By insurancejournal

“A must read for everyone wishing to truly understand workers’ compensation sales”

This is not your ordinary workers’ compensation book

Workers’ compensation coverage is relatively easy to understand. It’s the legal, procedural and contractual issues surrounding workers’ compensation that are complicated.

Unlike most, this book details the workers’ compensation legal, statutory and contractual risk transfer issues that trip agents up most often.

What you will learn in this book

- How does each state view LLC’s?

- What are the First Report of Injury requirements of every state?

- How many employees can an insured have in a particular state before workers’ compensation is required?

- When should a state be listed as a primary “3.A.” state? A “3.C.” state?

- Is employers’ liability coverage really that important?

- How should coverage be set up when using a PEO?

These and many more legal and procedural questions are answered in this guide to workers’ compensation.

You should be your client’s best resource

Know more than the other guy, win clients and secure your client relationships by knowing the answer to the many questions that surround workers’ compensation.

Book information

ISBN: 978-0-578-02096-9
Publisher: Wells Publishing, Inc.
Author: Christopher J. Boggs, CPCU, ARM, ALCM, LPCS, AAI, APA
185 Pages
© 2009 Wells Publishing, Inc.
Price:
Download $49.95
Paperback Book $55.00

The New Health Insurance Solution: How to Get Cheaper, Better Coverage Without a Traditional Employer Plan

• Author: Paul Zane Pilzer
• Hardcover: 336 pages
• Publisher: Wiley (September 8, 2005)
• Language: English
• ISBN-10: 0471747157
• ISBN-13: 978-0471747154
• Product Dimensions: 9.2 x 6.3 x 1.1 inches

Product Description
You no longer need a traditional employer plan to get good, affordable health insurance. The New Health Insurance Solution can help you cut your health insurance costs in half if:

* You’re self-employed, an independent contractor, or your employer doesn’t provide health insurance (you can probably get coverage on your own for about $94/month—a fraction of what an employer would have to pay for the same coverage)
* You are employed and pay extra to cover your spouse or children under your employer-sponsored plan—you may save 50% by taking them off your employer plan
* You own a small business and are getting killed by double-digit premium increases—you can now give employees tax-free money to buy their own plans and get your company out of the health insurance business.

The book also explains in detail the best solutions for you if:

* You can’t find affordable health insurance because you or a child have an expensive preexisting medical problem (your state has a program to provide you with guaranteed coverage )
* You’re currently putting money into an IRA or a 401(k)—because you don’t realize that an HSA is always a better option
* You’re unsure how you or your parents will be able to afford health insurance during retirement, or how to maximize benefits from Medicare—including the new Part D prescription drug plan

The New Health Insurance Solution is the definitive guide to the new ways every American can now get affordable health care—without an employer.

PAUL ZANE PILZER is a world-renowned economist, a former advisor in two White House administrations, an entrepreneur/employer, an award-winning adjunct professor at NYU, and a New York Times bestselling author.

From the Back Cover
A Health Insurance Revolution is Here!

“Americans can finally get affordable lifetime health insurance for themselves and their family. Pilzer’s The New Health Insurance Solution shows you how every step of the way.”
—Mark Victor Hansen, cocreator, #1 New York Times bestselling series Chicken Soup for the Soul®, and coauthor, The One Minute Millionaire

“Millions of entrepreneurs and small businesspeople think they can’t afford health insurance. Now they can.”
—Randy Fields, cofounder, Mrs. Fields Cookies

“A priceless guide for every American, and especially for anyone with a family member with a health problem.”
—Anthony Robbins, author, Awaken the Giant Within and Unlimited Power

“I was on COBRA health insurance and the information in this book lowered our monthly premium by $700 a month.”
—John Grillos, Hillsboro, California

American families and businesses don’t realize there are affordable new ways to get health insurance—without a traditional employer plan. The New Health Insurance Solution explains how you can get better, cheaper, and safer health insurance, and save thousands of dollars a year on all your healthcare costs. The book also explains why you should take your spouse and children off your employer health plan, how to use the new Health Savings Accounts (HSAs) to get a double tax break, how to cut prescription drugs costs by 50% or more, how to get health insurance between jobs, and how to get affordable healthcare for yourself or your parents in retirement.

- amazon.com -

Title:

Author: Jay Davidson

Inside it, you’ll learn…

• How to get insured even with Pre-Existing Health Conditions . . .
• How to Know If Your Family Healthcare Insurance is Adequate. . .
• Secrets about Health Savings Account (HSA) that Most People Don’t Know . . .
• The intricate differences between PPOs, HMOs and POS and why Making the Right Health Care Choice will save you Thousands . . .

• Four Specific Steps to Reduce Medical Bills for you and your family, even if you’ve already received the service and have gotten billed! . . .

