Congress, Obama Toil to Help Jobless Get Health Care

Congress and the incoming Obama administration are contemplating profound shifts in the government's role in health insurance to try to alleviate a significant ripple effect of the damaged economy: Americans losing health coverage as they lose jobs. As part of a sprawling $825 billion strategy to heal the economy that House Democrats laid out this week, lawmakers and transition officials envision a two-prong approach to help unemployed people retrieve health benefits. One would reshape a basic entitlement program, allowing states temporarily to sign up jobless residents for Medicaid, with the federal government for the first time paying the entire cost. The other proposal would provide unprecedented federal subsidies to help people afford coverage under COBRA, a law that allows some laid-off workers to buy health benefits that they used to get through their jobs. The twin ideas, preliminarily estimated to cost $39 billion through the end of next year, would represent sharp departures in two long-standing programs and already are sparking debate along the ideological continuum on Capitol Hill and beyond. In Congress, several key Democratic House members and senators have endorsed the broad contours, while a few Republicans, including Senate Minority Leader Mitch McConnell (R-Ky.) have signaled that they are wary. Debate, however, will not solidify until lawmakers learn more precisely how much the proposals would cost and how many people they might help. Among outside health policy specialists, conservatives are critical of expanding an entitlement and are predicting that states would have a hard time shutting the spigot of help once the federal money stopped. Liberals are predicting that, even with the large federal investment, coverage could remain unaffordable for too many people.

Dallas police connect to statewide car insurance database

Dallas police have given no grace period to uninsured drivers this year as they enforce the new towing ordinance. Those pulled over for traffic violations get their cars towed on the spot. As of Friday, 256 vehicles had been towed as a result. Dallas police also say they've now connected to the Texas Insurance Database, which contains license tag information on those with insurance. "In cases where there is an "Unconfirmed" response, officers will continue to use additional measures such as contacting insurance companies directly to verify insurance," said a recent DPD news release.

Health insurance unaffordable for most who get laid off

The cost of paying for continuing family health insurance consumes most unemployment insurance payments for those laid off, according to a new report.
Continuing family health insurance coverage after being laid off consumes 84 percent of employment benefits nationally, according to a new report by Families USA, a health care think-tank.

In Wisconsin and 40 other states, paying for such health insurance coverage consumes 84 percent of unemployment benefits.

Single people do not fare much better. In Wisconsin and 16 other states, the cost of continuing single health insurance coverage consumed more than one-third of unemployment insurance income.

Des Moines area insurance companies plan merger

Two Des Moines area insurance companies have signed a letter of intent to merge.

West Des Moines-based Homesteaders Life Co. and American Enterprise Mutual Holding Co. of Des Moines will merge under the plan, with Homesteaders' seven board members joining American Enterprise's board.

American Enterprises is the holding company of American Republic Insurance Co. in Des Moines and Omaha-based World Insurance Co.

Homesteaders is the nation's second-largest provider of burial insurance. American Republic is a provider of health savings accounts and Medicare supplement insurance. American Republic has 548 employees in Des Moines. Homesteaders has 129 workers in the Des Moines area and 33 field employees nationwide.

Insurance denial can seem arbitrary

Three years ago, Ivy Emery left her job at Aveda Corp. to work as an independent hair stylist at an Uptown salon.

No longer covered by Aveda's group health insurance, Emery applied for individual coverage for her husband and herself. Her husband, a self-employed construction worker and a smoker, was accepted. Emery, then 32, was rejected.

The denial letter from Blue Cross and Blue Shield of Minnesota listed three reasons: She was using topical medication for acne, she had once sought emergency care for a migraine and she was on Paxil, a drug for anxiety and depression.

"It was just insane," she said, her voice rising at the memory. "They wrote 'acne.'"

An outraged Emery found herself a member of a club nobody wants to join: the Uninsurables.

It's a bigger club than you might think. Each year, one in six Minnesotan applicants for health insurance in the individual market is denied coverage because of a variety of pre-existing conditions.

The market is small but growing fast.

In 2002, there were 192,942 enrollees, or 3.8 percent of Minnesotans, in the individual market. By 2007, the number had climbed to 246,190, or 4.7 percent of the population.

