Covid-19

Summer 2020 Issue

Injured Patients and Families Compensation Fund Announces Premium Holiday

On Wednesday, June 17, 2020, the Injured Patients and Families Compensation Fund (fund) approved waiving the upcoming fiscal year’s premiums for physicians, CRNAs and hospitals enrolled in the fund.

The Society has been working hard to find ways to assist its membership during these unprecedented times. The premium holiday was originally requested by the Society and endorsed by the fund’s Actuarial and Underwriting and Finance/Investment/Audit committees before it was approved by the Board. The premium holiday will be in effect from July 1, 2020 through June 30, 2021. Read More

MPL Market + COVID-19 = What Next?

The COVID-19 crisis will add pressure to an already “stressed out” underwriting environment.

Carriers are now responding to demands of COVID-19 with premium relief and underwriting flexibility (e.g. waiving requests for supplemental information on telemedicine or cross-state boarder practice). This lowers their premium base and handicaps underwriting.“In this environment, I’ve never been more acutely aware of our mission at the Wisconsin Medical Society and WisMed Assure and I am proud of how we and our community of physicians have responded,” says Shawna Bertalot, WisMed Assure President.  Read More

Shawna Bertalot is the president of the WisMed Assure agency. With her strong leadership skills and knowledge of the industry, our skilled team of agents are motivated and well prepared to find solutions for our clients. 

Navigating Testing in a COVID Environment

By Chris Noffke, GBDS – VP of Employee Benefits

Navigating insurance benefits is complex and confusing for consumers and business owners alike. People seeking benefits are expected to understand insurance terms like deductibles, coinsurance, out of pocket limits, annual out of pocket limits (yes this can have a different maximum risk amount) and many others.

On top of that, you now have to understand the ins and outs of preventative care coverages and COVID related no-cost, shared-cost coverages.  Read More

Announcement

Chris Noffke: Vice President, Employee Benefits

I am pleased to announce the promotion of Chris Noffke from Director of Group Benefits to Vice President, Employee Benefits. Chris has been with WisMed Assure for four years and has worked as an insurance advisor for more than 15 years.

In his role as vice president, Chris will focus on advancing WisMed Assure’s ability to deliver superior employee benefit solutions and service to an ever-growing number of healthcare providers.

Chris has already played a key role in the creation of several important initiatives and programs including the association health plan, a pooled disability program, and the improvement of the pricing and value of our dental program. He is currently working on the development of a national medical cooperative and a national association health plan.

Prior to joining WisMed Assure, Chris held positions at WPS, EPIC Life, Group Health Cooperative of South-Central Wisconsin and Ameritas Group, as well as operating his own insurance agency. He has completed the National Association of Health Underwriters Voluntary/Worksite Certification and holds a Group Benefit Disability Specialist (GBDS) designation and is studying to become a Certified Self-Funding Specialist (CSFS).

Chris has a Bachelor of Arts degree from the University of Nebraska.

On behalf of the entire WisMed Assure team, I congratulate Chris on reaching this important milestone and look forward to supporting his continued success.

Shawna Bertalot, CIC, ACI, President

We’re growing!
Insurance Advisor joins the WisMed team

At WisMed Assure, we are always looking for and developing new and better ways to serve the Wisconsin medical community. This includes developing our team of dedicated professionals through education, training, and, when needed, hiring proven expertise.

We are delighted to announce Tom Strangstalien has joined our team to bolster our financial services capabilities. Tom specializes in individual financial protection including life, disability and long-term care insurance.

Tom has over 25 years of experience in the financial-protection business. He believes clients should be treated in the same way he and his family would like to be treated and that building relationships is crucial to delivering the best possible service and value.

Tom attended Viterbo University, majoring in Business Administration and Finance, graduating with honors, Magna Cum Laude. Throughout his career, Tom has earned numerous awards and recognition, including top of the table at several insurance companies, and becoming a member of the Million Dollar Round Table.

When Tom is not busy protecting the financial wellbeing of his clients, he enjoys traveling and seeking out new experiences with his wife and their four children. On any given weekend, you can find Tom, fishing, hunting, or hiking and creating memories that will become tall fish tales, some even true.

We are excited to welcome Tom to the WisMed Assure team and look forward to working with him to assure our clients’ financial health and security.

