More CAHU Royalty!

Last month we congratulated CAHU “royalty” — the insurance folks who have been with CAHU over the long haul. It seems we left off a few names, though. We apologize and thank the following kings and queen of the business for their dedication:

Lawrence Kent (33 years of service)

Tony Schlossmann (33 years of service)

Dorothy Cociu (32 years of service)

CDI’s Lara Reappoints Bystry and Roxborough

Insurance Commissioner Ricardo Lara announced two reappointments to the California Organized Investment Network (COIN) Advisory Board. In a written statement, Lara said CDI is committed to socially responsible investing in communities and the environment, and that board members are critical to ensuring public accountability. The reappointments include Douglas Bystry, president and CEO of the Clearinghouse CDFI, a for-profit community development financial institution, and Nick Roxborough, co-managing partner of Los Angeles law firm of Roxborough, Pomerance, Nye & Adreani, LLP. Bystry, who was first appointed in 2012, is considered an expert in affordable housing, community development and New Markets Tax Credit lending. Roxborough has been instrumental in numerous trial and appellate decisions concerning the insurance industry. He was first appointed to the COIN Advisory Board in March 2013.

BenefitMall Introduces Agency Workspace

BenefitMall  announced its newest innovative technology, Agency Workspace. Agency Workspace will provide a home base for BenefitMall’s technology for brokers to support their clients. Agency Workspace is instrumental in streamlining the management of a broker’s BenefitMall book of business. Broker can use the tool to manage clients, start or review quotes, set up enrollments, view commissions or more.

Growing Importance of Social Determinants of Health (and their codes)

UnitedHealth and the American Medical Association are teaming up to push new billing codes that have to do with “social determinants of health,” which they say hugely impact any person’s health and well-being.

Among the more than 20 new codes under consideration:

  • unable to pay for prescriptions
  • unable to afford child care
  • worried about losing housing
  • unable to count on family and friends
  • feeling unsafe in current environment

While the codes wouldn’t immediately lead to reimbursement changes, capturing data about a patient’s social needs may be a step toward paying for interventions that address them.

Stanford Health Care Joins Sutter Health | Aetna 

Sutter Health | Aetna announced that Stanford Health Care has joined the Northern California joint venture’s network of health care providers. This marks the latest in the organization’s efforts to provide members with access to some of the highest quality health care services available in Northern California. As a teaching institution, Stanford Health Care is on the leading edge of developing new procedures and therapies. This includes renowned expertise in areas such as cancer treatment, neuroscience, surgery, cardiovascular medicine, and organ transplants, and the implementation of the latest medical breakthroughs. The Sutter Health | Aetna network will include Stanford Hospital as well as more than 1,500 specialists and nearly 200 primary care physicians across Stanford Medicine located throughout the Bay Area, including physicians from University Healthcare Alliance and ValleyCare Physicians Associates. With the addition of Stanford Health Care, the Sutter Health | Aetna network now features two nationally recognized health care systems and access to a Northern California network that includes 33 hospitals, more than 1,700 primary care physicians, more than 9,400 specialists, 74 urgent care locations, and 25 walk-in clinics. All Sutter Health | Aetna joint venture members gained access to Stanford Health Care services on April 1.

CMS Will Give MA Plans More

The CMS announced it will raise average payments to Medicare Advantage plans by 2.53% in 2020, higher than the 1.59% hike first proposed by the agency. The agency will also give MA plans more flexibility starting next year to offer supplemental benefits to help address social determinants of health for people with chronic conditions.

GTI Launches Precision Care Cancer Policy

Guarantee Trust Life Insurance Company announced a new cancer insurance policy called Precision CareTM. Precision CareTM provides access to and pays for the Translational Genomics Research Institute’s (TGen) genomic sequencing tests and expert oncology consultations. The policy also provides a lump-sum cash benefit to help pay for other medical and non-medical expenses which can be costly while fighting cancer. Precision CareTM policy form is approved in over 30 states and will be available for sale through the company’s network of independent agents and agency partners located throughout the country. 

Assurance Launches Ensight for Term

Assurance, a leading FinTech technology platform provider of cloud-based sales acceleration tools for life insurance and annuity products, announced today the addition of term life insurance to Ensight™ Intelligent Quote, the next generation life insurance quoting platform. The integration of term life insurance makes Ensight™ Intelligent Quote the first ‘single-entry’ quoting platform to cover both principal product classes sold in the United States.

