insurance – West Boca News

Check Your Bill: The FEMA Flood Flop

Homeowners in flood zones (including most of West Boca and South Florida) should watch their flood insurance premiums closely. A recent policy change will cause most of us to face a surcharge of $25. But if you’re not careful the surcharge will be $250 instead. Flood damage can be detrimental to a home and must be dealt with quickly by using such things as flooded carpet drying services, however, this can be harder to do if homeowners are paying over the odds for their flood insurance.

Owners of single family homes and individual condo units will pay the $25 surcharge, but only if it’s their “primary residence” meaning they live there for 80% of the year, though more than 50% may be enough. Otherwise the surcharge is $250. We’re sure our snowbird readers will enjoy that.
Check your latest flood insurance bill to make sure you’re not getting hit with a big increase.
This was a bipartisan surcharge supported by our local congressman, Ted Deutch (D), and Senators Bill Nelson (D) and Marco Rubio (R). All three voted for this.
It gets worse. FEMA set this up in a way that is designed to screw people. They sent out a mailing that you’re supposed to respond to, proving that your house or condo is your primary residence. If you don’t get it or don’t respond, you pay $250 instead of $25.

In other words, the government assumes your home is not your primary residence and the burden is on you to notice the new rule and prove you live there.
Fortunately for us we noticed the increase and our insurer got us the form before the bill was due. We should have this resolved shortly. Here’s the form we were sent:
[gview file=”https://westbocanews.com/wp-content/uploads/2015/07/primary_residence_verification.pdf”]
For any readers who pay flood insurance, we recommend you check your latest bill and compare it to the previous year. You can visit the website to find out more information about water damage coverage for your condo. Ours went up nearly $300, and it’s more than $200 higher than it should be under the new law.
You can be sure that if Citibank did this to its customers there would be outraged politicians calling for their heads. But when the government does it to us apparently it’s okay.
We heard from one of our regular readers, Angela Sapone-Brunelle:

Funny you should ask as my bill just came in today. Yes, the premium nearly doubled. In 2014 I paid $379 and the new bill states the policy costs $662. I was so excited because my overall homeowners insurance went down $200 this year…NOW I KNOW WHY! I never knew I could get such cheap homeowners insurance!
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OK, I figured part of this out. I have to sign an affidavit that states the house is my primary residence, then it will go down to $437…still a 15% increase, but not 75%.
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And I thank you because if you wouldn’t have posted this, I may never had looked at my bill because it’s paid out of my mortgage escrow! My insurance co is making it really easy to turn in the affidavit, you just have to sign the form and upload it to their website with a copy of my drivers license.

We reached out to Congressman Deutch’s office and spoke with Communications Director Ashley Mushnick. She sent us the following statement:

Major hurricanes like Katrina and Rita left the National Flood Insurance Program with over $26 billion in debt, jeopardizing the only federal program that makes affordable flood insurance available to Florida homeowners. If we want affordable flood insurance to remain available at all in Florida, we must prevent the National Flood Insurance Program from going bankrupt. Yet when implementing reforms Congress passed in 2012 to improve the program’s fiscal footing, FEMA officials failed to keep rates affordable and thus undermined the entire purpose of the program. Some homeowners were informed that their flood insurance would cost more than $25,000 per year. That’s why we passed the Homeowners Insurance Affordability Act of 2014 to place limits on annual increases and require FEMA to maintain affordability into the management of the flood insurance program.
No one likes to pay an additional $25, but that is far more affordable than the multi-thousand dollar rate increases we were seeing before the Homeowners Insurance Affordability Act, and we must all share in the burden of restoring solvency to the vital National Flood Insurance Program.

