Questions about health reform? Check out www.healthcare.gov
For those of you who've followed the Affordable Care Act since it's passage, you've probably spent considerable time at the federal government site: www.healthcare.gov. Well, it just got a whole new look. They've streamlined the information and given it more of a consumer focus. We like it - a lot. Check it out for yourself. There's even specific information for people who already have health insurance. And even a live chat option 24/7 if you want your question answered right away.
To (PCORI) Fee…or Not to Fee. THAT is the Question!
One of the Affordable Care Act‘s (ACA) 18 new “Taxes, Elimination of Deductions, and New Fees” (click on - http://www.uschamber.com/health-reform/added-costs)is something called the Patient -Centered Outcomes Research Institute fee (or PCORI for short). The fee is applicable to virtually any health insurance plan (both fully insured and self-funded), specifically the following:
To access the complete article, click - https://smstevensandassociates.com/ResourceLibrary/tabid/192/Default.aspx
Spokane man's own smartphone is a witness against him in insurance-fraud case
Last summer, a Spokane man named Bryan Gilbert Robb filed an insurance claim, saying that his home had been burglarized. The police report listed an $800 loss.
Robb's claim, however, totaled $26,569, most of it from computers, games and DVDs. He included several photographs of the items that he said had been stolen.
Digital cameras and smartphones typically record the date and time that an image is taken, with what device, etc. This information, which is embedded in the photo file, is called metadata.
The problem: The metadata for 7 of the 9 photos submitted by Robb showed that the images were taken after the burglary date.
Robb's company, Assurant, denied the claim and turned it over to our Special Investigations Unit, which found a very similar 2004 burglary claim at Mr. Robb's previous address. That claim reported the loss of almost identical computers, a game console and DVDs.
Robb was charged June 14 in Spokane County Superior Court with one count of felony insurance fraud and one count of second-degree attempted theft. Arraignment is set for July 1.
To report insurance fraud or insurance scams here in Washington state, here's how to reach us.
Robb's claim, however, totaled $26,569, most of it from computers, games and DVDs. He included several photographs of the items that he said had been stolen.
Digital cameras and smartphones typically record the date and time that an image is taken, with what device, etc. This information, which is embedded in the photo file, is called metadata.
The problem: The metadata for 7 of the 9 photos submitted by Robb showed that the images were taken after the burglary date.
Robb's company, Assurant, denied the claim and turned it over to our Special Investigations Unit, which found a very similar 2004 burglary claim at Mr. Robb's previous address. That claim reported the loss of almost identical computers, a game console and DVDs.
Robb was charged June 14 in Spokane County Superior Court with one count of felony insurance fraud and one count of second-degree attempted theft. Arraignment is set for July 1.
To report insurance fraud or insurance scams here in Washington state, here's how to reach us.
Allianz Life Insurance fined $150,000
Washington State Insurance Commissioner Mike Kreidler has fined an insurance company $150,000 after its agents sold unapproved annuities.
Allianz Life Insurance Company of North America has agreed to pay the fine.
Several Allianz Life agents have been fined, suspended or have lost their insurance licenses in recent years for selling unapproved annuities to Washingtonians. In some cases, the customers were flown to Idaho; in others, the agents falsely claimed that the forms had been signed in Idaho or Florida. Kreidler’s office had been raising concerns with the company about these problems since at least 2007.
As required by law, Allianz Life reported the agents to Kreidler’s office and offered refunds to the affected customers. In April 2012, the company implemented procedures designed to prevent illegal cross-state insurance sales.
“I’m glad to see that the company’s taking efforts to rein in this ongoing problem,” said Kreidler. “I understand the pressure to make sales, but agents and companies selling to Washingtonians have to use products that are approved here.”
For more, please see the press release.
Allianz Life Insurance Company of North America has agreed to pay the fine.
Several Allianz Life agents have been fined, suspended or have lost their insurance licenses in recent years for selling unapproved annuities to Washingtonians. In some cases, the customers were flown to Idaho; in others, the agents falsely claimed that the forms had been signed in Idaho or Florida. Kreidler’s office had been raising concerns with the company about these problems since at least 2007.
