Insurance Agency Cyber Security - Insurance WebsitesCyber security threats are constantly changing. It is important to stay on top of emerging trends to keep your insurance agency website secure. A secure website not only protects your customers, it protects your brand. Here are the six top tips to help you keep your insurance website protected.

  1. Be Cautious When Creating Login Credentials
    Giving someone access to the back-end of your website is sort of like giving someone a key to your business. Maintain caution when giving someone login access and always keep login access to the minimum amount of people necessary to keep your website up-to-date.
  2. Update Security Patches, Limit Password Attempts, Use Malware Protection Software
    One of the most proactive ways you can keep would-be hackers at bay is to keep all aspects of your website’s code updated. When security patches, plugins, or dependency updates are released, install them as soon as possible. Hackers are constantly looking for code weaknesses. When one is discovered it is typically patched by the code developers as quickly as possible. The sooner you update your code the sooner you remove a threat that’s accessible to thousands of hackers. It is extremely important for all insurance websites to use a malware detection and prevention solution, and limit password attempts.
  3. Create a “We’ve been hacked” Response Plan
    Even the best attempts at keeping your site from hacking can fall short. It is absolutely imperative you have a response plan. Audit logs, backups, and contact information for IT support should be included in your response plan.
  4. Collect Detailed Activity Logs
    Make certain you have access to log reports on all back-end website functions, to help pinpoint issues when a breach occurs. Every login attempt, page adjustment, code adjustment, and plugin addition should be logged with user time stamps.
  5. Perform frequent backups and keep a copy of recent backup data off premises.
    Backing up your website should be an integral part of your response plan, and some hosting providers offer daily backup services. How often you need to backup your website will depend on how often you update it. When your insurance agency backs up your site, save a copy of the backup off of your server in easily accessible cloud storage. If your host is hacked and the server’s contents are compromised, you will have an unaltered version stored out of the hands of hackers.
  6. Train Users on How to Stay Secure
    Once you have your Cyber Security plan enabled, train all users on how to stay safe and prevent attacks. Educate users on how to generate very strong passwords and keep them safe by using a password manager, recognize email phishing scams, and how to encrypt emails that contain sensitive information. What’s a strong password? Today, use at least 10 characters, with alpha (including a cap), numeric (random not a sequential string), and special characters (exclamation, etc.). Many website platforms such as WordPress, will generate and/or measure the strength of your password.

To protect your website, start with the basics above, then determine if you have the expertise to continually stay abreast of potential cyber attacks. If not, consider outsourcing this initiative to a proficient web hosting and development company or insurance marketing agency.

 Visit our website for more information on Insurance Agency Marketing Solutions.

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: B2B Sales & Marketing, Insurance Agency Leads, Insurance Agency Marketing, Insurance Agency Web Marketing, Insurance Agency Websites, insurance web marketing
Read More

ItAmazon Buys Whole Foods was less than three weeks ago when I wrote, Etail Goes Retail – Amazon’s Opens NYC Bookstore. In that blog I discussed Amazon’s foray into retail bookstores, an interesting brick and mortar venture for a company that is a notorious retail killer. But that announcement pales in comparison to the explosive news on Friday, that Amazon agreed to buy the Whole Foods grocery chain for $13 billion!

Opinions were rampant on the potential reasons and impact of this paradigm shift. Stocks of traditional grocery chains and pharmacies suffered heavy losses during the day, as investors may have feared increased competition and concerns about market disruption. Amazon is now a behemoth with $136 billion in revenues in 2016, dramatically increasing from $10 billion in 2006. During this ramp up, Amazon has left their imprint on everything from shipping, to books, to electronics and online video.

Can Amazon reshape and rebuild retail? They will need to change the perception of Whole Foods, a chain many think offers choices that are too limited at price points that are too high. One thing is certain, it will be interesting to compare and contrast the Whole Foods of today, with Whole Foods a year from now.