Most Minnesotans have never ventured into the individual market, but if they did they might be surprised by its rules.

"Once you get individuals out there trying to shop for insurance, the [companies] will slice and dice those people, take the healthy people and charge them for whatever package," said Judy Waxman, a vice president at the National Women's Law Center in Washington. "This is why we want to get away from people being judged individually. It's not really insurance."

Ironically, the conditions that can cause a denial are sometimes the very reasons why consumers seek insurance in the first place.

In Minnesota, the most common reasons for denial are obesity, mental health conditions, hypertension, diabetes and cardiovascular disease. But there are less well-known reasons insurers consider on a case-by-case basis: chemical dependency, allergies that require costly injectable drugs, a previous C-section, previous use of infertility medicine or something as simple as being pregnant.

Blue Cross and other insurers say they face a dilemma. If they took in too many sick people, they'd have to raise everyone's premiums.

"We understand people are going to be very upset and surprised [when they get denied]," said Craig Ashby, director of individual products at Medica, the state's second-biggest health insurer after Blue Cross. Denials help ensure a "competitive price for the vast majority of people," he said.

In states such as New York, where insurers are required to take all applicants, healthy people sometimes put off buying insurance until they get sick. The result: Premiums tend to be higher for everyone, according to a study commissioned by America's Health Insurance Plans. The association is urging the Obama administration to consider a system in which insurers must accept all applicants but all consumers must buy insurance.

Group vs. individual

About two-thirds of Minnesotans get group coverage through their employers, where health is not a factor for coverage. The rest are covered by federal and state plans, by policies in the individual market, or simply are uninsured.

But many employers are asking employees to pay more of the cost, to the point where some employees are dropping company coverage and buying cheaper, leaner policies on their own -- or going without.

But the individual market isn't like group insurance.

"In the individual market, people can and do get denied for things that are automatically covered in the group market," said Bob Schmitz, president of Schreifels & Associates, a benefits consultant in Brooklyn Center.

Blue Cross and Blue Shield of Minnesota said its denial rate is 15 percent. Medica says it's in that range, while HealthPartners declined to be interviewed for this report.

To further complicate matters, underwriting guidelines vary by insurer and can change from one year to the next.

Denied applicants may appeal. Sometimes a letter from a physician can help. Or they can go straight to the insurer of last resort: the Minnesota Comprehensive Health Association, or MCHA, a state pool for sick people who have been rejected by at least one private insurer.

That's where Emery and her husband ended up. They now have a toddler and pay a monthly premium of $427 with an annual deductible of $15,000. (A Blue Cross spokeswoman said the insurer doesn't comment on individual clients as a matter of policy.)

Emery is now applying to nursing school in a quest to get a job with health insurance.

Gender bias?

Some think women applicants have it harder than men. Last year, the National Women's Law Center published a report titled "Nowhere to Turn: How the Individual Health Insurance Market Fails Women," citing disqualifiers such as pregnancy and a previous C-section.

Women in Minnesota fare better than elsewhere, said the center's Waxman. Unlike some other states, Minnesota prohibits plans from charging higher premiums for women compared to men of the same age and health status. It also has MCHA, where premiums are capped at 125 percent of comparable private plans.

Some worry, however, that as the weak economy pushes more individuals into the high-risk pool, MCHA will become overextended.

Already, MCHA members spend over $100 million more annually in medical bills than they pay in premiums. That shortfall is now covered by a 2 percent premium tax on certain other segments of the insurance market. MCHA may seek legislation to expand that tax to the rest of the market, said Lynn Gruber, MCHA's chief executive. "We have to," she said, "because it's not sustainable."

'Don't get mad'

Deborah Morse-Kahn, 56, of Minneapolis, applied for individual coverage three years ago after she lost her job at the University of Minnesota. She's not sure why the first insurer rejected her. "There was a veil of mystery over it," she said. But she's convinced that "age was the biggie."

She had a history of hypoglycemia, or low blood sugar, and was taking prescriptions for restless leg syndrome and for nausea associated with menopause. She had also sought psychiatric counseling in the past.

What she remembers clearly, though, is her insurance agent walking her through the process -- and predicting a rejection.

