Life and Health

New federal regulations under the Affordable Health Care Act (ACA) require insurance companies and health care providers to treat mental illness and addiction in the same way as physical ailments. That’s good news for everyone with health insurance.

The ACA prohibits denying coverage or charging higher premiums to due pre-existing conditions, which include mental illness, while expanding coverage for screening and behavioral assessments and eliminating co-payments or out-of-pocket fees.

The rules beef up the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 by closing loopholes and setting implementation guidelines– an advance that Secretary of Health and Human Services (HHS) Kathleen Sebelius calls “the largest expansion of behavioral health coverage in a generation.” Under the regulations, mental health benefits must match those for medical and surgical treatment, including copayments, deductibles, number of visits to providers, residential treatment, and outpatient services.

The regulations could affect 62 million people, including 23 million substance abuse addicts. Administration officials called the new rules a response to the need to help the mentally ill get help before they commit such violent acts as the massacres in Aurora, DO and Newtown, CT.

Cynthia Moreno Tuohy, Executive Director of the National Association of Alcoholism and Drug Abuse Counselors, and American Psychiatric Association President Jeffrey Lieberman praise the rules for providing expanded care.

“Health plans have supported MHPAEA and worked to implement these requirements in a manner that’s affordable, safe and effective,” adds Karen Ignagni, President of America’s Health Insurance Plans, a trade group of health insurance companies. “The new regulations enable patients with mental and behavioral health conditions to keep benefitting from the innovative programs and services that health plans have pioneered.”

To learn more about how these rules will apply to your health insurance, feel free to get in touch with us.

College students are graduating deeper in debt than ever, as tuition and fees keep escalating while family incomes stagnate. The average student debt jumped to nearly $30,000 for the Class of 2012, compared to $26,000 in 2011, according to the Project on Student Debt at The Institute for College Access and Success. Average student loans in 2012 were even higher for newly minted physicians ($167,000), veterinarians ($152,000), and attorneys ($125,000).

If you’re a young professional with debts on this scale, you might well find it difficult to pay off these loans during the early years of your career, before you earn enough to build up savings. If you died before paying your loans, who would be responsible for the balance? Although federally financed student debts are forgiven in case of the borrower’s death, the burden of payment for a private loan would fall on your family or the guarantor (co-signer) of the loan – most likely your parents.

Not to worry. A term life insurance policy can cover this risk, so your loved ones won’t take a financial hit when they’re already reeling from grief. The policy will cover you for a fixed period, such as 10, 15, 20 or 30 years. You can either buy coverage for as long as the loans are likely to be paid off, or have a co-signer (for example, your mother) purchase a policy on your life, with herself as the beneficiary.

You can obtain this financial peace of mind for pennies a day. A 20-year, $250,000 term life policy for a healthy 30-year-old costs only about $150 a year, according to LIMRA, a life insurance trade group.

For more information, just give us a call. We’re always here to help.

Just because you have a pre-existing medical condition doesn’t mean you can’t afford life insurance.

A nationwide survey by Genworth Financial concluded that many Americans fail to buy life coverage because they have a chronic illness that they believe will make insurance unaffordable. The study of 24,000 adults found that between 39% and 54% of those aged 18 and 64 with common, self-reported pre-existing conditions don’t have a life policy. (Overall, more than 118 million American adults went without life insurance in 2012, continuing a trend of fewer people buying less coverage).

However, recent advances in medicine and wellness care are making it easier for people to manage chronic conditions. At the same time, the insurance industry is using more sophisticated underwriting practices to provide preferred rates to people with less-than-perfect health, allowing companies to balance the need the need to price policies competitively with their ability to pay claims.

“We need to redefine the word ‘healthy’ in the context of life insurance eligibility,” says Janet Deskins, Genworth Senior Vice President for Product Development. “For adults with conditions such as anxiety, asthma, depression, high cholesterol, and sleep apnea, life insurance can still be an affordable part of their overall financial plan, especially if they’re actively taking steps to manage their condition.”

Eric Tyson, author of Let’s Get Real About Money and Personal Finance for Dummies, points out that not all insurance companies gauge risk the same way; “Some companies have a better understanding of certain medical conditions. You may be able to get much better rate that you expect. The key is managing your condition well.”

Even if you’re not in the best of health, the professionals at our agency would be happy to help you find quality life insurance coverage at an affordable rate.

Not that long ago a diagnosis of cancer often meant a death sentence. Fortunately, rapid advances in early detection and treatment during the past three decades have led to a dramatic rise in the odds of surviving the disease. The result: it’s easier than ever for cancer survivors to find life insurance at an affordable rate.