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: B2B Sales & Marketing, Customer Service, Insurance Agency Marketing
Read More

Long Tail Keywords & Insurance Agency Leads

  • Posted on June 7, 2017
  • by Alan Blume

Insurance Search Engine Optimization and Insurance SEOHave you heard the famous saying that about the tail wagging the dog? When it comes to long tail keywords, it can often be beneficial for the long tail phrase to wag the dog. Long tail keywords are often a three to five (or more) word search phrase, some of which may only be searched five or ten times a month. These phrases are often very specific, but when a user types in the phrase, they can be an ideal prospect for your insurance agency services, and you want to make sure their search engine results page (SERP), lists your agency at the top. Let’s take a look at some examples of insurance long tail keyword phrases:

  • Arizona Garage Keeper Insurance
  • New York Owner Operator Insurance
  • California Professional Liability Insurance
  • Best Florida Business Insurance Rates
  • Florida Coastal Condominium Insurance

The more keywords included in a phrase and the more specific the term, the narrower the results, and the less frequently that term is searched. And of course, the shorter the phrase, the broader the results, and the greater the competition for the phrase.  An example of a broad phrase might be “Trucking Insurance”. When targeting long tail keywords, quantity is important. Your agency should target 100 or more long tails, along with more competitive phrases, for a comprehensive approach to your insurance agency search engine optimization efforts.

On page insurance search engine optimization (insurance SEO), includes both content and Meta data. This is the text, images and video that appears on your page, and the Meta such as Page Description, Alt Tags and Header Tags and blog content. Effective insurance search engine optimization also includes off page optimization such as news releases, social media posts, bookmarking, and videos to mention a few. Effective long tail optimization will result in improved insurance website traffic and increased insurance agency leads.

With the increasing number of mobile searches, your agency should add questions to your long tail efforts. Some examples include:

  • Where do I buy Arizona Garage Keeper Insurance?
  • What are the best New York Owner Operator Insurance agencies?
  • What are the lowest California Professional Liability Insurance rates?
  • Where do I find the best Florida Business Insurance Rates?
  • Where can I get the lowest Florida Coastal Condominium Insurance prices?

Though organic insurance search engine optimization and social media marketing are an important aspect of insurance agency marketing, agencies seeking to rapidly build their pipeline often find that insurance agency email marketing and targeted appointment setting calls can represent a faster path to lead generation.

For more information on insurance web marketing and lead generation, go to: www.startupselling.com

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: insurance agency email marketing, Insurance Agency eMarketing, Insurance Agency Leads, Insurance Agency Marketing, Insurance Agency SEO, Insurance Agency Websites, Insurance Content Marketing, Insurance Search Engine Marketing
Read More

Etail Goes Retail – Amazon’s Opens NYC Bookstore

  • Posted on May 31, 2017
  • by Alan Blume

What’sAmazon Etail Goes Retail up with this, Amazon the king of Etail is opening retail bookstores? This sounds like an April fools story rather than a new strategic initiative. But as it happens, the latter is true as Amazon opened the first of three New York City retail book stores in May.

It was reported that the first Amazon store occupies 4,000 square feet, carries 3,000 book titles, and is located at Columbus Circle. It also carries Amazon tech products like the Echo and Kindle, and faces all books outward for easy viewing of the covers. Signs underneath the books note the Amazon online star rating (only 4 stars and up are selected for the store) and the total number of reviews for each book. Amazon Prime members pay a preferred rate, while non-members pay a higher rate.

To add a further touch of irony to the story, the store is located in a mall that once included a Borders bookstore. Will this be a trend for the giant Etailer, identifying retail opportunities once the retail competition has been decimated by their more efficient Etail model?

Amazon likely envisions a new type of retail opportunity, because the traditional retail book business has hardly been robust. According to The Street, Barnes and Noble continued to see declines in their 2017 comparable store sales, expecting a drop of approximately 7% for the year. Then again, Amazon’s new books store is not the same animal as Barnes and Noble, taking a page from the Apple Store concept with their own Amazonian twist. With malls trying to reinvent themselves, as more and more retailers shut their doors, a national chain of Amazon retail book stores would be a warmly welcomed surprise.

Looking for assistance with your marketing and lead generation – contact the experts at StartUpSelling for a complimentary marketing and lead gen review.

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: business, emerging business, Virtual Business
Read More

Poor Customer ServiceLast night around 8pm, I called Netflix because an error message was displaying on my TV. I got a recording, which said my wait time would be less than two minutes. I’d estimate a customer service agent answered within a minute, completely fluent in English (likely US based), and not from an offshore call center. They solved my issue quickly and cheerfully. It was the second time I called Netflix over the past year. The prior instance provided the same result, fast, friendly, even cheerful service. I spend about $100 bucks a year for Netflix, so at that price, one would think almost any company could offer great service like this.