Her agent warned her ahead of time not to get mad, said Morse-Kahn, now self-employed as a public historian and writer. "She said: here's what they [the insurance companies] have to do, here's what we'll have to do [apply to MCHA], and you're going to get your coverage because this is Minnesota."

Insurance that worsens crunch

Taken fromBBC News that might give you an usefull information.

An essential element in the Government's forthcoming package to stem the pernicious shrinkage of credit in the economy will be measures to compensate for the devastating impact on many companies of the withdrawal of trade credit insurance.

That probably sounds deeply dull and technical. But please read on, because this stuff matters to all of us.

For smaller companies, the importance of trade credit insurance is often that they can't borrow from banks, unless they've insured their sales to corporate customers.

The banks make this stipulation because it absolves them from having to assess the credit-worthiness of their borrowers in detail - because at least part of the credit risk has been laid off to an insurance company.

So the availability of such insurance is literally a matter of life and death for many businesses.

Woolworths is one of the more extreme examples.

When insurers would no longer provide cover to Woolies' suppliers in the autumn, that was the penultimate nail in the coffin of the ailing general retailer - because suppliers insisted that Woolworth pay cash upfront to them for orders, which meant that Woolies was forced to draw on its borrowing facilities, which in turn took the retailer up to the limit of what its bankers were prepared to lend.

And the rest is the sorry story you know: the demise of a historic high street name that was forced to liquidate everything so that the bankers could get their money back.

The point is that trade credit insurance is central to hundreds of billions of pounds in trade and the provision of finance to companies of all sizes.

When it's withdrawn, as has been happening for months, small companies are unable to fulfil valuable orders placed by big companies and those bigger companies lose access to vital supplies.

So a rational decision by insurers to scale back their cover on sales to companies perceived as vulnerable to our economic contraction is rippling through the economy in a damaging way: cover is being withdrawn because we appear to be in a sharp recession, and its withdrawal is making that recession significantly worse.

Part of the problem is that the insurers seem to me to have massively under-priced the cover they provide. Just as banks charged ludicrously low rates of interest during the years of the credit bubble, so the trade credit insurers insured hundreds of billions of pounds of trade for tiny premiums.

According to statistics from the Association of British Insurers, there were £334m of premiums written by the insurers in 2007, covering £282bn of sales by British companies.

Or to put it another way, insurers were receiving premiums equivalent to the turnover of a medium size business to protect more than 20 per cent of the output of the entire British economy.

Scary or what?

Those aggregated premiums were equivalent to a minute 0.1 per cent of the sum insured - down from 0.26 per cent in 1995. Which would only make economic sense in a world where there are never recessions.

One illustration that the premium was too low is that claims received by insurers in 2008 are likely to have been rather more than total aggregated gross premiums received in the previous year, extrapolating from trends in the first nine months of the year.

But the insurers have been protecting themselves from the worst losses by simply withdrawing cover for new orders to companies seen as weak. In other words, unlike insurance provided to you and me on our homes, for example, the trade credit insurers have been able to withhold protection as soon as they detected stormy conditions.

To restate the painful paradox: insurance designed to give confidence to companies that they would be paid by corporate customers is being scaled back in a way that's magnifying the woes of businesses big and small.

What's to be done?

Well in France a new system is being implemented whereby taxpayers are sharing the insurance risk with private-sector insurers on supplies to viable companies.

And I would expect the Business Department and the Treasury to implement a similar system of co-insurance by taxpayers.

But that can only be a short-term solution.

In the longer term, the supply of finance to small and medium-size businesses has to be overhauled, so that the viability of those businesses is no longer dependent on insurance that's only available when the sun is shining.

