Christmas
HIPAA Versus Underwritten: Premium Issue
Hope everyone had a good Thanksgiving and we are now heading into the Christmas season.
I ran across something interesting a few weeks ago and I wanted to share it with you. It forms the basis for the order in which I help people enroll in individual & family coverage in California.
As I mentioned in an earlier blog post, CA PPO plans are able to be rated up from the standard premium in increments determined by each carrier. Some carriers offer more tiers, meaning more chances to get coverage approved.
Anthem Blue Cross (CA) Level 1 (standard), +20%, +25%, +50%, +75%, +100% (6 tiers)
Blue Shield CA Tiers 1-5 (1 being 80% of standard cost which is not always realistic) (5 tiers)
Health Net CA standard, +25%, +50% (3 tiers)
Aetna A (standard), B and C (3 tiers)
As you can see, Anthem offers the best range with 6 full tiers, Blue Shield next with 5 (as stated, Tier 1 is less than likely in the majority of cases), and Health Net and Aetna have less at 3 tiers before decline.
With all of that out of the way, here is something to consider for those who are HIPAA-eligible:
There are cases where a rated premium on an underwritten plan can exceed the premium of the duplicate HIPAA plan. If you are approved say Level 1 + 50%, that premium may in fact be higher than the HIPAA PPO.
Now it gets sticky. Since you are enrolled in an underwritten plan, you have lost HIPAA eligibility (perhaps). There is a way around this if you are working with a good, head's up agent. During the 10-day free look period, you can cancel as never effective and retain HIPAA eligibility. It is a very short little window there.
The advantage of working with an agent (besides not costing you anything) is that we can see how the policy was rated before they even mail anything out to you. You won't know how you were approved until you receive the information in the mail if you bought direct.
Since this situation can and does happen, I prefer to enroll in HIPAA first then follow up immediately with an underwritten application. That way the HIPAA coverage is secured and we can try to get you a better offer through underwriting and make the switch.
General insurance
General insurance includes
- motor insurance;
- household insurance;
- some travel insurance (see below for travel insurance we do not regulate);
- health cover; and
- pet insurance.
Mandir Shri Nimbark Peeth
Brief of the Diety:Shalagram idol of the size of a Gunja (Abrus prectorious grain) representing Shri Sarveshwar Prabhu
Important Architectural Characteristics:Bhati chief of Khejarli Shri Sheoji and Gopal Singh Ji Bhati founded this Peeth following instructions of his holiness Shri Nimbarkacharya Peethadhishwara Shri Parashu Ram-Devacharya Ji. The temple has been so designed that the Deity is visible for Darshan the moment one enters the main gate.A flight of seven steps leads to the main entrance . The wide main gate has two small upraised gates, one on earchside. This is typical of the architectural designs adopted for the main gate of a temple in the 15th century .
Emerald
Seed
If you want to choose the Ideal Spa
We are constantly inundated with magazine and newspapers articles about “must visit” new spas – they are popping up all over the UK. The marketing seems good, the treatments, we are told, are all totally indulgent and the images draw us in to what they all seem to describe as a “haven of tranquillity”. So how do we really know where to spend our money?
There are so many things to consider. What is a spa? I’m told I need to pre-book my treatments, but if you’ve never visited a spa before, how do you know which treatments you should have? Are the prices competitive or can you get the same treatment nearer home for less money? What facilities does the spa have? Will the swimming pool be full of children playing on an inflatable dolphin whilst you are trying to indulge in some much needed rest and relaxation?
Spas come in all shapes and sizes but in the UK they tend to fall into six main categories:-
Day Spas – These offer a good range of facilities without the option of accommodation. Most spas will have a pool and other facilities such as a sauna and steam room. They will offer a comprehensive range of treatments including massages and facials and a relaxation room to chill out in afterwards.
Hotel Spas – There are a great number of hotels with spa facilities attached. The quality and quantity of the facilities varies enormously, and the grading of the hotel isn’t necessarily an indicator as to the quality of the spa. You should bear in mind that if you’re planning to spend the day chilling out at a hotel spa, you could be joined by other hotel guests, including children and corporate groups. The hotel may also have a members club, in which case you should expect a steady flow of guests throughout the day. Not all hotels spas provide robe, towel and slippers for use on a spa day, so check this out before you book.