From other conversation we understand the Congressman’s position (mirrored by our senators) that they’re saving us money because if they hadn’t acted our premiums would have gone up even more under the Biggert-Waters Act of 2012. But all three of them voted for Biggert-Waters in 2012. And Biggert-Waters would have increased premiums only for property owners who are not primary residents. It would not have affected most West Boca homeowners. Some homeowners may have previously planned for this, just to be on the safe side, and looked at home warranty florida services to use in case of damage.
Congressman Deutch’s statement also ignores the careless manner in which FEMA and NFIP are hitting primary residents with a $250 increase if they fail to prove they are primary residents, as well as the $250 increase faced by snowbirds and others.

Update
Congressman Deutch’s office added this:

It depends on when you bought the home, primary or not. People looking to buy a new home after the law took effect had to pay substantially more than the current homeowner. This made it very difficult for many people to sell their homes, and dissuaded people from buying homes. And, for primary residences re-categorized by the FEMA remapping process, the full-risk rate would be phased in over 5 years by 20 percent each year beginning at the end of 2014. And obviously, in South Florida with our large retiree population there are many non-primary residences, and many of them are not multimillion dollar beachfront second-homes. The bill language you pulled is from the short-term extension of Biggert-Waters – the bulk of the legislation is significantly longer and was tucked into a highway resurfacing bill (H.R. 4348 of the 112th Congress) as a miscellaneous section that passed in July 2012 as public law 112-141.

Humana Dumping Boca Regional Hospital?

Update: Responses from Boca Regional and Humana, at bottom.

Thanks to a reader tip we’ve heard that health insurer Humana may be removing Boca Raton Regional Hospital from its network of providers, effective October 1st. Humana now tells us (see bottom) that the change was initiated by Boca Regional. That was not clearly conveyed in their letter, and the “he hit me first” argument is not terribly important.
Here’s the letter from Humana that our reader sent to us (click on image to see larger version):

We’ve seen this before with Humana. When we initially looked at the “Obamacare” plans, Humana had the cheapest options we saw and the provider networks were very limited. We mentioned this to the reader who said this was not an Obamacare or HMO plan, but rather a PPO.
Humana was also featured in an article last year for “shaving networks.”
Earlier this year we covered a similar situation involving Cigna and West Boca Medical Center. That was resolved before the coverage was dropped.
According to the letter Humana customers will still have West Boca Medical Center and Delray Medical Center in the network along with several others. The letter does not mention Broward Health facilities such as Northwest Medical Center in Margate.
Boca Regional Hospital responded quickly with the following statement from Thomas Chakurda, their VP of Marketing:

Boca Raton Regional Hospital is presently negotiating in good faith with Humana on our contract, which expires October 1st, 2014. We are hopeful that these discussions will result in a mutually acceptable agreement and one that affords us rates that are comparable to other providers in the region. In situations like this, it is a normal occurrence for both a provider and a payor to alert their respective constituencies of the possibility that a contract may not be renewed.

Humana also responded via an e-mail from Mitch Lubitz, media relations:

Boca Raton Regional Hospital has informed Humana that it is terminating the existing Medicare and commercial network agreement with Humana effective October 1st. This contract termination was initiated by Boca Regional, not Humana. We remain ready to negotiate an agreement with Boca Regional at terms that are beneficial to both parties. In the meantime we have informed our affected health plan members of the pending network change and provided then with information about alternative hospitals and providers in Palm Beach County, ahead of the Medicare annual election period which begins October 15. Hope that is helpful to you and West Boca News readers. Thank you.

We should note that our reader specifically told us she is not in a Medicare plan.

Cigna Dropping Tenet & West Boca Medical Center?

Story updated with response from Cigna. See bottom of story.

Note that both sides agree that patients will still be able to get emergency care at Tenet facilities at Cigna’s in-network rate.

