As you
know, United American Insurance Company has been extremely proactive
in designing innovative programs to assist our customers in obtaining
affordable alternatives to health insurance policies. While Underage
Health has certainly been a focus, we have had an equally strong focus
in setting up programs to help keep customers' costs down for the
Medicare Market too. As evidenced by this year's modest Med-Supp rate
increases, these programs have already begun bearing fruit. Many
states had no rate increases and a few even had a reduction in rates.
The positive effects of these inflation control programs are
anticipated to continue in the future, by the addition of a new
program to those already in place.
First, let's review what
we've already accomplished:
1. Rapid Inspection
Process: We added a Rapid Inspection Process (RIP calls) to
verify the customer's understanding of underwriting questions, in
order to ensure we are accepting the proper risks based on health
questions seen on the application.
2. Enhanced
Underwriting: About 2 years ago, at the suggestion of our
President's Council, UA introduced a new Medicare Supplement
application with additional underwriting.
3. Excessive Outpatient
Hospital Charges: After an intensive effort by UA and
others, the government agreed to change the way Medicare coinsurance
is calculated for outpatient hospital services. Previously, the
patient always owed 20% of the total bill, while the percentage paid
by Medicare had steadily dropped over the years until it averaged
about 50% of the total bill. With the change, Medicare established set
"approved" amounts for outpatient hospital services limiting
the amount hospitals can receive for those services, and the
percentages of those amounts paid by the patient and Medicare are
gradually being shifted back to 80% by Medicare and 20% by the
patient. This change is reducing our expenditure for outpatient
hospital charges dramatically. Because of the positive impact seen
from this change, further improvements in this area are also being
pursued.
4. Revisions to Medigap
Standardized Plans: The NAIC currently has a committee
charged by Congress with the revision of several of the standardized
Medicare Supplement plans. The committee will revise the Plans H, I,
and J in order to reflect the recent addition of a prescription drug
benefit to the core Medicare program. In addition, the committee will
draft two new Plans, dubbed "K" and "L." Plans K
and L are intended to promote cost-sharing between policyholders and
insurance providers, most likely in the form of co-pays. The good news
for UA Agents is Torchmark has a representative on the NAIC committee,
who will be intimately involved in the committee's planning and
proceedings. The current Plans' revisions and the two new Plans are
expected to be available by the end of 2005.
5. UA Part A Deductible
Waiver Program: Over the last several years, UA sought an
opinion from the Office of Inspector General of the U.S. Department of
Health and Human Services regarding our intended use of a preferred
network as part of our Medicare Supplement health insurance policy. As
previously announced, we received the favorable opinion we wanted.
United American is now contracting with
Participating Hospital Networks to include its Medicare Supplement
policyholders in the hospital network. Customers can continue to go to
any Medicare approved hospital, preserving the freedom of choice they
have always had; however, for customers choosing to go to a
participating hospital, that hospital has agreed to waive all or part
of the Medicare Part A Deductible, which is $876 for 2004. UA saves by
not having to pay this deductible to the provider and passes along a
portion of the savings to its policyholders.
In what ways do UA's
policyholders benefit? The most immediate benefit is the
share in savings. UA saves all or part of the Part A deductible that
was waived by the hospital. After discharge from the hospital, the
insured will receive a credit from UA that can be used to help pay
their next premium payment. At this time, the credit is $100
(available where state approved, see pg. 2 for details) and this
represents the policyholder's direct participation in the savings.
UA's Part A Deductible Waiver program is applicable only to those
customers on Plans B, C, D, F and G; Plan A will not be included
because the Part A deductible is not a covered benefit under Plan A.
The best news is the long term effect this new
program can have on UA's Med-Supp insurance premiums across the board.
The primary benefit to the insureds under this program should be in
the area of controlling rising health care costs which has a direct
impact upon health insurance premiums. Savings gained by both the
customer and UA have the potential to positively impact future
Med-Supp premiums not only for those policyholders who select network
hospitals (without increasing costs for those who do not), but for all
UA policyholders.
In order for Agents to promote this program to
their new business customers in any state, two things must happen. UA
must first get advertising approval for the program for that specific
state and secondly, obtain hospital networks in the state to provide
services. After this occurs, we may then promote the Part A Waiver
Program brochure and participating hospitals. As outlined below, 19
states have approved our advertising so far, with the 11 newest ones
in the process of being released.
1. The 8 states where we have
already released the Part A Waiver Program's advertising material are:
FL, GA, IL, IN, MS, OK, SC and OH.
2. The 11 additional states
where approved advertising will be released next week are: AL, AZ, DE,
IA, MI, NE, NV, NM, UT, WV and WI.
Branch Office Supply will ship brochures to
Branch Managers and GAs in each of these new states as approved.
The participating hospitals within approved
advertising states may be seen on UAOnline. If your state is not yet
reflected on this list, or if you do not see as many hospitals
included as you would like in your state, please be patient. Intense
action is underway to expand advertising approvals and hospital
networks within each state. Approval has been a priority for every
state. UA has two outside firms actively involved in signing up
hospitals and may consider adding another firm to assist.
As each new state's approval is received, or new
hospitals are added, these will be updated on UAOnline. We anticipate
that only a few states may not approve the program for advertising.
These are very exciting changes! I suggest that
the Agents in approved states immediately begin making lead marketing
plans for our quickly-expanding Medicare Supplement sales
opportunities! UA has always been a great value, and that value is
being increased!