‘This is not a guarantee of payment’

USA Today has covered yet another reason why agents want to tear their hair out (and another reason why insurance carriers aren’t winning popularity contests): retrospective denial. In a nutshell: people are increasingly getting preauthorizations, but that doesn’t mean carriers are always paying. In fact, some carriers authorize with the caveat “This Is Not A Guarantee of Payment.” And then they don’t pony up. This article is quite simply a must-read!

CMS Says It Wants to Put Downward Pressure on Premiums

U.S. Centers for Medicare & Medicaid Services is examining ways to put downward pressure on premiums for consumers, according to CMS Administrator Seema Verma. CMS is proposing “periodic data matching standards” in Affordable Care Act exchanges to ensure premium subsidies aren’t being paid to deceased or dual-eligible enrollees. The agency is also seeking comments regarding a proposal requiring low-income exchange enrollees who pay no premiums to revisit the exchange during open enrollment to assert they’re entitled to the same level of subsidy the following calendar year.

NAIC Names 2020 Consumer Liaison Representatives

The National Association of Insurance Commissioners  recently named 32 consumer liaison representatives for 2020 (with a few Cal Broker contributors among them!). The 20 funded and 12 unfunded consumer representatives began their terms Jan. 1.

Established in 1992, the Consumer Liaison Program promotes consumer interaction with the NAIC’s members, the insurance industry and interested parties.

The 2020 Funded Consumer Liaison Representatives

New funded representatives are noted with an asterisk.

Amy Bach: Executive Director, United Policyholders

Birny Birnbaum: Executive Director, Center for Economic Justice

Brendan M. Bridgeland: Director, Center for Insurance Research

Courtney Bullard: Education and Collaborations Director, Utah Health Policy Project*

Bonnie Burns: Training and Policy Specialist, California Health Advocates

Thomas M. Callahan: Executive Director, Massachusetts Affordable Housing Alliance

Laura Colbert: Executive Director, Georgians for a Healthy Future

Brenda J. Cude: Professor, Department of Financial Planning, Housing and Consumer Economics, University of Georgia

Kimberly Donovan: Chief Policy Analyst, Office of Public Insurance Counsel*

Erica Eversman: President, Automotive Education & Policy Institute

Justin Giovannelli: Associate Research Professor, Georgetown University Center on Health Insurance Reform

Ross Hammond: Strategic Advisor, The Sunrise Project*

Katherine (Katie) Keith: Consultant Advisor and Steering Committee Member, Out2Enroll

Karrol Kitt: Emeritus Associate Professor, The University of Texas at Austin School of Human Ecology Department of Human Development & Family Sciences

Peter R. Kochenburger: Associate Clinical Professor of Law, Executive Director, Insurance Law Center, University of Connecticut School of Law

Sarah Lueck: Senior Policy Analyst, Center on Budget and Policy Priorities

Wayne Turner: Senior Attorney, National Health Law Program*

Caitlin Westerson: Policy Director, Colorado Consumer Health Initiative*

Jackson Williams: Vice President, Public Policy, Dialysis Patient Citizens

Silvia Yee: Senior Staff Attorney and Analyst, Disability Rights Education and Defense Fund

The 2020 Unfunded Consumer Representatives

New representatives noted with an asterisk.

Ashley Blackburn: Senior Policy Analyst, Community Catalyst

Benjamin Chandhok: Senior Director of State Legislative Affairs, Arthritis Foundation

Lucy Culp: Executive Director, State Government Affairs, The Leukemia & Lymphoma Society

Deborah Darcy: Director of Government Relations, American Kidney Fund

Eric Ellsworth: Director, Health Data Strategy, Consumers Checkbook/Center for the Study of Services

Marguerite Herman: Consumer Advocates: Project Healthcare

Anna Howard: Principal, Policy Development, Access to and Quality of Care, American Cancer Society Cancer Action Network

Amy Killelea: Director, Health Systems Integration, National Alliance of State and Territorial AIDS Directors