And that’s just a tiny sample!

A glossary of Terms You Should Know Regarding Health Insurance

A Health insurance policy is a contract between an insurance company and an individual. The contract can be renewable annually or monthly. The type and amount of health care costs that will be covered by the health plan are specified in advance, in the member contract or Evidence of Coverage booklet. The individual policy-holder’s payment obligations may take several forms:

Prescription drug plans are a form of insurance offered through some employer benefit plans in the US, where the patient pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan.
Some, if not most, health care providers in the United States will agree to bill the insurance company if patients are willing to sign an agreement that they will be responsible for the amount that the insurance company doesn’t pay. The insurance company pays out of network providers according to “reasonable and customary” charges, which may be less than the provider’s usual fee. The provider may also have a separate contract with the insurer to accept what amounts to a discounted rate or capitation to the provider’s standard charges. It generally costs the patient less to use an in-network provider.

- 7secretstohealthinsurance.com -

The Complete Book of Insurance: The Consumer’s Guide to Insuring Your Life, Health, Property and Income, Revised Edition (Paperback)

Product Description

The Complete Book of Insurance provides all the information a consumer needs to make intelligent insurance-buying decision. Written by a nationally known expert on insurance, the book is geared for everyday consumers who are confused about the variety and complexity of today’s insurance products.

In easy-to-understand language, the book explains everything from variable annuities to disability insurance. Most important, the book shows how to determine the right insurance for consumers of different incomes, age group and family responsibilities. Specific topics include: Spend your insurance dollars wisely. Provide adequate coverage for you and your family; Disability, medical, homeowner’s, automobile, liability and life insurance products; Managing your life insurance; Selecting an insurance agent and insurance company.

Product Details

• Paperback: 275 pages
• Author: Ben G. Baldwin
• Publisher: Irwin Professional Publishing; Revised edition (February 1, 1996)
• Language: English
• ISBN-10: 1557388806
• ISBN-13: 978-1557388803
• Product Dimensions: 9.2 x 6.1 x 0.8 inches
• Shipping Weight: 13.6 ounces

- amazon.com -

• Hardcover: 720 pages
• Authors: Emmett J. Vaughan and
  Therese M. Vaughan
• Publisher: Wiley; 10 edition (December 21, 2007)
• Language: English
• ISBN-10: 0470087536
• ISBN-13: 978-0470087534
• Product Dimensions: 9.9 x 8 x 1 inches

Product Description
This classic book presents a thorough and comprehensive introduction to the field of insurance while emphasizing the consumer. The new Tenth Edition first examines the concept of risk, the nature of the insurance device, and the principles of risk management. It then discusses the traditional fields of life and health insurance as solutions to the risks connected with the loss of income. And it deals with the risks associated with the ownership of property and legal liability.

From the Back Cover
Take no chances!  Learn about risk and insurance from the premier text.

Why learn about risk and insurance? You might be thinking of a career in the diverse and rewarding fields of risk management and insurance. If you plan on managing a business, you’ll need to know how to protect your organization from risk. And as an individual, you’ll want to make informed decisions about protecting yourself and your family with life, medical, home, auto, and many other kinds of insurance.

Whether you want to prepare for our career or simply become a more knowledgeable consumer, Vaughan and Vaughan’s Tenth Edition of Fundamentals of Risk and Insurance gives you a comprehensive, consumer-oriented introduction to the many facets of risk management and insurance.

The Tenth Edition presents the principles of risk management, summarizes the nature of pure risk on the individual and on society, and illustrates how insurance can be used to deal with the problems posed by such risk.  In addition to clear and engaging coverage of insurance principles and theory, you’ll walk away from this book with practical, how-to advice that will come in handy in both your professional and personal life.

NEW FEATURES

• Includes the changes to pension regulation introduced by the Pension Protection Act of 2006.
• Reflects changes to the Medicare program that were introduced by the Medicare Prescription Drug Improvement and Modernization Act of 2003, including Medicare Part D.
• Updated discussion of the personal auto policy incorporates changes introduced in 2005.
• Incorporates changes in commercial lines forms, including the 2004 commercial general liability form, 2006 commercial crime program, and 2006 business owners policy.
• Revised to reflect the 2001 CSO mortality table.
• New discussions of enterprise risk management, insurance-linked securities, developments in auto insurance pricing and underwriting, and recent innovations in life and annuity products.

- amazon.com -

Laurie Channer, a pet owner in Chicago, says that over the past five years since she adopted her beagle mix, Marley, her pet health insurer, VPI, has reimbursed her thousands of dollars.

More recently, Marley had a lipoma tested along with a blood test as a precaution for dental cleaning. The cost to Channer at the time of service was $578.23. VPI reimbursed her $216.10. So Channer’s actual cost was $362.13.

