20. March 2019 12:31
by John

11 Things You Should Know About Cobra Health Insurance

20. March 2019 12:31 by John | 0 Comments

What you don't know about COBRA could come back to bite you.

If you've lost or left a job and have employer-sponsored health insurance, you'll likely be offered something called COBRA. This extends your employer-sponsored health insurance for a period that typically lasts 18 months.

Here are 11 things you should know about COBRA coverage:

1. What is COBRA?

COBRA is a federal law designed to let you pay to keep you and your family on your employer-sponsored health insurance for a limited time after your employment ends or you otherwise lose coverage.

2. What does COBRA stand for?

COBRA is an acronym for the Consolidated Omnibus Budget Reconciliation Act, the federal law that also amended ERISA to enable temporary health insurance for people who have lost or left their jobs. The law took effect in 1985.

3. Who is eligible for COBRA?

People who qualify for COBRA include employees who have voluntarily or involuntary lost their jobs, had their work hours reduced, are transitioning between jobs, or have experienced a life-changing event such as a death or divorce. This coverage is available to covered employees, their spouses, their former spouses, and their dependent children. Each year, about 3 million individuals and families use COBRA benefits.

4. How will you learn about your COBRA eligibility?

You'll receive a letter from the employer or the health insurer outlining your COBRA benefits.

HR director at Seattle-based real estate developer Geonerco Management, warns that the six-to eight-page letter can be difficult to understand “because it contains all manner of mandatory government language." If you're having trouble deciphering that language, contact the employer's HR department or the insurer.

5. Which employers are required to offer COBRA?

Generally, COBRA requires that group health plans sponsored by employers with at least 20 employees (in the previous year) must offer employees and their families the opportunity to temporarily extend their health insurance in circumstances like the ones outlined above. State and local government agencies also fall under the COBRA umbrella. Some states have COBRA-type laws that apply to employers with fewer than 20 employees.

6. Which employers are not affected by COBRA?

The law does not apply to health insurance plans sponsored by the federal government, churches, and certain church-related groups. However, federal employees are covered by a law similar to COBRA.

7. How much does COBRA cost?

The cost depends on how much insurance coverage you received from your previous employer. If you decide to accept COBRA coverage, you'll pay up to 102 percent of the insurance premiums, including the portion that your employer used to pay. In 2012, the average COBRA premiums for a family plan totaled $15,745, plus the 2 percent fee.

For some, the steep increase in financial responsibility that accompanies a COBRA plan is not always realistic—especially when unemployed. The Affordable Care Act marketplace offers alternative coverage options that can be “a lot cheaper, particularly with tax credits,” says Ivan Williams.

8. What sort of benefits will you get under COBRA?

Once you choose COBRA coverage, you retain the same rights as an employee who remains with the employer sponsoring the insurance, Szymanski says. “That means that you must go through open enrollment, which may change insurance companies, benefits offered, pricing and coverage," he says.

9. What are some alternatives to COBRA?

If you reject COBRA coverage, your health coverage options include your spouse's health insurance plan, the federal government's health insurance marketplace, your state's health insurance marketplace, the government-backed Medicaid program, or a short term medical policy designed for gaps in health coverage. These alternatives may or may not cost less than COBRA coverage, so it pays to weigh all of your options.

One option that Szymanski doesn't recommend: skipping health insurance altogether. “Electing to go uninsured is almost always a very unwise decision, with lots of potentially catastrophic downsides and very little upside," he says.

10. What if you change your mind and decide you want COBRA?

If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days. If you decline COBRA coverage during the normal 60-day decision period, you must be allowed to rescind your coverage waiver. However, you must reverse your decision during that period, and your final decision will become permanent after the 60-day window closes.

11. What happens if you miss a COBRA payment?

Szymanski cautions that you must pay premiums (usually via monthly checks sent by regular mail) in a timely manner (often a grace period of 30 days) or your coverage will be canceled.

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18. March 2019 11:56
by John

3 Ways Life Insurance Can Benefit a Charity You Love

18. March 2019 11:56 by John | 0 Comments

Would you like to make a charitable gift to help organizations or people in need; to support a specific cause; for recognition such as a naming opportunity at a school or university? Perhaps you would do it just for the tax incentives. There are any number of reasons, and life insurance can be one of the most efficient tools to achieve these purposes. So the question becomes, how does this work?

Let me list the ways.