Two days ago, I was buying TVG train tickets to go from Paris to Avignon. I went online to the SNCF website (French National Railway Corporation website). I was having an issue processing my credit card, so I called them. They answered immediately, the customer service agent spoke English (quite well), and was very polite and helpful. However, he informed me that since I was from the US, I had to pay through their partner, Rail Europe.

When I went to the Rail Europe site, I found the ticket prices were significantly higher, so I called their support line. The estimated wait time was, 45 minutes! They did offer a call back service, but I would still have to wait 45 minutes. The tickets would run about $600. After reviewing online comments, complaining that Rail Europe charges extra fees, and there is nothing that can be done about that (sounds like Ticketmaster doesn’t it), I purchased the tickets.

Then we come to United Airlines customer service specifically, and the airlines in general. Another day, and another video surfaces. This one was about a United customer getting charged $300 to check a bag, and then having their reservation cancelled because they were video recording the discussion. The customer service agent seemed really cranky, the baggage fee seemed excessively high, and United seems to have a massive customer service issue. But for that matter, so does American, Spirit and many other airlines. Last winter, we pulled a delay due to an engine issue on an American flight, and missed our connecting flight. The next flight we could take was 6 hours later. American did nothing for us, and the customer service agent we conversed with seemed to care little about our delay or predicament. That said, I recently flew Alaska Air and Jet Blue, and thought their customer service was fairly good. I try to fly these two airlines whenever possible, as I’ve have mainly good experiences with them.

It seems that customer service has little to do with the price tag, and much to do with the company culture. There are plenty of companies that provide great customer service, and too many that don’t. It starts from the top down, and as consumers, we should do everything possible to reward those companies with great service, and avoid those who with a poor service record. Unfortunately, with companies like Rail Europe, and the airlines, sometimes there is no choice but to voice our frustration.

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: business, Customer Service
Read More

Top Tips to Improve Your Email Deliverability

  • Posted on May 11, 2017
  • by Alan Blume

Insurance Agency Email MarketingBusiness of all types can benefit from a well run email marketing initiative. Today however, they must take extra precautions to ensure they maintain a high quality sender reputation to optimize delivery, and improve conversions. Review these top tips and make sure your organization is following all of them:

Ping Test Emails

Always ping test your emails prior to your initial campaign, especially if it is an older list, a trade show list, or a prospect list. And once ping tested, never use failed ping tested emails.

No Longer At

Monitor your autoreplies and remove no longer at and retired immediately after every campaign. These email responses must be closely reviewed, as the autoreply can come for a source that is different from the actual email that should be removed.

Consistency & Frequency

The consistency and frequency of your email campaigns is important in maintaining a positive sender reputation. ISPs attempt to create and evaluate the email marketing history for your domain. The more consistent you are, and the more reasonable you are with your frequency, the more likely you are to create a solid reputation as a sender. That assumes you are following the other tips listed herein.

Avoid/Diminish Complaints

Lots of complaints will spell lots of trouble for your sender reputation and domain. The best way to avoid complaints is to limit campaign frequency (every two weeks for most general campaigns is a good rule of thumb), honor opt-outs immediately, focus on quality content and collateral, and restrict “sales” pitches.

Avoid Spam Traps (Honeypots)

Spam traps, sometimes referred to as honeypots, are email addresses specifically created to catch email from marketers who don’t follow email best practices. The traps target marketers who are scraping email addresses from the web or are simply blasting emails using poor quality lists. Sufficient “catches” by spam traps can result in low deliverability or even domain blacklisting.

Use Relevant, Educational Content

“Buy my stuff and save money now”! If your content is salesy, spammy and irrelevant, your sender reputation will be adversely impacted, and it will happen quickly. Try to make your content relevant and educational. Changing regulations, industry innovation, important news of the day, and educational webinars are going to be better received than an invitation to buy your products or services.

Email marketing is both an art and a science, and is increasing in complexity and deliverability nuance. It can be a great lead generator when properly used, or a waste of time and money when used with an email “blast” mentality. Agencies and businesses seeking guidance on their email marketing and lead generation can contact StartUpSelling for a complimentary email marketing and lead gen review.

