Health: What does good health really mean?

The word “health” refers to a state of complete emotional and physical well-being. Healthcare exists to help people maintain this optimal state of health.

In 2015, the population of the United States (U.S.) spent an estimated $3.2 trillion on healthcare costs.

However, despite this expenditure, a study by the U.S. National Research Council, published in 2013, showed that Americans die at a younger age and experience more illness and injury than people in other developed countries.

Good health is central to handling stress and living a long and active life. Fast facts on health

Here are some key points about health. More detail is in the main article.

  • Health can be defined as physical, mental, and social wellbeing, and as a resource for living a full life.
  • It refers not only to the absence of disease, but the ability to recover and bounce back from illness and other problems.
  • Factors for good health include genetics, the environment, relationships, and education.
  • A healthful diet, exercise, screening for diseases, and coping strategies can all enhance a person’s health.

What is health?

In 1948, the World Health Organization (WHO) defined health with a phrase that is still used today.

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” WHO, 1948.

In 1986, the WHO further clarified that health is:

“A resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”

This means that health is a resource to support an individual’s function in wider society. A healthful lifestyle provides the means to lead a full life.

More recently, researchers have defined health as the ability of a body to adapt to new threats and infirmities. They base this on the idea that modern science has dramatically increased human awareness of diseases and how they work in the last few decades.

Types

Mental and physical health are the two most commonly discussed types of health. We also talk about “spiritual health,” “emotional health,” and “financial health,” among others. These have also been linked to lower stress levels and mental and physical wellbeing.

Physical health

In a person who experiences physical health, bodily functions are working at peak performance, due not only to a lack of disease, but also to regular exercise, balanced nutrition, and adequate rest. We receive treatment, when necessary, to maintain the balance.

Physical wellbeing involves pursuing a healthful lifestyle to decrease the risk of disease. Maintaining physical fitness, for example, can protect and develop the endurance of a person’s breathing and heart function, muscular strength, flexibility, and body composition.

Physical health and well-being also help reduce the risk of an injury or health issue. Examples include minimizing hazards in the workplace, practicing safe sex, practicing good hygiene, or avoiding the use of tobacco, alcohol, or illegal drugs.

Mental health

Mental health refers to a person’s emotional, social, and psychological wellbeing. Mental health is as important as physical health to a full, active lifestyle.

It is harder to define mental health than physical health, because, in many cases, diagnosis depends on the individual’s perception of their experience. With improvements in testing, however, some signs of some types of mental illness are now becoming “visible” in CT scans and genetic testing.

Mental health is not only the absence of depression, anxiety, or another disorder.

It also depends on the ability to:

  • enjoy life
  • bounce back after difficult experiences
  • achieve balance
  • adapt to adversity
  • feel safe and secure
  • achieve your potential

Physical and mental health are linked. If chronic illness affects a person’s ability to complete their regular tasks, this may lead to depression and stress, for example, due to money problems.

A mental illness such as depression or anorexia nervosa can affect body weight and function.

It is important to approach “health” as a whole, rather than its different types.

Factors for good health

Health depends on a wide range of factors.

A person is born with a range of genes, and in some people, an unusual genetic pattern can lead to a less-than-optimum level of health.

Environmental factors play a role. Sometimes the environment alone is enough to impact health. Other times, an environmental trigger can cause illness in a person who is genetically susceptible.

Access to healthcare plays a role, but the WHO suggests that the following factors may have a bigger impact on health than this:

  • where a person lives
  • the state of the surrounding environment
  • genetics
  • income
  • education level
  • relationships with friends and family

These can be summarized as:

  • The social and economic environment: Including how wealthy a family or community is
  • The physical environment: Including parasites that exist in an area, or pollution levels
  • The person’s characteristics and behaviors: Including the genes that a person is born with and their lifestyle choices

According to the WHO, the higher a person’s socioeconomic status (SES), the more likely they are to enjoy good health, a good education, a well-paid job, afford good healthcare when their health is threatened.

