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long term

Long Covid treatment can lead to debt after insurance denies claims

In June 2021, 32-year-old Alyssa Maness was diagnosed with POTS, a nervous system disorder that her doctors believe was triggered by Covid.

POTS, or postural orthostatic tachycardia syndrome, caused numbness throughout her arms and legs, a pins-and-needles sensation and sudden drops in her heart rate.

Because her heart problems didn’t go away, in early 2022 her doctors began conducting a series of lab tests in an attempt to better understand her long-term Covid symptoms.

When Maness submitted the testing to her insurance — Anthem Blue Cross — the provider deemed the testing medically unnecessary and decreased to cover the cost. She’s now on the hook for the medical bills, which have already cost her more than $10,000 out of pocket.

“I’m kind of at the point sadly where I’ve just been given up,” said Maness, a Ph.D. student in Sacramento, California. Many of her insurance appeals have been denied. “I don’t have the mental bandwidth to even battle this anymore, because it’s become clear that it is most likely going to be unsuccessful.”

Maness is among several long Covid patients in the United States interviewed by NBC News who say their insurance providers are declining to provide coverage related to their illness.

Alyssa Maness.
Alyssa Maness.Courtesy Alyssa Maness

But there are likely many more. Up to 4 million full-time workers are out of the labor force due to long Covid, according to research from the Brookings Institutiona Washington-based think tank.

NBC News has asked insurance providers for comment.

For some, the care they need to manage their chronic illness has left them in medical debt, which can easily balloon into the thousands or even tens of thousands of dollars, experts say. It’s unclear how many are being denied coverage, but a paper published in May in JAMA Health Forum

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March 11, 2023 by INSURANCE

Humana to exit employer-sponsored health insurance

The health insurer Humana will stop providing employer-sponsored commercial coverage as it focuses on bigger parts of its business, like Medicare Advantage.

The insurer said Thursday it would leave the business over the next 18 to 24 months. It includes medical coverage provided through private companies and for federal government employees.

Humana will still provide insurance through its military service business. It covers active duty service members, their families and retirees and a total of nearly 6 million people. It will also still provide employer-sponsored specialty coverage like vision and dental benefits.

Employer-sponsored health insurance is one of the more common ways for Americans to get coverage. But at nearly a million people, it amounts to a small part of Humana’s enrollment of more than 13 million.

Humana’s business largely centers on the military and Medicare Advantage plans. Those are privately run versions of the federal government‘s Medicare program for people age 65 and older.

Humana also runs Medicaid coverage in several states.

CEO Bruce Broussard said in a prepared statement that the exit from employer-sponsored coverage lets Humana focus on its “greatest opportunities for growth.”

The company also said its employer-sponsored business “was no longer in a position to sustainably meet the needs of commercial members over the long term or support the company’s long-term strategic plans.”

Employer-sponsored enrollment growth has been partially slowed for insurers, including market leaders like UnitedHealthcare. Companies have turned more to government-backed coverage like Medicare Advantage or Medicaid for growth.

Humana does not expect the change to affect adjusted profit this year, which the company projects to be at least $28 per share.

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February 28, 2023 by INSURANCE

People Want Certainty: Is Insurance Back? -The Streets

With uncertainty in financial markets, it’s time to turn back to insurance and estate planning, focused strategy, and fundamental financial planning.

With the recent volatility in financial markets, there is a sudden rush to return to traditional, perhaps “safe” investments. And it’s a good time to revise your estate planning.

Our investment portfolios have dropped significantly in 2022 and, for many of us, our confidence in the financial markets remains uncertain. We know historically that “markets” have performed and provided us a stable way to systematically invest, with assurance that over time our assets will grow.

Hopefully, we are also reallocating our investments to reflect our risk tolerance as well as our need for liquidity as we age and consider retirement

There seems to be a renewed interest in certaintyin products like annuities and insurance, things that provide guarantees to families and to our retirement incomes, especially should the markets not return to some level of stability. Investors have returned to annuities and T-bills for certain investment returns—trading volatility for certainty—strategies not seen since the 2008 financial crisis. In short, people want to sleep at night!

