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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.
  Wednesday, 11/14/18 - www.DailyInsuranceReport.com

The "Daily Insurance Report" is now subscribed to by almost 25,000 elite insurance industry influencers who receive it Monday - Friday at 5:05 am EDT, and have a quick overview of what is appearing in the media regarding the insurance industry; with an emphasis on life, health, and employee benefits.

Oscar Health sues Florida Blue, alleging monopoly of individual ACA health insurance market
Naseem S. Miller / Orlando Sentinel

Oscar Health, the new player in Florida’s ACA marketplace, has filed a federal lawsuit against Florida Blue, alleging that the insurer is using improper tactics to stifle competition in the state and monopolize the individual plan market.

In an antitrust lawsuit filed on Tuesday morning in the federal court’s Middle District of Florida, Oscar alleges that Florida Blue, the largest provider of ACA plans in Florida, has launched a “targeted campaign” to prevent Oscar from entering Orlando by “coercing” brokers into “anticompetitive exclusive agreements” and preventing them from selling Oscar’s plans.

More than 190 brokers have backed out of agreements to sell Oscar’s individual plans, resulting in loss of sales for Oscar, it said.

“When we go to a new city, one of the first things we do is to introduce ourselves to local brokers,” said Bruce Gottlieb, general counsel and executive vice president of strategic partnerships at Oscar. “In every city we've gone to, we've been able to sign up most of the largest brokers in the city. … Except for Orlando. Florida Blue is preventing brokers telling clients about the lowest-priced plans in the region.”

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Americans are not happy with their health insurance
Sam Baker / Axios
Consumers aren’t too wild about their health insurance companies, according to the latest evaluation from the American Customer Satisfaction Index.

How it works: The ACSI is based on interviews with about 250,000 people per year about different industries. It assigns a numerical score, between 0 and 100, to each company and sector it covers.

Health insurance scored a 73 this year — near the bottom of the pack among the industries surveyed. (For context, health insurers tied with airlines.)
Consumers were especially dissatisfied with insurers’ call centers, and said information from their insurers is often difficult to understand.

“Health insurance is, by far, the most problematic and least satisfying category in the sector, in part because it is also the most complicated and controversial,” the survey says.

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Short-Term Insurance Plans Offer A Much-Needed Escape From Obamacare
Sally Pipes, Contributor / Forbes

Several patient advocacy groups recently sued the Trump administration to overturn an August 2018 rule that expands access to short-term health insurance plans. They argue that short-term plans, which they deride as "junk insurance," violate the Affordable Care Act.

The courts ought to toss this meritless lawsuit. The new rule is legal and sensible -- and will allow millions of Americans to purchase more affordable insurance that fits their needs.

Obamacare requires all conventional health plans to cover an extensive list of benefits, including prescription drugs, mental health services, maternity care, and substance abuse treatment.

Many people -- young people in particular -- don't want or need such comprehensive coverage. They just want bare-bones plans that protect them from financial calamity in the unlikely event they sustain a broken bone or face an unforeseen hospital stay.

California Was Already Facing an Insurance Crisis. The Deadliest Wildfires in State History Are Making It Even Worse

Fire insurance was already an issue in California before the most recent blazes started. Premiums are on the rise for homeowners in areas at risk of wildfires, and some insurers are refusing to renew policies for people in danger areas. Insurers in California lost nearly $16 billion last year, four times their losses in 2016, reports insurance credit rating agency A.M. Best.

Annual insurance payouts (in 2018 dollars) surpassed the $1 billion threshold just nine times since 1990, but 2018 was going to be the such fourth consecutive year even before this month’s wildfires in California, Intelligent Insurer reports. The 2017 wildfires triggered nearly $16 billion in insurance payments, almost entirely from the fall blazes in California.'

“This is not the new normal, this is the new abnormal,” Brown told reporters on Sunday. “It will continue for the next 10 to 15 to 20 years. The best science is telling us that this warmth and dryness will intensify. This is a real challenge here threatening our whole way of life.”

LIMRA SRI: Twice as many clients with a formal retirement plan are satisfied with their advisors than those without one

Retirement planning can be challenging for everyone that is involved. For clients, it can be stressful to plan the golden years of your life and consider the possible costs. For advisors, it can be a drawn out process that involves a lot of personal questions and proper asset gathering. However, new LIMRA Secure Retirement Institute (LIMRA SRI) research suggests that this process of creating a retirement plan helps both clients and advisors achieve their desired goals.

Clients with a formal retirement plan feel that their advisors better understand them and their needs and were satisfied with their advisor (chart):

Sixty-five percent of pre-retirees and retirees with a formal retirement plan said that their advisor understood their long term needs. Just 34 percent of those without a formal plan said their advisor had the same understanding.

More than half (56 percent) of those with a formal plan felt that their advisor provides an excellent value for the fees they were charged; only 28 percent of those without a plan felt they were getting the same value.