Destination Spas - You are unlikely to find any children here! A resort dedicated to treatments, relaxation and luxurious pampering. Many destination spas are a complete “get away from it all” experience. They are usually set in beautiful surroundings and have a broad range of facilities, classes and activities. Guests can visit for a day or stay over for as long as they wish. Those on longer stays tend to have a goal in mind whether it’s weight loss, detoxing or just recharging batteries after a particularly stressful time. Prices at destinations spas tend to be high in comparison to other options, but they do offer fantastic service, excellent facilities and a high ratio of staff to guests.
Treatment Rooms - These tend to be like day spas but without the wet facilities. Guests tend to book anything from a one off treatment, to a selection of treatments but due to the lack of wet facilities and other activities, it is more of an opportunity to unwind with luxurious treatments. Ideal for those who need to de-stress but don’t have the time for a “spa day”.
Health and Leisure Clubs - These are available to members and spa day guests. They can be connected to a hotel or, quite often are just a stand alone venue. Most have a large swimming pool, sauna, steam room and a good range of sports equipment. They also have fitness trainers on hand to assist with equipment and exercise programmes.
Basically, no two spas are the same. Choosing the right location depends on what you are looking for. A spa suitable for a group of girls on a hen party is a very different proposition to a venue suitable for a romantic spa break for two. So how do you know which spa to choose? The only real way of finding out is to either visit the spas in advance or save yourself time and speak to a reputable spa agent.
A good spa agent will have visited every spa they promote so that they can make personal recommendations based on your requirements. They have already done all the hard work, so you don’t have to. Whether you are looking for a one off spa treatment, a spa day or a spa break, with their detailed knowledge a good spa agent will be able to advise on a suitable spa venue with the treatments and facilities you require at a price you can afford.
My advice…… don’t accept a recommendation unless the person or company you are dealing with have actually visited the spa. We can all read the brochures, but how else, other than by first hand experience, can anyone truly advise you on how to part with your precious pounds?
Treat stretch marks and dark lips with skin treatment products
A healthy skin ensures a fresh and radiant look. Apart from helping you look young healthy skin also takes care of your general health. A healthy skin prevents unwanted organisms from entering our body.
So it is always important to take care of your skin.
Good skin care treatment does not require long hours of care. It in fact involves regular care. The first step involving skin treatment usually begins with proper cleansing. Cleansing removes the film of dirt that settles on the skin from our surroundings. If you live in a polluted surrounding cleansing needs to be done with unfailing regularity. Important skin treatment products include a gentle non allergic pH-balanced cream, lotion or soap which can easily dissolve surface dirt. A gentle scrub must be used to remove normal dead cells. As scrubbing and cleansing may remove the essential oils in your skin it is important to restore them. This can best be done by using moisturizers. Last but not the least one must use sunscreen lotions before stepping out into the sun. This prevents harmful rays of the sun from affecting the skin.
Stretch marks on skins can be a cause of great embarrassment. It is often caused by pregnancy, weight gain, extreme weight loss or other extraneous factors. Most stretch marks occur in the abdominal area, hips, breasts, thighs, lower back or upper arms. Proper stretch mark treatments can check such scars on the skin. Today there are several creams and lotions which can remove light marks. Surgical methods are used to erase deep and age old marks. However the effect of stretch mark removers depends on your age, your skin tone and at times on your diet.
Many people are also embarrassed by their dark lips. Lips of chain smokers usually turn dark due to the ill effect of nicotine. In some other case lips turn due to some ailment or rough brushing. People addictive to beverages also develop such symptoms. The right treatment of dark lips can restore the original color.
Chandan Yatra
Chottanikkara Temple
Chola Temples
The Brihadisvara temples are situated at Thanjavur, the ancient capital of the Chola kings. King Rajaraja Chola constructed the Brihadisvara Temple in 10th century AD, designed by the famous architect Sama Varma. The Cholas were great patrons of art, during their reign, as a result, the most magnificent temples and exquisite bronze icons were created in South India.
