a loss for the year, the FDIC reported
Tuesday.
But FDIC Chairman Sheila Bair acknowledged that while lenders are still grappling with rising
losses and delinquent customers, the industry has managed to stage a dramatic comeback
over the past year.
Banks collectively reported a relatively small profit of $914 million in the fourth quarter of
2009. During the fourth quarter of 2008, banks lost a combined $32.1 billion.
0:00 /5:55Why more banks will fail in 2010
"Usually a lack of profits is not considered a good result, but compared to the record loss the
industry reported a year ago it represents a significant improvement," she said during a
press conference Tuesday.
But there is no indication things will improve anytime soon for the country's top banking
regulator. With the FDIC having shuttered 20 banks so far this year, it is on track to seize at
least as many financial institutions, if not more, as it did in 2009. Last year, the FDIC shut
down a total of 140 lenders nationwide.
Bair confirmed that the pace of bank failures would pick up this year, which would likely put a
further strain on the agency's deposit insurance fund.
This fund, which covers customer deposits when a bank fails, slipped into red last fall for the
first time since 1991. The fund's deficit continued to balloon in the fourth quarter to nearly
$21 billion - its largest deficit on record.
Last year, the agency took a variety of steps to help shore up the fund, including imposing a
special assessment on all banks and having lenders prepay their insurance premiums for the
next three years.
Bair said Tuesday that these steps, combined with some improvement in the sector, should
mean that the fund will be able to handle further bank failures.
"Assuming we don't have a significantly more adverse scenario than most people think, I
think we will be in good shape this year and we will start seeing the deposit insurance fund
balance go back up toward the end of the year," she said.
HERE’S A LIST OF 30 BANKS THAT
ALREADY FAILED - SO FAR IN 2010:
(NOT TO BE USED FOR PRESENTATIONS)
Over 30 U.S. Banks Have Failed So Far in
2010
Mar 16, 2010
2010 list of failed banks
Failed bank
Date closed
Estimated cost to DIF ($millions)
Desert Hills Bank, Phoenix, AZ
3/26/2010
106.7
Unity National Bank,
Cartersville, GA
3/26/2010
67.2
Key West Bank, Key West, FL
3/26/2010
23.1
McIntosh Commercial Bank,
Carrollton, GA
3/26/2010
123.3
State Bank of Aurora, Aurora,
MN
3/19/2010
4.2
First Lowndes Bank, Fort
Deposit, AL
3/19/2010
38.3
Bank of Hiawassee, Hiawasssee,
GA
3/19/2010
137.7
Appalachian Community Bank,
Ellijay, GA
3/19/2010
419.3
Advanta Bank Corp, Draper, UT
3/19/2010
635.6
Century Security Bank, Duluth,
MN
3/19/2010
29.9
Statewide Bank, Covington, LA
3/12/2010
38.1
Old Southern Bank, Orlando, FL
3/12/2010
94.6
The Park Avenue Bank, New
York, NY
3/12/2010
50.7
LibertyPointe Bank, New York,
NY
3/11/2010
24.8
Centennial Bank, Ogden, UT
3/5/2010
96.3
Waterfield Bank, Germantown,
MD
3/5/2010
51
Bank of Illinois, Normal, IL
3/5/2010
53.7
Sun American Bank, Boca Raton,
FL
3/5/2010
103.8
Rainier Pacific Bank, Tacoma,
WA
2/26/2010
95.2
Carson River Community Bank,
Carson City, NV
2/26/2010
7.9
La Jolla Bank, F.S.B., La Jolla,
CA
2/19/2010
882.3
George Washington Savings
Bank, Orland Park, IL
2/19/2010
141.4
The La Coste National Bank, La
Coste, TX
2/19/2010
3.7
Marco Community Bank, Marco
Island, FL
2/19/2010
38.1
First American State Bank of
Minnesota, Hancock, MN
2/05/2010
3.1
American Marine Bank,
Bainbridge Island, WA
1/29/2010
58.9
First Regional Bank, Los Angles,
CA
1/29/2010
825.5
Community Bank and Trust,
Cornelia, GA
1/29/2010
354.5
Marshall Bank, N.A., Hallock,
MN
1/29/2010
4.1
Florida Community Bank,
Immokalee, FL
1/29/2010
352.6
First National Bank of Georgia,
Carrollton, GA
1/29/2010
260.4
Columbia River Bank, The
Dalles, OR
1/22/2010
172.5
Evergreen Bank, Seattle, WA
1/22/2010
64.2
Charter Bank, Santa Fe, NM
1/22/2010
201.9
Bank of Leeton, Leeton, MO
1/22/2010
8.1
Premier American Bank, Miami,
FL
1/22/2010
85
Town Community Bank & Trust,
Antioch, IL
1/15/2010
17.8
St. Stephen State Bank, St.