Pet owners considering insurance might ask their vets about their experience with health insurance. Not all are comfortable recommending a specific company, but many vets have found that owners with insurance are more likely to seek treatment for their pets’ ailments.

“If you have to pay out of pocket, this depends on the practice area and economy, of course, but if you are paying more out of pocket, you might not go in quite as much or do quite as aggressive a course of therapy,” says Shawn Messonnier, a veterinarian and author of “The Natural Health Bible for Dogs and Cats.”

Pet owners who are consistent savers might open a savings account  earmarked for pet health care.

“Making regular contributions to a savings account for your pet’s health care costs can be the right answer in the long run because many pets don’t face catastrophic illnesses or accidents. So that money builds and builds and without ever being taken advantage of,” says Kim Saunders, vice president of shelter outreach and public relations with Petfinder.com.

Estate planning for pets

Most pet owners are unaware that they can legally set up a trust to provide for the care of their pets.Forty states and the District of Columbia allow statutory pet trusts. That means you can set aside money for your pet and name a caretaker. A trustee oversees the finances and makes sure the pet is getting the care specified in the trust.

Pet owners living in states without a pet trust statute — Connecticut, Georgia, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, Oklahoma, Vermont and West Virginia — can still set up a trust for their pets, but it won’t be as easy or enforceable as a specific pet trust.

Danny Meek, a Florida estate plan lawyer and blogger on Pettrustlawblog.com, explains why:

“In the 10 states that do not have statutory pet trusts, you can still set up a trust that will take care of your pet, but there are some big obstacles. Most states have specific rules against perpetuities, which are time frames that the documents cannot exceed, and a general trust is not necessarily enforceable by a third party,” he says.

Enforcement by a third party is particularly important if you want to make sure your pet is actually getting care.

“One of the benefits of the statutory pet trust is that if I’m the trustee and you’re supposed to be taking care of Fido and I see that you’re not, then I can go to the court and ask for a successor caretaker to be appointed or have myself appointed to make sure that the pet is being taken care of. In most states, the general trust statutes do not allow for that,” says Meek.

That leaves the door wide open for unscrupulous caretakers to take the money earmarked for the pet’s care and run — with predictably dire consequences for the pet.

Pet advocates such as Buchwald believe a discussion about a pet trust should be initiated by the attorney or financial planner assisting with a client’s estate plan.

Unfortunately, a large number of attorneys involved in estate planning are also unaware of the option of providing for companion animals, Meeks says.

“It’s hard to believe that a lot of attorneys are still unaware of this, but we’re educating them more and more on it,” he says. “Clients get most of their education from the professionals who are helping them out.”

Buchwald and the ASPCA see many pets relinquished to shelters after the death of their owners.

“The ASPCA just last week took in two pets from someone who had died, and the pets were at risk — there was no one to take care of them. There was a local caregiver and a will, but the will did not specify what should happen to them,” Buchwald says.

“They were obviously much loved and well cared for. They’re really lovely pets. The deceased had spent a lot of time drawing up with legal counsel a very elaborate, well-thought-out will when it came to her financial assets. It’s hard to believe she would have left them out had she known it was possible to provide for their care,” she says.

If your financial planner or estate attorney doesn’t mention planning for your pets, ask what would be appropriate for your situation and your companion animals.

Cost for a pet trust can range from $500 to $3,000, depending on its size and complexity. But if you add it to your basic estate planning package at the same time you draw up a will, says Meek, “then it could be very affordable for pet owners.”

- bankrate.com -

Overview

The move toward high-deductible health plans (HDHPs) was given impetus by 2003 legislation granting tax preferences to funds set aside to pay for out-of-pocket medical expenses—conditional on enrollment in a plan having a minimum deductible of $1,000 for individuals and $2,000 for families. The major purported advantages of HDHPs are that they will a) lower health care costs by causing patients to be more cost-conscious, and b) make insurance premiums more affordable for the uninsured. This report, based on the Commonwealth Fund Biennial Survey of Health Insurance (2003), finds that such plans are unlikely to have a substantial effect on either costs or coverage. Furthermore, HDHPs can undermine the basic purposes of health insurance: to reduce financial barriers to needed care and protect against financial hardship. The authors suggest legislative modifications to protect lower-wage adults and ensure access to early preventive and primary care.

Executive Summary

Many market advocates have turned to high-deductible health insurance plans (HDHPs) as a strategy for making patients more cost-conscious. In 2003, the move toward HDHPs was given impetus by a provision in the Medicare Modernization Act granting tax preferences to funds set aside to pay for out-of-pocket medical expenses—conditional on enrollment in a plan having a minimum deductible of $1,000 for individuals and $2,000 for families. So while only 8 percent of privately insured adults under age 65 (7 million people) have deductibles of $1,000 or more, this number could well grow in future years.