The Brihadisvara temple is crowned by a pyramidal 65-m vimana, a sanctum tower. Its walls are covered with rich sculptural decoration. The second Brihadisvara temple complex built by Rajendra I was completed in 1035. Its 53-m vimana has recessed corners and a graceful upward curving movement, contrasting with the straight and severe tower at Thanjavur. It has six pairs of massive, monolithic dvarapalas statues guarding the entrances and bronzes of remarkable beauty inside.
The other two temples, Gangaikondacholisvaram and Airatesvara were also built in the age of Cholas and testify their brilliant achievements in architecture, sculpture, painting, and bronze casting.
The great Temple of Tanjore (Thanjavur) was built between 1003 and 1010 in the reign of the King Rajaraja, of the Chola Empire which stretched all over South India and the neighbouring islands. Surrounded by two rectangular enclosures, the Brihadisvara Temple (built from blocks of granite and, in part, from bricks) is crowned with a pyramidal 13-storey tower, the vimana, standing 61 m high and topped with a bulb-shaped monolith. The walls of the temple are covered with rich sculptural decoration.
Kurta,Paijamas and Dhoti
The dhoti is a style of East Indian men's wear. It is formed by wrapping a piece of cloth in a specific manner about the waist and legs. It is usually white or cream in colour and worn with a kurta on top.
Location of body fat
Underwriting Tip (Individual & Family California)
I wanted to address an issue with regard to underwriting for individual and family health insurance plans in California. A little tip to help you determine what plan rates to target and whether or not you would be considered for coverage.
Ignoring for a moment any health conditions that are ongoing (these are dealt with separately), we need to talk about your Rx and how it affects underwriting.
Here is a simple formula for you:
Take you monthly retail brand Rx costs and multiply them by four.
This is the minimum premium amount that you would need to target before a carrier would even consider underwriting your case.
So, let's say you have the following brand drug costs per month (you can go to drugstore dot com and get average retail pricing):
1 brand drug at $131.00
1 brand drug at $97.00
Total brand = $227.00
Minimum target premium = $908.00 (4x brand drug cost)
That means that the approximate minimum premium rate that a carrier might consider to underwrite would be over $900 per month. If you choose a $120 per month plan, since the maximum rate increase on PPO plans (there is no rate up on California HMO plans) is 2x standard premium, you would be declined for coverage right off of the application since the max rate for that plan would be $240.00 at the top rate-up.
If you can't find any PPO plan in the carrier's options that costs at least 1/2 of $908 ($454), then there is no point in even applying for coverage.
Remember this is a tip regarding Rx usage. And be aware that carriers check through services like Intelliscripts to verify every fill you've had for any Rx over the last few years. If there are further health conditions beyond the Rx, even if you can find a plan that meets this basic rule, you might (and probably will) still be declined for coverage.
Underwriting and Declines (Individual & Family)
I wanted to talk a bit about something that has come up quite a bit recently concerning declined coverage and health insurance underwriting in California.
I always maintian that, with the exception of MRMIP enrollments which require a decline, generating a decline unnecessarily is never a good idea. Many people have called me in the last few months who have been advised by another agent to submit an application for health insurance even though the health history appears to be problematic. This is never a good idea and is, truthfully, not necessary to determine within a reasonable degree the outcome of the underwriting.
We, as agents, are able to call into the carrier's underwriting departments and, anonymously request and underwriting "review" for any prospective applicant. In most cases, given a reasonably accurate history, that underwriter can tell us whether or not the application would be declined for coverage. Also, agents have an underwriting guideline for each carrier they represent and often the answer can be found there without the need to even call an underwriter. No need to expose you to a decline that will be on your record for 10 years.
Now, some will say "yes, but each carrier does its own underwriting without regard to another carrier's decision" and this is absolutely true. However, if a person is declined for coverage, for the next 5-10 years, depending on the question in an application, that person MUST indicate that he/she was declined for coverage. This will be an instant red flag to the new underwriter who will likely take a very thorough approach to the applicant. This question will appear on both individual and employer-sponsored group applications. It's a stigma that should be avoided whenever possible. Kind of like a ding on your credit rating.