Jobless, with no health insurance

One of the impacts from global crisis economy thaat occured. Many peoples is jobless without having their health insurance. Their job gone so is their health insurance. What is the solution of this manner?
Nearly 200,000 Minnesotans have one thing in common right now: They’ve lost their jobs and, in many cases, their health insurance. These historic unemployment numbers are just one symptom of the current economic crisis facing our state and nation. Families are losing their homes, bankruptcies are on the rise, and a lack of health insurance exacerbates both. When the Legislature undertakes its staggering task this year of balancing the state budget, we must do so with an eye to easing the pain job loss wreaks on our communities and families. We can start with short-term, affordable health insurance. Most of us can identify with the toll on families when they don’t have insurance. Cost-effective, preventive care is often delayed or skipped altogether; visits for injury or illness may be put off until more costly emergency care or hospitalization is required. A lack of health insurance may even compound the challenge of finding a new job when chronic conditions go untreated.In addition, there is a broader economic impact as fewer people seek care. More than one in eight Minnesotans work in the health care industry. As people put off routine care and delay treatment for more serious ailments, local clinics and hospitals suffer. We have already seen major health-care layoffs in recent months. We cannot afford to let rising unemployment and the subsequent loss of health insurance further weaken one of our state’s largest economic engines. The one option that is currently available to laid-off workers, Continuation of Health Coverage, otherwise known as COBRA, is too expensive for most families. Qualified individuals are required to pay 102 percent of both the employer’s and employee’s share of the cost of the policy. The cost of COBRA premiums is more than $1,000 per month on average for family coverage, simply unaffordable when unemployment benefits average about $324 a week. As a result of this high cost, only 20 percent of those individuals who qualify for COBRA actually buy it, leaving 80 percent of the newly unemployed uninsured. That is unacceptable. What can we do? One immediate option is to offer MinnesotaCare — the state’s health-care plan for working Minnesotans — to those who are approved for unemployment benefits. People would remain covered as long as they continue to receive unemployment benefits and pay the low-cost premiums. This unique program could sunset in two years, after the current economic crisis has passed. Using the MinnesotaCare fund, which currently has a surplus balance of dedicated health-care dollars, to help Minnesotans in this time of economic crisis is the right thing to do, will help Minnesotans get back to work even faster, and offers additional stimulus to our economy. Admittedly, this is a short-term solution. We must continue to move forward on more fundamental, broad-ranging reform of our health-care system. But right now there is a need for immediate relief. The Legislature can and should deliver it.

California Hosts Insurance Recovery Forum for Wildfire Survivors

The first of such town hall meetings was held Jan. 8 in Sylmar, Calif. Commissioner Poizner was joined by local, state and federal officials, as well as representatives from the insurance industry who answered specific insurance questions for fire victims. Since the wildfires broke out in Southern California in November 2008, 4,968 residential and commercial property claims have been filed, and 837 of those claims are known to be total losses, with an estimated exposure for insurers of $721 million. More than $162 million has been paid out by insurers so far, according to the Department of Insurance. As a result of the Sayre Fire, 1,847 residential and commercial property claims have been filed, and 383 of those claims are known to be total losses, with an estimated exposure for insurers of $118 million, CDI noted. Nearly $17 million has been paid out by insurers to Sayre Fire survivors. Commissioner Poizner has ordered his Department to continually monitor these numbers to make certain that insurers are meeting their obligations to pay all valid claims presented to them. The Department's Consumer Services Division has received 35 consumer complaints from fire survivors. Twenty of those complaints are from the Sayre Fire. Two of the complaints from the Sayre Fire are related to underinsurance. The remaining complaints involve claim denial, claim delay and low settlement offers. Commissioner Poizner will continue to monitor the wildfire recovery efforts, assist consumers with complaints and make sure that insurance companies are fulfilling their legal obligations to customers. He will also continue to host Insurance Recovery Forums in the communities impacted by the recent wildfires. Commissioner Poizner will hold an Insurance Recovery Forum for Triangle Fire survivors on Thursday, Jan. 15. He will host a Forum for Tea Fire survivors on Thursday, Jan. 29. At Commissioner Poizner's Insurance Recovery Forum, he was joined by Assemblymember Cameron Smyth, Los Angeles County Supervisor Zev Yaroslavsky, Los Angeles Councilman Richard Alarcon, and representatives from the following agencies: the California Department of Insurance; Small Business Administration; Federal Emergency Management Agency (FEMA); California Department of Housing and Community Development, and insurance companies with policyholders in the fire-impacted areas.

