Mann's Blog

Health Care Reform Bill (OR PILL?)

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Thu, 19 Nov 2009 15:55:51 -0600

As widely reported in today's press, Senate Majority Leader Harry Reid (D-NV) last night released the legislative language for "The Patient Protection and Affordable Care Act." The Congressional Budget Office (CBO) estimates that provisions in the 2,074 page bill will cost $849 billion between 2010 and 2019. Below is a brief summary of key provisions of interest, followed by the latest information on the expected schedule for the Senate debate.

KEY PROVISIONS

Imposes Excise Tax on High-Cost Plans: Beginning in 2013, imposes a 40 percent excise tax on plans that exceed $23,000 for families and $8,500 for individuals [Note: The previous version set the excise tax threshold at $21,000 and $8,000, respectively.] Contributions to FSAs, HSAs, and MSAs would be included in determining the threshold for the excise tax.
Caps Flexible Spending Accounts (FSAs): Beginning January 1, 2011, caps contributions to FSAs at $2,500 with no indexing for future inflation.
Requires Prescription to Receive Reimbursement for Drugs Under Account-Based Plans: Beginning January 1, 2011, requires individuals to obtain a prescription for drugs, including over the counter medicines, as a requirement for reimbursement. [Note: The previous version made this provision effective on January 1, 2010.]
Establishes Small Business Cafeteria Plans: Beginning January 1, 2011, establishes simple cafeteria plans [Note: At first read, the language appears to mirror the language in the previous version of the bill and discussed in yesterday's conference call. We will send an update should we identify any changes from the Finance Committee-approved version].

SCHEDULE Tomorrow, Senator Reid is expected to begin the process to hold a procedural vote that would take place on Saturday. If Senator Reid obtains sixty votes, the Senate could debate the motion to proceed to the health care legislation for up to thirty hours bringing them into Sunday. Should the Senate adopt to motion to proceed, Senator Reid will offer the "Patient Protection and Affordable Care of 2009" as a substitute amendment to H.R. 3950, a "shell bill" that will serve as the legislative vehicle for the health care reform legislation. Some Republican Senators have expressed their intent to require a reading of the bill, which would likely take the Senate into Tuesday and at the conclusion of which, the Senate would recess for Thanksgiving. Upon return from the recess, the Senate floor debate would begin in earnest with the bill fully amendable.

Please note that the schedule is still very fluid. We will provide updates as additional information becomes available. Take Action! We strongly encourage you to voice your opinion on healthcare reform! Click here to locate and contact your State Represenative or Senator today!

The more support we gather, the greater chance we can change this legislation and continue to provide continued excellent service to our clients. We cannot forsee a plan that has absolutely no fiscal accountability.

Jack Mann

630-546-9303

jackthemann@manninsurance.net

Agent Owned Realty - Call Me For Insurance Coverage for Rental Units

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Wed, 26 Aug 2009 11:57:30 -0500

Mann Insurance specializes in the coverage for rental units whether habitational, commercial, or industrial. Of course each one has its own special kind of coverage needed depending on the geographic location of each type of risk. We just want to assure that

Depending on whether or not the property is habitational (apartment), commercial, or industrial we can write any one of them. Whether it is a single family rented out, 10 flat, 200 unit apartment building, commercial building, commercial warehouse, commercial retail/wholesale/service/office, or an industrial steel plant we write it all.

Call Jack Mann 530-546-9303 to assure the best pricing.

Least Expensive Small Business Insurance

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Sun, 14 Jun 2009 00:09:23 -0500

Small Business Insurance is an expense that must be looked at very closely. In order to make that happen we must have the finest coverage, with the best pricing available. By choosing the correct carrier you must have the a very good agent with a small business understanding all over the USA. We bring you the understanding, knowledge, and integrity to assure the best solution for small businesses all over America. Our company is one of the finest insurance brokerage's for small business owners. We deal with our customers, regardless of size, as if they were a large client. There is no business that gets put before another. We pride ourselves by bringing the element of service to the educational level. We wish to teach the customer our process from begining to end. We also bring our customer into the actual process of obtaining insurance. By making our customer a part of the insurance purchasing experience we make them an active participant with a role in our business. A customer who is part of the Mann Insurance Experience will allow themselves to understand enough of the insurance to believe Mann Insurance will always do what is best for them. That is our role as a Trusted Insurance Advisor, to do what is best for their clients.

Mann Insurance is ready to assist you with your every need: 630-546-9303.

COBRA Continuation Coverage For American Recovery and Reinvestment Act of 2009

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Tue, 31 Mar 2009 01:58:50 -0500

COBRA Continuation Coverage Assistance Under The American Recovery And Reinvestment Act Of 2009

If you are anything like me you will want to know all about the way in which the new COBRA Continuation Coverage Assistance will affect the small business owner.