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: B2B Sales & Marketing, insurance agency email marketing, Insurance Agency Marketing, Insurance Content Marketing, insurance email marketing, insurance web marketing
Read More

Insurance Agency Drip Campaigns & Email Workflow

  • Posted on May 3, 2017
  • by Alan Blume

Insurance Agency Email MarketingLet’s begin with a simple definition of insurance email drip campaigns. A drip campaign is a direct marketing method used to engage prospects and retain clients leveraging ongoing, dynamic content generated email marketing programs. The campaigns send targeted, and conditional content based upon existing and changing preferences. The content is sent to prospects and clients over varying periods of time to nurture leads and improve retention.

An email workflow is a series of automated emails which are sent (or not sent), based on the targeted subscribers, to help facilitate how they interact with your agency. The email workflows are triggered based on information you know, or learn, about your subscribers (using branching for Yes, No, If, Then). The workflows allow agency marketers to send precise emails, at predetermined times to specific prospects or clients. Well-designed email workflows can help insurance agencies improve conversion rates, and customer retention. Let’s discuss one of the many types of workflows insurance agencies can use, we’ll follow up with additional blog posts on other types of workflows in this ongoing series.

Insurance Webinar Workflow

Let’s say that your insurance agency is planning a webinar on a topic such as: ACA Compliance in an Uncertain Era, or Changes with CSA Regulations & the Impact on Truckers. Email workflows allow agency marketers to communicate the information your attendees need to know, and when they need to know it. Your agency webinar workflow can be triggered as soon as a date is set, though it is recommended a webinar registration landing page is ready at that time.

Once triggered, the webinar email workflow starts sending out automated emails, providing timely and useful information about the webinar, up to the webinar, and after completion of the webinar. This can include dates and times, if the webinar will be recorded, where to get the presentation slide or companion materials, and certification information for credits with HRCI, SHRM, etc. It’s beneficial, to begin a few weeks before the webinar, and to remind those who have not registered, and retain those who have registered.

Insurance agency email workflow branching allows for robust personalization and very specific content fulfilment. For example, if a registrant responds that they want to receive the slides, a Call To Action (CTA) can be created to drive them to a download page. Or for registrants who would like to share the recorded webinar at a later date, and email can be automatically generated, the day after the webinar, providing the recording link, and perhaps a CTA to set up an appointment to discuss coverages with your agency.

Needless to say, every agency should be using simple email campaigns. However, for many agencies, the time has come to invest in insurance agency email workflow drip marketing. Those agencies lacking the staff or tools to accomplish this can reach out to the insurance agency marketing experts at StartUpSelling.

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: insurance agency email marketing, Insurance Agency eMarketing, Insurance Agency Leads, Insurance Agency Marketing, Insurance Content Marketing, insurance email marketing
Read More

Top Tips To Improve Insurance Agency Video Marketing

  • Posted on April 20, 2017
  • by Alan Blume

Insurance Agency Video InfographicInsurance agency owners, producers and marketers looking to jump start their video content marketing, or improve their existing insurance marketing video campaigns can review these top tips to augment their current marketing initiatives. Here are your top tips to improve Insurance Agency Video Marketing:

  1. Use Educational Content, Not Sales Brochures

Case studies, client success stories, educational content pertinent to the industry. Here is a simple example.

  • Good: Impact of Trump Executive Orders on ACA Compliance
  • Bad: We Can Save You Money on Your Group Health Plan
  1. Create a Compelling Thumbnail

Your agency has a short time to convince prospects to watch your video. It begins with an attractive and attention getting thumbnail. Invest time to ensure your thumb nails look great, and make sure you add these images when publishing or sharing over social media.

  1. Share on Social Media – Then Share Again

You’ve invested time and money to produce a great video, now your agency needs to leverage it across all relevant social media platforms. The big four are obvious, YouTube, Facebook, LinkedIn and Twitter. But you should also include Google+ and some of the bookmarking platforms such as Tumblr. And remember that you can share content more than once, and in many nuanced ways. Create a blog, Tweet the blog, add as a LinkedIn post, Tweet the LinkedIn post and so on.

  1. Don’t Underestimate the Importance of Background Music

How many movies or commercials do you watch without background music? Background music will help convey your message and mood. Will you use edgy, modern instrumentation to convey you are an up to date digital agency, or more traditional music, inferring sound guidance and sage advice?