Twice as many clients with a formal retirement plan felt their advisor put their interests first as those without a plan (54 percent versus 25 percent).
In total, 65 percent of those surveyed with a formal retirement plan said they were extremely satisfied with the advisor, compared to less than one third of those without a formal plan.

The robocallers that are killing benefit advisers’ reputations
By Caroline Hroncich / Employee Benefit Adviser

The robots are calling, and it’s a nightmare for real healthcare brokers.

Although it may seem like an everyday annoyance, robocalls peddling health insurance could be having a direct impact on consumers that are shopping for healthcare.

Some robocalls are scams or sell skimpy insurance plans that may not meet the requirements set by the Affordable Care Act. In California, for example, the Department of Insurance filed a court order in August against Health Plan Intermediaries Holdings for “deceptive acts or practices in the business of insurance.” The court order mentions robocalls offering consumers “special enrollment” opportunities. Many of these calls are coming as companies handle annual open enrollment.

Whither the American pension?
Fewer and fewer workers covered by pension benefits as 401(k) and similar plans proliferate
John Cropley

The sudden erosion of pension benefits for 1,100 former employees of the old St. Clare’s Hospital in Schenectady is a scenario that isn’t supposed to happen.

In 1974, Congress enacted the Employee Retirement Income Security Act, which regulated workplace pensions and created the Pension Benefit Guaranty Corp. Since then, employers with pension plans are required to follow PBGC regulations and pay premiums to the PBGC. In return, the PBGC takes over pension payments to retirees if a guaranteed pension fund fails.

However, the Employee Retirement Income Security Act contained a religious exemption that was later expanded to hospitals operated by religious groups, and St. Clare’s took advantage of that. Now, many of its former employees are on their own.

“This is a broken promise to these folks who were promised these benefits, earned these benefits,” Ferguson said.

Aflac Launching Latest Lump Sum Critical Illness Insurance, Finding New Ways to Reach Patients in Need
Aflac expands distribution to make policy available to more people working in nontraditional settings

Aflac, the leader in voluntary insurance sales at the worksite in the United States, announced today the initial launch of its latest lump sum critical illness insurance policy, which has been redesigned to include new riders and a wider range of benefits to offer a holistic approach to recovery and care.

With the latest lump sum critical illness insurance policy, Aflac is expanding its direct-to-consumer portfolio, further opening up the voluntary insurance market to millions of Americans by expanding the way consumers can access benefits. Other Aflac plans available directly for consumers to apply for include cancer, accident, life, dental and specified health event, with more planned for 2019. As more American workers build careers outside of the traditional workplace as freelancers, contractors, self-employed solopreneurs and in startups, Aflac is making more and more plans available to everyone, no matter where or how they work.

Failure to Plan for Long-Term Care Often Leaves Caregiving to Female Family Members, According to Lincoln Financial Group Study
Study finds that 60 percent of people who have provided care underestimated how demanding it would be further illustrating the need for families to prepare

A new Lincoln Financial Group (NYSE: LNC) study released during Long-term Care Awareness Month finds nearly 75 percent of people believe they will be responsible for caregiving of a family member in need, yet 7 in 10 people worry they will not be able to provide adequate care. Women surveyed were significantly more likely than men to believe familial long-term care responsibilities will fall on them, and 65 percent of those surveyed agreed that parents expect more help with long-term care from their daughters than from their sons.

“Planning before care is needed is the best way to ease those stresses. Think about the type of care you’d want, and discuss your preferences with your family and advisor; then, together, you can determine strategies on how to make those preferences a reality if the need arises.”

More than one in two people turning 65 are expected to need some form of long-term care supports and services in their lifetime, typically beginning in the home with family caregivers. Of those surveyed who have provided care, more than 60 percent said they had no idea how demanding it would be, and that an insurance product to help with long-term care would have made their role easier. Interestingly, emotion was the most commonly cited challenge experienced by caregivers.

More than half of respondents said they would hire professional services specifically to relieve the burden on children or a spouse.

Marsh to Combine Its Specialty Unit with JLT Specialty to Form New Business Called Marsh-JLT Specialty

Marsh, a global leader in insurance broking and innovative risk management solutions, today announced the formation of Marsh-JLT Specialty. Marsh-JLT Specialty will be a new specialty business within Marsh that combines the specialty teams of Marsh and Jardine Lloyd Thompson Group plc (JLT), effective upon closing of the transaction between Marsh’s parent company, Marsh & McLennan Companies and JLT, which remains subject to the receipt of certain antitrust and financial regulatory approvals.


Monday, 11/12/18 - PwC's 5 takeaways for healthcare leaders from 2018 midterms

Tuesday, 11/13/18 - EEOC Secured $505M For Workers In Banner FY 2018

Wednesday, 11/07/18 - Florida-based Simple Health Plans shut down for selling “sham insurance”

Thursday, 11/08/18 - $1 billion lawsuit over CalPERS insurance rates moves forward with trial date

Friday, 11/09/18 - Obamacare Repeal in Congress Is Dead. Next, a Battle Over Medicare for All

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Walt Bernard Podgurski - - Editor