This is President Obama's attempt to give a little "stimulus" to the small business owner. Basically it works as follows:

•· All USA Employers MUST notify employees by 4/18/2009 of their rights under the new assistance.

•· If an employee left employment or was terminated this new assistance applies IF they left employment on or after 9/1/2008.

•· IF they are under COBRA rules there is an 18 month time period from when they were eligible for COBRA benefit. Once that 18 months are up (from when their employment ceased) there is no coverage.

•· IF they are under State Continuation rules there is a 9 month period from when they were eligible for State Continuation benefits. Once the 9 months are up (from the date their employment ceased) there is no coverage.

•· IF the Employee declined COBRA or State Continuation benefits (only if employment ceased on or after 9/1/2008) they are able to be added to the plan with coverage effective 3/1/2009.

•· The subsidy goes into effect on 3/1/2009.

•· If the Employee paid 100% of COBRA or State Continuation coverage prior to 3/1/2009 they get nothing back.

•· Employees will enjoy having their employer paying 65% of their premiums, and the employee is responsible for 35% of the premium.

•· Employers who are paying for the 65% premium there is a credit coming their way on the next quarterly wage and tax form. They can maintain that credit on their quarterly wage and tax forms until this subsidy ends.

Subsidy ending? Who are we kidding, the small business is paying 65% of the premiums. The credit comes at the end of the quarter. The small business is still working out in the fields to earn money to pay the 65% of the premium. The small business has to wait for the next quarterly statement to add in some credit which theoretically offsets the outlay of cash for the 65%. Funny thing about this credit is that it comes after the small business shells it out for a while, then receives it.

I am sure you are all reminded of Wimpy from Popeye The Sailor Cartoons. "I will gladly pay you Thursday for a hamburber today". Same thing the US Government is doing for us with this "subsidy" for group health insurance. When the Government decides to pay us back for a credit to employees today the US Government has just become our own personal version of WIMPY. Also we are going to be paid back for AIG, Mortgage Businesses, Banks, and of course the BIG 3. So when do we owe it, how long to pay it back?

No one is talking about that. I believe my children's children will be paying for this.

Let's watch and see what happens and if we can pull this out a little.

Jack Mann

630-546-9303

Zurich North America Compared To Church Mutual Programs FOR AME CHURCH INSURANCE

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Thu, 29 Jan 2009 12:29:07 -0600

Carrier Name	Church Mutualhttp://www.manninsurance.net/church_program.html	Zurich
Coverage	Limit	Premium	Notes	Limit	Premium	Notes
Property	13,073,000	$14,755		13,073,000	$18,439
Liability	$1M/$3M		$300K Prop dam legal lia	$1M/$3M	$1,709
Auto		$1,463			$1,273
WC		?$2,796?	unsure what current prem is		$2,796
Abuse	$300,000	included		1,000,000	$732
Umbrella		N/A		$1,000,000	$450
Total		$19,014			$25,399
					$24,586	Final Quote after UWconsideration
Pkg Built in Coverage Property
Accounts Receivable				$25,000
Antennae and Satellites				$1,000		$1,000 deductible
Money & Securities	$25,000		100 deduct, X2 Holidays	$50,000/$25,000		$50K in / $25K out
Blanket Bond	$25,000
Identity Theft	$15,000		Case Mgt 12 months
Fine Arts	$30,000		250 decuctible	$30,000		$1,000 deductible
Newly Constructed Bldg	$1,500,000		up to 180 days	$500,000		$1,000 ded - up to 180 days
Newly acquired Bldg	$1,500,000		up to 180 days	$500,000		$1,000 ded - up to 180 days
Pers. Prop at Newly Acq Locas			$250,000		$1,000 ded - up to 180 days
Personal Property Others	$10,000
Bus Pers Prop Clergy	$25,000
Tools & equipment	$5,000			$5,000		$1,000 deductible
Valuable Pap & comp records	$15,000			$25,000
Prop temp off premises	$25,000		up to 180 days	$25,000		$1,000 deductible
Outdoor tress & plants	$10,000		up to $1,000 per item	$10,000		$1,000/per item and $1,000 ded
Outdoor structures	$10,000
Dwellings for related structures		10% of policy limit
Property in dwelling			5% of policy limit
Loss of dwelling rental value			5% of policy limit
Additional living expenses			10% of policy limit
Debris removal			25%limit pluse $15,000	$10,000		each location
Prop moved off premises			for up to 30 days
Fire Dept service charges	$30,000			$10,000
Recharge fire extinguishers			actual cost covered	$1,000
Loss of Business income	$20,000		and extra operation exp	ALS		12 months actual loss sustained
Lock repair if stolen keys	$1,000			$1,000
Food spoilage	$2,000		for off premise power fail	$5,000		$1,000 deductible
Arson Reward	$10,000
Pollution Clean up	$10,000			$10,000		$1,000 ded
Demolition undamaged building	$100,000
Employee Dishonesty				$10,000
Back up of Sewers/Drains				$25,000		per loca - $1,000 ded
Building Ordinance or Law				$50,000
Full Glass Breakage				included		$1,000 ded
Theft of Personal Prop				included		$1,000 ded
Equipment Breakdown				included		$1,000 ded
Forgery or Alteration				$10,000
Free Standing Fences/Walls				$2,500		$1000 ded
Inventory/Appraisal				$5,000
Money Orders/Counterfeit Currency			$5,000
Off Prem Power/Water Failure			$10,000		$1,000 ded
Personal Property - EE's				$2,500		$1,000 ded
Signs				$5,000		$1,000 ded
Personal Property in Transit				$2,500		$1,000 ded
Peak Season Pers Prop Incr						50% of limit