Let your agent do the work up front, look at all of your options, and make your decision based on the most accurate probability, not just flinging an application into underwriting and hoping for the best.
Welcome!
I would like to welcome you to my California Health Insurance weblog. Unlike other insurance blogs, which are sales-oriented, the intention of this blog is to provide the reader with pertinent and important information about health plans, benefit provisions, peculiarities, underwriting, and many other topics not frequently disclosed to the public.
If you visit my web site (www.davefluker.com), you will find that I am a non-traditionalist as an independent agent. I work primarily with individuals, families, seniors and very small businesses (mostly spousal) who have difficulty in obtaining quality health insurance and may be unaware of programs available or protections under the California law.
I hope that you will find this weblog and my web site of value and I welcome feedback and comments.
Dave
Light, Volatile Oils
Whole Foods or Supplements?
For some people, fortified foods or supplements can be helpful in getting the nutrients their bodies need. A fortified food contains a nutrient in an amount greater than what is typically found in that food.
The Platy
Mango
Mango is grown for the egg-shaped, 2- to 6-inch long, greenish or yellowish to reddish fruit, which has a skin slightly thicker than that of a peach. The juicy, sweet to acid flesh around the hard mono- or polyembryonic stone is a popular fruit for millions of people in the tropical and subtropical areas around the world.
Crop Diseases, Pests and Genetics Research Unit
solar energy technologies program
Information Technology (IT)
The Government has also provided special incentives for the IT industry subject to the prescribed conditions. These include:- (i) exemption from environmental clearance; (ii) exemption from zoning regulations for purposes of location; (iii) self-certification for purposes of compliance with certain Acts; (iv) general permission to run a three-shift operation; (v) rebate in the cost of land allotted to an IT Industry subject to the prescribed conditions; etc.
Sociology of education
Alkali soils
As the word akali correspond to sodic, the notion alkali soil is, similar to the notion sodic soil, is not explicit.Alkali, or alkaline, soils are clay soils with a comparatively high exchangeable sodium percentage, a relative high pH (> 9), a poor soil arrangement and a little infiltration capacity. Frequently they have a hard calcareous layer at 0.5 to 1 m. depth in India this coating is called 'kankar'. Alkali soils owe their unfavorable physico-chemical properties mostly to the dominating presence of sodium carbonate. Akali soils are normally not saline, i.e. the some amount of soluble salts, particularly sodium chloride, is not extreme .
Alkali soils are also called sodic soils, since sodium is an alkali metal. This, however, does not distinguish alkali soils adequately from saline soils.
Shipping
Land or "ground" shipping can be either by train or by truck. Trucking is easily the most well-liked form of shipping. Even in Air and Sea shipments, ground transportation is still required to take the product from its origin to the airport or seaport and then to its destination. Ground transportation is typically more reasonable than air shipments, but more expensive than shipping by sea. Trucks are also much faster than ships and rail but slower than planes.
Shipping can more usually refer to the transport of freight "shipments", independent of the mode of transport.
Lotus Temple
Shaped like a Lotus, the Lotus Temple is situated in Kalkaji in the south of Delhi. Made of marble, dolomite, sand and cement, the temple is the modern architectural wonder of India. A perfect place for meditation and obtaining peace and calm, the temple is visited by people from all walks of life. The Lotus Temple is a very new architectural marvel of the Bahai faith. The Bahai Faith is the youngest of the world's self-governing religions. Its founder, Bahadullah (1817-1892), is regard by Bahais as the most recent in the line of Messengers of God that stretches back beyond recorded time and that include Buddha, Moses, Abraham, Zoroaster, Christ and Muhammad.
False advertising
British Empire
By 1921, the British Empire detained bend over a population of about 458 million people, about one-quarter of the world's population. It enclosed about 36.6 million km² (14.2 million square miles), about a quarter of Earth's total land area. As a result, its inheritance is widespread, in legal and governmental systems, educational system, militarily, economic practice, sports (such as cricket, rugby and football), traffic practices (such as driving on the left), and in the global extend of the English language. At the peak of its power, it was frequently said that "the sun never sets on the British Empire" because its span crossways the globe ensured that the sun was always shining on at least one of its numerous colonies or subject nations.