Stephen, MN
1/15/2010
7.2
Barnes Banking Company,
Kaysville, UT
1/15/2010
271.3
Horizon Bank, Bellingham, WA
1/08/2010
539.1
FINANCIAL STRENGTH: A+ SUPERIOR
Liberty National has an A+ (Superior) Financial Strength Rating by
A.M. Best Company
According to A.M. Best: The rating of Liberty National
Life Insurance Company reflects the company's strong
earnings, favorable capitalization, and high credit quality
bond portfolio. This rating also acknowledges the strong
financial support of the Torchmark Corporation and
Liberty National's established position.
For more than 30 consecutive years, Liberty National has earned the A+ (Superior)
Financial Strength Rating from A.M. Best Company (as of 06/09).
We are also rated AA- "Very Strong" for Financial Strength by Standard & Poor's (as of
12/08).
Additionally, Liberty National Life has once again been recognized as one of the Ward's 50
Benchmark Group of life-health insurers based on safety, consistency, and performance.
Industry Ratings
A+ (Superior)
A.M. Best Company - more than 30 consecutive years for Company financial
strength
Superior companies are defined by A.M. Best as having achieved superior overall
performance when compared to Best's standards. These companies have a very
strong ability to meet their policyholder and other contractual obligations over the
long term. (as of 6/09)
AA- "Very Strong"
Standard & Poor's - financial strength
Very Strong companies are defined by Standard & Poor's as offering very strong
financial security. The capacity to meet policyholder obligations is strong for
these companies under a variety of economic and underwriting conditions. (as of
12/08)
These ratings refer only to the overall financial strength of the company and are not a recommendation of the
specific policy provisions, notes or practices of the insurance company.
Guaranty Funds and Guarantee Associations
(NOT TO BE USED FOR PRESENTATIONS)
What happens when an insurance company is declared insolvent? The mechanism
which protects policyholders is called the "State Guaranty Fund" or Guarantee
Association system. All fifty states and the District of Columbia operate guaranty
funds which may pay the claim of a financially-impaired company that operates in
their state. You are strongly advised to contact your state association to obtain
current information for your specific financial situation. This web site is not to be
held responsible for the accuracy of the information in this table. A good source
for further information about the state guaranty funds is the National Organization
of Life and Health Insurance Guaranty Associations (www.nolhga.com).
Important Disclaimer --- Insurance companies and insurance agents are
prohibited by law from using the existence of the state guaranty associations as
an inducement to sell you insurance or annuities. The guaranty funds should not
be a substitute for selecting an insurance company which is well-managed and
financially stable.
ESTIMATED COVERAGE OFFERED BY THE STATE GUARANTY
ASSOCIATIONS
State
Estimated coverage for an annuity
Alabama
$300,000 in annuity benefits; $100,000 in net cash surrender value
Alaska
$100,000 in the present value of annuity benefits
Arizona
$100,000
Arkansas
$300,000 in present value annuity benefits
California
Present value of annuity benefits including net cash surrender and net cash
withdrawal values: 80% of the present value up to a maximum of $100,000
Colorado
$100,000 in present value of annuity benefits, including net cash surrender
and net cash withdrawal values
Connecticut
$500,000 in present value of annuity benefits
Delaware
$100,000 in present value of annuity benefits
Dist. of Col.
$300,000 in present value of annuity benefits
Florida
$300,000 in annuity benefits; $100,000 in net cash surrender value
Georgia
$300,000 in present value of annuity benefits; $100,000 in net cash
surrender
Hawaii
$100,000 in the present value of annuity benefits
Idaho
$250,000 in net cash surrender or net cash withdrawal values
Illinois
$100,000 in present value of the annuity benefits per annuitant, including
net cash surrender and withdrawal values
Indiana
$100,000 in present value of annuity benefits
State
Estimated coverage for an annuity
Iowa
$250,000 in present value of annuity benefits, including net cash surrender
and net cash withdrawal values
Kansas
$100,000 in present value of annuity benefits
Kentucky
$100,000 in the present value of annuity benefits including net cash
surrender and net cash withdrawal values
Louisiana
$250,000 in present value of annuity benefits
Maine
$250,000 of annuity benefits, including net cash surrender and net cash
withdrawal values
Maryland
$100,000 in present value of annuity benefits, including net cash surrender
and net cash withdrawal values
Massachusetts $100,000 in present value of annuity benefits
Michigan
$250,000 in present value of individual qualified retirement annuities
(issued under section 403(b), 408, or 408A of the Internal Revenue Code),
and $100,000 in present value of all other annuities
Minnesota
$250,000 net cash surrender value; $410,000 in present value if with a
period certain benefit of at least ten years to life
Mississippi
$100,000 in present value of annuity benefits
Missouri
$100,000 in present value of annuity benefits
Montana
$100,000 in present value of annuity benefits
Nebraska
$100,000 in present value of annuity benefits
Nevada
$100,000 in present value of annuity benefits
New
Hampshire
$100,000 in present value of annuity benefits
New Jersey
$500,000 in present value of annuity benefits; $100,000 in net cash
State
Estimated coverage for an annuity
surrender
New Mexico
$100,000 in cash or cash surrender value
New York
$500,000 in present value of annuity benefits
No. Carolina
$300,000 in present value of annuity benefits
North Dakota
$100,000 in present value of annuity benefits
Ohio
$100,000 in present value of annuity benefits
Oklahoma
$300,000 in present value of annuity benefits
Oregon
$100,000 in present value of annuity benefits
Pennsylvania
$300,000 in annuity benefits, including $100,000 in net cash values
Rhode Island
$100,000 in present value of annuity benefits
So. Carolina
Aggregate of $300,000
South Dakota
$100,000 in present value of annuity benefits per contract owner
Tennessee
$250,000 in present value of annuity benefits
Texas
$100,000 per insured life (per annuitant)
Utah
$200,000 in present value of annuity benefits
Vermont
$250,000 in present value of annuity benefits
Virginia
$100,000 in present value of annuity benefits
Washington
$500,000 in present value of annuity benefits
West Virginia
$100,000 in present value of annuity benefits
State
Estimated coverage for an annuity
Wisconsin
$300,000 in present value of annuity benefits
Wyoming
$100,000 in present value of annuity benefits, including net cash surrender
and net cash withdrawal values
From: King, Andy
Sent: Thursday, April 01, 2010 11:53 AM
Subject: MUST READ ----NEW UA/LNL MEDICARE SUPPLEMENT OPPORTUNITIES - RECRUITING COULD
NOT BE EASIER - RIGHT NOW!
