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: 21^st 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

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