Category Archives: Individual and Medicare

What is Medication Therapy Management

Under Medicare Rules, all Part D Medicare Prescription Plans are required to have this program beginning January 1, 2014.

The program is designed to provide the optimal treatment regimen for those with Chronic Conditions.  There is a focus on ensuring that the right drug is being taken by the appropriate groups, and in reducing drug interactions.  In most cases it will administered by your Pharmacist, and Medicare Beneficiaries with multiple Chronic Conditions are eligible, or those that are likely to incur $3,017 or more in drug costs in 2014.


Information on MTM programs is available on the Centers for Medicare and Medicaid Services website (

Monthly Economic Update for August 2013

At the closing bell on July 31, the S&P 500 settled at 1,685.73 thanks to a 4.95% monthly gain – another triumph for a bull market that has overcome a host of challenges. This striking July advance came even as fundamental economic indicators sent mixed messages. The Federal Reserve said nothing definite about when it would taper QE3. Overseas, there were hints of a slightly better economic picture in Europe, contradictory signals out of China, and numerous stock market advances.1

July offered both encouraging and discouraging economic statistics. The Institute for Supply Management’s July PMIs seemed to show an economy gaining traction. ISM’s manufacturing PMI leapt to 55.4 compared to 50.9 in June, and its service sector PMI jumped to 56.0 from the previous 52.2. The Commerce Department said that consumer spending was up 0.5% in June, corresponding to the projections of economists surveyed by Reuters; consumer incomes rose another 0.3 on the heels of a 0.4% improvement in May. Unemployment declined to 7.4% in July, but the pace of hiring also declined. Non-farm payrolls expanded by 162,000 jobs (compared to 188,000 in June), with retail, bar and restaurant positions representing much of the additions. Durable goods orders had increased 4.2% in June, but they were flat with the volatile transportation category removed. As the quarter ended, the federal government issued its first estimate of Q2 GDP: 1.7%, indicative of the economy’s slow comeback.2,3,4,5,6

July also offered a mixed picture of consumer confidence. The Conference Board’s July poll came in at 80.3, 1.8 points lower than June’s reading and below the expectations of analysts surveyed by MarketWatch. The reading on the University of Michigan’s final July consumer sentiment index was better – 85.1, up a full point from June to its highest level since July 2007.6,7

Prices increased in June, but it seemed more an anomaly than a trend. The Consumer Price Index rose 0.5%, but a 6.3% leap in gas prices was a major factor; the core CPI was up just 0.2%, and annualized core inflation had increased just 1.6%, the smallest amount in two years. Wholesale prices jumped 0.8% in June, though the core Producer Price Index only advanced 0.2%. Retail sales were up 0.4% in June; there was a 1.8% gain in auto purchases and a 2.4% improvement in furniture sales.8,9,10

In early July, the Obama administration decided to postpone the Affordable Care Act’s employer health insurance mandate for a year. Businesses with 50 or more full-time employees won’t have to provide health insurance to workers until 2015; retail franchises and restaurant owners welcomed that decision. The move raised big-picture questions about whether all aspects of the ACA (such as the coming online health insurance exchanges) could be implemented on schedule. In mid-July, Federal Reserve chairman Ben Bernanke cited the need for a “highly accommodative monetary policy for the foreseeable future,” buoying financial markets. The central bank’s July 31 policy statement offered no hint as to when it would start to reduce its asset purchases, and it termed the current economic expansion “modest”, which seemed slightly less enthusiastic than its “moderate” assessment from June.11,12,13


Two closely-watched China manufacturing PMIs offered different estimates of the performance of the world’s biggest economic engine. The HSBC PMI came in at just 47.7 for July. The “official” PMI from China’s National Bureau of Statistics (which, incidentally, surveys a greater percentage of state-owned enterprises) rose 0.2 for July, showing a bit of expansion at 50.3. Still, this was nothing special. Neither was India’s July Markit manufacturing PMI reading of 50.1; Markit manufacturing PMIs for South Korea, Vietnam, Australia and Taiwan were all under 50 last month, with Australia’s dropping 7.6 points. HSBC and Markit service sector PMIs tracking Asian economies also moved lower in July; India’s showed contraction for the first time in 21 months at 47.9, and those for Japan (50.6) and China (51.3) showed slower growth.14,15