High-deductible plans can undermine the two basic purposes of health insurance: to reduce financial barriers to needed care and to protect against financial hardship. This report, based on the Commonwealth Fund Biennial Survey of Health Insurance (2003), finds that:

• Adults with a high deductible have significantly greater difficulty accessing care due to cost compared to those with a lower or no deductible. Thirty-eight percent of adults with deductibles of $1,000 or more reported at least one of four cost-related access problems: not filling a prescription, not getting needed specialist care, skipping a recommended test or follow-up, or having a medical problem but not visiting a doctor or clinic. By contrast, 21 percent of adults with no deductible report one of these four access problems.
• High-deductible plans would be particularly problematic for lower-income Americans: a predicted 44 percent of people with incomes below $35,000 and with a deductible of $500 or more would experience cost-related access problems, compared with 21 percent of higher-income, insured adults with deductibles under $500.
• People who are sick would have a more difficult time obtaining needed care under an HDHP: among adults with a deductible of $500 who rate their health as fair or poor, or who have a chronic condition or disability, a predicted 45 percent would have a cost-related access problem, versus 19 percent of healthier adults with a deductible under $500.
• Medical bill problems are more common among those with higher deductibles. Over half (54%) of those with a deductible of $1,000 or more reported difficulties paying medical bills or are paying off accumulated medical debt, compared with just 24 percent of privately insured adults with no deductible.
• Medical bill problems and medical debt are greater among lower-income adults with higher deductibles. An estimated 55 percent of those with incomes under $35,000 and deductibles of $500 or more would experience medical bill problems or accrue medical debt, compared with 27 percent of adults with higher income and deductibles under $500.
• For insured adults who are ill, having higher deductibles would mean they would be more likely to have difficulties paying medical bills or accumulate medical debt: 59 percent of sick adults with deductibles of $500 or more would experience medical bill or debt problems, compared with just 24 percent of comparatively healthy adults with a lower deductible.The major purported advantages of HDHPs are that they will a) lower health care costs by causing patients to be more cost-conscious in their health care decisions, and b) make health insurance premiums more affordable for the uninsured. The authors find, however, that such plans are unlikely to have a substantial effect on either costs or coverage.
• Only 4 percent of health care expenses are accounted for by households with spending below the minimum deductibles required for participation in a health savings account (HSA). Altering the financial incentives for patients with health care spending under the deductible is unlikely to affect health care outlays significantly.
• The major effect of high deductibles is not lower total health care costs, but rather a one-time shift in spending from insurance premiums to patient out-of-pocket outlays. In future years, premiums are likely to continue to rise.
• High-deductible plans in the individual health insurance market are unlikely to be affordable for those Americans who are currently uninsured. Two–thirds of the uninsured have incomes that are less than twice the federal poverty level. Premiums for HDHPs equal about 6 percent of income for a 25-year-old man living at twice the poverty level and about 20 percent of income for a 60-year-old woman at that same income level. Researchers have found that few low-income individuals can afford to purchase coverage if premiums exceed 5 percent of income.
• Low-income individuals and families would be at risk for spending substantial sums of income out-of-pocket. The ceiling on out-of-pocket expenses constitutes 26 percent of income for single individuals and families at twice the federal poverty level.

Little advantage can be gained from providing people with incentives to choose an HDHP. Such incentives are essentially a tax break for higher-income individuals and, moreover, drain the federal treasury of $6 billion to $16 billion over 10 years. Further tax incentives proposed by the President in the fiscal year 2006 budget would provide an additional $48 billion over 10 years in subsidies to small businesses and individuals for HDHP/HSAs—funds that might be better spent on covering the uninsured through public programs or helping states maintain or expand coverage through Medicaid or other state insurance programs.

If HSAs continue to be conditional on purchase of an HDHP, several policy changes might be considered to better target incentives and ensure access to care:

• Permit employers to lower deductibles for lower-wage workers.
• Exempt primary care and preventive services from the deductible.
• Guarantee choice of a comprehensive health plan to workers covered under employer plans.
• Permit greater flexibility in benefit design.
• Set an income ceiling on eligibility for HSAs.

High-deductible plans can deter patients from seeking needed care and add to financial burdens, particularly on low-income families and those with chronic illnesses. The modifications suggested here—particularly those intended to protect lower-wage adults and ensure access to early preventive and primary care—would help mitigate the most potentially harmful effects of these plans.

How High Is Too High? Implications of High-Deductible Health Plans, Karen Davis, Ph.D., Michelle M. Doty, Ph.D., and Alice Ho, The Commonwealth Fund, April 2005, Download

- commonwealthfund.org -