Shutterstock_1408299788

Interest in life insurance has also suddenly skyrocketed, with people understanding that a reduction in their assets means fewer assets for heirs should they die prematurely.

Makes sense—with news reporting war, global and weather-related disasters, shootings and random killings, escalating crime (and even with the era of COVID potentially in our rearview mirror), we have all suddenly come face to face with events that bring us in direct view of our mortality. As Jim Morrison said, “No one here gets out alive.”

When was the last time you actually reviewed and contemplated the economic needs of your family or business, if you died tomorrow? What plans would you want to have in

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December 1, 2022 by INSURANCE

New report shows impact of Michigan’s civil legal aid services

A new report has found that in 2019 and 2020, for every one dollar invested in Michigan’s civil legal aid services, they delivered nearly seven dollars in financial benefits.

That includes savings in law enforcement and court systems as well as reductions in community medical care expenses.

WKAR’s Sophia Saliby spoke with Angela Tripp, the vice chair of the state’s Justice for All Commissionwhich issued the report.

Interview Highlights

On why this report was created

Unlike the criminal context, where everyone is entitled to an attorney even if they can’t afford one, there is no such guarantee on the civil side. And so civil legal aid is kind of the only option for people with civil legal needs to get legal help if they can’t afford to hire their own attorney. One of the Justice For All Commission’s goals is to increase funding for civil legal aid, you know, the more funding these programs have, the more people they can help, the more needs they can meet.

On the return of investment for offering civil legal aid

So to be able to say that, you know, for every dollar you give a civil legal aid program, we deliver $6.69 in immediate and long term consequential financial benefits, really puts that in a framework that a lot more people understand and appreciate. And so, it’s not just this mother and her three children who get to retain housing because, you know, that’s a priceless benefit. You can’t really put a price tag on that, except that you can put a price tag on what that saves in other areas in terms of money saved in sheltering that family and access to emergency public benefits.

On how the report will impact the state of legal aid services in Michigan

I

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November 2, 2022 by LEGAL

Legal Aid Society files lawsuit to stop illegal apartment conversions in NYC

Oct 29, 2022, 10:33pmUpdated 1d ago

By: News 12 Staff

Legal Aid Society filed a lawsuit against the New York City Department of Buildings, the New York State Department of Homes and Community Renewal and landlords of a Brooklyn building after they say illegal apartment layout alterations have been initiated. The Legal Aid Society says these alterations can displace long-term rent-stabilized tenants.

After a three-alarm fire destroyed Marshall Reese’s apartment building on Thanksgiving last year, he and his wife were forced to vacate the rent-stabilized apartment they lived in for 40 years. They say their landlord has been trying to change the layout of the building’s apartments.

“All the apartments had eat-in kitchens, all of the kitchens were moved to the center of the building, being replaced by kitchenettes, closets were being removed,” said Reese.

New York City law says that landlords are supposed to get approval from both the city’s Department of Buildings and the state’s Department of Homes and Community Renewals before making changes to layouts in rent-stabilized apartments.

“What these landlords are doing is ignoring the laws, they’re circumventing the process and they’re going right to the Department of Buildings…We’re seeing them alter the apartments in ways that will permanently displace long-term rent-stabilized tenants ,” said a representative from the Legal Aid Society.

In a statement, DOB said “We are legally obligated to issue a permit for a construction project when all of the requirements that we are legally allowed to enforce are met. DOB approvals do not absolve a property owner of their responsibility to comply with the regulations of other government agencies. We are reviewing the suit.”

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October 31, 2022 by LEGAL

Free Legal Aid services yields immediate and long-term benefits

Civil legal aid services in the state of Michigan yield 669% return on investment in social and economic value, according to a recent report released by the Justice for All commission.