As mounting evidence of a slowdown came from Asia, another question emerged in Europe. Was the Eurozone recession coming to a close? The EU manufacturing sector grew in July for the first time since 2010 – the Markit PMI hit 50.5, up from 48.7 in June. Germany’s manufacturing PMI reached a 5-month peak of 52.1, France’s hit a 17-month high of 49.1, and Italy’s reached a 26-month high of 49.7. July also saw the fewest eurozone job losses in 16 months, and the German economy saw a net job gain.14,15,16

Big gains were the order of the month, especially in Europe. The FTSE 100 climbed 6.53%, the DAX 3.98%, the CAC 40 6.79%, the RTSI 2.97% and the STOXX 600 5.11%. In the Asia Pacific region, some losses crept in among the gains: the Sensex slipped 0.26% and the Nikkei 225 0.07%, but that was overshadowed by advances for the KOSPI (2.72%), the KSE 100 (10.98%), the Hang Seng (5.19), the Shanghai Composite (0.74%) and the Asia Dow (1.17%). On our side of the pond, the TSX Composite rose 2.95%, the MERVAL 12.82% and the Bovespa 1.64%.The Global Dow advanced 5.87% in July, the MSCI World Index 5.19% and the MSCI Emerging Markets Index 0.77%.1,17i COmposite : the TSX Composite (-2.30%), the  gan’


The price of NYMEX crude soared 9.15% in July. That put oil at $105.03 a barrel at the end of the month. Natural gas prices, on the other hand, descended 3.25%. Gold settled at $1,313.00 at month’s end, the culmination of a 7.46% monthly ascent. Silver went +1.45%, platinum +6.77% and copper +2.40%. As for crops, coffee lost 1.37%, but cocoa rose 4.74%, wheat 2.71% and sugar 2.48%. The U.S. Dollar Index lost 1.76% for the month.18,19


On August 1, Freddie Mac’s Primary Mortgage Market Survey had the average rate on a 30-year fixed home loan at 4.39%, up from 4.29% on July 3 and 3.81% on May 30.20


Existing home sales fell 1.2% in June, with tightening inventory being a factor; still, the National Association of Realtors reported a 13.5% yearly improvement in the median sale price. The May S&P/Case-Shiller Home Price Index recorded a 12.2% overall yearly rise in home prices across 20 cities. New home sales were up 8.3% in June, with a 38.1% year-over-year increase in the sales pace (the best on record since 1992).6,21

Not all the news was so impressive. Pending home sales dipped 0.4% for June, partly reflecting the shrinking inventory of existing properties on the market. As for building permits and housing starts, they both fell in June: building permits sagged 7.5% from May but were up 16.1% annually, while starts dipped 9.9% but were still up 10.4% in 12 months.6,22

The 0.58% rise in conventional mortgage rates across two months was mirrored by other types of home loans. Average rates for 15-year FRMs went from 2.98% to 3.43%; average rates for 5/1-year ARMs and 1-year ARMs were but 2.66% and 2.54% on May 30, yet respectively 3.18% and 2.64% by August 1.20

To broadly recap,  July ended with the DJIA settling at 15,499.54, the NASDAQ at 3,626.37, the S&P 500 at 1,685.73 and the Russell 2000 at 1,045.26 (it rose 6.93% for the month). Fear ebbed: the CBOE VIX fell 20.23% for the month, settling at 13.45 on July 31.1

Affordable Care Plan raises rates in SC 50-70%

The SC Department of insurance announced last week that, after reviewing the rate submissions, rates in the Federal Facilitated Exchange will be 50-70% higher than current rates in the state.  This is due in large part to the new mandated benefits (such as maternity coverage, new taxes and fees, wellness programs) that were not previously available.

Group rates are expected to rise 10-20%.