To: ALL UA/LNL CROSS-SELL AND CONVERSION BMs
FROM: ANDY KING
RE: NEW MEDICARE SUPPLEMENT OPPORTUNITIES
SEE THE ARTICLE BELOW AND ATTACHED!!!!
Beyond the examples sent earlier of how healthcare reform is
causing great reductions of commissions for Agents
selling Maj-Med plans, there’s even
more marketing and
recruiting gifts from the healthcare overhaul for you –
FOR
MED-SUP - WHICH WILL MAKE RECRUITING
easier than it’s ever been - like shooting fish in a barrel!!!
Please see an article below outlining EXTREME pressures being faced
by Medicare Advantage companies, as the President and Congress
continue to slash government MA reimbursement rates. Remember,
their mission is to cut MA costs to bring them into line with
Traditional Medicare, which makes YOUR Medicare Supplements far
more attractive as they cut benefits – with provider restrictions - and
raise both premium rates and out-of-pocket costs too. With our new
LNL Med-Sup rates and plans now being introduced, as well as a new
HIGH-POWERED HDF Marketing STRATEGY (soon coming your way by
separate email), things could not be shaping up any
better for us!!! There will be as many as 10.2 million MA
beneficiaries disenrolling in the next few years – NOW is the time to
recruit in preparation – the vets will remember our rallying cry during
the old HMO disenrollments, when we had year-over-year increases
for three CONSECUTIVE years of 55%, 52% and 46%!!!! WHAT A
GREAT WAY TO BUILD A HUGE RENEWAL ACCOUNT!
RECRUITING COULD NOT BE
EASIER - RIGHT NOW!
And the BEST PART is that we are now one of the only Med-Sup
companies left - in all of America - that DOES NOT cut off ALL
renewals at the 5th renewal year! That’s not our way - but it SURE IS
for other companies, who began doing this years ago… now, their
agents are in a box – a REAL FINANCIAL FIRESTORM – just
after a HUGE recession that already affected their assets!!! For those
with ANY sense, they’ll want to get their customers BACK into OUR
plans WHICH DO NOT cut off their renewals on their
5th renewal year!!! Many of these agents are BOOMER AGE
agents – who would like to soon retire. How CAN they retire
that when 1/5th of their renewals roll off each year?
After all, average mortality says a senior at age 65 will live ANOTHER
18.6 YEARS – how could they be so short-sighted to sacrifice nearly
3/4ths of their in-force premiums’ renewal streams?? Do the math –
these agents will only get 5 years of renewals on another 18.6 years of
a senior’s life… they can only get 26.8% of the 18.6 years of
renewals!!! They’ll have to work until they also reach end-life
mortality, like a rat on a treadmill! If they don’t have a 20% increase in
sales each year, THEY MAKE LESS MONEY!!! WHO GETS THEIR
RENEWALS – THEIR “CHEAP” COMPANY DOES!!!
“CHEAP” HAS MANY CONNOTATIONS, DOESN’T IT?
Just how much PERSONAL “SERVICE” will a senior get when the agent
gets ZERO renewals – what a POINT for the customer, IF THEY ONLY
KNEW!!! UA/LNL is willing to an agent to service seniors - much, much
longer - because WE CARE ABOUT CONTINUED
PERSONAL SERVICE FOR SENIORS – we don’t want
an agent to FEEL like they have to try to roll
customers just to get continued renewal
commissions!!! What a terrible business model!!!
And so, the spending and healthcare overhaul trends continue – this
helps our MED-SUP SALES TREMENDOUSLY! TO QUOTE:
‘But now’s the party’s over….Previous cuts by
Congress caused a rise in premiums for millions of
seniors, as well as a reduction of benefits, or “loss
of their coverage altogether…”’
Thank you, Mr. President!!! I may become a Democrat after all!
Andy
See THE ARTICLE BELOW!!!