Wisconsin Medical Society Declares Racism to be a Public Health Crisis

Racism is a constant threat to health, medical care and longevity in America. The Wisconsin Medical Society, driven by its mission to improve the health of the people of Wisconsin, declares racism to be a Public Health Crisis and calls for equity in health.

Racism threatens health. Racism worsens the social determinants of health, including housing, employment, education, community and neighborhood, food and medical care. Poor housing, including homelessness, results in illnesses such as diabetes and asthma. Unemployment increases heart disease risks and overall mortality; poor education increases death from diabetes; physical space loss for exercise increases childhood obesity; and food deserts significantly increase African-American obesity. The greatest health threat faced today in COVID-19 has further revealed these profound disparities demonstrated by the disproportionate mortality in communities of color.

The human toll is destructive and untenable. To move forward, we must take a stand against racism. In doing so, we stand in solidarity with organizations across the state and our country condemning racism, injustice, and health disparities.
The Society, along with many other healthcare organizations, is taking a strong stand and has identified seven key recommendations for change. You can learn more here.

Different Kinds of Debt: The Good, the Bad, and the Just-Don’t-Do-It!

By Rufus Sweeney

Amassing a considerable amount of debt during medical school is “situation normal” for practically every medical student. Even though debt is rarely seen as a good thing, you need to know the difference between good debt, bad debt, and debt to be avoided at all cost.

Choosing wisely now makes paying off your debt much easier. Read More

Navigating Testing in a COVID Environment

By Chris Noffke, GBDS – VP of Employee Benefits

Navigating insurance benefits is complex and confusing for consumers and business owners alike. Today’s insurance landscape requires people seeking benefits to understand insurance terms like deductibles, coinsurance, out of pocket limits, annual out of pocket limits (yes this can be different caps) and many others.

On top of that, you now have to understand the ins and outs of preventative care coverages and COVID related no-cost, shared-cost coverages.

Currently most insurers are covering the COVID tests, antibody testing, and treatment with no cost share. But be aware, these 100% covered costs will eventually become the patient’s responsibility. Some testing may continue to be covered at no cost to the patient but you may be billed if you go outside of your network or don’t have an approved reason for testing.

We can begin to understand why by looking at the cost of one of these tests. A local PPO (preferred provider organization) reported that they have seen the cost of COVID Antibody testing (Codes 86328 and 86769) range from $23 – $1,023.92, which is one of the major issues with understanding your cost shares.

So, while this test may be covered based on current legislation, when will it no longer be covered? As of right now, there is a lot of speculation that once the “state of emergency” ends, you may see no cost end too.

Currently, to get an antibody test done, it needs to be ordered by a healthcare professional in an office visit, urgent care room or emergency room. Although there are some guidelines for how out of network visits will be covered, patients are sure to see costs shifted to them.

What does the future hold?

When I think about our healthcare future and how COVID-19 will impact the cost of care, it causes a significant sense of concern. With so many people avoiding seeing a physician during social distancing, we should anticipate a surge of chronic illnesses with higher than average claims costs. Staying home means those with anxiety, depression and obesity may be spending even more of their time on couches and this means less physical activities and socialization.

A recent report by Milliman – the highly respected risk management consulting firm – states, “We expect an increase in costs after the Pandemic due to deferred care and pent-up demand… The estimate of services deferred to 2021 is beyond the scope of this paper, but those costs are likely to be very significant.” The report says that ‘very significant’ is an understatement, as it speculates there will be at least $75 billion and as much as $575 billion in deferred care.

And that’s for non-COVID care! Another analysis, commissioned by America’s Health Insurance Plans, estimates that total costs of COVID-19 for commercially insured individuals could range from $44.6 billion to $438 billion over the next two years.

Arriving at a clear conclusion is impossible given the volatility of our times. But, what we can do is work together to protect each other while aggressively looking for ways we can collaborate to protect our healthcare future.

For a comprehensive look at COVID-19 related insurance coverage, check out this Health Affairs article by Katie Keith and take a look at Wismed Assure’s Covid-19 Updates page for added tools and resources.

MPL Market + COVID-19 = What Next?

How the pandemic may impact an already hardening market

Consider the degree of uncertainty COVID-19 has introduced while reading this statement by Tom Baker, a University of Pennsylvania Law School professor.

Baker says, “understanding how insurers define cost is, key to understanding the insurance under-writing cycle… when insurers set their prices, most of the costs of the insurance coverage will be incurred only in the future. As a result, insurers constantly have to imagine the future to decide how to price their products today. This situation creates a remarkably high degree of uncertainty. This uncertainty about insurance costs is the fuel that drives the underwriting cycle.”