1. Make a charity the beneficiary of an existing policy. Perhaps you have a policy you no longer need. Make the charity the beneficiary, and the policy will not be included in your estate at your death. This also allows you to retain control of both the cash value and the named beneficiary. If you want or need to change the charity named as beneficiary, you can.

2. Make a charity both the owner and beneficiary of an existing policy. This gives you both a current tax deduction along with removing the policy from your estate. Once you gift the policy, you no longer have any control over the values.

3. Purchase a new policy on your life. Life insurance is an extremely efficient way to provide a large future legacy to a charity in your name without needing to write the large checks now. The premiums are given directly to the charity which then pays the premiums on the policy. The charity also owns the cash value as an asset. I am using this concept in my own planning.

Many charities would prefer to have their money upfront, but if you cannot write that large check or don’t want to part with your cash today, a gift of life insurance is a most efficient method to leave a large legacy in your name.

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7. March 2019 19:10
by Ammelia

Life Insurance After Heart Bypass Surgery

7. March 2019 19:10 by Ammelia | 0 Comments

After a major life event like bypass surgery, it’s understandable that you’d be in a hurry to buy life insurance as soon as possible. This is often a mistake. Life insurance companies will see your past surgery and this could prevent you from receiving a policy.

To qualify for insurance after a bypass, you need to plan right and fill out a good application. To get you ready, here is a review of the insurance guidelines for after bypass surgery as well as some tips to help you with your application.

When you’re shopping for life insurance protection, there are dozens of different factors that you’ll need to consider. It can be a confusing and difficult process, especially if you’ve had a bypass surgery in the past. Life insurance is one of the most important purchases that you’ll ever make for your loved ones, and your health shouldn’t keep you from getting the protection that your family deserves.

Life Insurance Underwriting after Bypass Surgery

When you apply for life insurance, you’ll need to answer several questions about your bypass surgery for your application. You’ll need to answer:

  • What did you have your bypass surgery?
  • Why did you need to have bypass surgery? Was it an elective or emergency procedure?
  • Have you ever had any other types of heart surgeries like a heart valve replacement?
  • Were there any complications after the surgery like internal bleeding, cardiac tamponade, or a stroke?
  • Do you have any other high risk factors for heart disease like smoking, high cholesterol, or high blood pressure?
  • Do you have a history of heart disease?
  • What medications are you taking because of the bypass surgery?

Common medications for after a stroke include: Clopidogrel, Beta blockers, Nitrates, ACE inhibitors, and Lipids.  All of these medications for a stroke could be insurable depending on your health after the surgery.

Be sure to answer all these questions in detail for your application. For life insurance underwriting, more information is better. If an underwriter felt your application was incomplete, especially after something major like bypass surgery, there’s a good chance you’d get a poor rating or a denial.

Life Insurance Quotes after Bypass Surgery

If you’ve had bypass surgery, it’s very important to delay your life insurance application for some time after your surgery. This is because life insurance companies typically deny applicants that just had bypass surgery; there are too many complications that can come up. It’s best to wait at least 6 months to a year before applying.

When you apply, insurance companies will review the details of your bypass surgery as well as your overall health to make a decision. Your rating would depend on how well the surgery went as well as whether you are taking steps to avoid future heart problems. While each insurance company uses slightly different underwriting standards, here are some general guidelines to help you estimate what rating you’ll get for your life insurance.

  • Preferred Plus: It’s not possible to get a preferred plus rating after bypass surgery, even if you are healthy and the procedure went well. There is just too high a chance of future heart problems for insurance companies to be willing to give the best rating.
  • Preferred:  Also usually impossible for applicants that have had bypass surgery. In very rare cases, someone that had an elective bypass and was otherwise in perfect health might qualify for a preferred rating, but this is not something you should expect.
  • Standard:  The best possible rating for most applicants after a bypass surgery. Applicants need to have waited at least a year after the surgery and be in perfect health otherwise. The bypass surgery also must have been a minor procedure, like elective surgery to get around a blockage early.
  • Table Rating (substandard):  A table rating is the most likely rating for applicants that have had bypass surgery. Applicants should have waited at least 6 months after their surgery to qualify. Rating will depend on the severity of the bypass surgery, whether there were any complications, whether the applicant had other procedures like a heart valve replacement, and the applicant’s general health and family history.
  • Declines: Applicants that apply within 6 months of their bypass surgery. Also, applicants that aren’t regularly seeing their doctor, have a history of serious heart problems, and/or have heart risk factors like smoking or high cholesterol could also be denied.

Bypass Surgery Case Studies

If you’ve had bypass surgery, it’s very important that you plan your application right. Here are a couple real life examples that show the difference your application can make.