People with a lower socioeconomic status are more likely to experience stresses related to daily living, such as financial difficulties, marital disruption, and unemployment, as well as social factors, such as marginalization and discrimination. All these add to the risk of poor health.

A low socio-economic status often means less access to healthcare. People in developed countries with universal healthcare services have longer life expectancies than people in developed countries without universal healthcare.

Cultural issues can affect health. The traditions and customs of a society and a family’s response to them can have a good or bad impact on health. For example, around the Mediterranean, people are more likely to consume high levels of fruits, vegetables, and olive, and to eat as a family, compared with cultures with a high consumption of fast food.

How a person manages stress will affect health. People who smoke, drink, or take drugs to forget their problems are likely to have more health problems later than someone who combats stress through a healthful diet and exercise.

Men and women are prone to different health factors. In societies where women earn less than men or are less educated, they may be at greater risk than men for poor health.

Preserving health

The best way to maintain health is to preserve it through a healthful lifestyle, rather than waiting until we are sick to put things right.

This state of enhanced well-being is referred to as wellness.

The McKinley Health Center at the University of Illinois IL defines wellness as:

“A state of optimal well-being that is oriented toward maximizing an individual’s potential. This is a life-long process of moving towards enhancing your physical, intellectual, emotional, social, spiritual, and environmental well-being.”

Wellness promotes an active awareness of and participation in health, as an individual and in the community.

Maintaining wellness and optimal health is a lifelong, daily commitment.

Steps that can help us maximize our health include:

  • a balanced, nutritious diet, sourced as naturally as possible
  • regular exercising
  • screening for diseases that may present a risk
  • learning to manage stress
  • engaging in activities that provide purpose and connection to others
  • maintaining a positive outlook and appreciating what you have
  • defining a value system, and putting it into action

Peak health will be different for each person, and how you achieve wellness may be different from how someone else does.

It may not be possible to avoid disease completely, but doing as much as we can to develop resilience and prepare the body and mind to deal with problems as they arise is a step we can all take.

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Insurance Coaching Tips You Need to Know for More Sales

4 Insurance Coaching Tips For More Sales

For those who oversee the sales team of an insurance agency, you know that coaching is essential to each agent’s success. Without effective coaching, revenues remain flat. You must inflate your team with confidence so that they’re rolling towards more sales each and every day. Here are 4 insurance coaching tips you need to know to get more sales:

1. One-on-One Meetings

How often do you sit down with each agent individually? Many times, salespeople are hesitant to share what their current struggles are when surrounded by the rest of the team. That’s why you need to sit down with each agent alone from time to time. To have the most effective meetings, have each sales representative come prepared with their sales-related questions and concerns. Listen carefully to what they’re telling you and, together, formulate and record a goal of theirs to achieve. Be sure to revisit the progress of the goal for accountability purposes at the next meeting. One-on-one meetings are also a great opportunity for you to share praises and offer suggestions on how to improve. When conducted properly, these meetings will build a bond of trust, boost positive morale, and provide motivation to achieve sales goals!

2. Coaching Intelligence

Without comprehensive sales reports, how do you know what you need to work on with your sales staff? That’s where sales software like Blitz can help. With full sales reports, you can ensure your sales team consistently achieves its goals. For example, if you want to see how much home insurance one of your agents has sold this quarter, you can pull that report in the sales software. If the amount sold is lower than the goal you had in place, turn this into an opportunity to offer coaching tips to your agent so that they can hit their goal the next quarter. Intelligence like reporting will allow you to pinpoint the areas where your staff is struggling and make adjustments.

3. Phone Coaching

In insurance, sales conversations which take place over the phone are common. Whether in inbound or outbound calls, agents will be selling your services and providing quotes. Over-the-phone sales can be difficult for many agents. This can lead to a decrease in sales performance. Fortunately for you, there are tools to help your agents succeed! With modern technology enhancements, most phone systems and auto dialers offer the ability to record calls. Then, you can listen to your agent’s calls when you need. Another insurance coaching suggestion you can use to your advantage is whisper coaching. Whisper coaching is the ability to be on the call with your agents without the prospect hearing you. It’s like the head coach talking to the quarterback through a headset, but the defense can’t hear him. With stellar coaching tools, you’ll become the Bill Belichick of your agency with a staff full of Tom Brady-caliber agents.

