Category Archives: Uncategorized

United AARP adds SC hospitals to Medicare Plans

We have some new network additions to report!


  • Abbeville Area Medical Center—effective February 1, 2018
  • Williamsburg Regional Hospital—effective April 1, 2018
  • The Regional Medical Center Orangeburg Calhoun—effective June 1, 2018
  • Georgetown Memorial Hospital—effective June 1, 2018
  • Waccamaw Community Hospital—effective June 1, 2018
  • Springs Memorial Hospital—effective June 1, 2018
  • Carolinas Hospital System Marion—effective June 1, 2018

Buying Life Insurance Online? Think again…

It seems so simple. Type “cheap life insurance” in google and you get 24,300,000 hits.   “No Exam Life Insurance!”  “Rates from $4.80 per month.”  Marketing can be so misleading.  Lets look at the facts…


How your health affects rates-   Insurance companies rate you based on a number of factors. Generally, if you are of “normal” height and weight, take no medications, don’t smoke and have not had any significant health issues in the past, you will probably get preferred. While companies may use different names, the rating categories (best to worst) are superpreferred, preferred, Standard Plus, Standard, and then rated.

Can I really get “Super-preferred?”- In fact we got a client this rating today, so it does happen. However, internet rates are often bait-and-switch– they promise you a low price based on this great rating, only about 5% will actually qualify!  Why? To get this incredible rate, you not only have to be superhealthy-  you also have to have no moving violations, and no history of cancer, diabetes, or heart problems in your family.

Why you need a broker- Rates are filed and preapproved with the state, and they are what they are. Everyone accesses pretty much the same rate database, so no one has a “better rate.” However, there are a lot of variables. Insurance underwriters look at illnesses differently, so a company may rate you standard for your problem, and another one might rate you standard plus – with a cost savings. Your broker will know that, and may have a little pull if you are on the fence between two rating categories.

What about the big name insurance companies? There are a lot of companies that use “captured” agents- they can only sell their employers products. They advertise a lot, to get people to know their names. Fact is, advertising costs money, and that tends to raise rates. Furthermore, since they only have one outlet, they can only sell you their product, even if its not the best one for your situation.

How different are rates between companies?

If we look at a 30 year old man, purchasing $500,000 of 20 year term insurance, here is the range of monthly premiums for 21 carriers:

Preferred Plus-            $20-$38

Preferred-                   $26-$45

Standard Plus-             $33-$56

Standard-                    $38-$66

So, if you chose the right carrier, you could be at $26 a month, while another carrier might be $56 for the same coverage- because they rate you differently and have higher rates. This difference is similar across all ranges of age and coverage.

Speaking to a knowledgeable broker doesn’t cost you anything, but believing everything you read on the internet? It might!





Responding to Pay or Play Mandate Letters

If you have gotten, or may receive a non-compliance pay or play letter from the IRS, this important article can help you through the process.

Published in Employee Benefit Adviser on July 6, click here for full article.

These letters can range from the employer paying the penalty outright, paying a portion of the penalties, none of the penalties, attend an IRS hearing disputing the penalties or pursue further legal action in federal court.  To give the accused a chance to plead their case, Letter 226-J gives employers the opportunity to refute the assessed penalty amount by filing Form 14764. Depending on the applicable large employer’s response the IRS has begun to issue one of five versions of IRS Letter 227 as a response to the action the employer chooses to take on Letter 226-J.


Medicare To Provide More Benefits For Chronically Ill

From Allwell Centene:”

In what the New York Times (6/24, Pear, Subscription Publication) calls “a rare instance of bipartisan cooperation on a major policy initiative,” the Trump Administration and Congress are “revamping Medicare to provide extra benefits to people with multiple chronic illnesses, a significant departure from the program’s traditional focus that aims to create a new model of care for millions of older Americans.” The changes, says the Times, “tackle a vexing and costly problem in American health care: how to deal with long-term illnesses that can build on one another, and the social factors outside the reach of traditional medicine that can contribute to them, like nutrition, transportation and housing.” The additional benefits “can include social and medical services, home improvements like wheelchair ramps, transportation to doctor’s offices and home delivery of hot meals.”

Risk Adjustment Suspension reversed by Trump

July 27-  In a reversal, the Trump Administration will resume risk adjusted payments to Health Insurers.  A few weeks ago we reported that the Administration was suspending payments to carriers under the risk adjustment payment program under the Affordable Care Act in the Individual and Small Group Markets. They now said they will restart the program that pays billions to insurers to stabilize health insurance markets.



3 recent articles covering the Trump administration’s decision to suspend Risk Adjustment payments to insurers which were intended to help insurers cover costs for sicker patients.  This will cause insurers to rethink and possibly refile their filed rates for Individual and Small Group plans for 2019.  Insurers were due to receive upwards of $10 billion dollars to offset high claimants in these markets.  This will certainly cause some turmoil and cause for debate and discussion.  In New York, Oxford has benefitted greatly from these payments, last year taking in around $250 million in payments from other carriers in New York state.  Risk adjustment payments are what also took down CareConnect, having to in essence pay over $100 million dollars to Oxford.  The risk adjustment payment programs are certainly a flawed methodology created by the previous administration, what the solution is.. no one is really certain of that, but this will certainly have some reaction to it and cause carriers to reconsider their intended filings for 2019.

We will keep you posted of new developments.

January 2019
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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA. - SIPC - Brokercheck