WHAT WILL HAPPEN TO MY RATES?  That depends.  If you are young and healthy your rates may go up the full 70%.  If you are older, or already have a rating with your insurance company because of a medical condition, your rate change won’t be a dramatic.  Smokers will pay 50% more as well, but see my other blog today on this topic.

I will be undergoing exchange certification over the next few weeks and will begin to provide guidance, once we have all the information we need – probably in mid-September.


Using Retirement Plans For Cash During Advanced Illness

This article appeared in Forbes, written by Carolyn McClanahan.

Money is saved in retirement plans in the hope that one day you will use it for retirement bliss. Unfortunately, advanced illness may hit unexpectedly and result in an immediate cash need. What do you do if you lack liquid assets but have money wrapped up in retirement plans? Fortunately, retirement plans can be used for advanced illness in certain situations. This article explains how to tap into your retirement plans during this difficult time in your life.

Step 1: Know what type of retirement account you have available

Each type of retirement plan has different rules for how money can be used during illness without penalty.

  1. 401k and 403b plans are very common and have similar rules. Your employer decides whether to allow hardship distributions when the plan is set up. Refer to the “summary plan description” that is provided to you each year or ask your human resource department if hardship distributions are available. For these plans, the IRS requires that you access all other available distributions and loans from the plan first.
  2. 457b plans have a slightly stricter definition of when plans can be utilized for illness. Distributions are allowed only when a participant has an unforeseeable emergency, so a sudden diagnosis of a serious illness would fit that category. The employer has to prove that you have no other resources in place to meet your need, so they will ask for appropriate documentation from you. Again, your employer has the ability to determine whether they allow hardship withdrawals in the first place, so check with your human resources department.
  3. IRA accounts can be used without penalty if you are older than 59 ½. If you are younger, there are three ways IRA accounts can be used for illness:
    • If disability is “total and permanent” as determined by a physician, and you cannot work for at least a year, or the condition will result in your death, you are allowed to use money from your IRA penalty free.
    • If you have unreimbursed medical expenses above 10% of your adjusted gross income, you can pay for those medical expenses out of your IRA account. Have an accountant or financial planner run calculations for you.
    • If you are unemployed and drawing unemployment benefits, your IRA can be used to pay for health insurance premiums for you and your family.

Step 2: Understand the tax implication of the withdrawal

All withdrawals from 401k, 403b, 457b, and traditional IRA accounts are taxed as regular income upon withdrawal. Have an accountant or financial planner provide tax projections to prepare you for the tax consequences. Make certain you withhold enough taxes so you will not be subject to underpayment penalties.

Remember that the more you withdraw from retirement accounts, the higher your adjusted gross income will be on your tax return. This increase in income may limit your ability to deduct some health expenses. Likewise, if you have no income other than from retirement plans, taking distributions will create income that medical expenses can be deducted against in the tax year. Again, it would be wise to get an accountant involved early.

Roth IRA accounts are funded with post-tax dollars, so if you take early withdrawals, the amount you deposited originally (the basis) is tax-free, but any earnings are taxed at regular income tax rates.

Step 3: Apply for the withdrawal

Make certain the withdrawal paperwork from your place of employment states the withdrawal is for hardship purposes. If making a withdrawal from your IRA account, instruct the custodian of your account that the withdrawal is for hardship purposes – either for medical expenses or for permanent disability.

Because of the distribution, you will receive a 1099-R for tax purposes in January. Check this document immediately to make certain the distribution is coded correctly. Box 7 of the 1099-R should be marked with code 2 – early distribution, exception applies (under age 59 ½) or code 3 – disability. If the code is not correct, contact the custodian immediately and have them issue a new 1099-R with the correct code. If not corrected, the IRS will charge you a 10% penalty for the withdrawal.