  1. Share Using Your Email Marketing Drip Campaigns

Agencies can and typically should invest in ongoing email drip campaigns, focused on providing high value content of interest to clients and prospects. High quality video content is often the preferred digital collateral to provide to clients and prospects, to improve renewal rates by providing added value and to increase insurance lead generation.

  1. Don’t Forget the Call To Action (CTA)

Leave sufficient time at the end of your video (assuming it’s a short two minute type video) for a Call To Action. What behavior are you trying to elicit from the person watching? Do you want them to submit a Contact Us Form, Schedule Appointment, Get A Quote, Call An 800#? Leave plenty of time for your CTA and contact information to show, and when possible, have CTA buttons continuously displaying below the video.

  1. Optimize for Insurance Agency Search Engine Optimization (SEO)

Make sure, you use your targeted keywords in your title, and description, tags, etc. What’s a good example of this? On this tip, the title includes the keyword phrase, “Insurance Agency Search Engine Optimization”, instead of just Search Engine Optimization or SEO. An example for your agency might include Risk Management for Manufacturers, or Surety Bond Strategies for Contractors, or Colorado Trucking Insurance.

  1. Add Video to Your Insurance Agency Website & YouTube Channel

Your videos can appear all over your website, on a relevant page, in a video library and in a blog (vlog). You should also take the time to create a branded YouTube channel for your agency, especially if you intend to do a video series. There are many types of video you can use, and don’t underestimate the value of a relevant recorded webinar or voice over PowerPoint.

As is evident by YouTube’s compelling statistics, people gravitate toward video. With over a billion users, watching videos over 40 minutes a day, and 400 hours of video uploaded each minute, it’s easy to see why insurance agency videos should not be ignored. Need help creating compelling videos for your insurance agency marketing initiatives? Contact the insurance agency marketing experts at StartUpSelling.

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: insurance agency email marketing, Insurance Agency SEO, Insurance Agency Websites, Insurance Content Marketing, insurance social media marketing, Insurance Video, insurance web marketing
Read More

UnitedHealth Group (UNH) had a banner quarter, as their 4th quarter earnings jumped to $1.7 Billion. Is this good news for UNH but bad news for healthcare consumers? With their stock currently trading at $165 a share, and total annual revenue approaching $200 billion, things are looking good for UNH executives and shareholders. But what does this mean for healthcare consumers?

For the past 12 years, as a business owner, I’ve paid for 100% of all my healthcare costs. This allows for a pragmatic view of the industry, regardless of political party rhetoric or politician promises. From my perspective the only constant has been increased premiums and reduced benefits. This was true under the Bush years and has not changed since. All the parties involved in our healthcare system, including hospitals, insurance carriers, pharmaceutical companies, and medical device manufacturers, are first and foremost seeking to increase profits. This includes many non-profit hospitals, which are actually extremely profitable, the difference being that their profits are reinvested in facilities, technology, research and of course compensation. Little has been done to provide patient visibility into the rising costs. Then again, why should these parties work to lower costs or increase patient visibility? Lower costs result in reduced revenue and profits, and these healthcare entities are motivated to earn compelling returns for their shareholders and executives. The same motivation as any business.

How Much Does an X-ray Cost?

Let’s look at a real life example of the problem. I had a sore ankle and was referred by my primary care physician assistant ($50 Tufts copay) to an ankle specialist. The ankle specialist ($75 Tufts copay) directed me to get an X-ray. So I asked the front desk staff at the ankle specialist a simple question, how much would the X-ray cost? They said, “Your insurance will cover it.” Of course this is no longer true, as deductibles and copayments often apply, and even if my insurance did cover it, shouldn’t I know what they get charged? The physician’s staff then told me to ask the radiology department.

About 10 minutes later, I was in radiology, and asked their scheduler the same question about the cost. She had no idea and seemed surprised by the question, but said she would call the radiology billing department. The billing department told me (indirectly since she was on the phone speaking with the scheduler) that it depended upon my insurance company. I provided my Tufts insurance card and asked again, how much the X-Ray would cost. I was then told to speak directly with their billing specialist, who would help me determine the cost of the X-ray. After a 10 minute discussion, and twice being placed on hold, I was finally told what my carrier allowed and the likely range of costs, which she estimated to be about $100 to $150. It was an arduous journey to get what should be easily and immediately accessible from the hospital and insurance carrier, on a PC or on a smart phone app.