Ken Klein: Professor of Law, California Western School of Law

Matthew Smith: Director of Government Affairs, Coalition Against Insurance Fraud

Andrew Sperling: Director of Legislative Advocacy, National Alliance on Mental Illness

Harold M. Ting: Healthcare Consumer Advocate


MDRT: 82% Worried About Recession. But There’s Some (sort of) Good News

With news of the yield curve inversion and the presence of additional economic indicators, many experts are warning of a pending recession expected to hit before the 2020 elections. And apparently people are paying attention. A recent MDRT study shows the vast majority of Americans (82%) say they are at least somewhat nervous they will personally be impacted by a recession in the next year or so. Now for the silver lining…

A looming recession is an opportunity for advisors to connect with clients considering nearly a third (32%) of survey respondents with an advisor say their dependence on their financial guidance would increase in a time of uncertainty. The MDRT study also found that over three-quarters (84%) of Americans with advisors report they feel more confident in their financial future after a meeting. So go ahead and start booking those appointments.


SCAN’s Charitable Giving for Seniors: $555K Last Year

With charitable giving decreasing and a national population that is growing older every day—10,000 baby boomers turn 65 each day—SCAN recently announced just how much it has stepped up its game with helping seniors. The company gave approximately $555,000 in 2019. A total of 45 grants were sent to California organizations that focus on senior nutrition, mental health, housing and caregiver support, including:

  • Los Angeles LGBT Center
  • Project Angel Food
  • Affordable Living for the Aging
  • Foodbank of Southern California
  • CAREGIVERS Ventura
  • Chinese Coalition for Compassionate Care
  • Meals on Wheels West
  • ONEGeneration
  • Food Share
  • AbilityFirst
  • EngAGE
  • Project Access

Way to go, SCAN!


Ridnour Named Head of Worksite Distribution for Mass Mutual

Bradley Ridnour has been appointed Head of Worksite Distribution for Massachusetts Mutual Life Insurance Company. Ridnour is now responsible for sales of voluntary and executive benefits at the workplace.


  • NAIFA Los Angeles/Society of Financial Service Professionals Award & Leadership Recognition luncheon, February 20, 11 a.m. – 2 p.m, Taix French Restaurant, 1911 Sunset Blvd., Los Angeles, CA 90026, members (includes NAIFA, FSP, WIFS, LAAHU, NAHU, CAHU, VCAHU): $50.00, More info here or email janet@naifala.org.
  • OCAHU 8th Annual Business Development Summit– We’ll see you here!
    February 28, DoubleTree by Hilton-Anaheim/Orange County
    Contact: Gail James Clarke (714) 441-8951, ext.3, email: orangecountyahu@yahoo.com
  • The 29th Annual IEAHU Symposium, March 10, Riverside Convention Center– We’ll see you here!
    Email Inland Empire Association of Health Underwriters for more info: ieahu.administration@gmail.com
  • Employee Benefits Planning Association, 2020 Employee Benefits Summit, March 13, Omni Los Angeles, more info here.
  • SIIA Self-Insured Health Plan Executive Forum
    March 16-18, Charleston, SC. More info here.
  • CAHU Women’s Leadership Conference, March 25-27, JW Marriott Resort&Spa, Las Vegas– We’ll see you here!
    More info at www.cahu.org.
  • April 6-7
    The Notary Hotel, Autograph Collection
    Philadelphia, PA
  • SIIA Washington, DC Fly-In (Meet Your Members of Congress)
    April 21-22,
    Washington, DC
    Event details to be announced soon
  • LAAHU Annual Symposium- Save the date!– We’ll see you here!
    April 22, Skirball Center, Los Angeles. More info soon!
  • The 16th Annual BenefitsPRO Broker Expo
    May 18-20 Hilton Austin in Austin, TX.
  • SIIA National Conference & Expo
    October 11-13
    JW Marriott Desert Ridge Resort & Spa
    Phoenix, AZ
    Registration will be open in April
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