4. Handle Those Objections!

As long as there are people in sales, there will be objections that need to be handled. Objection handling is one of the most difficult parts of the sales conversation your agents will face. For those agents who handle objections effectively, they will rise to stardom in your agency and boost revenue. To help every agent do so, you must first practice with them because practice makes perfect! Have a weekly sales meeting with your staff and go over current objections your staff is facing. Give a scenario and practice. When your employees struggle, walk them through the scenario with coaching tips. One way you can assist your agents in objection handling is to develop an internal guide. A guide is helpful and also prevents agents from interrupting your work with questions.

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What You Need to Know to Ace Your Insurance Sales Interview

Do You Need Help Preparing for an Insurance Sales Interview? We Have You Covered.

So, you’ve decided to interview for a new position as an agent at an insurance agency. Perhaps you already have experience in the industry, or maybe you’re making the move to try something entirely new. No matter the circumstance, you’ll have to make your first sale on the day of the interview (that sale being yourself). Why are you the one that the agency owner should hire over all other candidates? What makes you qualified? These and many more are all questions that you will need to consider and address in-depth.

Prepare Yourself

Prior to the big insurance sales interview, you’ll need to be fully prepared. Have yourself or someone else quiz you on elements of your resume, including company history, work history or experiences you’ve learned from. Do you know who is interviewing you? If you do, use this to your advantage to learn more about the person by researching them online to find their professional accomplishments and passions. This will come in handy during the rapport building of the insurance sales interview process! As you prepare, use your resources. There are endless sample interview questions online, so challenge yourself to answer them the best you can!

Know the business and Leverage Past Experience

If you’ve already worked in the insurance industry, you’re ahead of the curve. If not, don’t sweat it! You don’t need to be an industry expert in your field to get the job. Once hired as a brand new insurance agent, you’ll go through training to learn the details of the products, procedures and take a test to become a licensed professional. What you need to do is to prove how your natural and learned skills can help the agency succeed. Below are a few skills every insurance agent needs to prove that they can apply:

1. Verbal Communication

Your interviewee will quickly be able to figure this one out during the sales insurance interview. This is a professional interview so keep the conversation professional.

2. Computer Literacy

An insurance agent will use several different systems daily including lead and customer management systems and email. Literacy in computers is necessary, so bring up any computer programs you’ve worked with when asked.

3. Sales Experience

This is a big one and, although sales can be taught, sales experience will shift you into top consideration for employment. Leverage any sales achievements or goals you met from prior experience. Sales is goal-oriented, so any examples in your life where you achieved goals will prove you are capable.

4. Persistence

An insurance agent must be persistent in order to make sales, so you will need to provide an example or two when the going got tough in your career. Maybe it was staying late to make a few more calls in order to reach your goal or solving a problem for a customer. Persistence can separate success and failure. Even former president Calvin Coolidge knows its significance, having once said: “nothing in this world can take the place of persistence.”

5. Teamwork

The saying goes, “teamwork makes the dream work,” and this couldn’t be more accurate inside an insurance agency. For each agency, staff size can vary, so the ability to work with others is vital to ‘getting stuff done.’ Be sure to provide examples of teamwork when the opportunity presents itself during the sales insurance interview.

The Interview Day

The big day is here and you’re ready to go. Unless otherwise stated, you must dress professionally (a suit along with dress shoes unless otherwise stated by the interviewee). If you don’t have a suit and can’t afford a brand new one, don’t sweat it. Most communities have thrift stores with professional clothing at a discount rate. Bring to the interview a pen, notepad or padfolio, along with extra resumes to hand out during the sales insurance interview (in case your interviewees(s) ask). Give yourself plenty of time to get there; experts recommend ten minutes is best. Be cool as you get ready to enter the interview room. Don’t forget to breathe! This will help you remain calm.

