Announcement: Hiltz, Isabelle (Updated)

To our clients, colleagues, and business associates nationwide,
I have received a large number of questions regarding the situation described earlier this week. While personnel turnover is a normal business event, a termination of a Principal, for cause, at a professional, regulated firm is extraordinary, we acknowledge this. This is especially true, given the degree of regulatory scrutiny that we receive from multiple entities, in multiple geographic locations. A partial list of answers to questions that I have received is included. It is here for public consumption: it is vital that my answers are 100% consistent with each other.
a. We are aware of the importance of confidentiality (my mother doesn’t know your identity, even if she has been your friend for years). For example, you can see that you are receiving these emails under blind copy (all of your identities and emails are not revealed to each other). At this time, we do not currently suspect that any theft of sensitive information has occurred. Given Ms. Hiltz’ prior position and privileges, she did have almost unlimited access to your private data. The reason for the public memo is that if you have reason to believe that your private data has been revealed to any other party, please contact us immediately.
b. Given GH2’s high visibility with large associations (example, State Bar of MI), and the fact that there is always a great deal of scrutiny that surrounds 501c3 charities, we will respond to your concerns within 1 business day. We have regulatory requirements which bind GH2 Benefits to this responsibility, and we will precisely meet these requirements.
c. Ms. Hiltz did cause GH2 Benefits financial damage, which is being actively resolved. The details of this will remain private, we will not answer questions, unless required by law. (Update: Ms. Hiltz has repaid the financial damage, without admission of guilt. The repayment itself is her tacit admission.)
I am personally gratified by the overwhelming support of the principles we pursue, as stated earlier this week, thank you.

Jae W. Oh, MBA CFP CLU ChFC
Managing Principal, GH2 Benefits LLC
Chairman, Great Humanity Healthcare Foundation, a 501(c)(3) tax exempt organization
Jae W. Oh, MBA, CFP®, CLU®, ChFC®
Founding Principal
GH2 Benefits, LLC
416 W. Huron St, Suite 1
Ann Arbor, MI 48103
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The original post is here:
April 20, 2018

To Whom It May Concern,

It gives me no pleasure to announce that Isabelle R. Hiltz, Principal, has been terminated, for cause.

GH2 Benefits continues to represent our clients without discrimination of any sort, including but not limited to sex, age, race, financial means, or orientation. Our professionals will also exhibit the highest professional standards in every instance.  Our clients, current and future, depend on this.

Our unparalleled career opportunities are available to those that share this vision, and to those that exhibit these professional standards. Any deviation from that standard will be deemed to be unacceptable, as in this case, and will be addressed decisively. No one is more accountable to meet those standards than I.

Jae W. Oh, CFP
Founding Principal, GH2 Benefits, LLC
Chairman, Great Humanity Healthcare Foundation, Inc, a 501(c)(3) organization

A signed copy of this document can be viewed here: Isabelle Hiltz Termination Announcement. Any and all questions will be answered by me and by me alone, directly.

Pew: Americans Can’t Tell Fact From Opinion

Ya Think?
Pew study finds Americans can’t tell fact from opinion”When you read, you begin with A, B, C. When you sing, you begin with do, re, mi….”  This quote from an article in TheHill.com.
Pew Director of Journalism Research Amy Mitchell said the study “raises caution” around news consumers’ ability “to sort news quickly.” “At this point, the U.S. does not seem to have become completely detached from what is factual and what is not. But with the vast majority of Americans getting at least some news online, the gaps in ability across population groups to sort news quickly and correctly raises caution,” said Mitchell.
I think that I am supposed to be grateful that this is out there, in print. To the subscribers of the Maximize Your Medicare Newsletter (subscribe here), you already know this. Here’s the (link) to the article. Before this article goes off the rails, let’s move on.

Announcement: Hiltz, Isabelle

Jae W. Oh, MBA, CFP®, CLU®, ChFC®
Founding Principal
GH2 Benefits, LLC
416 W. Huron St, Suite 1
Ann Arbor, MI 48103

April 20, 2018

To Whom It May Concern,

It gives me no pleasure to announce that Isabelle R. Hiltz, Principal, has been terminated, for cause.

GH2 Benefits continues to represent our clients without discrimination of any sort, including but not limited to sex, age, race, financial means, or orientation. Our professionals will also exhibit the highest professional standards in every instance.  Our clients, current and future, depend on this.

Our unparalleled career opportunities are available to those that share this vision, and to those that exhibit these professional standards. Any deviation from that standard will be deemed to be unacceptable, as in this case, and will be addressed decisively. No one is more accountable to meet those standards than I.

Jae W. Oh, CFP
Founding Principal, GH2 Benefits, LLC
Chairman, Great Humanity Healthcare Foundation, Inc, a 501(c)(3) organization

A signed copy of this document can be viewed here: Isabelle Hiltz Termination Announcement. Any and all questions will be answered by me and by me alone, directly.

Is “No Medical Questions Asked” Life Insurance Real?

Is “No Medical Questions Asked” Insurance Real?
Yep, But Many Variations Exist

Questionable Health? It’s Actually OK…
You have almost certainly received a postcard which advertises life insurance. Here are some of the snippets used to get your attention. Frequently, these postcards will have something that looks like No Medical Exam Required,”  “No Medical Questions Asked,” etc. Technically, that may be true.