Health insurance company Cigna is threatening to drop Tenet Healthcare hospitals from their provider network. West Boca Medical Center and Delray Medical Center are both Tenet hospitals.
By a letter dated March 26, 2014, Cigna informed customers of discussions between the two companies, and stating that Tenet hospitals will no longer be in the Cigna network at the end of May if no agreement is reached. Cigna uses language suggesting that Tenet ended their contract early, is seeking higher rates, and will be leaving the network. Tenet claims that Cigna is attempting to reduce previously agreed rates.
The two companies last announced an agreement in July of 2012 that became effective in May of 2013.
West Boca News reached out to both sides Tuesday. Cigna has not responded yet and we did not find anything on their website about the dispute. Tenet responded with the following statement:

We have been negotiating with Cigna for new contracts covering the care our hospitals provide to Cigna members. If an agreement is not in place by June 1, 2014, access to our hospitals could be affected for Cigna members.
In our previously signed contract, Cigna agreed to payment rates for the care our hospitals provide its members. However, Cigna then changed its course and proposed a reduction to our previously agreed upon rates. We need fair payments from insurance companies to recruit and retain top physicians, invest in technology, and maintain our facilities at the level you have come to expect. These factors allow us to provide quality care. We are disappointed that Cigna has taken this position in our negotiations.
While we continue our negotiations to preserve patient access, it is important to know that prior to June 1, nothing changes and Cigna members can still come to our hospitals for healthcare services. Regardless of what happens with our network status, Cigna members can always access emergency care through our hospitals’ emergency rooms.
Cigna members with questions about their coverage should visit www.protectmyaccessfl.com or call (866) 966-3680.

Tenet Healthcare Corporation (NYSE: THC) has over 100,000 employees and over $11 Billion in revenue in 2013. They operate 189 outpatient centers and 77 hospitals including West Boca Medical Center and Delray Medical Center. WBMC is the closest hospital to most of our readers and is known for its pediatric emergency room. DMC is the trauma center for patients from West Boca, and recently treated the victims in the Jimmy the Greek stabbing. Wikipedia notes that Tenet has earned various awards including “214 CIGNA Quality Designations.”
Boca Raton Regional Hospital, an independent not-for profit, is not part of Tenet. BRRH is the next closest hospital after WBMC and is currently in Cigna’s network of commercial plans, but not for Cigna Medicare plans.
Cigna (NYSE: CI) has over 36,000 employees, approximately 75 million customers and over $32 Billion in revenue in 2013. Their main business is health insurance offered in all 50 states, other US territories, and a number of other countries. The company made news yesterday after announcing they had signed up 75,000 to 100,000 people in “Obamacare” plans in five states including Florida. At this time it’s unclear whether the Affordable Care Act plans will be included in BRRH’s network.
Update April 2, 12:30 pm:
Cigna responds:

Regarding your story about Cigna and Tenet, the assertion that Cigna is threatening to drop Tenet Healthcare hospitals from our network is not correct. In fact, it’s the other way around.
Cigna was notified by Tenet Corporation of its intent to leave the Cigna network as of May 31, 2014. We are in active negotiations to try to reach mutually acceptable terms on a new contract. While the specific terms of the contract and negotiations are confidential, I can say that we remain far apart on multiple issues of critical importance to our customers and their employers – issues that impact the future cost and affordability of care from these health care facilities and professionals.
We are willing to continue negotiations and would welcome Tenet facilities and physicians to remain part of our network. However, we have an obligation to protect the interests of our clients and customers and ensure that they have access to high-quality doctors and hospitals at a competitive cost, both now and in the future.
We hope to continue our relationship with Tenet and are willing to continue negotiations. However, if an agreement is not reached by May 31, 2014, then any claims for non-emergency services provided by Tenet facilities and affiliated employed physicians after that date will be processed according to an individual’s out of network benefits, if their plan includes coverage for out of network facilities and health care professionals.
In an emergency, customers can use any nearby facility and still be covered at the in-network level.
We are also actively working to minimize disruption and will offer “continuity of care” benefits to our customers who are in the middle of treatment. This will enable them to continue that treatment until arrangements can be made for a safe transfer of care to another hospital or doctor.
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We will make every effort to accommodate people who are under the active care of a Tenet facility or affiliated physicians for one of these situations. We encourage any customer who has questions to call the customer service number on their Cigna ID card; our service team is available to help and answer questions 24 hours a day, seven days a week.