As required by law, Allianz Life reported the agents to Kreidler’s office and offered refunds to the affected customers. In April 2012, the company implemented procedures designed to prevent illegal cross-state insurance sales.
“I’m glad to see that the company’s taking efforts to rein in this ongoing problem,” said Kreidler. “I understand the pressure to make sales, but agents and companies selling to Washingtonians have to use products that are approved here.”
For more, please see the press release.
Understanding Employer Shared Responsibility (per the ACA)
In my travels and presentations to various employer organizations around the country, I'm finding a great deal of misunderstanding concerning one of the more pressing aspects of the Affordable Care Act (or Obamacare) - the so called "employer shared responsibility" provision. Also referred to as the "employer mandate" and the "pay or play provision", this aspect of the ACA poses two distinct types of penalty exposure to affected employers (generally those that employ at least 50 full time and full time equivalent employees). It’s extremely important to clarify that these penalties represent EXPOSURE, first and foremost; and only become actual payable penalties if specific action is taken by EMPLOYEE(s).
So let's examine the 2 penalty exposures and more importantly how each is triggered...
To access the complete article, click - https://smstevensandassociates.com/ResourceLibrary/tabid/192/Default.aspx
To access the complete article, click - https://smstevensandassociates.com/ResourceLibrary/tabid/192/Default.aspx
Spokane man sentenced for insurance fraud and attempted theft
Four years after filing a bogus insurance insurance claim that tried to turn $4,000 in storm damage into a $200,000 payment, a Spokane man has been sentenced to 240 hours of community service, 15 days of electronic home monitoring and more than $7,000 in fines.
Keith R. Scribner, seen in the surveillance photo above, was sentenced Friday in Spokane County Superior Court on felony charges of insurance fraud and attempted theft.
The case stemmed from a claim filed in late July 2009 by Scribner's mother, Marilyn Warsinske. She said a patio roof at a home she'd purchased had collapsed due to the weight of snow some 6 months earlier. The policy covered "like kind and quality" replacement. Her son, she told the company, would handle the claim.
Scribner told the insurance company that patio cover was an extensive structure, spanning the entire length of the patio and wrapping around the home's chimney. Claims officials, inspecting the site, wondered why was there no flashing or holes in the masonry. Scribner said that house painters must have made repairs.
He sent the insurance company three bids to replace the cover based on his description. The bids ranged from $195,586 to $213,815.
Claims officials asked Scribner for any photos of the roof prior to the damage or after it collapsed. Perhaps some were taken during a home appraisal prior to the purchase, they suggested. Scribner said there were no photos and was no appraisal.
But a claims handler discovered an aerial photo of the home on a real estate website. It showed a much smaller patio cover than Scribner claimed.
The company launched a fraud investigation and notified Insurance Commissioner Mike Kreidler's anti-fraud Special Investigations Unit.
As it turned out, there had been a home appraisal, the investigators discovered. In fact, Keith Scribner met with the appraiser. And the appraisal included photos of the patio cover. A real estate agent interviewed by investigators described the cover as being "small and nothing special or significant."
The home's previous owner also provided photographs of the structure. It was originally canvas. When that because troublesome to remove each year, the homeowner bought a polycarbonate cover. Cost: About $300.
An architect told a state fraud investigator that he'd met with Scribner in 2008 -- months before the snow collapse -- to discuss plans to replace the deck cover with new, larger one.
A local company, provided with measurements and photographs of the original structure, drew up replacement bids at the request of a state fraud investigator. The bids: $3,913 and $4,782.
New report cites increased flood risk in coming decades
FEMA on Wednesday released a report on flood risk and the potential impact of climate change, particularly sea level rises.
The upshot: the report said that areas considered flood-prone could substantially increase, particularly here in the Pacific Northwest, by the end of this century. The impact on federal flood insurance -- the National Flood Insurance Program -- would be profound, with substantial increases in both cost and the number of policies.
Mother Jones magazine summarized the report here.
The upshot: the report said that areas considered flood-prone could substantially increase, particularly here in the Pacific Northwest, by the end of this century. The impact on federal flood insurance -- the National Flood Insurance Program -- would be profound, with substantial increases in both cost and the number of policies.
Mother Jones magazine summarized the report here.
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