Many millions of X-rays are done in the U.S. every year and the costs should not take on a mystical property. If we can quickly learn the cost to add the most insignificant item to a new car (readily available online), or quickly determine the average cost paid for any model car, new or used, in any given area of the country, why should medical procedures be different? The simple answer lies with the providers, as hospitals, clinics, labs, etc. don’t want us to know. Keeping rates hidden, helps mitigate competition and limits patient insight into their costs. If “Hospital A” charged $200 for an ankle X-ray, and “Hospital B” which was 5 miles away charged $100, patients might choose the latter (assuming they were in your network which must also be checked). Look at this a different way, if you wanted to purchase some groceries and they would cost $200 at the convenience store around the corner, but only $100 five minutes away, would you drive the five minutes for the savings?

Fortunately, this is changing, albeit much too slowly. There are progressively more online sources and services to help determine the best quality of resources available at the best price. This includes pharmacy sites and apps (GoodRX) which compare drug costs by pharmacy within a specific area, physician (PriceDoc) and hospital quality and costs (LeapFrogGroup or even medicare.gov/hospitalcompare), surgical costs, and there are numerous sites to now compare dental fees. This is potentially good news for consumers, and the faster and more pervasive the better.

It’s all about the Profits

Now let’s get back to UnitedHealth specifically, and healthcare carriers in general. What happens when healthcare insurance companies are focused mainly on profits? Our capitalistic system is in many regards the most enviable model for the entire world. It’s typically efficient, often transparent, and open to most everyone (anyone can start a business in America). It fosters innovation in part because of the inherent competition. That’s pretty impressive. But when it comes to healthcare, the system seems to break down.

You may recall that in 2016 UNH was pulling out of certain markets relating to Obamacare. Forbes reported that, “UnitedHealth entered 2017 selling individual coverage under the ACA in just a handful of states after scaling back its Obamacare footprint significantly.” That said, UNH did see promise in offering coverage under Medicaid, which was expanded to 31 states under ACA. Why did they do this? Remember, their top priority is not about providing health insurance and caring for patients, it’s about making profits. And if $7 billion dollars in profits is insufficient for their shareholders, then UNH needs to go (or leave) and find a place they can make even greater returns. Granted, healthcare companies do need to make a profit in the current climate, the question is, how much profit and how do they make these profits.

Are profits derived from selling cars different than profits derived from saving (or not saving) lives? Before Obamacare, insurance companies could turn down people they deemed an unacceptable risk. For example, let’s say there was a 60 year old male we’ll call “Mike the mechanic”, who was changing jobs and moving to a new health plan. Mike was healthy for his entire adult life (almost 40 years from age 18 to 58), but then had a heart attack on his 59th birthday. Prior to Obamacare (ACA), this would be a preexisting condition, and even though Mike the mechanic really needed health insurance, and had been a net contributor for almost four decades, insurance companies could simply say no, or charge him dramatically higher rates.  That doesn’t sound like a fair or equitable deal, and it leaves the insurance carriers holding all the cards.

Mike’s Premiums Versus Steve’s $110 Million Paycheck

But wait a minute, what happened to Mike’s 40 years of barely used premiums? During that time, Mike’s premiums went to pay for less healthy people, and to pay for health insurance company profits. Let’s look at an example. Let’s say that UNH charged $10,000 a year when Mike was 50 and healthy, and earned 10% on an average policy. Mike contributed $1,000 toward their profits, while the remaining $9,000 would pay for his healthcare costs (which were nominal for 40 years) and others who needed more care than their premiums would cover. Of course profits can be a deceptive metric, as they are determined after executive compensation, perks and other costs. And just in case you’re wondering how much that might be, UnitedHealth Group’s CEO, Stephen Hemsley, received total compensation of about $110 Million in 2010 and $66 Million in 2014. Total compensation can include salary, stock option rewards which are often a great factor in compensation, deferred compensation benefits, expense account perks, health benefits, life insurance policies and more. Whether or not you think some of these CEOs are paid too much, it seems like it should be different when it comes to healthcare and health insurance. When a health insurance company turns down someone with a preexisting condition, they are enriching themselves by refusing to pay for those most desperately in need. That makes sense from a profit standpoint, but not from a healthcare perspective.