Baker’s statement was published in a three-part Antidote series on the hardening of Medical Professional Liability (MPL) insurance market months before the world was turned upside down by the pandemic we are still finding our way through.

At the time, no rate-making actuary could imagine a worldwide pandemic would cause such a massive disruption of healthcare delivery, consume the energy and resources of the healthcare system while simultaneously causing many physicians, clinics and hospitals to incur an unprecedented loss of patients and revenue. And it is not over yet.

Underwriting is “stressed out”

The COVID-19 crisis will add pressure to an already “stressed out” underwriting environment. On a macro level, MPL insurance carriers are experiencing higher loss ratios that force increased premiums and more judicious underwriting in an effort to lower claims costs. This is what is referred to as a “Hard Market.” Carriers are now responding to demands of COVID-19 with premium relief and underwriting flexibility (e.g. waiving requests for supplemental information on telemedicine or cross-state boarder practice). This lowers their premium base and handicaps underwriting. The story becomes much more complicated when you consider insurance carriers are collecting premiums now to pay claims that will be made in the future. 

Susan Forray, FACS, MAAA, Principal and Consulting Actuary with Milliman, published an article in May in which she examines the complexity of the COVID-19 impact, writing, “Actuaries are accustomed to pricing future costs based on past losses. But the COVID-19 pandemic has taught us the past is only one piece of data in making these estimates. Modeling the coronavirus pandemic itself is difficult, but modeling MPL costs affected by this pandemic is exacerbated by tort law changes, variations in effect among specialties, and an apparent reduction in current claims that may prove to be only a delay contributing to an increase in future claim frequency.”

What should you do now?

Continue to look for stability and security by renewing your coverage with a financially strong insurer; a long-term player committed to the MPL insurance marketplace. This is where an experienced broker can play a key role in helping you understand the quality of the insurers willing to do business with you and help you navigate your options.

“In this environment, I’ve never been more acutely aware of our mission at the Wisconsin Medical Society and WisMed Assure and I am proud of how we and our community of physicians have responded,” says Shawna Bertalot, WisMed Assure President.  

Please contact Shawna Bertalot to discuss this article or your insurance needs and concerns.

Shawna Bertalot, CIC, ACI, President WisMed Assure
shawna.bertalot@wismedassure.org
608.442.3738

Injured Patients and Families Compensation Fund announces premium holiday

On Wednesday, June 17, 2020, the Injured Patients and Families Compensation Fund (fund) approved waiving the upcoming fiscal year’s premiums for physicians, CRNAs and hospitals enrolled in the fund.

The Society has been working hard to find ways to assist its membership during these unprecedented times. The premium holiday was originally requested by the Society and endorsed by the fund’s Actuarial and Underwriting and Finance/Investment/Audit committees before it was approved by the Board. The premium holiday will be in effect from July 1, 2020 through June 30, 2021.

“COVID-19 has posed unprecedented health and economic challenges to our state, and the health care industry is no exception,” said Bud Chumbley, MD, MBA, a Fund Board member and the CEO of the Wisconsin Medical Society. “The premium holiday approved yesterday by the board will provide some financial relief to many of the Wisconsin medical professionals and providers who have been affected by the pandemic and who face ongoing challenges.”

This action will help those covered by the Fund who have experienced a significant decline in revenues due to the COVID-19 pandemic, particularly physicians in solo and small group practices.

The Fund is an essential element in maintaining medical liability insurance premiums at a manageable rate for those covered by the Fund. The favorable medical liability environment in Wisconsin helps recruit physicians to Wisconsin and retain physicians in Wisconsin.

Full-time physicians will save between $382 and $2,521, depending on their specialty, with Residents saving $229 and part-time or retired physicians saving $95.

As of June 30, 2019, there were a total of 17,261 fund participants composed of 147 hospitals with 19 affiliated nursing homes, 15,003 physicians, 855 nurse anesthetists, 20 hospital-owned or controlled entities, 73 ambulatory surgery centers, 1 cooperative, 14 partnerships, and 1,129 corporations actively participating in the Fund. As of June 30, 2019, Fund participants consisted of 87 percent physicians, 6 percent corporations, and the remaining 7 percent included all other participants.

Additional details can be found in the Society’s update or the Fund’s press release.