During The Interview

The test has come. It’s now time to sell yourself during the sales insurance interview. The good news is that if you’ve arrived on time, dressed professionally, and appropriately groomed, you’ve passed the appearance test. Give a firm handshake to your interviewee(s) and take your seat. Don’t forget that you should be interviewing them just as much as they are interviewing you! Ask questions about tasks that will be expecting of you, time commitments, etc. You need to determine if this is the person you want to be working for and if the company is a good fit for you. You’re investing in each other, so don’t waste your time or theirs if your gut tells you this job is not a good fit.

Put the Cherry on Top

A few days after the sales insurance interview is over, handwrite a thank you note for the employer’s time and consideration. Include a detail from the interview as well to show you’ve remembered. This simple gesture will speak volumes about your professionalism and appreciation for the opportunity. Handwritten thank-you notes show personalization and care.

Informational Source

Insurers Continue Fight for Disability Insurance Awareness

Some U.S. insurers are still out there trying to educate Americans about the need for private disability insurance, in the face of low interest rates, a focus on short-term thinking, and U.S. society’s general hostility toward use of private insurance to manage risk.

LIMRA recently reported, based on its own survey data, that only about 20% of all U.S. adult consumers have disability insurance; that about 30% of  the workers who can get disability insurance at work turn it down; and that just 4% of U.S. consumers appear to have a high level of knowledge about disability insurance.

This month, the disability insurance community is trying to wake U.S. consumers up with the 13th annual Disability Insurance Awareness Month (DIAM) campaign.

Here’s a look at what four insurers are doing and saying to support the DIAM campaign.

OneAmerica Financial Inc.

OneAmerica is supporting the DIAM campaign by releasing the results from a new survey of 1,017 U.S. adults ages 18 and older who are employed full-time or part-time.

The company found that about 41% of working Americans said they believe they have employer-sponsored disability insurance.

About 24% said they have voluntary disability insurance purchased at the worksite.

Here’s a look at the reasons survey participants gave for not having voluntary disability insurance:

  • Their employer doesn’t offer it (or: they don’t think their employer offers it): 47%.
  • They don’t see the value: 14%
  • They don’t think they can afford the coverage: 12%
  • They think they don’t need the coverage, because they’re healthy: 12%.
  • They have other, higher-priority expenses: 11%

Unum Group

Unum has been trying to sell more group life insurance voluntary benefits, but it’s still known for its disability insurance products.

One of the ways the company has tried to promote the DIAM campaign is to release a new version of its “top causes of disability” list. Here’s a look at the frequency of the top three causes of short-term and long-term disability at Unum group disability plans in 2018, with the 2017 frequency rates for  those causes in parentheses:

Short term disability

  • Pregnancy: 28% (28%)
  • Injury (excluding back): 11% (11%)
  • Joint disorders: 8% (8%)

Long term disability

  • Cancer: 16% (17%)
  • Injury: 13% (12%)
  • Back disorders: 13% (13%)

Unum is emphasizing that a disability insurer can help people return to work, as well as protecting them against loss of the ability to earn a paycheck. In the causes of disability update release, the company quotes Marcy Ledford, director of its workforce solutions unit, talking about return-to-work support programs.

Prudential Financial Inc.

Prudential has been trying to tie the need for disability insurance in with its press for the need for overall financial wellness.

The company has posted a new white paper about income protection, with a landing page with the headline, “Disability Happens. Protect Your Income.”

Here are Prudential’s three income protection takeaways:

  1. Most Americans could not cover three months of living expenses if their income were interrupted.
  2. Financial stress can raise the likelihood of incurring a short-term disability.
  3. Protecting against a loss of income due to disability helps mitigate the risk of financial damage.

Prudential is listing three executives from its Prudential Group Insurance unit as the authors of the white paper: Jessica Gillespie, who’s head of distribution; Kristin Tugman, who’s a vice president for health and productivity; and Leston Welsh, who’s head of disability and absence management.

Guardian Life Insurance Company of America

Lawrence Hazzard, head of disability product and marketing strategy for Guardian’s individual disability income business, has been out trying to talk to any reporter he can talk to about the need for disability insurance awareness.

