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Walt Bernard Podgurski,  Editor,  440-773-1108, 

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Editorial Mission Statement: The goal of this publication is to provide readers a broad selection of what is being written about the insurance industry and related issues. Some articles may have a “tilt” towards a particular perspective one way or another. Inclusion in this newsletter is not an endorsement of any views or content; but report the various and differing views appearing in media.
  Daily Insurance ReportMonday, 12/18/17

Obamacare Subsidy Lawsuit Settled by White House, Democrats
By Anna Edney and Andrew M Harris / Bloomberg
Could pave the way for payment of health insurance subsidies
Trump administration stopped making CSR payments this year
A long-running lawsuit between the Trump administration, House Republicans and Democratic attorneys general over billions of dollars of Obamacare subsidies has been settled, according to an agreement filed in federal court Friday.
The settlement agreement, details of which weren’t available in the filings but described as “conditional,” could pave the way for eventual payment of the cost-sharing reduction payments, or CSRs. The CSRs had been paid to health insurers as a way to subsidize some lower-income patients’ insurance co-payments and deductibles, allowing them easier access to health care.
The Trump administration had stopped making the payments, throwing the Affordable Care Act’s markets into chaos and causing premiums to rise, and state Democratic attorneys general continued the legal effort to try and preserve the subsidies.
The White House, Justice Department and several offices for Democratic attorneys general either didn’t respond to requests for comment or declined to comment late Friday.

Life / Health / Employee Benefits

Christians snub Obamacare for faith-based health plan
Trish Choate, For the Times Record News
But Medi-Share doesn’t share costs for pre-existing conditions, birth control, abortion, Viagra or long-term medication. Clients must also sign a statement of Christian faith.
They have to meet other conditions: be tobacco free, refrain from abusing alcohol and prescription drugs, and say no to illegal drugs.
“The cost of health insurance is so expensive that those people that are healthy are looking at this,” Wichita Falls insurance agent Kelly Fristoe said.
He tells his clients to closely read the 50-page booklet Medi-Share has posted online before signing up.
Fristoe said insurance premiums shot up 60 percent for 2017 and 30 percent for 2018.
He came on board with Medi-Share about three years ago after noticing he was losing clients to it, said Fristoe, a regional vice president for the National Association of Health Underwriters. This year, perhaps 20 percent of his approximately 1,000 clients have signed on with Medi-Share.
Texas has more people in Medi-Share – 52,636 – than any other state, said Michael Gardner, director of communications at Christian Care Ministry, which operates Medi-Share.
In total, 326,365 people are in Medi-Share, Gardner said.

Top people moves of 2017
By Phil Albinus / Employee Benefits Adviser
Along with a series of mergers and acquisitions, 2017 saw a wave of promotions, retirements and outright job hopping inside leading brokerages, insurers and other firms that serve the benefits market.
In February, Zenefits hired Jay Fulcher as its newest CEO and chairman. Hailing from online video technology startup Ooyala and Agile Software, Fulcher oversaw the struggling firm’s exit from the brokerage market and repositioning as a benefits technology firm.
Zenefits’s move triggered a new wave of hires, including Jeff Carr as COO and Kevin Marasco as chief marketing officer. Lisa Reeves was named senior vice president of product, following stints as vice president of corporate strategy at Workday and co-founder and CEO of GridCraft, a data analytics company. Zenefits also named Beth Steinberg as its chief people officer. She is a veteran of Facebook, Electronic Arts, Nike and HP.

Belknap County commissioners say a recent switch of medical insurance providers will save the county $400,000 a year in health insurance costs in 2018.
County Administrator Deb Shackett said the county’s current insurance provider, New Hampshire Interlocal Trust, which partners with the nonprofit Harvard Pilgrim Healthcare to provide group health insurance plans for local governments, was asking for a 22 percent rate hike.
Commissioners received a quote from the county’s former insurer, Health Trust, which offered a rate that would represent an increase of only 8 percent.
Health Trust is a nonprofit public risk pool that provides insurance for public sector employees.

A Commonsense Compromise On Health Care: Free Market Coverage For Everyone
Paul Scotchmer / Forbe Contributor
With Obamacare self-destructing and a meaningful Republican alternative nowhere on the horizon, the way might be open for a far better—and bolder—solution than anything we’ve seen to date.
Imagine this, for example: a health care system that provides generous coverage for all 320 million Americans, a national market for health insurance, transparent and competitive pricing for health services and products, financial incentives for Americans to get or stay healthy, compensation for supervisory care of family members, and continued Medicare coverage for those who want it.
Now the cherry on top: All this could be had for considerably less than the $3 trillion-plus spent last year on health care in the United States—and without adding a dime to the national debt.
Here’s how:

Understanding the Differences Between HSAs and FSAs
The difference between health savings account (HSA) and flexible spending account (FSA) can translate into potential money savings for you and your employees. It's important to understand how they differ and which is the best fit for you and your employees. An HSA and FSA are similar in that they both allow an individual to contribute tax-free to save for medical costs. But it’s important to understand what these accounts offer, along with their notable differences.
At its basis, HSAs are designed to encourage health care consumerism, while FSAs focus on using pretax dollars to cover expenses. Contributions to both accounts are made pretax, which can reduce taxable income. Shannon Britton, Paychex HR generalist, frequently explains the primary characteristics and differences of a HSA and FSA to her clients using the following:
An HSA, which can be funded by employees, employers, or both, is designed to work specifically with a qualifying high deductible healthcare plan (HDHP) to allow tax-free payments of current and future qualified medical expenses. Contributions are automatically deducted from employee paychecks every pay period and deposited into their individual HSA account.
An FSA is employer-established plan that pays for qualified medical and dependent-care expenses with pretax dollars, prior to federal withholding, FICA or state withholding taxes (in most states) being applied to the amount deducted from the employee’s pay. An FSA is typically funded solely by the employee, but employers may also contribute.