Congressional health-care reform proposals would offer coverage to many without insurance

Plan to cover the uninsured through Medicare reduces health-care spending by $58 billion in 2010; Individual requirement to have insurance necessary to achieve universal coverage. With health reform high on the agenda of the incoming Congress and President, a new analysis of legislative proposals—including the plans of President-elect Barack Obama and Senate Finance Committee Chairman Max Baucus (D-MT)—shows that several proposals already put forth could substantially reduce the number of uninsured Americans, and would either reduce health care spending or add only modestly to annual health care expenditures. The proposals demonstrate that it is possible to cover everyone with little or no additional total health spending, but to do so means requiring that everyone have coverage, and achieving administrative savings and purchasing efficiencies by building on public programs and group purchase of private insurance—either through employers or insurance exchanges. The analysis, by Sara Collins and colleagues at The Commonwealth Fund, finds that the proposals outlined by President-elect Obama and Senator Baucus could cover almost all Americans; however, analysts say that to guarantee near universal coverage, mixed private-public proposals like these would need to require that all Americans obtain coverage. The new report provides coverage and cost estimates for 2010 prepared by the Lewin Group, assuming full implementation of health care plans by then. Lewin projects that by 2010, absent the implementation of any large-scale reform, nearly 49 million Americans will be uninsured. "Many of these proposals offer ways to significantly expand health care coverage and also improve the quality of benefits and the efficiency with which they are provided," said Sara R. Collins, Assistant Vice President for the Program on the Future of Health Insurance at The Commonwealth Fund and lead author of the report. "Though most proposals which cover more people come with a higher federal budget price tag, they can achieve significant administrative and health system savings. Universal coverage will need to be accompanied by health system reforms aimed at improving overall health system performance." Several Plans Could Result in Lower Total National Health Spending or Modest Increases According to the report, proposals that expand coverage significantly would add to the federal budget but, if designed appropriately, could reduce total health spending. Total health spending declines when a plan builds in ways to reduce administrative costs or efficiencies from greater purchasing power and thereby offsets new use of services by the uninsured. Federal spending increases, however, when the government assumes responsibility for part of the current health spending of households, state and local government, and employers. Representative Pete Stark's (D-CA) AmeriCare proposal offers the greatest potential to ensure health insurance coverage for all, by broadening access to Medicare. At $188.5 billion in federal dollars in 2010, his plan has the highest federal budget price tag, but it would reduce national health care spending by $58.1 billion in 2010—by covering more people through Medicare, a program with significantly lower administrative costs than private insurance, according to researchers. The Building Blocks proposal—a framework for universal coverage developed by Cathy Schoen and colleagues at The Commonwealth Fund which mirrors most elements of President-elect Obama and Senator Baucus' plans—would add an estimated $17.8 billion in health care expenditures in 2010, about 1 percent of current health care costs, which totaled $2.2 trillion in 2007, according to the latest figures available from CMS. Lewin based its assessment on the Building Blocks proposal because plans by President-elect Obama and Senator Baucus lack key details—such as the amount of premium subsidies for low-income families—which are needed for analysis. The report estimates that Building Blocks would cost the federal government a net $103.9 billion in 2010. New initiatives to improve quality and efficiency in the health system, such as reforming the way providers are paid, have the potential to offset both health system and federal costs. The Building Blocks plan would cover 44.9 million people by expanding the nation's current employer and public insurance system. This is a less disruptive approach that builds on what is currently working in the U.S. health system, according to the report authors. Senator Baucus' proposal is similar in that it includes a requirement that all individuals purchase health insurance when it is deemed affordable. President-elect Obama's plan does not include such a requirement. Massachusetts is currently implementing a similar plan with an individual requirement to have coverage. Tax Codes Affected in Some Proposals Some plans build in measures to finance improved coverage through new tax revenues or spending reductions. Senator Ron Wyden's (D-OR) Healthy Americans Act would expand health insurance to an estimated 46 million uninsured people. Senator Wyden proposes to expand coverage by replacing the income tax exclusion for employer benefits with an income tax deduction and premium subsidies. People would gain access to insurance through regional insurance exchanges offering private insurance plans, or through an employer. This plan would add $1.21 trillion to federal spending in 2010, but is the only plan to specify sufficient new revenues and spending offsets ($1.25 trillion) to achieve net federal budget savings (of nearly $40 billion). Revenue increases and spending offsets included