Personal Finance Tips

Well, for better or worse, the healthcare bill has been signed into law. There is no immediate benefit in being angry. There are a number of legal actions started by various Attorneys General alleging that the reforms are unconstitutional. Even if some of these cases succeed on the issue of mandatory insurance for private individuals, this will not necessarily strike down the whole bill. The likelihood is we will be left with all the provisions dealing with small businesses. Keeping it real, we have to start planning for the future on the law as it is. The good news is that the main raft of provisions will not become active until 2014. This gives the lawmakers plenty of time to have second thoughts. Just as important, there are sets of regulations to be written clarifying the detail of how some of the new features are to work at state level. However, this is an outline of what we can expect.

The states are to establish SHOP exchanges where small businesses can group together and buy insurance. For these purposes, until 2016, a business is considered small when it has no more than 50 employees, with states having the option of increasing the limit to 100 employees. To calculate numbers, you pro-rate the full- and part-time employees. Independent analysts predict group premiums will drop no more than 4%, while the value of the cover will rise by up to 3%. To bridge until the exchanges are operating, a tax credit system will come into force. If your business has less than ten employees with an average annual pay of less than $25,000, the credit is 35% of the health plan cost. There are partial credits where the number of employees is less than 25 and their average annual pay is less than $50,000. When the exchanges start, the credit increases to 50% for the first two years.

With immediate effect, there are a ban on terms designed to cap the value of claims, and limits on the right of insurers to cancel policies except in cases where actual fraud can be proved. As from 2014, the insurers must accept all employees without regard to pre-existing conditions. Their calculation of premium rates can only be based on location, age and whether an individual smokes. As from 2014, small businesses with more than 50 employees will be required to provide a health plan or pay an annual penalty of $750 for every full-time employee denied cover. This can rise to $2,000 if coverage is still denied.

So, tomorrow, you will be going out into the same market as before the reform bill became law. Finding cost-effective small business insurance will continue to be a struggle. Indeed, many insurers may increase premiums now so that, when the SHOP exchanges do come into force, they have a margin to play with to deal with the competition. However, when you buy, check that the new terms on the total value claimable and restrictions on the right to cancel have been introduced. If you buy your small business insurance through an agent, ask direct questions. It saves time fighting over whether wording is unlawful later on.

The market for insurance in the US is somewhat very different from the other world. In most every other line of business, companies are allowed to compete with each other across state lines. This helps to keep pricing to lower levels and the quality of the product to higher levels and protect the consumer. But unfortunetaly the insurance industry is licensed and regulated state-by-state. There’s no such thing as a federal insurance policy. You have to buy a policy written by a company licensed in the state where you live. This is slightly frustrating because, if you live near the border, your friends and colleagues at work probably tell you how little they pay or complain you have the better deals. Either way, it’s not very fair. Worse, the companies often decide not to set up in all fifty states, but pick and choose where they will operate. The result is that many states only have a small number of licensed insurance companies. Because there is no real competition, their premium rates tend to be high. This produces a big political divide. In Republican states, this is the free market at work and no intervention is necessary.

If you do not like this, move to another state which has lower rates. In Democratic states, there is more interest in protecting consumer interests. Some states have intervened in their local markets to introduce “managed competition”. Needless to say, this has outraged the insurance industry and the insurance agents who survive on the commission earned from the insurers. There have been heated debates between the lawmakers. Where the local Department or Office of Insurance has produced new rules, they have been referred to the local courts. Who would have thought helping millions of average people to save money on their premium rates would produce so much heat.

Anyway, the latest state to surface in this national debate is Massachusetts. In some ways, this state differs because of the dominance of the local agents who handle about 80% of the insurance business. Agents have more to lose if the markets are opened up to competition. Not surprisingly, they have been the fastest to the courts in the fight to protect their business. We have just had the decision of the Massachusetts Supreme Court on two rule changes made by the state’s Insurance Commissioner Nonnie Burnes. Let’s start with the effect of the move to open up the state to competition. Before the rule changes, there were nineteen insurers writing auto insurance policies. Twelve more companies have now entered the markets. In most cases, premium rates have been stable as insurers cut their costs and accepted a reduced profit. But agents have been hit because the opportunities to earn commission have been reduced.

The Massachusetts Supreme Court has supported the reforms, finding the effect of managed competition is sufficiently beneficial that it should represent the prevailing public policy in the state. Put another way, the judges think the many consumers should pay less rather than the few corporate officers and stockholders earn excessive profits. Because one of the agent’s automatic rights to a commission has disappeared, they will be looking to recover their losses in other ways. There are two morals to this story. The first is that, if you want to find cheap car insurance, support the lawmakers in those states who promise to introduce more competition into the car insurance market. Secondly, always get your auto insurance quotes through a site like this and avoid agents who earn commission.