Case Study #1: Female, 63 y/o, non-smoker, had bypass surgery for a small blockage at 61, tried applying right away and was denied, otherwise in good health.

This client has a small valve blockage a few years ago that she decided to have removed through elective bypass surgery. Immediately after the procedure, she tried to buy more life insurance. Since she didn’t give anytime between her procedure and her application, the insurance company denied her application. At this point, the client thought she couldn’t get coverage. After contacting us, we recommended she try again. Since she had waited the appropriate amount of time, she qualified for a standard policy this time around.

Case Study #2:  Male, 57 y/o, needed bypass surgery at 54, former smoker, recently lost weight and reduced cholesterol levels, taking lipids for cholesterol.

This applicant had an unhealthy lifestyle. He smoked, had a poor diet, and didn’t exercise. This lifestyle eventually forced him to have bypass surgery. After the surgery, this client started living a much healthier life. He also started taking lipids for his cholesterol, as this was a big part of why he had heart problems.

Despite these improvements, this applicant still had trouble getting life insurance. We believed this was because insurance companies were too focused on his past history. We recommended this applicant meet with his doctor and get a note vouching for his improved health. By reapplying with this note, the applicant got a Table Level 2 Policy, a decent rating for someone in his condition.

As you can see from the examples, there are dozens of different factors that the insurance company is going to look at, and every applicant is going to be different. There are no two applications that are the same, and every company is going to view your application differently. Some insurance companies are going to view a history with a bypass survey more favorably than other companies are going to. Finding the right company could be the difference in getting approved for affordable coverage or getting a plan that’s going to break your bank every month.

Getting Affordable Life Insurance Coverage After Bypass Surgery

As an applicant with a bypass surgery in the past, you’re going to be facing higher premiums, but that doesn’t mean that you have to purchase a policy that is going to break your bank every month. There are several ways that you can get lower insurance rates for your coverage.

The first thing that you should do is cut out any tobacco. Using tobacco is hands-down one of the worst things that you can do for your life insurance premiums. In fact, anyone that uses tobacco is going to pay twice as much for their plan versus what a non-user is going to pay for the same sized plan.

Another way to save money on your life insurance protection is to improve your health. As a person with a bypass surgery, you’ve already have one red flag on your application, which means it’s important that you improve the rest of your overall health. Starting a healthy diet and getting regular exercise can help you lose weight, lower your cholesterol, and a whole host of other health benefits. All of these are going to translate into lower rates for your insurance coverage. If you want to save money every month on your coverage, it’s time to lace up your running shoes.

Comparing different policies is always going to be the best way to save money. As we mentioned, every company is different, and all of them are going to give you different premiums. You’ll get drastically varying rates based on the company that you get the quote from.

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11. December 2017 12:58
by Nicki

COBRA: One of Health Care’s Comfortable Commodities

11. December 2017 12:58 by Nicki | 0 Comments

With summer break upon us, most of us are reminded that home has its perks. Think back to your spring break vacation … Maybe you were stuck at the airport with your kids when their devices ran out of power. Or, maybe you spent hours in the car taking direction from a computer-generated voice telling you to turn in 0.5 miles. Every year, we crave an escape from our daily routines. Then, halfway through our vacations, we yearn for the comforts of home.

Now, take a moment to equate your last family travel experience with the current state of healthcare regulation. The Affordable Care Act (ACA) may have brought the change that some were craving, but the environment has now become a bit chaotic. Instead of craving change, we want reliable routines.

Fortunately, we still have COBRA. COBRA feels comfortable, sort of like home. With COBRA, you know what to expect. You mostly know the rules and how they will be applied. At one time, you might have been overwhelmed by COBRA concepts like qualifying events, applicable premiums, or election notices. However, now that you’ve made it through ACA compliance, COBRA administration is as easy as pie.

Now, you are COBRA-confident. You’ve got this. And, even if you don’t, the basic refresher below will bring it all into focus …

What is COBRA?

COBRA is the continuation of group health insurance by a qualified beneficiary who loses coverage due to a qualifying event. The qualified beneficiary must pay 102% of the cost of coverage.   

What Plans are Subject to COBRA?

COBRA applies to group health plans that provide medical care and are maintained by an employer. Examples of plans subject to COBRA include health plans; dental and vision plans; cancer (disease-specific) policies unless they are completely voluntary, employee-pay-all; prescription drug plans; health FSAs; HRAs; drug or alcohol treatment programs; wellness programs that offer physical exams, cholesterol screening, flu shots and nutrition counseling. 