If you have survived cancer, the first step in buying coverage will be to provide the insurance company with your comprehensive medical records. Any attempt to fudge these records could lead to cancellation or denial of some or all of benefits.

Most policies will require you to complete an extensive health questionnaire and provide blood and urine specimens. However, some insurance companies will waive these steps in return for offering more limited coverage at a higher premium.

Generally, to purchase life insurance, a survivor must be in good health, with the malignancy cured or in remission, and no history of treatment for three months to as much as five years (depending on the nature of the cancer. A survivor who has been in complete remission for at least five years might be able to obtain life coverage at a reasonable rate.

Insurance companies are most likely to cover survivors of early breast cancer (Stage 1), prostate cancer, and conditions that are caught and cured early. Those in whom the disease is more advanced (Stage 2 or higher), have suffered a recurrence or multiple malignancies, whose cancer has metastasized, or who use tobacco products will find it more difficult, or pay a hefty surcharge, to buy a life policy.

For more information, just give us a call.

Although the Affordable Care Act (ACA) requires health insurers to cover most preventive care, the definition of this term remains unclear.

“A lot of consumers, doctors, and pharmacists don’t know what’s required,” says Judy Waxman, vice president of health and reproductive rights with the National Women’s Law Center.

To avoid surprise costs, healthcare experts recommend that you:

1. Know what’s covered: Under the ACA, insurance companies must cover the full cost of many preventive services, including vaccinations, cancer and other health screenings, annual well visits, breast pumps, and all FDA-approved contraceptives, based on input from a nationwide panel of primary care experts. (For a list of services covered, go to http://www.healthcare.gov/what-are-my-preventive-care-benefits).
2. Know how your insurance company interprets these guidelines. For example, because mammograms are recommended for women over 40 every one or two years, some insurers will pay for the test annually, while other will only do so every other year.
3. Stay in your health plan’s provider network. Once you see a doctor who doesn’t participate in your plan, you’ll be subject to costs, even if the visit is for a preventive service that the law requires insurers to cover in full.
4. Get to the bottom of unexpected bills. If you’re billed for a service you thought was preventive and covered in full, begin by calling your doctor’s office and then go to your health plan. If that doesn’t work, you can appeal to an independent third party. For a tool kit on preventive services, including sample appeals letters, go to The National Women’s Law Center, http://www.nwlc.org.

To learn more about this key issue, feel free to get in touch with our health insurance professionals at our agency.

Term life insurance is temporary, but it doesn’t have to stay that way. Most term life policies sold today can be converted to permanent whole life or universal life which will provide coverage until you die and can offer significant advantages.

When you convert from term life to permanent, you won’t have to answer questions about your health or undergo a medical exam. If you bought a policy when you were in excellent health but then later got sick, you’ll maintain the health rating you had when you purchased coverage.

If you’re relatively young, the conversion feature also allows you to build your life insurance investment gradually as money becomes available. More and more people are using this strategy to accumulate a life insurance nest egg for their beneficiary(ies). For instance, you might convert $100,000 of a $1 million term life policy to permanent life every few years.

When shopping for convertible term life coverage, ask yourself:

• Is there a deadline for converting? Although some policies let you convert at any time until the end of the term, others only allow conversion during a specific period.
• What are your conversion options? This will depend on the insurance company and the quality of its portfolio.
• What are your options if you don’t convert? Once your policy reaches the end of its term, the premium spikes and is no longer guaranteed. To keep coverage in force, you’ll either have to either pay a far higher rate or shop for a new policy, which might be difficult if your health has declined.

We’d be happy to review your financial situation and offer our recommendations. Just give us a call.

A recent report from the Department of Health and Human Services (DHHS) reports that individual health insurance under the Affordable Care Act will cost an average of $2,988 yearly or $249 a month. Subsidies, tax credits, and Medicaid payments should reduce these premiums to no more than $100 a month for nearly 30 million people who don’t have insurance.

Although some individuals might pay more for coverage, these averages are still 16% lower than the Congressional Budget Office projected in 2012.

The health care reform act extends coverage to low-income Americans, including the 48 million now uninsured. To help offset the cost of covering older, sicker individuals in this group, the law requires every American to buy insurance or face a fine, under the “individual mandate” provision. The 55% of adults who have health coverage through their jobs are considered in compliance with the mandate.

According to the DHHS report, rates under the ACA’s state-based insurance exchanges, where individuals will shop for health plans, will vary significantly depending on the state and the level of coverage (Bronze, Silver, Gold, or Platinum). For example, in Wyoming, the least expensive Bronze plan will cost $425 a month, compared to only $192 a month for the same coverage in Minnesota.