Yabit, We Can Get the Info Without Asking You

Your prescription history is stored, and is accessible. When you are signing an application for life insurance, you are almost certainly granting permission to the carrier to access this information. It is very, very unlikely that the prescription database is incorrect. Further, it is also very likely that if you are prescribed a particular medication X, then it is for medical situation A. Voila, the carrier knows your medical history.

All Is Not Lost, No-Medical Life Insurance Does Exist
There are conditions, as expected, but it is true that there are viable life insurance policies that exist for those that will fail medical examination.

  • The benefit amount will be limited (almost impossible to purchase $100,000 on a guaranteed-issue basis)
  • You may not be insured for the full benefit amount on day 1. This is called Graded Benefit, and you are insured for a portion of the full benefit amount on day 1, and that increases over time.
  • The cost of this insurance will be higher than other life insurance. This means that those that CAN pass medical questions would likely receive better value for his/her money at other carriers.
There are MANY carriers, and carriers have many varieties of questions, levels of questions, and levels of benefits. To simply answer a flyer, without further information? Probably not the best approach.
Costly? Maybe. Worth It? It Can Be.
We encountered this situation the other day. A married couple, seriously ill husband greater than 65 years old, and healthy wife, age 55. The issue is that if the husband passes away prior to the wife turning 62, She will not be able to receive Social Security benefits until she turns 62, at the earliest. That will be a huge problem for her. So while the cost is high in this case, there can be reasons that this is necessary, and valuable.

Inaugural “See Me After Class” Award

 Didya Know The Press May Distort Stuff?

The problem with the inexact presentation of facts is that it limits the ability for people to reach a practical, workable compromise. Everyday people cannot be reasonably expected to know these facts, unless they are spoon-fed. The source of that spoon-feeding is usually the press. “See Me After Class” awards are going to those that may look like they are presenting facts, but that presentation is skewed, calling into question the entire conclusion of the article, study, whatever. Does “inaugural” mean most “egregious?” No, there are worse examples out there, this is just one of many.

This is a paragraph from the link (here), “Insurers want to raise Obamacare rates as much as 53 percent.” The writer is Sarah Kliff, one of the internet’s most prolific reporters on healthcare policy on the internet. Vox.com is founded by Ezra Klein, formerly of the New York Times.

First, the caveats. It is not my principal position that people are stupid or uneducated. In fact, reporters with the resumes of Mr Klein and Ms Kliff are impressive. It isn’t as if the positions attained were simple to get. That doesn’t mean that they are experts in the pricing of financial contracts, and that doesn’t mean that the reporting of facts is even-handed. Omissions of facts is a very important part of debate on a topic that is worth almost 20% of the national GDP. 

Everyday people need to be VERY careful in scrutinizing information or “reports.”

Let’s Take a Look
This article starts with facts, i.e. that proposed individual health insurance rates have been proposed in a list of states, and the highest proposed increase is in Maryland, at a whopping 53%.

This is the next paragraph (everything in blue is an exact reprint taken from  the article), and my comments are in red.

The big question: Why are insurance plans requesting such big rate hikes?

It is incredibly hard to pinpoint which part of the rate increases are a product of the instability and uncertainty the Trump administration has created around Obamacare’s future — and which part reflects a marketplace that was already struggling.

There are some clear ways the Trump administration has driven up rates.For example: CareFirst, a big marketplace carrier in the DC area, has tacked 15 percent onto its rates because it does not expect the White House to enforce the individual mandate. DC Area = a small fragment of all markets nationwide. This is could easily be an outlier, especially after you present a much large carrier, with a nationwide presence, immediately thereafter, and have omitted other published financial data. Further, if this turns out to be unwarranted, and the carrier has not spent 80% of premiums on claims, then policyholders will receive a rebate based on Medical Loss Ratio rules.

But other factors leading to the 2018 rate increases aren’t so clear-cut. Lots of insurance plans have said in their rate filings that they are worried about a “shrinking market” or sicker enrollees that will drive up premiums. Here’s what Anthem (Anthem is a national carrier, one of the nation’s 5 largest, and publicly held, meaning that its statements are subject to securities regulation), for example, told regulators in Connecticut about why it wanted a 33.8 percent rate increase:

“We are forecasting that the individual market will continue to shrink and that those individuals with greater health care needs will be the most likely to purchase coverage and retain their coverage, thereby accelerating the trend of increased morbidity. … This dynamic is driven by a guaranteed issue market with rating constraints and an individual mandate penalty that continues to be far less than the cost of coverage for most individuals.”

