Archive for February, 2012

President’s Message

Posted on: February 13th, 2012 by Kristine No Comments

It’s hard to believe that March is almost here already.  We started the year off with a bang with a trip to Washington DC with the National Association of Health Underwriters.  We also completed open enrollment as the Exclusive Broker for ASBB (Arizona Small Business Benefits), and are excited to continue working with their group to offer alternative options like we offer our other clients to fit their health insurance needs and budget.  And of course I am keeping up with Association commitments such as NAWBO Phoenix, Tempe Chamber and Gabriel’s Angels.

I wanted to share some news about all the awesome opportunities we had in DC.  Of course, the conference included amazing speakers on Healthcare Reform such as Steve Larsen, the Director for Consumer Information and Insurance Oversight Center, Dan Schwartzer, the Deputy Commissioner for Life and Health, and the highlight was John Boehner, the Speaker of the House.

We received first-hand information on where things stood with the different government departments and committees involved with Healthcare Reform.  The Speaker of the House, John Boehner, spoke the morning following President Obama’s State of the Union address which was worth the entire trip.  He was very direct and had a sense of humor, providing insights that the President’s focus the past few months and in the future months is the campaign.  This will not help the bottleneck within Congress, especially the changes regarding Healthcare Reform.

At the same conference I personally met with a few of our representatives, including Jeff Flake and Ed Pastor, and Gabby Giffords’ office gave us a personal tour of the Capitol the same day she resigned her position.  What timing!

The meetings with our representatives were to inform them of a few issues highlighted in the Healthcare Reform Updates section of our newsletter and blog.  It truly illustrates how they do listen as Ed Pastor cosponsored a bill just days after we informed him about it.  Please try to reach out to your representatives if you have an issue affecting your business.  They will listen as you are the expert!

The next legislative event I will be attending is locally with the Phoenix NAWBO chapter.  We are having our day at the Capitol on February 29th, followed by a reception at Alexis Grill on Central.  Please join us if you can to get more involved.  We will have several State Representatives in attendance and possibly our Governor Jan Brewer depending on her schedule.

I look forward to keeping you posted on all the changes that are going on within the Health Insurance industry, and thanks again for your business!  This allows us the opportunity to make a difference in the community.

Healthcare Reform Update

Posted on: February 13th, 2012 by Jon No Comments

We wish we had more black and white guidance, but the reality is that many provisions are still in play with the Patient Protection and Affordable Care Act (PPACA), such as:

  • U.S. Supreme Court to hear arguments in March regarding the constitutionality of the Individual Mandate and Medicaid Expansion provisions
  • House votes to repeal CLASS act, the long-term care (LTC) provision
  • Arizona moving forward but several other states delaying implementation of Health Insurance Exchanges
  • Current Medical Loss Ratio (MLR) calculation reducing the number of licensed health insurance agents that service small businesses and individuals

U.S. Supreme Court

Florida and 25 other states, including Arizona, have challenged the constitutionality of the Individual Mandate and Medicare Expansion provisions of the PPACA.  The U.S. Supreme Court is scheduled to hear arguments March 26-28th and a ruling is expected this summer.

The Individual Mandate is the requirement for all individuals to buy health insurance or pay a penalty, and is the underpinning for the guarantee issue provision.  The argument against is it exceeds the federal government’s power.

The Medicaid Expansion is the additional population covered when increasing the Medicaid qualifying income of individuals and families to 133% of the federal poverty level.  The argument against is it is a federal infringement on state legislative authority.

Regardless of the outcome of the Supreme Course case, we do not anticipate the whole PPACA will be repealed, especially given the popularity of provisions already in place (e.g., dependents now covered to age 26).  Instead, it will continue to be tweaked and refined via legislative and legal avenues.


Last October Health and Human Services (HHS) determined the Community Living Assistance Services and Support program (CLASS Act) was not financially solvent and earlier this month the House voted to repeal it.  We expect more legislative activity in this space given it is projected that by 2020, 15 million Americans will need LTC assistance, but currently less than 10 percent of people purchase private LTC insurance, putting further strain on Medicaid.

Health Insurance Exchanges

28 states, including Arizona, have taken steps to establish insurance exchanges; however, that is less than 60% overall.  Many states are holding off given the uncertainty of the outcome of the Supreme Court case (see above) and/or choosing to use the to-be-built federally run exchange instead.

Kristine Kassel continues to participate on the Arizona exchange work group for brokers and agents focusing on broker licensing and compensation, including the TBD “Navigator” role.  Other work groups include a health plans work group led by the Department of Insurance and concentrating on plan management requirements; a tribal work group developing outreach and education plans; an information technology infrastructure work group led by the Arizona Health Care Cost Containment System (AHCCCS); and a legislative work group.

Medical Loss Ratio (MLR)

The current MLR calculation received much attention during the National Association of Health Underwriters (NAHU) Capitol Conference in Washington DC last month.  Kristine Kassel and Jon Dolgaard were on the Arizona team who met with Representatives Jeff Flake (R-AZ) and Ed Pastor (D-AZ) to discuss the following.

  • Most small businesses work with a licensed independent health insurance agent given they do not have the expertise in-house to do this on their own.  This is the same approach they use for their legal, tax, 401(k) administration, etc. needs.
  • Independent health insurance agents do not work for insurance carriers; however, their commissions are paid by insurance carriers as a pass-through percentage of their client’s premium or client’s employee headcount.
  • Many independent insurance agents are already cutting back on health insurance services or no longer selling health insurance which is impacting small businesses’ and individuals’ ability to make educated choices about their health insurance.  The reason is that the PPACA’s MLR calculation currently includes insurance agent commissions; therefore, carriers are reducing the commissions to meet these requirements.

Two Congressional bipartisan bills are in progress to address this.  H.R. 1206 (Access to Professional Health Insurance Advisors Act) was introduced in the House last March and has more than 170 cosponsors thus far, including David Schweikert and more recently Ed Pastor from Arizona.  S. 2068 (Access to Independent Health Insurance Advisors Act) is the corresponding bill introduced earlier this month in the Senate.

Congratulations Kristine!

Posted on: February 13th, 2012 by admin No Comments

Congratulations to Kristine Kassel being one of Phoenix Business Journal’s 2012 Women in Business Honorees!  The honorees were selected by peers, colleagues and the Phoenix Business Journal news team for their leadership, professionalism, dedication and impact on our community.