In Comparison, a recent Government Accountability Office report on the cost of individual health insurance found that people who are young and healthy can buy relatively inexpensive policies. According to the GAO 30-year-old nonsmoker might pay as little as $30 a month in Georgia or $85 a month in Alaska. As always, our agency’s health insurance professionals are stand ready to offer their advice on selecting the health plan that’s best for you.

Tobacco users could face sticker shock when buying coverage in the state-wide health insurance marketplaces that opened for enrollment on October 1, thanks to a controversial clause in the Affordable Care Act (ACA). The law seeks to discourage smoking, the nation’s largest preventable health hazard – which kills some 443,000 Americans a year at a cost of $193 billion in medical care and lost productivity,

To reach this goal without discriminating against smokers, the ACA will allow insurers to continue charging tobacco users a so-called “smoker surcharge” limited to 50% above what they charge nonsmokers, as of January 1, 2014.

However, combining this surcharge with another health reform rule that prohibits low-income applicants from using federal tax subsidies to help offset it could price some lower-income smokers out of the market. According to the Kaiser Family Foundation, a 50-year-old male smoker earning $15,000 a year would pay $8,100 a year for Health coverage, including a $2,700 tobacco-use surcharge. The federal low-income subsidy would reduce his premium to about $3,000. But if he didn’t smoke, his premium would be just $300.

According to the Center for Medicare and Medicaid Services before the ACA, health insurance companies could impose a surcharge far higher than 50% on smokers – or refuse to cover them. Tobacco users can avoid the 50% surcharge if they live in states that set lower limits on surcharges or prohibit them – or by enrolling in a stop-smoking program.

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Says Rick Curtis, president of the Institute for Health Policy Solutions; ”Long story short, smokers usually won’t pay more for insurance compared to current or previous years. Most of them will have better access and more affordable premiums under the ACA restrictions.”

Although both term life insurance and permanent life policies have their advantages, if you prefer permanent life, here are key guidelines to help you choose the best option:

1. All policies are not created alike. Whole Life insurance combines a fixed premium with a guaranteed cash benefit and a death benefit. Universal Life offers a flexible premium plan that works like a combined term life insurance policy and bank account; you pay as much money as you want and the leftover funds paid will earn a variable interest rate. Variable Universal Life is similar, except that you can choose between mutual funds in which to invest your cash value.
2. Because permanent life is written for a lifetime, rather than a limited term, you will be required to take a medical exam – the better your health, the lower your premium.>/li>
3. Permanent life provides a tax-free investment vehicle. In most cases, a loan against the cash value of your policy will not be not taxable – and cash withdrawals (for tuition, medical expenses or other emergencies), up to your basis in the policy, will be tax free. What’s more, the “forced savings” of permanent life can help you build a financial safety net.
4. Check the reputation and financial stability of the insurance company, as well as the underlying performance of its investments.

1. You’ll pay more for permanent life than for the same amount of term insurance. Premiums depend on your health, age, and gender, as well as how much coverage you buy. Permanent life policies have sales charges, administrative fees, a mortality risk charge and fund management fees. If you cash in your policy during a certain period, you might be charged a surrender fee.

Our Life insurance professionals stand ready to offer you their advice on making this important decision.

You can’t beat the return on investment by a Powerball jackpot winner in Zephyrillis, FL, last May 18– $590.5 million for a $2 lottery ticket. However, if you’re serious about leveraging dollars for your family, a life insurance policy is a far better bet than the lottery.

Sure, the lottery produces a bigger bang for the buck. The latest payout, in fact, was the largest in history. However, your odds on winning big are infinitesimal: one in 175 million for the Powerball jackpot.

With life insurance, in return for a relatively small premium, the policy pays a large benefit to your loved ones if you die within the term of the policy – an event that’s more likely than winning the lottery, (A study for the LIFE Foundation found that the chance of dying after age 25 before reaching normal retirement age is one in six for men and one in nine for women). The average cost of 20-year, $250,000 level-term life coverage for a healthy 30-year-old male comes to about $150 a year, according to LIMRA. Even better, a permanent life policy will provide a guaranteed payout to your beneficiary(ies).

Life payouts are generally tax free, while Uncle Sam will take a healthy 25% cut up front if you take a lottery payout as a lump sum on a lower amount, rather than an annuity. For example, the tax bite would have reduced the Florida Powerball winner’s one-time payout of $371 million to $278 million.

We’d be happy to demonstrate how life insurance can play an essential role in providing financial security for your family.