Awareness seems to have improved slightly since the industry began organizing the DIAM campaigns, Hazzard said.

“People get it,” Hazzard said. “But they really don’t like talking about it. A lot of people find out what they really have when they go on claim.”

One challenge insurers face is finding ways is to adapt a product designed with year-round, full-time workers in mind for the gig economy, Hazzard said.

Another challenge is finding ways to help consumers deal with disability risk along with other, more attention-grabbing risks.

“It’s rare for anyone to come for disability insurance,” Hazzard said.

He said financial professionals need to be prepared to talk about the risk in conjunction with other risk management and financial planning matters.

Still another challenge, he said, is generational shifts in how clients want information.

Boomers tended to want recommendations from their advisors, Hazzard said.

Millennials do want mentoring, but “they’re very clear that they will make the decision,” Hazzard said.

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Women, Health and Group Critical Illness Insurance

May marks National Women’s Health Month and is dedicated to educating women about how to take control of their health and make positive changes.

Despite this, the inadequacy of health care coverage continues to play a pivotal role in women pursuing preventive care or services and following through on recommended tests and treatments.

In addition, the growing cost of health care means medical bills can add up quickly. According to a Kaiser Family Foundation report, 26% of women indicated they delayed or went without care due to costs, and the same number reported having trouble paying medical bills within the past year.

Fortunately, innovations in group critical illness insurance have helped create a turning point in addressing women’s health issues. Depending on the plan, traditional critical illness coverage can pay benefits when a person experiences a covered serious illness, such as a stroke, coma, cancer and more. Insurers understand now more than ever the challenges women face — medically and financially — and are adapting their plans to include more benefits covering diseases that impact women.

This could be a particularly time to talk about this kind of coverage with your group health clients.

Meeting women’s holistic health needs

Critical illness coverage can be particularly relevant to women’s health needs. For example, heart health is a major issue for women. Cardiovascular disease is the No. 1 cause of death in American women, claiming more than 400,000 lives each year, according to the American Heart Association. Critical illness coverage can help with expenses related to heart attack, cardiac arrest and more — and at a time when recovery should be the most important thing, the high cost of medical treatment can be overwhelming.

But critical illness coverage is not just for the heart. Women account for almost two-thirds of Americans living with Alzheimer’s, according to the Alzheimer’s Association. Similarly, two to three times more women than men develop multiple sclerosis, according to the National Multiple Sclerosis Society. Companies like Aflac offer benefits as part of their group critical illness coverage for these diseases in case of a diagnosis.

Another innovative benefit for health screenings helps cover tests performed as the result of preventive care, including diagnostic procedures ordered in connection with routine examinations. This can encourage women, who often put their family’s health concerns over their own, to be proactive.

Showing care and focusing on what matters most

Workers and consumers alike are increasingly looking to businesses to do their part in helping take care of their employees beyond traditional benefits. That is why supplemental coverage, which is different than health insurance, can be important in helping demonstrate care for employees. Insureds choose how they want to use their cash benefits, allowing them to focus less on their finances and more on recovery.

As you connect with clients during National Women’s Health Month, see how innovations in group critical illness coverage can help empower women to better take care of themselves and live fearless and get help with expenses health insurance doesn’t cover.

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Where to Buy Low Cost Life Insurance

Searching for life insurance can be a tedious task, considering the implications and complexity of certain policies. Looking for low cost life insurance can add to the complexity of the search, but luckily there are many companies that specialize in this type of policy.

Shop Around

The cost of your premiums will depend on the type of policy you select, your desired amount of coverage, risk and medical condition.

Conduct the Search

Start by obtaining a quote from your insurance agent, if applicable. You might also want to use quote comparison tools to secure rates from other providers in the industry, such as those offered by AccuQuote and NetQuote. These online tools may not offer quotes from every available insurance company, so it is important to do some additional research to find out if there are better options available to you at a lower cost.