By providing resources for more than 100 civil legal aid issues, the report found that the added economic value adds both immediate and long-term benefits to communities and the state. It accounts for the money that would be otherwise spent on assistance, if free legal aid wasn’t available to prevent possible long-term issues.

The report is being used to help understand the importance of free legal aid in the state of Michigan, as investment in these programs rises, many expect to see even greater social economic benefits.

The civil legal issues that are addressed by these aid programs include, custody, healthcare, consumer protection (such as foreclosure and debt collection), eviction and more. These programs assist with legal advice, paperwork, and legal representation. There are more than 1.7 million Michigan residents eligible for assistance from Michigan Legal Aid.

Angela Tripp is the director of the Michigan Legal Aid Help program, and the Vice Chair on the Justice for All commission. She explains that the report allows the commission to monetize the work in legal aid, and justify further investment.

“It’s not just helping these individual people with an immediate crisis but it’s creating long-term benefits,” she explained.

The report suggests that addressing and providing aid to address these issues, rather than leaving the community without legal help or knowledge, have longer term benefits that exceed the cost of offering these services.

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October 30, 2022 by LEGAL

Why auto insurance fees are going back up after $400 refunds

In the spring, eligible Michigan drivers got a $400 refund check from their auto insurance companies, the purported product of savings from a 2019 law that imposed cost controls on the long-term care of badly injured drivers.

Now auto insurers want $48 back because of a sudden $3.7 billion deficit at the Michigan Catastrophic Claims Association, the multibillion-dollar trust fund for motorists who sustain horrific injuries.

David St. Amant, 35, of Dansville, protests cuts in home health care services with injured motorists and their guardians in front of the Livonia offices of the Michigan Catastrophic Claims Association on Oct. 12.

Auto insurers are publicly blaming the deficit on a Michigan Court of Appeals decision that, if allowed to stand by the Michigan Supreme Court, will restore medical benefits for injured drivers.

But there’s another factor that has hindered the trust fund: the sagging stock market.

Just like pretty much everyone’s 401(k) retirement savings or pension fund, the MCCA’s assets have taken a beating on Wall Street.

Last November, when Gov. Gretchen Whitmer called on the MCCA’s board of auto insurance executives to liquidate up to $5 billion in cash from the fund in the form of per-vehicle refunds, the fund had recorded $27 billion in assets and roughly $22 billion in liability, leaving an apparent surplus .

The $27 billion figure was the actuarial value of the fund on June 30, 2021, according to MCCA financial records.

But between July 1, 2021 and June 30 of this year, the MCCA’s investments lost $2.8 billion in value, said MCCA Executive Director Kevin Clinton.

All told, the MCCA’s trust fund has declined by $5.9 billion — roughly half from the investment losses and half from refunds.

In the Andary decision, the Michigan Court of Appeals ruled that the 2019 law cannot retroactively reduce the benefits injured drivers were entitled to before they were hurt.

The Michigan Supreme Court declined to halt the state Court of Appeals decision from going into effect while it considers the case,

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October 25, 2022 by INSURANCE

Hanover Insurance Group (NYSE:THG) shareholders have earned a 10% CAGR over the last five years

The Hanover Insurance Group, Inc. (NYSE:THG) shareholders might be concerned after seeing the share price drop 11% in the last quarter. But at least the stock is up over the last five years. However we are not very impressed because the share price is only up 36%, less than the market return of 56%.

So let’s assess the underlying fundamentals over the last 5 years and see if they’ve moved in lock-step with shareholder returns.

While markets are a powerful pricing mechanism, share prices reflect investor sentiment, not just underlying business performance. One imperfect but simple way to consider how the market perception of a company has shifted is to compare the change in the earnings per share (EPS) with the share price movement.

Over half a decade, Hanover Insurance Group managed to grow its earnings per share at 19% a year. The EPS growth is more impressive than the yearly share price gain of 6% over the same period. So it seems the market isn’t so enthusiastic about the stock these days.