Built in coverage Liability
Medical expenses	$10,000		Per person per occurrence	$10,000
Loss of life	$10,000		Per person $20K per acc.
Sexual Abuse	$300,000		per claim and aggregate	$1,000,000		$1,000 deductible
Hired & nonowned auto	$1M/$3M			$1,000,000
Rented vehicle	$100,000		$250 deductible	$1,000,000		hired/non-owned
Damage to property of others	$500
Legal Defense	$5K/$15K			unlimited		not incl in pol limit
Catastrophic Violence	$50K/$300K	$300K limit for policy term
Professional Liability	$1M/$3M		Counseling Prof Liab	$1M/$3M		Counseling Prof Liab
D&O	$1M		$1,000 retention w retro date	$1M/$3M		D & O Liab
Affiliated entity dispute	$25K/$50K		add on to D&O
				http://www.manninsurance.net/church_program.html

Home Medical Equipment Companies

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Tue, 28 Oct 2008 19:33:48 -0500

On 10/28 I attended the MEDTRADE convention in Atlanta, GA. It is a great show for businesses that sell home medical equipment, rent home medical equipment, or service home medical equipment. From now on I will use HME for Home Medical Equipment. The HME providers will provide equipment for use in the home: hospital beds, specialty beds, mobility equipment, wound care, oxygen products, and any other disposable, consumable, or durable used in the HME industry.

During my attendance at MEDTRADE I noticed there are many insurance needs or the HME business. The number of insurance companies providing this insurance is smaller, yet there are a few that are totally committed to this business. Pharmacists Mutual, Gemini, United National, and a few others are very serious about this class of business.

We provide the liability insurance, property insurance, workers compensation, and any auto insurance needed for the HME industry.

Jack Mann 630-546-9303 is the person to contact for quotes.

A TRUE ADVISOR DOES WHAT IS BEST FOR THEIR CLIENT

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Thu, 02 Oct 2008 22:02:43 -0500

Jack Mann wrote the insurance for Reliable Plating in Chicago, IL in 2001. After writing the insurance Jack Mann chose to reccomend quite a few changes for the customer. The most important reccomendation ever made was for the client to hire a firm to come through their facilities to assure the correct REPLACEMENT COST was in place for their commercial property insurance.

After the firm found out what the actual REPLACEMENT COSTS were, Jack Mann figured out what the potential loss for DEBRIS REMOVAL would be in the event of a loss. Based on the number of gallons of chemicals, caustics, acids there would be a lot of debris costs after a loss. Once the cost of debris removal is approximated Jack Mann found out a way to cover all of the buildings, contents, and debris removal without the threat of a coinsurance penalty.

In 2005 Jack Mann no longer had a competitive market for metal finishing job shops. Jack then directed the owners of Reliable Plating in Chicago to another direct writer. After the direct writer wrote the account for a year or so Reliable moved to another insurance brokerage. The principles were still in place as Jack Mann instructed Reliable Plating to maintain the level of coverage, the property insurance form, and the coinsurance being taken out of the picture.

On October 23, 2008 the work Jack Mann did with his former client came to be an amazing meeting of proper insurance advice and a horrible catastrophe:

Extra-Alarm Fire Destroys Warehouse

Investigation Into Cause Delayed Due To Chemicals Inside

SLIDESHOW: Lake Street Warehouse Fire

Get breaking news alerts

Reported by CBS 2's Mai Martinez and Kris Habermehl
CHICAGO (CBS) - Chicago firefighters were still on the scene late Monday morning after a fire destroyed a warehouse on the Near West Side.

The fire broke out in the early morning hours in the warehouse belonging to Reliable Plating, at 1514 W. Lake St.