Let’s leave the politics of healthcare reform to one side and focus on a proposal to change the law to allow free market competition between insurers in different states. A policy consistently mentioned by the Republican party is to break the state monopolies in the insurance market. Since the 1800′s, the individual states have claimed the sole right to regulate the sale of insurance within their own borders. Each state has asserted the right to license insurance companies and to set the terms on which they can conduct business. This has led to a patchwork of different sets of regulations with each state creating unique laws. In turn, this forces an insurance company to set up separate subsidiaries to trade in each state. No licensed company can sell a policy to someone who has a residence in another state. There was a brief moment in 1944 when a decision of the Supreme Court allowed the possibility of federal supervision. But the lawmakers in Washington immediately changed the law to retain state control. Why is this a bad thing? The national insurance companies have divided up the states between them and choose not to compete against each other. This keeps the number of insurance companies in each state artificially low and, because there is no real competition, premium rates are higher than they should be for weak policy terms.

You are reading this article on the internet. When online, you can buy more or less any product or service across state or national boundaries. Although there are some restrictions, e.g. some states limit your right to import drugs from foreign countries, there is an almost free market where you can search for the cheapest price and buy whatever you need. There is no possible economic justification for retaining this historical privilege for insurance companies. All it does is preserve their ability to maximize their profits at your expense. For example, in Minnesota three insurance companies dominate 80% of the market for health plans. There is no doubt that, if more companies entered the market, the premium rates would fall. During his run for President, Senator John McCain was in favor of free markets for health plans. President Obama supports it and the proposal is in both versions of the healthcare reform bills currently stalled in Washington. But because the Republican party’s only policy is to oppose everything the Democrats propose, it seems even this simple change in the law may be lost. What will the result be? The anticompetitive behavior of the insurance industry will continue and you, the consumer, will suffer.

Could the law change tomorrow and allow everyone access to cheap health insurance wherever it can be found? The problem is that the states have different sets of regulations and compliance leads to different costs. The playing fields are not level. So, premiums are significantly lower in those states which have the fewest consumer protections. It would not be fair competition if people living in Minnesota, which has strong consumer protections, could all get health insurance quotes from states with little or no consumer protections. The only way in which there could be a free market is to have a single set of federal regulations for the sale of health insurance plans. Sadly, the political parties do not want to talk about this even though we would all benefit. In the US, the political elite’s interests do not match the needs of the ordinary citizens.

Insurance is a slightly nonstandard business in that all the major regulatory functions are left to the individual US states. Federal government has decided to abandon its normal role as the regulator of business to protect the consumers’ rights. Such regulation as does exist is down to the political climate in each state and the will of the lawmakers to take on the economic power of the insurance industry. That said, all Departments of Insurance start off equal. Their primary function is to license companies to sell insurance in their state. Unlike other businesses, an insurance company is licensed state-by-state. No company can sell a policy across state lines. That means every national insurer must establish separate subsidiaries in each state and each company must hold a license. There are also minimum capital holdings set by the Department to protect the solvency of the local companies. There must always be enough money held by each company to pay out on the claims made. Some states require actual cash to be available. Others have a formula to prove the availability of money as required. But, for the most part, this is historical. The major players established their presence in multiple states years ago and newcomers moving across state lines are rare. In fact, the general lack of competition in state markets gives no incentive for companies to seek new licenses.

Once all the players hold their licenses, the personality of the Commissioners in charge comes to the fore. Many view their role as political either to run the Department with the lowest possible level of regulation or to be an effective watchdog to protect consumer rights. You can tell which way your local Department is run by logging on to your state’s website. Some sites are very pro consumer, offering detailed help and advice on how to buy insurance and get a good deal. But the key test lies in the way complaints are handled. Without exception, all Departments accept complaints from people holding policies. In theory, they should all investigate these complaints and apply a judicial process to decide whether the insurer is at fault and, if so, what the remedy should be. For example, Road Island has just imposed a fine of $5,000 on a leading insurer. Following a traffic accident, the insured wanted the repair work done at his regular auto body shop. This was refused by the insurer because the shop was not on their list of approved body shops. Local regulations drawn up by the RI Department allow the insured a free choice of repair facilities. The fine of $5,000 and publicity for it represents a small penalty in itself. But if there were many such fines, the cumulative bad publicity would damage this insurance company’s reputation and its market share would fall.

The best Departments are completely open about the complaints process, publishing details of the complaints, the identity of the insurance company and whether the complaints were upheld. When you are looking for cheap car insurance, this gives you an excellent guide to all the companies’ performance in selling policies and handling claims. Sadly, the majority of Departments do not identify the bad insurance companies by name. The worst do not publish any useful information about complaints. This leaves you in the dark when looking for cheap car insurance with a reliable company.