in the plan, such as new income tax revenues from substituting employee cash compensation for employer premium contributions, family premium contributions, employer payments, and the elimination of Medicaid and the Federal Employees Health Benefits Program (FEHBP), more than offset the incremental federal budget outlays. While Senator Mike Enzi's (R-WY) Ten Steps to Transform Health Care in America Act and Senator Richard Burr's (R-NC) Every American Insured Health Act both aim to expand coverage by replacing the employer benefit tax exclusion with new standard income tax deductions and tax credits, their proposals don't go as far as others in covering the uninsured. Senator Enzi's plan would cover an estimated 26.9 million people and Senator Burr's plan would cover 22.3 million. Senator Enzi's plan includes an auto-enrollment process for uninsured people but does not impose a requirement that all obtain coverage. Senator Burr's plan also lacks such a requirement. Both proposals also rely on the individual insurance market which is more costly in general than group insurance. This means that the Enzi and Burr proposals cover fewer people compared to other plans and create higher health spending. Several Proposals Seek Incremental Coverage Expansions In addition to proposals seeking more widespread reforms, researchers examined incremental reform bills that seek to expand existing public insurance programs, bills which provide new options for small employers, and proposals to expand health savings accounts. Though incremental bills cover far fewer people, they would be targeted to vulnerable groups. The Lewin analysts estimate that Senator John Kerry's (D-MA) and Representative (D-CA) Waxman's Kids Come First Act of 2007 would cover 6 million out of 12 million uninsured children and young adults in 2010. Proposals Also Seek to Improve Quality and Efficiency Many of the proposals analyzed in this report include standards for ensuring high quality care. Plans of both President-elect Obama and Senator Baucus are explicit about the need to establish rules for private insurance markets and define new benefit standards to ensure access to timely care. Senator Baucus proposes to establish an Independent Health Coverage Council that would be appointed by the President and work to ensure that coverage is affordable, appropriate, and accessible. Senator Enzi's plan also promotes setting standards for rules governing private insurance markets. "These health care proposals represent a tremendous amount of work by Congress over the last year to move us on the path to a high performance health system," said Commonwealth Fund President Karen Davis. "Our new leadership in Washington can now use this thinking as a foundation on which to build a viable health care reform plan which ensures affordable, high-quality care for all Americans." This analysis compares 11 leading Congressional bills and proposals designed to expand health insurance coverage and is the first of a two-part series (see list of plans reviewed below). Part II of the series to be published in February 2009 will analyze and compare Congressional bills that seek to improve health care quality and efficiency. ### The Commonwealth Fund is a private foundation supporting independent research on health policy reform and a high performance health system. PROPOSALS AND BILLS COVERED IN AN ANALYSIS OF LEADING CONGRESSIONAL HEALTH CARE BILLS, 2007�: PART I, INSURANCE COVERAGE Fundamental Reforms of the Nation's Health Insurance System Building Blocks (mirrors most elements of proposals by President-elect Obama and Senator Baucus) Senator Ron Wyden's (D–Ore.) and Representative Brian Baird's (D–Wash.) "Healthy Americans Act" (S.334 and H.R. 3163) Senator Mike Enzi's (R–Wyo.) "Ten Steps to Transform Health Care in America Act" (S.1783) Senator Richard Burr's (R–N.C.) "Every American Insured Health Act" (S. 1886) and Senator Tom Coburn's (R–Okla.) "Universal Health Care Choice and Access Act" (S. 1019) Senator Jeff Bingaman's (D–N.M.) "Health Partnership Act" (S. 325)/ Representative Tammy Baldwin's (D–Wis.) "Health Partnership Through Creative Federalism Act" (H.R. 506)/ Senator Russ Feingold (D–Wis.) and Senator Lindsey Graham's (R–S.C.) "State-Based Health Care Reform Act" (S. 1169) Representative Pete Stark's (D–Calif.) "AmeriCare Health Care Act of 2007" (H.R. 1841) and Senator Edward Kennedy (D–Mass.) and Representative John Dingell's (D–Mich.) "Medicare for All Act" (S. 1218 and H.R. 2034); Representative John Conyers' (D–Mich.) "United States National Health Insurance Act" (H.R. 676) and Representative Jim McDermott's (D–Wash.) "American Health Security Act of 2007" (H.R. 1200) Expansions of Existing Public Insurance Programs Senator Jeff Bingaman (D–N.M.) and Representative Gene Green's (D–Texas) "Ending the Medicare Disability Waiting Period Act of 2007" (S. 2102 and H.R. 154) Senator John Kerry (D–Mass.) and Representative Henry Waxman's (D–Calif.) "Kids Come First Act of 2007" (S. 95 and H.R. 1111) New Options for Small Employers Representative Sam Johnson's (R–Texas) "Small Business Health Fairness Act of 2007" (H.R. 241)/ Representative Vern Buchanan's (R–Fla.) "Small Business Growth Act of 2007" (H.R. 1012)/ Representative Howard McKeon's (R–Calif.) "Working Families Wage and Access to Health Care Act" (H.R. 324) Senator Richard Durbin (D–Ill.) and Representative Ronald Kind's (D–Wis.) "Small Business Health Options Program Act of 2008" (SHOP Act) (S. 2795 and H.R. 6210); Representative Thomas Allen's (D–Maine) "Small Business Health Plans Act of 2007" (H.R. 2132) Expansions of Health Savings Accounts Representative Eric Cantor's (R–Va.) "HSA Improvement and Expansion Act of 2007" (H.R. 3234)