Compile a List of Providers

Reputable and financially stable companies offering affordable life insurance products and high customer satisfaction ratings include:

  • American General has been in the insurance industry and served over 13 million customers in the last 160 years. Claims and benefits paid out in the past five years total $36 billion. The company has also received the MarketTools, Inc. CustomerSat Achievement in Customer Excellence six years in a row.
  • ING possesses over $460 billion in assets and currently services 13 million customers.
  • Northwestern Mutual is the nation’s largest provider of life insurance products and has $202 billion in assets. The 155 year old company currently serves three million clients, and is ranked on the Fortune 500 list.
  • Prudential Financial is 137 years old and serves clients in 38 distinct countries and territories. The company also possesses more than one-trillion dollars in assets.
  • Metlife serves 90 million customers worldwide and has over 140 years of experience in the insurance industry.
  • New York Life Insurance, a member of the Fortune 500 list, possesses over 138 years of service in the insurance business. The company also has $287 million in assets under the care of management.

Research Top Providers

Before securing a policy with a life insurance company, make sure you aren’t signing up for a product that is cheap, yet offers no real value. Check out company ratings through Moody’s or A.M. Best to find out if the company you decide to purchase a policy through is credible and financially secure.

Policy Options

It is much easier to secure life insurance when you are younger and in good health because your risk to companies will be substantially lower, making the premiums more cost-efficient.

If you do have medical conditions, disclose this information in the initial application and the insurance company should be willing to discuss alternatives that may be available to you.

Keeping Costs Low

Term life insurance guarantees that a certain amount of funds will be disbursed if the covered individual passes away during the period of time that the policy is valid. Some policies have a return on premium option that allows you to collect the premiums you have paid in over the duration of the policy at the end of the term.

Most financial planners recommend term insurance because it is simple to understand and is generally more affordable than whole life insurance.

Consider coverage provided by your employer since group rates tend to be a lot cheaper than independent policies.

Selecting a Policy That’s Right for You

When negotiating the terms of your life insurance policy with the company you select, present the competing quote. This grants you bargaining power and also helps to lock in the lowest rate possible.

Be sure to carefully review the terms and conditions of the policy and seek clarification, if necessary, prior to committing.

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How to Find Out if Someone Has a Life Insurance Policy

It’s upsetting enough when a loved one dies, but it can be difficult if you don’t know how to find out if someone has a life insurance policy to figure out exactly what his or her assets are worth. There are several ways to determine if someone has a life insurance policy. If none of these methods work, you can also hire an investigator to research every potential avenue of information.

How to Find Out if Someone Has a Life Insurance Policy

If you’re curious about whether or not your relatives have life insurance policies while they are still alive, the only way to find out is to ask them. You can’t write away to banks, life insurance companies, or their employers and ask; the information is confidential. If, however, a relative has died, there are several steps you can take to find out whether or not they had life insurance. The following steps assume that you have a copy of the person’s death certificate, duly endorsed or stamped by the state as an official and legal copy of the death certificate, and/or the executor of the estate of the deceased.

Look Through Financial Records

Look for a paper trail showing premiums paid to life insurance companies. Review cancelled checks, checkbook records, and credit card statements. If you see the name of a life insurance company, contact the company and explain the situation. They will not release information to you over the telephone but may ask for legal proof that the person is deceased and that you have the legal right to review their financial records.

This method isn’t foolproof. Some insurance premiums may be paid in one lump sum or the policy may have been paid off years ago, with no recent record of premium payments. If you don’t find a record of a life insurance policy, don’t give up but continue on with another avenue of inquiry.

Contact Employers

If the deceased was employed at the time of death, the executor should contact the company’s human resources department and ask if they provided life insurance. Many companies provide life insurance as part of their benefits package. The human resource department should be able to help you file the appropriate paperwork to process the claim.

Veterans Administration

Many people who served in the military purchased life insurance benefits, especially veterans of active wars. Such benefits may increase over time. If you know your relative served in one of the branches of the military, you’ll need a copy of his or her official discharge paperwork as well as a death certificate. Start with the Department of Veterans Affairs near you and call them for more information.