It’s true that before Trump’s election, insurance plans worried that the people signing up for coverage were sicker than they had expected and that enrollment numbers weren’t as robust as forecasters had expected. Where is the example where Aetna has reported $900 Million of losses in individual markets over the past 3 years alone, and there is no mechanism by which to recover those losses? Humana and UnitedHealthcare have reported results which are very similar in scope and scale to Aetna. Where are the examples where Marketplace carriers have made, on average 2-3% profit on individual health insurance over the past 3 years (reported by the Commonwealth Fund, a think-tank, and shown in this Newsletter in prior editions), and accepted all of the risks inherent in being the seller, such as unlimited lifetime maximum benefits?  It’s also true that the uncertainty around the law’s future — whether the administration will, for example, continue doing outreach around Obamacare enrollment — has exacerbated those concerns. If your stated evidence was the only information available, then yes, your conclusion may be feasible. But since you have completely ignored the other widely available data by the largest carriers and think-tanks in the nation, your conclusion of “exacerbated” doesn’t seem warranted.

At no point is there any mention of the fact that the risk corridor is now gone, and the risk corridor protected carriers from losses. The costs of the losses were borne by the US Government, which has not reported the size of those losses. In addition, where is the part that says that the comments in red above, occurred even with the risk corridor (reinsurance) in effect. That extra layer is now gone. The omission of this fact displays either an incomplete knowledge of the facts, or an intended distortion of facts.

At this point, it seems fair (your omission of facts is equal to fair?) to say that some part (unless you are in position to quantify, you shouldn’t be assigning “parts,” that means that it could be 1% for one part and 99% the other, is that your defense here?) of the 2018 rate increases are due to the Trump administration and some part are due to the law itself. It seems clear to me that the Trump administration is making Obamacare more expensive, which I’ve written about at greater length here. Attributing a particular amount of the increase to Trump, however, is going to be awfully difficult, if not impossible. So the only fully-reasoned sentence is here, at the very bottom of the article? In fact, if you added the information in red, the other conclusion could be “this is entirely possible,” and the primary reason for rate increases is ongoing difficult in individual health insurance markets which we have ample evidence to support, with a secondary, speculative reason being the proposed AHCA. 

SEE ME AFTER CLASS
Don’t worry, you won’t be the only one, and the others that are required to see me after class will be omitting and skewing actual information just as badly as you have.

FOR IMMEDIATE RELEASE: GH2 Benefits Welcomes Jamie Collon-Vella

[pdf-embedder url=”https://www.gh2benefits.com/wp-content/uploads/2017/01/JCV-Announcement-Letter.pdf” title=”JCV Announcement Letter”]

Medicare 2016 Changes

My blog post as Expert Contributor to Humana-powered website, www.mymedicareanswers.com, is here.

Medicare 2016 Changes

There are some changes to Medicare that are forthcoming, above and beyond the changes announced in the headlines.

Please see an updated grid of original Medicare rates here.

Higher premiums

In 2016, the Part B premium will not increase for 70% of existing Medicare beneficiaries. Originally, an increase of greater than 50% was supposed to occur, but last-moment legislative action prevented this. Therefore, only new Medicare beneficiaries and high-income earners (subject to IRRMA) will face higher Part B premiums. Bottom line: existing Medicare beneficiaries that earn less than $85,000 ($170,000 for married couples) will face no increase in Part B premiums. New enrollees will not be as fortunate: $121.80 a month will be the monthly Part B premium.

Higher Deductible and Copays

In 2016, the Part A deductible will be $1288.00 per benefit period, from $1260.00 in 2015. The Skilled Nursing Facility coinsurance amount will be $161.00 per day, during days 21-100. The Part B deductible will be $166.00 for the year. It is important to note that the “hold harmless” provision that would’ve protected 70% of Medicare beneficiaries (when Social Security benefits do not increase) does NOT protect beneficiaries from Part A or Part B deductibles or copays.

IRMAA

For high-income earners, Medicare Part B and Medicare Part D adjustments will increase. The reality is that the increase is the result of two factors. First, the “permanent doc fix” enacted in April 2015 made an initial increase in the IRRMA. Second, the last-minute budget deal during November 2015 created a second increase. This means that while the second factor may decline, the first reason for an increase in IRMAA will remain intact. Further, you must remember that IRRMA is, in fact, a “rate,” not an “amount.” The “permanent doc fix” has legislated a higher rate, which implies that if Part B increases, then the IRRMA will increase by a higher rate, meaning that the IRMAA will also be higher.

Two-Midnight Rule

Retroactive to October 1, 2013, the much-discussed “two-midnight rule” will take effect. This means that if you are admitted to the hospital, and that hospital stay is expected to cross two midnights, then you will be presume to have inpatient hospital status. This is very important because it addresses many misunderstandings regarding Part A. First, inpatient hospital status means that Part A will be the coverage, and not Part B. Second, and related to the first point, Skilled Nursing Facility care can be covered by Part A, if your hospital stay lasts over three midnights.

It has been the case that Medicare beneficiaries have been unaware of their patient status in a hospital, and then have been transferred to a Skilled Nursing Care facility. If the patient was not admitted on an inpatient basis, then the Part A benefit under Skilled Nursing Facility care would not apply, but instead, would be covered by Part B (with 20% coinsurance, after covering the Part B deductible). Under the “two-midnight rule,” one important layer of this confusion should be resolved. It is important to note that the three-day criteria still remains in effect. A patient must be both admitted on an inpatient basis, and that hospital stay must cross three midnights, in order to be covered by Part A at a Skilled Nursing Care facility.