Who is Eligible to Elect COBRA?

Qualified beneficiaries who are covered by a group health plan immediately before a qualifying event are eligible to elect COBRA. Qualified beneficiaries include a covered employee (including retirees, independent contractors, partners of a partnership – basically anyone provided coverage because they are performing or have performed services for the employer).  Qualified beneficiaries also include the spouse and dependent child of a covered employee.

What Triggers COBRA?

COBRA kicks in upon the occurrence of a qualifying event if that qualifying event causes a loss of coverage under the group health plan. There are seven qualifying events: (1) termination of the covered employee’s employment (other than for gross misconduct); (2) reduction in the covered employee’s hours of employment; (3) death of the covered employee; (4) divorce or legal separation from the covered employee; (5) ceasing to be a dependent child under the terms of the plan; (6) the covered employee becoming entitled to Medicare; and (7) the employer’s bankruptcy (only for retiree plans). 

Remember, the qualifying event must cause a loss of coverage. A loss of group health plan coverage means “to cease to be covered under the same terms and conditions as in effect immediately before the qualifying event.” This encompasses much more than simply losing group coverage entirely. For example, suppose a company has two plans for employees at different locations and the premiums are higher at one location. If an employee is transferred to the location with the more expensive plan and no longer qualifies for his or her current plan, the qualified beneficiaries have a COBRA right under the old plan.

What is the Maximum Duration of COBRA Coverage?

Generally, COBRA lasts for up to 18 months if the qualifying event is a termination of employment or a reduction of hours. COBRA can last for up to 36 months upon the death of an employee, divorce or legal separation, child’s loss of dependent status, or an employee’s entitlement to Medicare. COBRA for a disabled qualified beneficiary can extend up to 29 months. Finally, retiree coverage that terminates due to the employer’s bankruptcy can lead to COBRA for the life of the retiree plus 36 months for the spouse after the retiree’s death. If the retiree is not living when the bankruptcy occurs, but the surviving spouse is covered by the plan, the spouse gets COBRA for life. Keep in mind, there are many ways that COBRA can end early such as due to nonpayment of premiums. 

What COBRA Notices and other Plan Disclosures are Mandatory?

Notification drives COBRA. Some of the notices and communications that are mandatory include: the initial (General) notice; the election notice; the notice of unavailability of COBRA coverage; the notice of early termination; the notice of COBRA premiums short by an insignificant amount; open enrollment materials; individual conversion policy notices; summary plan descriptions; summary of benefits and coverage; summary of material modifications, and; a notice of change in COBRA premiums.

Just the Beginning

This basic refresher gets you through the front door, and comfortable with daily NEW LIFE INSURED routines. But like any home, NEW LIFE INSURED has its own nooks and crannies. If you venture into the basement or attic, you may encounter some scary topics including premium calculations, coverage terminations in anticipation of qualifying events, deadline calculations, notice contents, and let’s not forget Medicare! When these things come up, don’t go it alone. 


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4. October 2017 18:32
by Jamie

Beyond health insurance – the digital revolution

4. October 2017 18:32 by Jamie | 0 Comments

Today, more than half of the world’s population are active social media users, and on average people spend five years of their entire lifetime on social media. That includes approximately 35 minutes per day on Facebook. But what does all this mean for the future of health insurance? I will try to answer that in less time than it takes you to check your Facebook feed…

At last week's 9th Global Health Insurance Conference in Amsterdam, it was no surprise that the focus of events was on the impact of technology on the future of health insurance, with a mixture of both optimism and caution amongst participants. Whilst technology has the potential to open many doors for our industry, the sheer scale and pace of technological evolution means it can be difficult to make sense of the changing headwinds.

The health insurance industry has made significant strides in recent decades, with smartphone Apps and online member tools now considered the norm, while technological advancements continue to improve back office processes such as underwriting and claims management. However, we are still only at the start of this journey, and the next five years are likely to be game-changing for our industry. 

It was clear from discussion at the Conference last week that there are three key trends driving the digital global healthcare and insurance markets; namely wearables, big data and telemedicine. The industry is already facing increased competition in these areas, including from outside the traditional insurance sector, as new digital tools change the way consumers think about how they protect and manage their health.

Approximately one in six consumers currently own a wearable, and these devices continue to be integrated into health insurance plans to reward consumers for healthy behaviours. But in the near future the wearables of today will become obsolete, and health insurers will have to contend with new devices, such as digital contact lenses that monitor blood sugar levels, or clothes that record your heart rate when you run. Ultimately the rise of wearables presents significant opportunities for health insurers to better manage risks and keep premiums down for consumers.