MIB Solutions

MIB Solutions is a company that helps people find lost life insurance policies. Their records go back only about 12 years, so any policies older than that may not be in their databases. But with 170 million records on file, there’s a good chance they may be able to help. The cost is around $75 per search.

Investigative Services

As a last resort, you can hire a professional investigator to help you. Paul D. Archibald is a former insurance company executive who maintains a database of nearly all life insurance companies. For a fee, he can help you find out if your deceased relative had a life insurance policy.

Unclaimed Life Insurance

If despite your best efforts you fail to locate a life insurance policy, there’s still a chance of finding it through Missing Money. Their database contains listings for unclaimed life insurance policies and other accounts, such as bank accounts.

Plan Ahead

As you can see, there’s no easy way of how to find out if someone has a life insurance policy. It’s critical to plan ahead if you obtain life insurance and talk to your loved ones, especially the elderly and ill members of the family, to fully understand their financial matters before they become incapacitated or pass away.

For yourself, make a list of all the insurance policies you have, including your life insurance policy. List the company, policy number, and details or make a copy of the policy papers. Place these in a safe deposit box or leave a copy with the attorney who has your will on file. It’s a good idea to talk to an attorney and draw up a will so that if you should die unexpectedly, your family won’t have to struggle through legal paperwork while they’re grieving.

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Affordable Care Act Defense Bill Nears House Floor

H.R. 986 would keep federal agencies from using the ACA waiver program to adjust ACA benefits and underwriting rules.

House leaders could bring H.R. 986, the Protecting Americans with Preexisting Conditions Act of 2019 bill, to the House floor this week.

If passed and implemented as written, H.R. 986 would keep federal agencies from using the Affordable Care Act (ACA) Section 1332 waiver program to adjust ACA benefits rules or underwriting rules.

The administration of President Donald Trump has proposed calling the ACA Section 1332 waiver program the State Relief and Empowerment Waivers program (SREW), and using the SREW program to let states take steps, such as setting up new reinsurance programs, or using short-term health insurance or other products other than ACA-compliant major medical insurance, to try to expand access to health coverage.

The bill was introduced by Rep. Ann McLane Kuster, D-N.H.

The House Rules Committee is preparing to meet at 5 p.m. Eastern Daylight Time today to package the bill for action on the House floor.

Rules members have proposed 25 amendments.

One, proposed by a Republican, would rename H.R. 986 “the Anti-State Innovation Act” bill.

Another draft amendment, proposed by a Democrat, would call for the U.S. Government Accountability Office to report on how SREW waivers might affect mental health care and treatment.

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California May Expand Access to Health Coverage Premium Help

SB-65 could provide premium help for people with incomes up to 600% of the federal poverty level.

The California Senate is looking at a bill that could give more people financial help with paying for Affordable Care Act public exchange plan coverage, and a related bill that could create a state coverage ownership mandate.

California lawmakers have been working on efforts to defend the state’s state-based ACA public exchange, Covered California, against eroding federal support since the 2016 general elections.

Now, they are considering Senate Bill 65 — the subsidy bill — and Senate Bill 175 — the mandate bill. Both bills were introduced by state Sen. Richard Pan, D-Sacramento, California.

SB-65: The Subsidy Bill

SB-65 could provide California residents with financial assistance to buy individual health insurance through Covered California.

SB-65 would provide state-funded coverage purchase subsidies for California residents with household incomes below 600% of the federal poverty level. In California, 600% of the federal poverty level is $72,840 for an individual and $150,600 for a family of four.

Members of the state Senate Health Committee voted 8-0 to approve SB-65 April 10, and members of the state Senate Appropriations Committees voted 6-0 to approve the bill April 29.

SB-175: The Proposed State Coverage Mandate

SB-175 would change California insurance and tax laws to impose a state individual health insurance mandate.

SB-175 would require most California residents to maintain a minimum level of health coverage for themselves and their dependents or else pay a tax penalty.

The bill would provide exemptions for state residents facing financial hardships, and for residents who failed to buy coverage because of their religious beliefs.

SB-175 would take effect only if SB-65 also took effect.

If SB-65 became law, the new SB-175 coverage mandate rules would apply starting Jan. 1, 2020.