Firefighters were called to the scene around 4 a.m., and while the fire was considered to be under control slightly over an hour later, it took firefighters several hours to battle the 3-11 alarm blaze.

Shortly after firefighters were notified, an alarm system summoned the company's owner and manager.

"They don't know how it started," said manager Coult Greenwall. "They say maybe when they investigate it they may be able to determine how it started."

Business owner James Greenwall said when he was notified, he was told, " There's a problem at the building. There's a fire. Looks like it's pretty extensive."

The Greenwalls said the plant specializes in electroplating, and also provides chrome plating for such companies as Harley-Davidson and Mercury Marine.

A witness at a nearby business said the fire spread very quickly.

Witness Gerald Sorensen said he saw "big flames, and then the walls started falling down. First the west wall fell, and then the back wall fell, and the roof collapsed. So then the flames went real high."

A witness said firefighters tried to make their way into the building when the roof collapsed.

Firefighters said initially, there were concerns that the blaze might spread to a joining business, but a firewall between the two businesses prevented that.

No one was injured in the fire.

But as a precaution, the Green Line 'L' was closed for a period of time between California Avenue and Clark and Lake streets. The line was later reopened, but the Ashland stop was kept closed as firefighters battled the blaze.

By 5:30 a.m., the fire was more than 90 percent contained, but hazardous materials crews had to be brought in to deal with chemicals used and stored at the plating facility. The chemicals included known corrosives.

Later in the day, "They'll be taking meter readings, and they'll find out if we can get in the building later on to see if any of the chemicals were compromised - meaning spillage - or actually on fire to that degree," said Fire Deputy District Chief John Nokes.

Reliable Plating has been in the building for more than 60 years. Chemicals are used and stored there, and because of their likely involvement in the fire, investigators have yet to get in to work on determining the cause. The investigation into the fire is expected to take days.

WOW!!!! After the fire Jack Mann called the owner of Reliable Plating as a friend to see if there was anything he could do, even though he did not insure the building that caught fire. It seemed that the owner was a bit upset when Jack Mann received a call back. Upon getting the call back Jack was asked to meet the owner in the building that did not burn the next morning.

After careful review Jack Mann informed the owners of Reliable Plating that hiring an outside adjustor would not be needed. Jack Mann also stated that the work done years before would make sure that this loss was well taken care of. Also Jack Mann reccomended that there be a "revision" of the replacement cost numbers from the firm that did the original "costimator". Jack Mann assured the owner that there was not a need to hire an independent adjustor, and the claim should be a smooth process.

The claim was smooth, the facility was cleaned up, and the operation was rebuilt in a different building. The customer is very happy, and the customer feels Jack Mann did the correct work for Reliable Plating in Chicago.

MAMES SHOW 2008

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Thu, 02 Oct 2008 21:09:51 -0500

I attended the MAMES show with over 120 other businesses that are in the Home Medical Equipment Sales/Leasing businesses. I met with John Webb of ZirMED who is a Sales Executive for them. ZirMED sells web solutions for the insurance claim, medicare, statement processing, and credit card issues that may arise with any Home Medical Equipment business. John and I spent the day together at the show and I know him now to be a very professional authority in this industry. I look forward to referring him business in the future. For any and all Home Medcial Web Based Solutions Call John Webb @ 502-762-3322.

Insurance For All Property

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Mon, 22 Sep 2008 03:59:47 -0500

Depending on where a property is located the property rates vary. lets say a home (or business) located in Chicago, IL in the Austin District. That is a protection clas two. Let us assume a building limit of $500,000 and a contents limit of $100,000. The premiun is unimportant as we are dealing with percentages, however this will cost $2,500 annually with an A rated insurance company. Now for the fun part....the very same building valued at $500,000 with the same $100,000 in contents in a rural town with a volunteer fire department. WOW. As you will see the cost for this can be quite different. A volunteer department will always bring a protection class 9. The cost for this will be $4,000 annually. The additional $1,500 are specifically attributed to the protection class 9 that dictates rating tiers with all insurance companies. Insurance companies do not all write business in a protection class 9, therefore it can be quite a task to even get a quote when a building is located within one. If anyone has a need to insure a "hard to write/insure property" please do not hesitate to call Jack Mann @ 630-546-9303.