What you should know about flood insurance

Here is some basic informations about flood insurance provided by Mike Howard, a spokesman for the Bothell office of the Federal Emergency Management Agency.

Q: How do I get flood insurance?

A: It's available only from the Federal Emergency Management Agency. But numerous insurance agencies can help owners of homes and businesses obtain it.

Q: How much does flood insurance typically cost?

A: The average annual cost for a residential policy in Washington state is $580. In King County, the average annual cost is $590.

Q: Is everyone eligible to buy flood insurance?

A: Anyone is eligible who lives in a community participating in the national flood insurance program. That program ensures communities are passing ordinances that protect their citizens against flooding. Virtually every community in Washington state participates in the program.

Q: If I sustained flood damage once and made a claim, can I still get insurance now?

A: Yes. That is the virtue of the national flood insurance program. But your degree of flood risk may affect your policy's cost.

Q: If my property floods repeatedly, can I still be insured?

A: Again, yes, if you've paid the premiums. No matter how often an area floods, properties there can be protected by insurance, so long as the properties comply with flood plain ordinances.

But FEMA may work with your community to reduce the incidence of flooding by encouraging a buyout or facilitating the elevation of your property.

What Employees Need Is Health Insurance, Not Cash

This is a story about a guy who started his career in the 1960s, it was generally assumed he would have health benefits funded by his employer for the remainder of his life. But now, as he heads toward retirement, those benefits have all but disappeared, with health care one of his largest monthly expenses.

This situation is not unique to him. As business owners have become saddled with double-digit increases each year for the cost of health insurance, workers are seeing diminished policies, higher co-pays, and higher cost-shares with employers. Today, many small businesses simply can't afford to provide the same level of health benefits they used to.

The entitlement once given my father has gone the way of the $1 cup of coffee.

I've seen how large corporations are now hiring people for the maximum number of part-time hours - just to avoid the expense of offering health insurance. And there is an alarming trend now surfacing that I believe has truly crossed the line. It is an issue of paramount concern to the New Jersey Association of Health Underwriters, of which I am affiliated.

We are seeing employers opt to give their employees an increase in their annual wages in lieu of health insurance. This is not a Health Savings Account, a tax-advantaged medical savings account available to U.S. taxpayers in high deductible health insurance plans. Rather, it is a simple payout of additional wages - not affiliated with any insurance plan.

Such an arrangement may seem to work well for the employer, who no longer feels the obligation to offer employee health insurance. And, for the employee, the additional bump in salary appears to be a nice perk - at first.

Yet, if this practice becomes a universal trend, nobody wins. That's because of human nature - many people tend to spend what they have and leave little left over for a rainy day. Without adequate health coverage in place, or the means to afford the escalating costs of medical care, the ramifications are sweeping. Simply stated:

• Employees without health coverage and their family members, unable to get preventative care or proper treatment for an illness, may become sicker, resulting in the loss of an employee for an extended period of time.
• Lacking other options, employees without health care and their family members may turn to the emergency room for non-emergency care. Under the state's charity care laws, the hospital must care for the sick person, whether they can pay or not. That drives up health costs for the rest of us, as we are the ones who ultimately pay for that care.
• Without the buying power of the company behind them, employees will wind up paying more for individual health coverage than their employers would have paid to put them on group coverage.
• Older employees or those with existing conditions will be hit especially hard by the higher cost of health insurance.