Quarterly Economic Update

Stocks advanced for the third quarter out of the last four: the S&P 500 rose 2.36% in three months and climbed to a new record close of 1,669.16 on May 21. While the Federal Reserve threatened to let the air out of the rally as the quarter wound down, key indicators largely showed improvement even as the effects of the sequester cuts presumably trickled down to Main Street. The dollar strengthened and gold was hit hard, though oil pushed toward $100 a barrel. The housing recovery continued undeterred.1,2


When Federal Reserve chairman Ben Bernanke mentioned on June 19 that the central bank might reduce its easing effort later this year and end QE3 altogether in mid-2014, global markets tumbled and the S&P 500 ended up having its first losing month in several (-1.50%). While this was the major event affecting investors in Q2, there were many other consequential economic developments.1,3


Non-farm payrolls expanded by (a revised) 199,000 in April and 195,000 in May, the Labor Department noted. The jobless rate was at 7.6% by May, with the long-term unemployed numbering 4.3 million (1 million fewer than a year before). Consumer spending staged a rebound – it declined 0.3% in April, but then rose 0.3% in May. Consumer incomes rose 0.5% in May (the biggest gain in three months) after a 0.1% rise in April. As for consumer inflation, it was certainly mild: the Consumer Price Index rose 0.1% in May to bring America’s annualized inflation rate to 1.4%. Perhaps as a reflection of the increase in personal spending and low inflation, retail sales were up 0.1% in April and 0.6% in May. While the Commerce Department revised Q1 GDP down to 1.8% in June (from an initial 2.4% estimate), the hope was that the Q2 figure might show solid improvement.4,5,6,7,8


Consumer sentiment improved. April’s Conference Board consumer confidence index was at 69.0; by May it was at 74.3 and in June it reached 81.4. The University of Michigan’s survey also logged an ascent, rising from 76.4 in April to 84.5 in May, then settling at 84.1 in June.9,10


The Institute for Supply Management’s manufacturing PMI had its ups and downs in the quarter. It wound up at 50.9 in June after coming in at 50.7 in April and 49.0 in May. ISM’s non-manufacturing index rose to 53.7 in May from a 53.1 mark a month earlier – and then it declined in June to 52.2. The Producer Price Index showed similar ups and downs, dropping 0.7% for April and rebounding 0.5% in May. Overall durable goods orders rolled in at a consistent pace: up 3.6% in May.11,12,13,14


When the Supreme Court repealed Section 3 of the Defense of Marriage Act (DOMA) in June, it brought federal recognition of same-sex marriages. Financially, that allowed married gay and lesbian couples to file joint tax returns with the IRS and tap into partner health insurance benefits; it also made surviving spouses in such marriages eligible for Social Security survivorship benefits. College students watched interest rates on Stafford loans double to 6.8% due to congressional inaction as June ended, though Capitol Hill lawmakers talked of a fix this summer. Finally, Standard & Poor’s upgraded America’s credit outlook to “stable” from “negative” in June.15,16,17


China’s economy showed distinct signs of cooling off in the quarter. Markit’s monthly PMI showed the nation’s manufacturing sector contracting in May (49.2) and June (48.2), and fears emerged that China might fall short of its 7.5% GDP target for the year. The PRC’s leaders were increasingly focused on rooting the country’s economy in personal consumption rather than exporting and investing. In an effort to clamp down on shadow banking, the People’s Bank of China attempted to curb funding in the interbank lending market, resulting in skyrocketing short-term interest rates. Chinese stocks fell 5.3% in the wake of that move. By the end of the quarter, manufacturing PMIs were at 50.3 in India, 51.0 in Indonesia, 49.5 in Taiwan and 49.4 in South Korea.18,19,20


The good news from Europe: by June, eurozone inflation had declined 0.8% in a year. The bad news: it had risen 0.4% since April to 1.6%. Unemployment for the euro area reached 12.2% in May, up 0.1% from April and up 0.9% in 12 months; at the quarter’s end, jobless rates among EU members ranged from 4.7% (Austria) to 26.9% (Spain). In June, the European Central Bank cut its 2013 GDP projection for the eurozone to -0.6%. It did forecast 1.1% growth in 2014.21,22,23