During the five decades following World War II, most of the territories of the Empire became independent. Many went on to join the Commonwealth of Nations, a free organization of independent states.
Snooker
Snooker is mainly popular in many of the English-speaking and Commonwealth countries, and in China, with the top expert players attaining multi-million pound profession earnings from the game.
Keychain
A keychain can also be a short chain used to link together a number of keys or other items. Sometimes key chains are hung on walls.
The Role of the Authority
John Rooney, Curriculum Services Manager, Renfrewshire Council
Providing guidance
The recommendations
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The Authority should assign personnel to keep up to date with Internet and personal safety issues.
*
On behalf of those in their schools, the authority should ensure it has access to legal advice concerning the Internet as well as to Internet specialists.
Developing policies
The recommendations
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The Education Authority should have clear policy guidelines regarding personal safety on the Internet for all those in its employ and within its schools.
Disseminating information and exemplars
Some Education Authorities, such as Renfrewshire Council, have produced full sets of policy exemplars for their schools.
The recommendations
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Authorities that have not already done so should approach those who have, to share information, ideas and resources.
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As new Internet-related curricular issues arise, Education Authorities should form a view and disseminate information to schools.
*
Education Authorities should have mechanisms in place to help schools to share Internet-related information.
Professional development
Significant professional development is required for those involved in the Internet in schools.
The recommendations
*
Education Authorities should ensure that an appropriate resource commitment is made, and that internal staff, as well as those in schools, has the opportunity to participate.
Watercolor painting
Driverless car
Driverless passenger programs include the 800 million ECU EUREKA Prometheus Project on autonomous vehicles (1987-1995), the 2getthere passenger vehicles (using the FROG-navigation technology) from the Netherlands, the ARGO investigate project from Italy, and the DARPA Grand Challenge from the USA. For the wider application of artificial intelligence to automobiles see smart cars.
Temple of Artemis
The temple was a 120-year project in progress by Croesus of Lydia. It was described by Antipater of Sidon, who compiles a list of the Seven Wonders:
I have set eyes on the wall of lofty Babylon on which is a road for chariots, and the statue of Zeus by the Alpheus, and the hanging gardens, and the colossus of the Sun, and the huge labour of the high pyramids, and the vast tomb of Mausolus; but when I saw the house of Artemis that mounted to the clouds, those other marvels lost their brilliancy, and I said, "Lo, apart from Olympus, the Sun never look on aught (anything) so grand".
Railways
A railway/railroad track includes of two parallel iron rails, usually anchored vertical to beams, termed sleepers or ties, concrete, or steel to keep a steady space apart, or gauge. The rails and perpendicular beams are normally then placed on a base made of concrete or condensed earth and gravel in a bed of weight to stop the track from buckling as the ground settles over time below and under the weight of the vehicles passing above. The vehicles traveling on the rails are placed in a train; a string of individual powered or empowered vehicles joined together, displaying markers.
Discounted cash flow
Discounted cash flow analysis is broadly used in investment finance, real estate development, and corporate financial management.
Fitness boot camp
Patients
The word patient is resulting from the Latin word patients, the present participle of the deponent verb pati, sense one who suffers. The lively patient is a challenge in terms, and it is the declaration underlying the obedience that is the mainly risky part. Unfortunately not any of the various terms look as if to suggest a better definition.
In itself the meaning of patient doesn't involve suffering but the function it describes is often associated with the definitions of the adjective form: enduring trying condition with even temper. Some have argue lately that the expression should be dropped, since it underlines the substandard status of recipients of the health care.
Forex swap
Structure
A forex swap consists of two legs:
A spot foreign exchange transaction, and
A forward foreign exchange transaction. These two legs are execute simultaneously for the same quantity, and therefore offset each other.
Entertainment
While people have laughing themselves since the opening of time, the entertainment industry first became the most important force in culture in the 20th century with the development of most recent electronic technologies of recording and spreading. The Western people are tired of serious purposes and get-together massacre turned to well-liked culture subsequent the two world wars. The financial basis of this new culture was advertising of free or reasonably priced entertainment program. In their peak, television networks were great selling machines which, besides pleasurable people, prohibited together commercial and political markets by providing straight way in to the group of customers. This "territory" is currently in danger by the explosion and segmentation of media and particularly by the growing meaning of communication by computer which lets the consumer to seek out the informational message as an alternative of having it broadcast to him or her. A new system of world history sees Americans in exchange between a fourth, entertainment-based "society" and a future fifth advancement based on computer communication.