More broadly, the true potential for wearables lies in the data they represent, which leads onto the next key trend – big data. With more than eight billion interconnected devices worldwide, business now have access to data on a scale that was previously unimaginable. Over the coming years, insurers and the healthcare sector more widely will need to significantly improve their ability to harness this data for commercial benefit; from customised product and marketing strategies for each individual, through to improved risk modeling tools to reduce loss ratios. 

Finally, the rise of telemedicine and mobile health is fundamentally changing the health insurance industry. While still relatively nascent, this technology has the potential to open up new markets by facilitating remote medical consultation for those living in poor or rural areas; increasing access to healthcare for groups who previously might not have been able to visit a doctor, let alone have health insurance.

More fundamentally, new technologies could help tackle the ever rising cost of healthcare and keep the costs of insurance claims down. Enhanced virtual care and monitoring services which spot early warning signs in high risk patients will help prevent the need for costly acute medical interventions. Meanwhile Apps that provide nutritional advice or support people to quit smoking could help address the growing danger from non-communicable diseases. Goldman Sachs has suggested the US alone could save US$300bn from digital health solutions, and the savings worldwide will be even more significant.

In summary, the future looks bright, with technology presenting significant opportunities for the industry as a whole. However, when dealing with people’s health and well-being, there is good reason to be cautious in the way we implement technological progress. Every week there is a new reminder of the vulnerabilities that technology can create. Given the sensitive nature of the data held by health insurers, ensuring effective protection of consumer information is paramount. This is not an issue that can be resolved overnight, and the industry must continue to collaborate and work with regulators to ensure the rules governing data protection are fit for purpose. 

So what does the future hold? One thing is clear – this is an ongoing journey. The health insurance industry will need to continue to innovate and adapt with the evolving technological landscape, and find new ways to meet the needs of our digitally savvy customers. Ultimately we must harness technology to go beyond the traditional parameters of health insurance, and deliver the truly integrated health solutions of the future. 

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15. September 2017 17:46
by John

How Do Smoking Cessation Products Affect Life Insurance Rates?

15. September 2017 17:46 by John | 0 Comments


Are you using cessation products to quit smoking?  There are ways for you to get great non-smoker prices on life insurance.  There are endless benefits to quitting a smoking habit.  It helps to increase both your lifespan and your wallet.  To quit smoking you need strong will power and sometimes the help of products whether those are gum, lozenges, patches, or e-cigarettes.  These products all contain nicotine and are used to wean your body off cigarettes while supplying you with the nicotine but sparing you from the other chemicals found in tobacco.

Because there is nicotine in these products, some life insurance companies will still classify you as a smoker even if you don’t actually smoke anything.  The use of these products will cause cotinine to show up in your urine test which would be enough for the carrier to classify you in one of the tobacco risk classes and issue you smoker rates.

Have no fear cessation product users!  There are insurance companies that will consider you for the non-tobacco risk classes and therefore be given non-smoker pricing.  To be offered non-smoker rates, you have to be cigarette-free for at least 12 months.  Let’s say you have been using a cessation gum to quit smoking, but you have only been cigarette-free for 5 months.  Even though you currently do not smoke, you will still get the smoker-rate because it has not yet been at least 12 months.  However, if you have been cigarette free for at least a year but still, for example, chew Nicorette Gum daily there are insurance carriers who will offer you non-smoker pricing.

Insurance carriers rate certain tobacco/nicotine uses differently.  While one company may give non-smoker rates to gum and e-cigarettes, another company may only give non-smoker rates to gum.  We asked 20 life insurance carriers if they would consider giving a non-tobacco risk class to an applicant who uses nicotine gum and four carriers said they would consider it.  Of these carriers, three said they would consider giving a non-tobacco risk class to e-cigarette users.

These examples explain why it is very beneficial for you to work with an independent life insurance agency, like Quotacy, who has contracts with multiple carriers.  It also shows how important it is for you to be very detailed about your tobacco and nicotine product use on your life insurance application.  If we have all the correct information we are able to go to the appropriate life insurance carrier to ensure you get the best policy for your individual situation.

You can still protect your loved ones with life insurance even if you use smoking cessation products, and what’s better is that there is even a possibility you can get great non-smoker rates.  No one ever anticipates needing to use life insurance, but the unexpected happens.

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