While there is no easy answer to the problem of health care in America today, we can all agree that leaving employees on their own to find insurance, rather than giving them the benefit of group rates, is not the solution. And if the next generation of workers can not expect adequate health care coverage from their employers, the numbers of uninsured workers will only continue to rise - careening our country's health care into a crisis.

In our corner of the country, the New Jersey Association of Health Underwriters spends much time discussing the future of health care. After all, there is no one who knows more about health insurance. We are the ones who meet every day with the consumers and the insurance carriers.

Health insurance brokers are the ones called upon when someone is standing at the pharmacy counter and wondering why their prescription is no longer covered. And, we are the ones who sit in lengthy meetings with insurance carriers, staring at PowerPoint presentations, as they reiterate why costs are rising, once again, for our clients.

For an honest and accurate discussion about the future of health insurance, our elected officials and political candidates need to rely on health insurance brokers. We cringe at the thought of our next President stepping into office with the misperception that his or her health insurance solution "won," and, more importantly, that this country can actually afford to implement it.

To that end, organizations such as the New Jersey Association of Health Underwriters need to have a seat at the table to ensure our policy makers have the proper perspective and to ensure that no American falls through the cracks

Insurance agent pleads guilty in mortgage fraud case

This is the case of insurance agent that commiting a fraud scheme. A self-employed insurance agent admitted guilt for his role in a $12.6 million mortgage fraud scheme that encompassed 25 residential properties in Lee’s Summit and Raymore. Ronald Brown, 39, of Gladstone, pleaded guilty on Thursday in U.S. District Court in Kansas City of defrauding mortgage lenders from June 2005 to May 2007, for which he was indicted on Oct. 29. Federal prosecutors accused Brown of participating with more than 12 others in buying and flipping new homes in upscale subdivisions in Lee’s Summit and Raymore. The homes would be bought at inflated prices caused by fraudulent mortgage applications, and then the conspirators would skim the extra proceeds. Brown worked as an insurance agent for The Brown Insurance Agency in Kansas City, Kan., and obtained insurance for the properties in question by using fake Social Security numbers. Brown faces as much as five years in federal prison and fines of as much as $250,000 and restitution. Sentencing has not yet been scheduled.

Insurance brokers EPIC and Arthur J. Gallagher settle lawsuit

San Mateo-based insurance brokerage and employee benefits consulting company also recognized as EPIC, said late Thursday it's settled a pending lawsuit by Arthur J. Gallagher & Co. Inc., Adding the dispute to a “mutually agreeable and confidential resolution.” Arthur J. Gallagher, one of the nation’s largest insurance brokerages, filed the late 2007 lawsuit in U.S. District Court in San Francisco, alleging that startup EPIC raided its Bay Area staff, ultimately hiring away 47 of 76 employees in Gallagher’s San Ramon office, including its top two executives there. The suit, by Gallagher and its California subsidiary, alleged that EPIC engaged in a “sneak attack” on Gallagher’s personnel and proprietary information leading up to early December 2007, when more than half of Gallagher’s San Ramon employees defected to EPIC. Charges in the now-settled suit included misappropriation of trade secrets, misappropriation of employer property, breach of contract and fiduciary duty, unfair competition and fraud. Privately held EPIC has offices in San Mateo, San Francisco, San Ramon, Folsom, Irvine, Los Angeles and Orange. No further details were disclosed in the Jan. 8 statement by Edgewood Partners. EPIC, launched in mid-2007 by Dan Francis and John Hahn, grew rapidly by recruiting senior executives from a number of local rivals, including ABD Insurance and Financial Services (now part of Wells Fargo), UnionBanc Insurance Services Inc., Brown & Brown Inc. and others. It acquired then-70-year-old Calco Insurance Brokers & Agents Inc. in July 2007 to serve as its statewide base of operations. Francis was previously ABD’s chief executive officer; Hahn was the founder and former CEO of San Francisco’s Tri-City Brokerage.