It was a down quarter for many benchmarks. Some Asia Pacific indices logged gains – the Nikkei 225 (+10.32%), the Sensex (+2.97%), the KSE 100 in Pakistan (+17.04%), the TAIEX in Taiwan (+1.81%). Others didn’t – the Shanghai Composite went -11.51%, the Jakarta Composite -2.47% and Australia’s ASX -3.30%. In the west, the TSX Composite went -4.87%, the Bovespa -15.78% and Mexico’s IPC All-Share -7.84%. While the DAX (+2.10%) and CAC 40 (0.20%) managed small Q2 advances, quarterly losses were more common in Europe – including descents for the RTSI (-12.64%), IBEX (-1.99%) and FTSE 100 (-3.06%). Among regional and multi-country indices, the Global Dow lost only 0.03%,  the DJ STOXX 50 3.46%, the Asia Dow 3.30%, the MSCI World Index just 0.07% and the MSCI Emerging Markets Index 9.14%.24,25


With hints of waning demand in China, U.S. stocks hitting new all-time highs and the dollar growing stronger, there was plenty of selling. The quarter was a disaster for gold, which dropped 23.3% to settle at $1,223.70 on the COMEX on June 28. (In the first half of 2013, gold futures declined $452.10.) Silver’s quarter was even worse: it dropped 31.3%. Platinum futures sank 14.9% in Q2, palladium futures 14.0%. For some other commodities, it was a different story: the first half of 2013 ended with oil up 2.4% YTD, natural gas up 3.9% YTD and cotton up 10.0%. The U.S. Dollar Index went +0.19% in the quarter.26,27,28


A steady stream of positive news arrived from this sector. The April Case-Shiller Home Price Index came out in June, and it showed home prices across 20 cities rising 12.1% in 12 months. The Case-Shiller hadn’t seen a yearly gain that large since March 2006. By May, the National Association of Realtors reported a 12.9% annual gain in existing home sales with a 15.4% increase in the median price of a residential resale; NAR also noted a 12.1% annual improvement in pending home sales. Housing starts and building permits were respectively up 28.6% and 20.8% above year-ago levels by May, and the Census Bureau also noted a 29.0% annualized gain in new home sales.14,29,30,31,32


This might have been the last quarter for rock-bottom mortgage rates. In Freddie Mac’s June 27 Primary Mortgage Market Survey, the average interest rate for the 30-year FRM had risen to 4.46%. (Compare that to 3.57% on March 28.) Other mortgage types also grew more expensive: 15-year FRM, 2.76% to 3.50%; 5/1-year ARM, 2.68% to 3.08%; 1-year ARM, 2.62% to 2.66%.33


Q2 2013 was not as spectacular for U.S. equities as its predecessor. Still, all three major U.S. indices advanced. At the close on June 28, the Dow settled at 14,909.60, the S&P at 1,606.28 and the NASDAQ at 3,403.25. In addition, the Russell 2000 gained 2.73% for the quarter, closing at 977.48 on June 28. Fear increased, at least as measured by the CBOE VIX. The VIX soared 32.26% in the quarter.1

Gloom invaded Wall Street late in the quarter when Ben Bernanke spoke of tapering QE3. Intellectually, investors knew the Fed couldn’t ease forever – but the market sure had a hard time swallowing the pill. The market dip was far from a correction, though, and subsequent economic indicators lightened the mood on the Street. The coming quarter presents the market with strong challenges: few analysts see great things ahead for this next earnings season, there is fear that the jump in mortgage rates may slow the housing comeback, and investors are keeping wary eyes on economic and political developments in China, Europe and the Middle East.  If the housing, hiring and personal spending numbers measure up to expectations in the coming months, stocks may move a little higher in Q3 while Wall Street waits for fall.