Health insurance provider in Thurston County fined $1.5 million by state for violations
Shawn Goggins / ifiberonenewsradio
A health insurance provider that does business in Thurston county is being fined $1.5 million for a violation.
Insurance Commissioner Mike Kreidler issued a cease and desist order Dec. 12 ordering the company to stop selling individual plans in Washington because it failed to maintain an adequate network of medical providers.
Coordinated Care admitted to not having enough anesthesiologists in King, Snohomish, Pierce and Spokane counties. According to company data, its provider network is also seriously deficient in other categories of providers, including immunology, dermatology and rheumatology.

Other Insurance News

Life Insurance Policy Locator Finds $6.6 Million for Georgia Consumers  
Office of Commissioner of Insurance
Atlanta, GA — Hundreds of Georgia consumers have reaped the benefits of Insurance Commissioner Ralph Hudgens and the National Association of Insurance Commissioners’ (NAIC) Life Insurance Policy Locator during the locator’s first year. The free consumer tool has matched 589 Georgia beneficiaries with lost or misplaced life insurance policies or annuities returning $6,617,801.60 to those consumers.  
“So far this year, hundreds of Georgians have been matched with lost or misplaced life insurance policies and annuities – totaling $6.6 million,” said Commissioner Hudgens. “The response from this application has been tremendous. I encourage everyone to log in to see if they have unclaimed money left to them from a deceased family member or loved one.”
Approximately 3,362 consumers have conducted searches for Georgia policies since the policy locator was launched in December 2016. The Life Insurance Policy Locator Service was created to help consumers locate benefits from life insurance policies and annuity contracts. Individuals who believe they are beneficiaries, executors or legal representatives of a deceased person may submit a search request form. Nationally, the consumer tool has matched 8,210 beneficiaries with payouts totaling $92.5 million.

How to search for unclaimed life insurance benefits
by Tyler Jett / Times Free Press
A national life insurance database search engine has netted $3 million in unclaimed benefits for Tennesseans and $6.6 million for Georgians, state commerce officials say.
The effort is part of a lengthy investigation of state regulators into the insurance business, dating back to 2008. At that time, the California Controller's Office audited 80 life insurance companies, finding that many companies were not making an effort to provide beneficiaries with the money they had not claimed, according to a news release by the controller's office.
Florida's Office of Insurance Regulation made a similar finding in 2009.
Florence said one of the key findings was the way some insurance companies used the Social Security Administration's Death Master File. Companies were using it to figure out when they could stop paying annuities to somebody, Florence said. However, they weren't using the same resource to determine which of their policyholders died — and who they were supposed to pay.
In 2011, the NAIC launched a task force to examine the life insurance industries' practices. According to the Florida Office of Insurance Regulation, the state has reached settlements with 25 companies, leading to payouts of $7.3 billion in unclaimed benefits. The agreements also led to $2.8 billion to the states.

Congress faces a deluge in fixing flood insurance
Among the laundry list of items Congress faces before year’s end is a Dec. 22 deadline to reauthorize the National Flood Insurance Program. It’s seen as an opportunity to bring reforms to the decades-old program, which has many widely acknowledged problems, including billions of dollars of debt.
The NFIP grants up to $250,000 in coverage. It’s long been criticized for how it incentivizes homeowners to rebuild in vulnerable areas, often at taxpayers’ expense, or to the detriment of others who are covered by the program in less risky inland areas.
“The problem is not that [homeowners] rebuild, but the problem is that they don’t face actuarially fair prices for insurance,” said Michael Greenstone, a professor of economics at the University of Chicago. “In that sense, the rest of us — the people who don’t live in those flood zones — are subsidizing people who want to live in flood zones.”
He said the low NFIP premiums for homes in floodplains are insufficient to cover the program’s actual costs. Then, when disaster hits, taxpayers make up the gap.

American Family Insurance Acquires Data Analytics Firm; Also Home Tech Firm
American Family Insurance said it intends to accelerate its use of data, advanced analytics and artificial intelligence (AI) with its purchase of Chicago-based data and analytics software company Networked Insights.
American Family is a Networked Insights client and has been a minority investor in the company since 2013, increasing its investment over time. With the acquisition, American Family became its sole owner. The purchase price is not being disclosed.
The insurer has been investing in technology and data platforms for the past three years including through its own data science and analytics lab, a strategic data analytics division, an innovation team and collaborative data-science projects with the University of Wisconsin.
American Family said it has also acquired HomeGauge, a home inspection software company with 21 employees, based in Asheville, North Carolina.

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