Back Of The Yards Association Narrative (Chicago, IL - New City Neighborhood)

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Mon, 25 Aug 2008 03:27:04 -0500

Date: Tue, 6 Aug 1996 05:49:22 CDT

Sender: H-Net/H-Urban Seminar on History of Community Organizing

& Community-Based Development

From: Wendy Plotkin

Subject: Alinsky & Back of the Yards Neighborhood Council

Posted by Wendy Plotkin

In light of the discussion of Alinsky (including Bob Slayton's review of Horwitt's LET THEM CALL ME REBEL and the presentation of Randy Stoecker's and Susan Stall's paper on Alinskyite and feminist styles of organizing) I thought it would be useful to bridge the past and upcoming discussions of Alinsky, the IAF, and contemporary organizing styles with a brief "biography" of the Back of the Yards Neighborhood Council (BYNC), Alinsky's first community organization. Both Bob Slayton in his BACK OF THE YARDS: THE MAKING OF A LOCAL DEMOCRACY (Chicago: University of Chicago Press, 1986) and Sanford Horwitt in LET THEM CALL ME REBEL: SAUL ALINSKY -- HIS LIFE AND LEGACY (New York: Alfred A. Knopf, 1989) offer similar accounts of the creation of the BYNC.

According to Slayton, the 1930s Depression in the U.S. itself was a catalyst for the BYNC. The loss of employment it engendered in this working class neighborhood overwhelmed the resources of the traditional "welfare" institutions, such as the churches, ethnic societies, and charity organizations. Although the New Deal led to federal assistance for the neighborhood, it also was inadequate in dealing with the deprivation of insufficient food, fuel, and funds for housing maintenance. Also, with New Deal resources distributed across the nation, it was largely up to local leaders to demand and/or negotiate for as much of the federal largesse as possible. Thus, the stage was set for an effort by local leaders and residents to establish new local institutions to express their interests to existing political and corporate institutions.

The corporate institutions that dominated the Back of the Yards were the packinghouses described in Upton Sinclair's 1906 THE JUNGLE. Protective of their own interests during the Depression, their policies extended the earlier, pre-Depression policies of low pay, poor working conditions, and little or no job security. With the economy of the neighborhood so dependent on these employers, they were among the most important neighborhood institutions, at a time when neighborhood and employment were intertwined to a greater degree than was to be true in the commuting world of the post-war period.

Thus, it is not surprising that prior to the BYNC, the attempts to organize the neighborhood were led by labor and the fledgling Congress of Industrial Organizations (CIO). The CIO was the liberal union affilation that emerged in 1935 as an alternative to the trade-based and conservative American Federation of Labor. The CIO assisted in 1936 in the establishment of the local Packinghouse Workers Organizing Committee (PWOC), and took aim immediately at Armour Company, one of the most important industries in the neighborhood. According to Slayton, the PWOC brought a unity to the neighborhood that overrode some of the previously divisive ethnic and religious rivalries - in spite of a tremendous amount of red-baiting based in part on the important involvement of Communists in the CIO.[1]

Another antecedent to the BYNC was a "council of [neighborhood] clubs" organized in 1937 by Aaron Hurwitz, the publisher of the neighborhood newspaper that eventually became the official organ of the BYNC. BYNC itself was a cooperative effort between Alinsky and Joseph Meegan, the manager of the Chicago Park District's Davis Square Park, that culminated in a first meeting of the new organization in July, 1939. According to both authors, Alinsky and Meegan shared a distaste for traditional social workers and settlement houses, including the University of Chicago Settlement House located in the stockyards district. They believed in identifying and involving neighborhood residents as leaders.[2] Alinsky had been sent to the Stockyards neighborhood by the Chicago Area Project (an anti-delinquency project) to assist the neighborhood with its delinquency problem, applying the Project's approach that the causes of delinquency were deeply embedded in the overall problems of the neighborhood. Alinsky was a Jewish outsider who saw Meegan as the most promising local leader to organize the neighborhood. Meegan was tied to the Catholic hierarchy and as a layman was, according to Alinsky, a better choice as an organizer than any of the local clergymen due to the competition and conflicts that existed among the local churches. As the manager of the neighborhood's Davis Square Park, Meegan had also moved beyond mere administration of the park to obtain significant social and welfare services, including the provision of a government-subsidized lunch program - thus displaying a lack of concern for bureaucratic boundaries that was essential to Alinsky's critique of officialdom.

In creating the BYNC, Alinsky and Meegan saw this new community organization as one that would cooperate and extend the efforts of the PWOC and labor organizing into all aspects of community life, outside of employment. The community and the union thus formed an alliance --the union addressed community-wide issues outside of the salaries and security of the workers, and the BYNC took on the cause of the PWOC as its most important initial endeavour. The early days of the BYNC were very much devoted to the PWOC, which continued to aim its forces against Armour and its defiance of the landmark New Deal legislation (the 1935 Wagner Act) allowing the formation of labor unions and requiring them where workers voted for them. The day before the first meeting of the BYNC (July 14, 1939), Herb March, the head of the PWOC, was shot at, and three days later, a mass meeting in support of the PWOC included on the stage John L. Lewis, the controversial national CIO founder, and Bishop Sheil, the Chicago clergyman who faced criticism by the church hierarchy for his support of the CIO-Led Labor Movement.