This material was prepared by MarketingLibrary.Net Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. Marketing Library.Net Inc. is not affiliated with any broker or brokerage firm that may be providing this information to you. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is not a solicitation or recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. The Dow Jones Industrial Average is a price-weighted index of 30 actively traded blue-chip stocks. The NASDAQ Composite Index is an unmanaged, market-weighted index of all over-the-counter common stocks traded on the National Association of Securities Dealers Automated Quotation System. The Standard & Poor’s 500 (S&P 500) is an unmanaged group of securities considered to be representative of the stock market in general. It is not possible to invest directly in an index. NYSE Group, Inc. (NYSE:NYX) operates two securities exchanges: the New York Stock Exchange (the “NYSE”) and NYSE Arca (formerly known as the Archipelago Exchange, or ArcaEx®, and the Pacific Exchange). NYSE Group is a leading provider of securities listing, trading and market data products and services. The New York Mercantile Exchange, Inc. (NYMEX) is the world’s largest physical commodity futures exchange and the preeminent trading forum for energy and precious metals, with trading conducted through two divisions – the NYMEX Division, home to the energy, platinum, and palladium markets, and the COMEX Division, on which all other metals trade. Nikkei 225 (Ticker: ^N225) is a stock market index for the Tokyo Stock Exchange (TSE). The Nikkei average is the most watched index of Asian stocks. BSE Sensex or Bombay Stock Exchange Sensitivity Index is a value-weighted index composed of 30 stocks that started January 1, 1986. The Karachi Stock Exchange (KSE) is Pakistan’s largest and one of the oldest stock exchanges in South Asia by market capitalization.  The TWSE, or TAIEX, Index is capitalization-weighted index of all listed common shares traded on the Taiwan Stock Exchange.  The SSE Composite Index is an index of all stocks (A and B shares) that are traded at the Shanghai Stock Exchange.  The Jakarta Stock Price Index is a modified capitalization-weighted index of all stocks listed on the regular board of the Indonesia Stock Exchange. The Australian Securities Exchange (ASX) is Australia’s primary securities exchange. The S&P/TSX Composite Index is an index of the stock (equity) prices of the largest companies on the Toronto Stock Exchange (TSX) as measured by market capitalization.  The Bovespa Index is a gross total return index weighted by traded volume & is comprised of the most liquid stocks traded on the Sao Paulo Stock Exchange. The Mexican IPC index (Indice de Precios y Cotizaciones) is a capitalization-weighted index of the leading stocks traded on the Mexican Stock Exchange. The DAX 30 is a Blue Chip stock market index consisting of the 30 major German companies trading on the Frankfurt Stock Exchange. The CAC-40 Index is a narrow-based, modified capitalization-weighted index of 40 companies listed on the Paris Bourse. The RTS Index (abbreviated: RTSI, Russian: ?????? ???) is a free-float capitalization-weighted index of 50 Russian stocks traded on the Moscow Exchange in Moscow, Russia. The IBEX 35 is the benchmark stock market index of the Bolsa de Madrid, Spain’s principal stock exchange.  The FTSE 100 Index is a share index of the 100 most highly capitalized companies listed on the London Stock Exchange. The Global Dow (GDOW) is a 150-stock index of corporations from around the world, created by Dow Jones & Company. The Dow Jones STOXX 50 is a stock index representing 50 of the largest companies in Europe based on market capitalization. The stock universe used for selection is an aggregate of the 18 Dow Jones STOXX 600 Supersector indexes, which together capture about 95% of the capitalization of the major stock exchanges in 18 European countries. The Asia Dow is an equal-weighted, 30-stock index that measures 30 of the leading blue-chip stocks traded in the Asia/Pacific region, The MSCI World Index is a free-float weighted equity index that includes developed world markets, and does not include emerging markets. The MSCI Emerging Markets Index is a float-adjusted market capitalization index consisting of indices in more than 25 emerging economies. The US Dollar Index measures the performance of the U.S. dollar against a basket of six currencies. Additional risks are associated with international investing, such as currency fluctuations, political and economic instability and differences in accounting standards. This material represents an assessment of the market environment at a specific point in time and is not intended to be a forecast of future events, or a guarantee of future results. Past performance is no guarantee of future results.  Investments will fluctuate and when redeemed may be worth more or less than when originally invested. All information is believed to be from reliable sources; however we make no representation as to its completeness or accuracy. All economic and performance data is historical and not indicative of future results. Market indices discussed are unmanaged. Investors cannot invest in unmanaged indices. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional.




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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