Say No and Hope That the Claim Goes Unpaid

About six years ago, my daughter travelled to Moscow for her “mod abroad” program at the university she attended. She was a government major, and had been studying international politics and learning Russian. At the time, our insurance carrier was Blue Cross Blue Shield of Massachusetts. We contacted them to ask about her coverage wile in Russia, and what our daughter should do if she became ill. They were very specific, offering three choices of physician offices and clinics in Moscow that she could visit in the event of illness.

Several months after her arrival, she came down with conjunctivitis, visited one of the clinics suggested, got a written receipt for the visit, and sent the receipt to me. I filled out the proper BCBS form with a detailed explanation and submitted the form and receipt to BCBS of Massachusetts. What happened to that claim? It was rejected! So I called the claims department, and was referred to a supervisor, who told me that the claim was reviewed, and it was determined that it wasn’t part of our coverage. I said, “They didn’t review it.” The supervisor again said that they did. We volleyed back and forth a couple of times, when I said, “So how many of your claim processors are fluent in Russian?” The receipt was in Russian (Cyrillic characters), which is essentially unreadable for your average English speaker. I also told her that we followed the BCBS protocol exactly, and that we documented everything to ensure we had an audit trail. The supervisor put me on hold, twice, and returned about five minutes later to say they would pay the claim. That was a lot of work for a claim that was around $150, but that seems to be the idea. Consumers tire out, fail to understand the nuances, or simply throw in the towel when it comes to dealing with these types of issues.

It’s been extremely difficult to get cost estimates from insurance companies. Here is another real life example. I had turned 50 which means the time had come for a routine colonoscopy. I called Tufts Health to ask about the procedure cost, and after a series of transfers and holds, was finally on the line with a representative who told me that the procedure would be covered 100%, as it was a preventative care procedure. A couple of months after the procedure, my EOB (Explanation of Benefits) arrived with the patient responsible portion costing me thousands of dollars. After another series of calls, Tufts agreed that there was an error, and said it would be 100% covered. Another month passed, and I received a new EOB, this one for hundreds dollars. Once again, I made the requisite call to Tufts, and they said that the new error would be fixed, and I would not owe anything. And after many months, and many calls, Tufts Health Plan finally did what they should have done in the first place, and paid for the procedure. But what happens to people who don’t have the time, the knowledge or the patience to make all these calls? Many give up, contributing to the profits of the insurance company. Does our compelling capitalistic system work well with most types of businesses, but fail to do so when it comes to providing healthcare?

ACA Protections versus the Pursuit of Profits

There are other protections which were created under Obamacare. Prior to ACA, many twenty something children were not covered under their parent’s policies after they graduated college. There were restrictions on yearly and lifetime maximums that were devastating to families which encountered a severe illness. And as mentioned prior, the ability to turn down people with preexisting conditions was a major problem for many healthcare consumers. These issues were exacerbated by the exorbitant “retail rates” charged by hospitals, pharmaceutical companies and medical device companies. For example, an ankle X-ray which might be billed at $150 for an insurance patient, could be $500 or more for a private pay patient without an insurance coverage.

One reason for all of the restrictions above gets back to the profit motive of healthcare related companies including the insurance carriers. Though profit opportunities typically yield positive results in our highly competitive capitalistic system, as companies work hard to cut costs and improve efficiency, healthcare creates some unusual barriers to this paradigm. For example, when Mike the mechanic was having a heart attack, he had no concern with price, he wanted the best care possible regardless of costs. And therein lies a big part of the problem. When it comes to the healthcare of our loved ones, we often don’t care what it costs. But not all problems are urgent care related, and in many instances patients can take the time to weigh the costs, quality and venue of procedures, if providers would just let us know.

Would UNH post lower profits if they provided better coverages, or less costly plans? The simple answer seems to be, yes. From what I’ve seen, there doesn’t seem to be much competition, as all the major healthcare carriers charge similar (and confusing) rates. When I’ve compared carrier rates and coverage each year, including the dizzying array of seemingly similar plans, they all look comparable. But that’s not the case when I compare auto and home insurance coverage – there is often a wide disparity – likely due to competition and transparency. Is there really any true competition between healthcare insurance carriers?

