Medicare, Insurance and Health Care

Table of Contents

 

Chapter 1: Medicare is Singed into Effect in 1965

1

    Medical Care for the Aged

2

Medicare Originally Intended to be a Cradle-to-Grave Coverage

4

    Affordable Care Act (ACA)

5

Medicare Supplemental Insurance Coverage

9

  Medicare Parts A, B & D

11

    Income Related Monthly Adjustment Amount

12

    Medicare Advantage Plans

13

    Medicare SELECT

15

Funding LTC on the Taxpayer’s Dime

15

Medicaid Qualified Annuities

17

Spousal Impoverishment Act of 1988

18

Health Care Reform

18

Expanding Medicare & Insurance Benefits

21

    Canada utilizes a one-payor system

22

    Canada’s single-payer system does not cause delays in health care.

23

    Universal health care programs need not be a cash cow

25

With COVID19 Medicare Programs Gain Popularity

26

    Repeal of the Independent Payment Advisory Board

27

COVID19 Changed Everything, including ACA’s Popularity

28

COVID19 Affected Insurance & will for Years

30

Insurer Risk Mitigation Requirements

30

Effective Business Interruption Policies Also Benefit Medical Plans

31

    Reimbursement of payments are based on

33

    Pandemics, viruses, or communicable diseases are excluded in policies.

34

Some States Intervened in Policy Exclusions

35

Claims & Industry Assessments

35

    Many states recognized that lowering financial barriers.

36

Federal Actions

36

Loss of Employment-Sponsored Health Insurance

37

Another Health Insurance Option

38

Short-Term Insurance Coverage

38

Understanding Medicare Insurance Post-Pandemic

39

A Changed Landscape for Insurance Producers

40

Insurance Company Actuarial Assumptions & Forecasting

43

Short-Term and Long-Term Insurance Impacts

45

Impact on Industry Growth

45

The Life Insurance Industry in America & Around the World

46

  Underwriting During the AIDS Criss Provides Guidance Today

46

  Non-Health Elements Affecting Policy Underwriting

47

  Underwriting Life Insurance in these COVID19 Time

47

    Equations require data

48

Application for Life Insurance Policies

49

    Foreign travel has often been a question on life insurance applications.

49

    Presenting fast-life insurance products

50

Policy Provisions Now Apply to COVID19

51

Defining the Contract

52

The Producer’s Role in Acquiring Policy Applications

52

Policy Ownership

53

Premiums

54

Policy Options

54

  Nonforfeiture Options

54

  Dividend Options

54

Settlement Options for Life Insurance

55

    The word "annuity" means "a payment of money."

55

State Required Provisions

57

Incontestability

57

  Misstatements in the Application

58

Deferment Clause

58

Nonforfeiture

58

Loan Values

59

Grace Period & Reinstatement

59

Allowed Policy Provisions

60

  Suicide

60

  Aviation

60

  War

60

  General Provisions

61

Deduction of Indebtedness & Premium Refund

61

    Example

61

Assignment

61

Beneficiary Designations

61

    Contingent & Vested Interest

62

    Crossman Co. v. Ranch in New York

63

  Change of Beneficiaries

63

Policy Payments

64

Cash Values

64

Dividends

64

Proceeds

65

Special Clauses

65

Contract Use

67

Contract Participants

67

  The Insurance Company

67

  The Insured

67

  Insurance Contract

67

Underwriting & Rating

68

Finance

69

Insurance has a Public Interest

69

Key Person Life Insurance

70

Buy-and-Sell Agreements

70

The Key Person Principle

71

  Insurable Interest for Life Insurance

72

    Example

72

  Disability Insurance on key Employees & Owners

73

    Example

73

The Small Company’s Exposure

75

Loss of the Small Business Owner

75

    A partnership may be terminated due to death.

76

    Closely held corporations

77

Planning for Death or Disability

78

Chapter 2: Medicare-Aged Individuals Funding Retirement w/ Annuities

80

  Defining an Annuity

80

Annuity Choices

81

  Joint and Survivorship Annuities

81

  Guaranteed and Life-Time-Certain Annuities

81

  Level Annuities

82

  Capital-Back Guaranteed Annuities

82

  Escalating Annuities

82

  Inflation-linked Annuities

82

  Enhanced Annuities

82

NAIC’s Annuity Best Interest Requirements

83

NAIC Section 5. Definitions

83

NAIC Section 6. Duties of Insurers and Producers

86

A. Best Interest Obligation

86

  Care Obligation

86

  Product Replacement with Best Interest in Mind

87

  Full Disclosure

88

Insurance Producer Compensation Disclosure Forms

88

  Appendix A

89

  Disclosure Obligation

91

  Conflict of Interest Obligation

92

  Documentation Obligation

92

Transactions not based on a recommendation

92

Supervision System

93

Prohibited Practices

95

Deceptive Sales Practices Forbidden

95

Annuity Phases

96

Choosing Between Fixed & Variable Annuities

97

Choosing Between a Lifetime Annuity & Term Annuity

97

Annuity Extras

99

  Built-In Protections

99

  Cost of Living Protection

99

Annuities Following COVID19

100

  Principal Protection

100

  Tax Efficiency

100

Reasons to Buy an Annuity

101

Reasons to Avoid Buying an Annuity

101

Choosing Annuities

102

Many Annuity Choices

103

Annuities for Retirement

104

Everyone is Living Longer, Despite Coronavirus

105

Putting Off Retirement

106

Fixed Rate Annuities

107

  How Fixed Period Annuities Work

108

Variable Annuities

109

Annual Annuity Expenses

110

Funding Variable Annuities

110

  Variable Annuity Fees

111

  Variable Annuity Death Benefit

111

  Surrender Fees

111

  Early Withdrawal Penalty

111

  Taxation

111

Equity Indexed Annuities

111

Massive Impact on Insurance from COVID19 in the US

112

Chapter 3: 21st Century Cures Act as it Relates to Medicare & Medicaid Insurance

113

Title XV, Medicare Part A

114

  Section 15001

114

  Section 15002

114

  Section 15003

116

  Section 15004

117

  Section 15005

118

  Section 15006

118

  Section 15007

119

  Section 15008

119

  Section 15009

120

  Section 15010

122

TITLE XVI - PROVISIONS RELATING TO MEDICARE PART B

123

  Section 16001

123

  Section 16002

124

  Section 16003

125

  Section 16004

126

  Section 16005

126

  Section 16006

126

  Section 16007

127

  Section 16008

128

TITLE XVII - OTHER MEDICARE PROVISIONS

128

  Section 17001

128

  Section 17002

129

  Section 17003

130

  Section 17004

130

  Section 17005

132

  Section 17006

133

  Section 17007

137

 

United Insurance Educators, Inc.

8213 – 352nd Street East

Eatonville, WA. 98328

mail@uiece.com

(253) 846-1155