The image below shows how EPS has tracked over time (if you click on the image you can see greater detail).

earnings-per-share-growth
NYSE:THG Earnings Per Share Growth September 25th 2022

We consider it positive that insiders have made significant purchases in the last year. Having said that, most people consider earnings and revenue growth trends to be a more meaningful guide to the business. This free interactive report on Hanover Insurance Group’s earnings, revenue and cash flow is a great place to start, if you want to investigate the stock further.

What About Dividends?

As well as measuring the share price return, investors should also consider the total shareholder return (TSR). The TSR is a return calculation that accounts for the value of cash dividends (assuming that any

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October 4, 2022 by INSURANCE

Don’t just get group life insurance, get individual as well

You can’t take it with you — that is, your group life insurance coverage.

There’s a common misunderstanding among employees that they can take company-sponsored insurance coverage with them when they leave a job. Unfortunately, in most cases, the group life insurance policy is not portable, leaving the employee lacking quality life insurance protection.

Meanwhile, procuring an individual life insurance policy after leaving a job or upon retirement is often a difficult task if an individual’s health condition has changed at any point during their previous employment.

InvestmentNews caught up with Bob Gaydos, CEO of technology-based insurance provider Pendella, to find out why individual life insurance — in addition to group life — should be a focus for employees, especially with open enrollment season just around the corner.

InvestmentNews: Why is individual life insurance necessary on top of group coverage from an employer?

Bob Gaydos: An individual life insurance policy is owned by the employee and can be purchased from a variety of carriers. Meanwhile, group life insurance is a single carrier policy owned by the employer, and the employee is only covered under a certificate. Typically, employers will purchase a small amount of group life insurance for the employee, for example $50,000, and allow the employee to purchase additional group life insurance. This coverage is significantly inadequate.

There may also be coverage limitations on the additional group life insurance purchased, such as a $300,000 limit, or spousal coverage limits, like a spouse can only purchase 50% of the employee’s coverage. This is also inadequate since a family of four with two school-age children may in fact have a need for $1 million on each parent.

Furthermore, the group life coverage is generally subject to actively ‘at work’ provisions. And group life insurance is not portable and in fact

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September 17, 2022 by INSURANCE

Genworth Financial: L&H Insurance Business Is Negatively Valued

Life insurance text from wooden blocks

Piotrekswat

Genworth Financial (NYSE:GNW) is a company that again provides an incredible margin of safety. It is an insurer of both mortgages and provides long-term care and life insurance policies. The company trades at a highly compressed valuation, and it is because its long-term care insurance business issued policies at very uneconomical rates for many years, which has created a substantial policy liability for the company. While it is true that this business isn’t great, with clear anchors of value for the other parts of the business including the mortgage insurance business which has gone through a minority IPO (trading also as Enact Holdings (ACT) on the NASDAQ) and the substantial non-operating loss tax assets on the books, we see that on a sum-of-the-parts basis the health and life insurance part of Genworth’s business has been given a negative value. Since investments still cover liabilities for the life and health insurance business, and we know this from being able to deconsolidate the separately trading Enact Holdings from the books, that negative value makes no sense. This is essentially a no-brainer buy.

Sum of the Parts

The Genworth Financial thesis is ultimately a sum-of-the-parts logic that can be easily followed. There are three elements to the business. The mortgage insurance business, which went through a minority IPO meaning Genworth still owns 81% of the shares (and therefore their results are still consolidated into Genworth’s), the tax assets that arise from a tax sharing agreement among the constituent subsidiaries of Genworth’s business and can now be realized thanks to their profitability, and finally the wart on the company’s face which is the life and health insurance business.

Life Insurance Segment

The life insurance segment as a whole isn’t such a problem, the issue is the long-term

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August 29, 2022 by INSURANCE
December 2023
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