With all of these healthcare players (insurers, hospitals, pharma companies, medical device companies, etc.) striving to increase profits, and lobby our politicians to allow them to do so, how will costs be reined in, and how can coverages be fairly administered? Just imagine how many more billions UnitedHealth (or any healthcare insurance carrier) could earn if they could refuse anyone they deemed to have an expensive potential condition. Or perhaps they could earn even more if they refused to cover those who were genetically predisposed toward a health condition. And actually, some of the carriers and large employers tried to do so, resulting in government legislation to prevent carriers and employers from refusing to insure people based on genetic profiling. The Genetic Information Nondiscrimination Act of 2008 (GINA), prohibited discrimination on the basis of genetic information with respect to both health insurance and employment.

What if health insurance companies could successfully lobby congress to cut back on those pesky annual or lifetime limits? Perhaps they could really make those profits soar, with shareholders recording windfall profits. Or perhaps insurance companies could lobby to cover only healthy young people up to the age of 50, or charge 10 times the rates for older people. These statements strike at the heart of the paradox, the fair distribution of health insurance versus the profit driven model of our current healthcare system.

Health insurers now operate under a law referred to as the 80/20 rule, which is designed to help consumers by guaranteeing that at least 80% of insurance premiums will be used to pay for health care related costs. The other 20% goes to general administrative, overhead, and marketing costs. In some cases, like group benefits, or certain state requirements, the spending level required is 85% to 88%. This regulation may be helping, but it is not be helping enough. The incentive to cut costs is mitigated because a bigger top line revenue number will often result in greater profits. Simply said, an insurer with a billion dollars in revue could earn $200 million while an insurer with half that revenue might only earn $100 million in profit, even though they are doing a better job controlling premiums and costs.

Imperfect but a Step in the Right Direction?

Obamacare is an imperfect solution, let’s examine why this happened. Obama needed to build consensus with existing players, to try to refine the existing system. His attempt to create a government option failed, and as a result of this and the special interests lobbying Congress, ACA didn’t do enough to reduce costs. It also added complexities and compliance issues for many businesses, and created a Cadillac tax to help defray the costs of the program. That said, it added many important protections and helped provide subsidized insurance for millions of uninsured US healthcare consumers. Though imperfect, it seemed like a step in the right direction, insuring tens of millions of people, and curbing potential abuses by insurance carriers.

Repeal And Replace

However, our new president and our Republican controlled Congress are trying to repeal ACA. Trump has promised to resolve all these issues, reduce costs, and retain the key benefits of Obamacare. To me, that seemed difficult to believe. And recently the POTUS seems to have realized that changes to our health system are difficult, “It’s an unbelievably complex subject, nobody knew that health care could be so complicated.” I’m not sure where he’s been, but it’s been complicated for as long as I can remember. Perhaps the POTUS should spend less time Tweeting and more time reading books like America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System, which details the highly nuanced politics and complexities involved in our healthcare system.

Will ACA be repealed and replaced with a “less expensive and much better… insurance for everybody,” as Trump has stated?  The American Healthcare Act, appeared to contradict Trump’s lofty and seemingly unrealistic promises. And though Trump said everyone will be insured, The U.S. Congressional Budget Office said that over 14 million people will lose their health insurance coverage if the American Healthcare Act is ever approved. As more details finally emerge about the Republican replacement plan for ACA, one of the early proposed changes is said to allow insurance companies the ability to charge older customers up to five times more than younger customers. Sounds like bad news for Mike the mechanic if this is allowed to happen.

It’s Still About Visibility

Regardless of the proposed changes, costs will never be curtailed if consumers don’t gain visibility into the prices we are all charged. Not that visibility is the sole answer to this complex issue. But it is a good beginning. We should all be concerned with the cost of an ankle X-ray, including the physician’s office referring the patient for the procedure. Does it cost $200 at the medical office building, but $100 around the corner? Is the radiology practice around the corner in “the network”? What are the patient ratings for each of those two providers? Sound complicated? If Yelp, TripAdvisor, and Edmunds can readily share a plethora of information, including specifics on restaurants (which meal to order), hotels (best rooms to ask for) and cars (average price paid in your zip code), isn’t it feasible to offer access to the billions we’re spending on healthcare?

Of course it would be great if we could all get what Trump promised, namely “less expensive and much better” health insurance. But since all these promises sound like empty promises, I’m not going to hold my breath, because that could cause a lung rupture, and that is likely to be a preexisting condition.

Email this to someonePin on PinterestShare on TumblrTweet about this on TwitterShare on LinkedInShare on Google+Share on Facebook

Posted in: business
Read More