The base tax penalty for individuals not exempted from the mandate would be $695 per year.

Members of the Health Committee approved SB-175 by a 6-1 vote April 10, and members of the state Senate Government and Finance Committee approved SB-175 by a 4-2 vote April 24.

Members of the state Appropriations Committee plan to consider SB-175 May 13.

What the Bill Analysts Are Saying

Analysts at the California Legislature’s Legislative Analyst’s Office (LAO) are predicting that SB-65 could add $891 million in new annual state subsidy spending and produce $482 million in new annual mandate penalty revenue.

The analysts state that SB 175 stems from concerns about the current cost and efficiency of the state’s health care system.

The federal Tax Cuts and Jobs Act of 2017 set the penalty for violating the Affordable Care Act individual coverage ownership mandate at zero beginning this year.

“The requirement that most individuals have coverage technically remains in effect, but without the penalty this requirement is unenforceable,” LAO analysts write.

About 3.5 million Californians were uninsured in 2017, and 2.2 million bought individual major medical coverage, the analysts write.

The elimination of the federal individual mandate penalty could increase the number of uninsured Californians and increase the cost of individual major medical insurance, the analysts predict.

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Independent Agents and Health Care Reform

The media frenzy that surrounded the U.S. Supreme Court’s monumental decision on the constitutionality of parts of the Patient Protection and Affordable Care Act (PPACA) has simmered down. But for insurance agents, the topic still looms large. The law – which most people know colloquially as “health care reform” or even “Obamacare” – will have a lasting impact on health care in America, particularly on health insurance.

The court’s ruling upheld the individual mandate – or the requirement that all Americans have health insurance – which was the lynchpin in determining whether the health care law would stand,  be dramatically altered or even scrapped altogether.  

Like most pieces of legislation, the Affordable Care Act is complex, and no quick glance at the thousands of pages it contains will give you an idea of how it will change the world of health insurance. Agents face many tough questions and new realities. So, what do you need to know and what can you do? Here are a few starting points:


Variances from state to state. While the PPACA is a federal law, much of how it affects insurance agents will vary from state to state. It remains to be seen whether and what kind of commissions will be allowed on state health care exchanges, which are essentially marketplaces that allow uninsured people and some groups to shop for health insurance on their own. For insurance agents, the concern is that allowing consumers to shop on their own will be a dramatic drain on business. It’s likely that the end results could vary widely. After all, comparing Montana to Massachussetts or Vermont to Kentucky is like comparing apples to oranges – the differences are too great to generalize. Pay close attention to the developments in your state – some already have accepted grants to either establish an exchange or consider establishing an exchange. Alaska, Louisiana and Florida are the only states to have outright rejected federal grants for exchanges.

Diversification is a good thing. The old adage about not putting all your eggs in one basket applies. To keep your business flourishing, it’s important to diversify the products you sell – now is a good time to explore selling other kinds of insurance. If you already do sell multiple types of insurance, it might be best to invest more in developing those lines of business. The next few years will bring a lot of changes to the ways in which you can benefit from selling health insurance, so it’s important to get to work now on creating new avenues for income. Getting started in a new direction might seem like a big hurdle, but it can pay off over the long term, particularly if you see a downswing in health care insurance-related revenues.

Make the extra effort to reinforce customer loyalty. One characteristic of the coming exchanges is that they will be Web-based and automated – functioning a little like an airfare search site. For a lot of customers, that will be a recipe for frustration and confusion – and it might already be a source of anxiety. Making the effort to help guide your clients through the coming changes in health insurance will establish you as an adviser in their minds. The health care reform changes will be a testing ground for just how much customer service can help you retain business, so it makes sense to invest in those relationships now. You could even get started by calling customers and offering to discuss how health care reform will affect them. Plenty of people are confused by the law, and if you provide pro-active guidance now, clients will see you as a knowledgeable resource in the future.  

Above all, it’s important to be aware and informed about how your business will be affected as more parts of the law are rolled out. After all, an adaptable agent is a successful agent.

Informational Source

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