Flexography Printing
Flexography is used for printing on a variety of materials including plastic, paper etc. This printing technique makes use of flexible printing plates made up of rubber, Plastic. The inked plates with a slightly raised image are rotated on a cylinder which transfers the image to the substrate.
Mouse
A contemporary computer mouse, with the most common normal features: two buttons and a scroll wheel. In computing, a mouse (plural mice or mouses) functions as a pointing device by detect two-dimensional motion relative to its supporting surface. Physically, a mouse consists of a small case, held beneath of the user's hands, with one or more buttons. It sometimes features other elements, such as "wheels", which let the user to perform various system-dependent operations, or extra buttons or features can add more control or dimensional input. The mouse's motion classically translates into the motion of a pointer on a display, which allows for fine control of a Graphical User Interface.
The name mouse, originate at the Stanford Research Institute, derives from the similarity of early models (which had a cord attached to the rear part of the device, suggesting the idea of a tail) to the common mouse.
Electrostatic Printing
It a printing technique done without any plate, ink or type form. The paper is covered with a thin layer of zinc oxide, making it an insulator in the dark and at the same time a conductor of electricity when exposed to light.
These machines are worn for printing of geographic maps. With the progression in technology and higher speed, the machines are also being used to print small books. Electrostatic printers are used for short run printing as they are faster and also do not cost much.
Salwar kameez
Salwar kameez is also spell shalwar kameez and shalwar qamiz is a customary dress worn by both women and men in Pakistan, India, Bangladesh, and Afghanistan. It is now and then known as Punjabi suit owing to its popularity in the Punjab region and the Pathani suit, due to the reality that the Pathans of Kabul set up the dress to the rest of South Asia.
It is loose pajama like trousers the legs are broad at the top and narrow at the bottom,
The kameez is a long shirt or tunic. The division seams known as the chaak are left open below the waist-line, which gives the wearer greater freedom of movement. In Afghanistan and Pakistan, it is the preferential garment of both sexes. In Bangladesh and India, it is most usually a woman's garment. Though the majority of Indian women wear traditional clothing, the men in India can be found in more traditional western clothing. Shalwar kameez is the traditional dress worn by a range of peoples of south-central Asia. In India and Pakistan it is a mainly popular style of dress. Shalwar or Salwar is a short loose or parallel trouser.
Cricket ball
Cricket balls are made from a core of cork, which is coated with tightly wound string, and covered by a leather case with a slightly raised sewn seam. The covering is constructed of four piece of leather shaped similar to the peel of a quartered orange, but one hemisphere is rotated by 90 degrees with respect to the other. The "equator" of the ball is stitch with string to form the seam, with a total of six rows of stitches. The remaining two join connecting with the leather pieces are left unstitched.
For men's cricket, the ball must weigh between 5.5 and 5.75 ounces (155.9 and 163.0 g) and determine between 8 13/16 and 9 in (224 and 229 mm) in circumference. Balls used in women's and youth matches are a little smaller.
Dye-Sublimation Printers
A dye-sublimation printer (or dye-sub printer) is a printer which employs a printing process that uses heat to transport dye to a medium such as a plastic card, paper or canvas. The process is generally to lay one color at a time using a ribbon that has color panels. Dye-sub printers are intended primarily for high-class color applications, including color photography; and are less well-suited for text. While once the area of high-end print shops, dye-sublimation printers are now increasingly used as dedicated customer photo printers.
Vitmains and Minerals
Vitamins and minerals are substances that are found in foods we eat. Your body needs them to work properly, so you grow and develop just like you should. When it comes to vitamins, each one has a special role to play. For example:
Vitamin D in milk helps your bones.
Vitamin A in carrots helps you see at night.
Vitamin C in oranges helps your body heal if you get a cut.
B vitamins in leafy green vegetables help your body make protein and energy.