In addition to this community-labor alliance, the BYNC was aided by the rise of a new breed of priests in the neighborhood, at a time when the priesthood was a popular career for many male Catholic Chicagoans. These younger assistants tended to shy away from the ethnic enclave mentality of the older Polish, Lithuanian, Irish, and Italian priests. They were influenced greatly by Bishop Sheil, the founder of the Catholic Youth Organization in Chicago and an activist in favor of workers' rights and against racial intolerance. Like Sheil, they supported labor organizing in spite of the conservative clergy's disapproval.

Aside from its support of local labor actions, early BYNC activities included expansion of the free lunch program. According to Slayton, this was the first time that a federal program to distribute surplus food was used by a nonpublic organization and it was the prime example of the Council's ability to obtain from outside agencies the kind of assistance that the community so badly needed. (Slayton, 212) The Council also convinced other institutions such as public and parochial schools to establish their own free lunch programs, and assisted them in their efforts to obtain federal financing for these. According to Slayton, the Council was a major source of support for continuing this federal effort when opponents attempted to end it in 1943 -- they organized a letter-writing Campaign that resulted in over 23,000 Chicago children sending letters to their federal Congressmen. The Council also advocated for children by identifying sources of cheaper milk than was made available by the public schools (who faced the constraint of acquiring milk from Politically connected dairies). The Council also engaged itself in anti-delinquency/ anti-gang programs, development of playgrounds and in-door recreation centers, youth employment, nutritional education, dental services, and housing. Its housing activities included a survey (via the schoolchildren) of Housing violations that were reported to the appropriate city agencies. In addition, it sponsored neighborhood clean-up through the distribution of garbage cans and the free loan of exterminating equipment.

The Council sponsored health awareness and education for adults, including support for the local cancer society. It was successful in improving the services in the neighborhood, including a new post office and a new library. It established an office in which neighborhood residents could come to register complaints about a variety of problems, such as broken street lights or gang violence.[3] It also established a credit union.

The Council achieved a wide base of support, but also its share of opponents, including the local political machine. The Democratic political machine had used the provision of services as a means of ensuring votes. It was thus threatened by the Council's own efforts to provide these services, and it attacked the Council in the 1940s, requiring its removal from the offices of the Davis Square Park district and tranferring Joe Meegan out of the district. The Council found alternate headquarters, and thus survived the attack. Slayton asserts that "[t]he larger successes of the Council were achieved in the 1950s and 1960s. During these decades, the community organization stabilized the neighborhood and helped it grow and prosper." (227) During these years, the Council increased its work in improving the area's housing, developing home rehabilitation programs and obtaining the support of local financial institutions for these. Local vacant storefronts were converted to housing, and new homes were built in the neighborhood in spite of a mass exodus of industry and many urban dwellers to the suburbs. Slayton argues that these activities broke the backs of the block-busting efforts of local real estate developers, although he does not describe the complex issue of race and racial politics as they played themselves out in the Back of the Yards these years. The issue of race is described in greater detail by Horwitt in his biography of Alinsky, both in its effects on the Back of the Yards and in Alinsky's other efforts. I'll describe these in a separate posting, at a later date.

The significance of the Back of the Yards Neighborhood Council, other than the improvements it brought to this Chicago neighborhood and the sense of empowerment it brought to the neighborhood residents, was its influence in obtaining acclaim for Alinsky, and serving as the main showpiece in his establishment of the Industrial Areas Foundation, or IAF.

I am interested in receiving any additional information, suggestions for sources or articles, and alternative views on the history of the Back of the Yards Neighborhood Council. Was the Council unique in the approach it took in involving local residents in improving their own situations? Were similar, less heralded schemes unfolding elsewhere in the U.S., and, in fact, the rest of the world? If so, what were the unique elements in the Council? [If you are interested in obtaining the review of Alinsky's biography and the Stoecker/Stall paper, send e-mail to listserv@uicvm.uic.edu with the message: GET ALINSKY PACKAGE]

Wendy Plotkin

COMM-ORG

[1]See Lizabeth Cohen, MAKING A NEW DEAL (New York: Cambridge U. Press, 1990) for a description of the effect of the Depression on Chicago's ethnic, working class communities and a close examination of the dual roles of the newly diverse Democratic Party and the labor movement, especially the CIO and PWOC in Chicago, in bridging divisions among ethnic and religious groups.

[2]See Noel A. Cazenave, "Chicago Influences on the War on Poverty," in Martin V. Melosi, URBAN PUBLIC POLICY: HISTORICAL MODES AND METHODS (Pennsylvania State U., 1993) for a more detailed discussion of Alinsky's conflicts with the Chicago Area Project, his initial sponsor in the Back of the Yards, and with the social work establishment.