Agents Exempt from Dynamex

CAHU announced a victory. Proposed legislation AB 5 (Gonzalez) was amended to exempt agents from the rigid ABC test created by the California Supreme Court’s Ruling on Dynamex Operations West Inc. v. Superior Court (Dynamex), which could have required many 1099 independent contractors — including agents –to become W-2 employees.

Without the exemption, many insurance agents could have been forced to forgo their independent status. This would have negatively impacted agents and brokers by restricting commissions and the ability to work independently while impacting existing tax reporting and deductions. CAHU partnered with agent allies IIABCal and NAIFA to work on this issue.

Schwab Makes Big News By Moving from AUM to Flat Charges

Ryan W. Neal reports in Investment News reports that there’s huge news coming from Charles Schwab. The company announced that it was moving from an assets-under-management fee to a flat monthly charge for its robo adviser. The move has been compared to a modern-day equivalent of May Day 1975, when the deregulation of commissions allowed for the creation of discount brokerages like Schwab.

Neal writes that instead of a 0.28% AUM fee that Schwab had been charging, it will now charge clients a one-time $300 financial planning fee and a $30 flat monthly subscription. Fees will not increase with assets.

“For just $360 a year, clients in the service, which is being renamed Schwab Intelligent Portfolios Premium, will get investment management, a financial plan and unlimited guidance from a certified financial planner, whether they have $200,000 invested or $2 million.”

Several other companies have also recently announced plans to support advisers who want to charge financial planning fees independent of AUM.

New Study Says ACA Benefits Many Women

A new study published in the American Journal of Preventive Medicine concludes that the ACA has had “significant benefits” for women, with the greatest outcomes for low-income women.

The study found:

  • Before the ACA, 40 percent of low-income survey respondents were uninsured. Afterward, that percentage dropped to 17 percent in 2014 and 11 percent in 2016.
  • The number of women in the lowest income group who said they had seen a doctor within the past year increased by 4.1 percent after the ACA was introduced. There was also a 2.3 percent increase in the number of middle-income women who saw a doctor in the previous 12 months following the ACA rollout. (No significant difference for high-income women, though.)
  • There were increases in blood pressure checks, cholesterol screenings and flu shots (between 3 and 7 percent) across all income groups after ACA policies went into effect.
  • The number of low-income women getting mammograms to screen for breast cancer increased almost 5 percent.

Medicare Beware: Wellness Visits Not Same As Physicals

Kaiser Health News reports that some Medicare folks are confused. And rightly so. Apparently, Medicare picks up the tab for a wellness visit, an ACA-mandated covered benefit. However, Medicare doesn’t pay for an annual physical, which may include lab tests:

“…if a wellness visit veers beyond the bounds of the specific covered preventive services into diagnosis or treatment — whether at the urging of the doctor or the patient — Medicare beneficiaries will typically owe a copay or other charges. (This can be an issue when people in private plans get preventive care, too. And it can affect patients of all ages. The ACA requires insurers to provide coverage, without a copay, for a range of preventive services, including immunizations. But if a visit goes beyond prevention, the patient may encounter charges.)”

Meanwhile, some Medicare Advantage plans cover annual physicals for their members free of charge. Good to know!

New Assessment Gives Insurers Innovation ‘Wellness’

ITL Advisory, the strategic consulting arm of Insurance Thought Leadership Inc., announced it is offering insurance companies a new innovation assessment service designed to evaluate whether their programs have critical elements for success—especially considering A.M. Best’s plan to begin evaluating insurance company innovation efforts.

Insurance rater A.M. Best recently released a draft of its proposed insurance innovation assessment process, kicking off a comment period before it formalizes the criteria and procedures that will form the basis for reviewing how comprehensive and effective an insurance company’s innovation efforts are.

ITL Advisory’s new assessment service is designed to provide insurance organizations with a quick, independent and confidential assessment of whether their innovation programs are on the right track and aligned with best practices, and that they contain essential elements to deliver a return on innovation investment. The assessment will help companies anticipate whether they are prepared for the Best review, or serve as a standalone check on their program elements. More info at