[3]Thus, in spite of the antipathy of the "founders" of community organizing for the settlement houses, many of their programs were similar to those offered by the settlement houses -- with the important difference, they'd most likely argue, that they were organized and controlled by community members and not outside social work professionals.

Prior and parallel to the development of community organizing as a technique by Alinsky, there existed an interest inside of the social work establishment for "community organization." See Stanley Wenocur & Michael Reisch, FROM CHARITY TO ENTERPRISE: THE DEVELOPMENT OF AMERICAN SOCIAL WORK IN A MARKET ECONOMY (Urbana: University of Illinois Press, 1989) for the emergence of community organization as a "distinctive method of social work akin to casework and group work" in the 1930s and 1940s. They observe that Community organization originated less as a specific method within social work than as a means by which social service providers could develop programs within a given community and mobilize the resources needed to support and sustain them. (233)

In the same year that the Back of the Yards Neighborhood Council was established (1939), the National Conference of Social Work (NCSW) issued the Lane report on community organizing drawn from discussions in six U.S. cities. The NCSW's definition of community organizing was much more tied to the social work establishment and social work methods than was Alinsky's and his followers, as the report identified community organization as a process of social work whose aim is `to bring about and maintain a progessively more effective adjustment between social welfare resources and social welfare needs'(Lane, 1939: 499) (Wenocur and Reisch, 236)

MEDICAL DEVICE & MEDICAL EQUIPMENT INDUSTRY INSURANCE NEEDS

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Sun, 03 Aug 2008 03:45:36 -0500

Medical device/equipment/consumables/disposables/durables companies inevitably face risks beyond the standard roster of conventional business risks. MANN INSURANCE 630-546-9303 INSURES ALL OF THESE RISKS.

At MANN CONSULTING, we realize that there are no cookie cutter insurance solutions, but MANN CONSULTING's medical device insurance specialists can greatly simplify the process for you. Our experience covers all possible bases. With it, we've earned a reputation for outstanding medical device policy development and client service. Unlike some insurance brokerage firms who rely on a "just provide us a quote" approach, our medical device experts will serve as true advisors to your company, whether you're a startup enterprise or a larger corporation.

Based on a clear understanding of your medical device business, we will educate, inform, and help you clarify your risks, identify your coverage needs and guide the development of customized policies and risk management programs specific to your company's circumstances. We'll provide you with a risk analysis that includes:

A review of your company's areas of potential exposure to risk
An audit and review of your current insurance contracts
An assessment of whether your existing coverage and risk management techniques adequately address your needs
Special attention devoted to identifying any gaps in coverage that put your company at increased risk

Should a distributor or independent sales rep be concerned about liability? You are probably getting pressure from more and more manufacturers to prove that you have insurance coverage for claims arising out of "your negligence." The bigger companies "self insure" the first $100,000 to $5,000,000 of their own liability, so unless they can transfer potential liabilities to others (you), that money comes out of their own pocket. If your manufacturing client is a start up or smaller player, they may not purchase adequate insurance to cover their own liability, let alone yours, which means that you may be drawn into a lawsuit. The burden is shifting to distributors and independent reps because manufacturers are wary of paying for claims that, in their opinion, are not their fault.

You can't count on the manufacturers' insurance policy and you should never assume that your defense will be picked up by someone else's policy. If a claim or lawsuit alleges negligent activities on the sales rep's part, all bets are off as to the manufacturer and its insurance company picking up your defense. It may not matter that the allegations have little or no merit. Mere allegations may remove the sales rep from the orbit of a manufacturer's product liability insurance coverage. Even if ultimately the allegations against a sales representative are exposed as fallacious, it may take the court system years to reach this level of certainty. In the interim, sales reps definitely need their own defense to lawsuits.

Potential Liabilities of Distributors and Independent Sales Reps

Contractual Risk Transfer: You may be required to hold the manufacturer harmless from any and all claims arising out of a breach of your duties as the distributor or sales rep.
It might be construed that you misrepresented the product and therefore the manufacturer holds you responsible for a claim that caused bodily injury or property damage.
It may also be construed that you gave the wrong advice or misrepresented a product and there is a consequential or financial damage that arises - "you said it would do X and because it didn't, we want our money back AND financial damages on top of that".
Workers Compensation
You may be responsible for product samples
Automobile exposures
Wrongful "employment practices"
Shipping of the manufacturer's product
Overseas travel
Handling of funds
Privacy issues
Business interruption

Methods to Manage Your Risk

1. Have your attorney review the contract. An insurance company will want the contract to be very specific. As an example, if the manufacturer is asking you to hold them harmless, then you should consider asking the manufacturer to hold YOU harmless as well. You should ask to be named as an "additional insured" under the manufacturer's general liability, professional liability and umbrella policies. It's also important to be added as an insured under "management liability" policies, such as employment practices coverage. You also need to watch out for contracts which state that you are responsible for payment of the deductible of an errors and omissions claim arising out of an incident that is deemed to be your fault.

2. The contract has a direct impact on the availability and pricing of both general liability and product liability insurance. Make sure you have general liability including products liability coverage to defend you for your alleged negligence (aka "Gap Liability").

3. Don't count on the manufacturer's insurance picking up injury to your employees. It may be your responsibility - Workers comp laws are different in each state, so check with an insurance professional for compliance.

4. Ask "Who's responsible for products in my possession?"

5. The manufacturers' automobile insurance coverage will provide limited benefits, if any. Watch out for "who is insured" provisions in the manufacturers' coverage. Also, it might make sense to read the fine print on the back of a rental car agreement to determine what protection is available.

6. If you travel overseas, never assume that your workers compensation or health insurance will follow you. It might make sense to invest in a "foreign insurance" policy which may also include "repatriation" coverage - the cost to get you back home.

How do you find the Right Insurance Coverage?

1. Find an insurance professional with specific experience in placing insurance for distributors of medical devices. Specialists will know the right questions to ask, which will save you time and money. Many times, these brokers have checklists which are specific to your industry.

2. Investigate "group buying." You may be able to save money by joining a buying group, which might provide some premium savings, but remember - you are now sharing limits of liability with others. One claim may reduce the limits available for future claims. It won't matter how much money you saved if you have an uncovered claim! Be extra careful when looking at "who is insured" provisions - you may not be getting what you paid for.

3. Value, Value, Value. Specialty insurance carriers (those who have specific policies for medical device exposures) provide more than just policies. Take advantage of the value added services they offer, such as loss control and risk avoidance advice.

4. Even though you may not be familiar with insurance policies, there are a few "safe" questions to ask your broker or insurance professional: Why are you recommending this insurance carrier? What are the important exclusions? How many insurance carriers offered a bid on my business? What value added services are available? Did the insurance carrier look over our contracts?

Make the time to review liabilities as a distributor of medical devices by seeking out professionals in the industry. As the burden of liability increases all along the supply chain, independent agents will find that protecting their businesses in the future will require more attention to risk management.

Latest Habitational Property Markets

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Sat, 01 Mar 2008 02:08:48 -0600

Apartment buildings are the hardest type of property to insure if there are more than 3 units in any state. When there is a 2 flat, 3 flat, or up to 4 3 flats a homeowner can add these to their home insurance. If there are more than 3 units the account must be placed in a commercial policy, then the rates go up quite a bit.

The best solution for the pricing wars on commercial habitational policies comes from the only true alternative for hard to place and hard to write habitational risks. That is an independent insurance agent who has access to multiple markets for habitational risks with 4+ units in a building. The various carriers that can do this will show how positive and maverick your broker / agent is. The best agents act as trusted advisors, bring multiple alternatives to the client, and assist in the decision making process.

Know that this is the best way to handle habitational risks. Mann Insurance is excellent with the placement of these types of risks. Call 630-546-9303 and ask for Jack if you wish to get a quote.

PROPERTY INSURANCE

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Tue, 25 Dec 2007 21:55:20 -0600

PLEASE contact me for a quote for property insurance. I can insure any property in any state.

My resources are over 10 national insurance companies that can insure any property at a competitive rate.

I am the authority in this industry on this site. Use me as I will point you and your clients in the right direction, even if it means referring them to a lower premium with another agency.

JACK MANN 630-546-9303

Investment Property Insurance

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Tue, 25 Dec 2007 21:39:39 -0600

Is it investment property to give a positive cash flow? IF SO then you must put a policy that has the same named insured as the property is titled to. Further, if it is personally titled, then you may add up to 4 rental properties with many insurers. I have access to all of them.

Is it a tear down rebuild OR new construction? IF SO then you must put a BUILDERS RISK POLICY in force that will provide coverage for the completed amount of the property. IF it is titled personally or commercially the pricing is the same. ZURICH is the best pricing in all 50 states for this coverage. Also they provide the best coverage enhancements. I can say this as I know the regional carriers cannot touch the coverage's. A Builders Risk Policy is usually 100% minimum earned with no payment options. IF the builder is going to have multiple projects going on at once they can purchase a REPORTING form that MUST be filled out monthly. Most contractors do not have the time for this and usually get forced onto a ONE SHOT REMODELING/BUILDING form due to non compliance of the REPORTING FORM. Reporting gives about a 15% discount annually.

Is this a speculative piece of property that is a vacant piece of land, or a rough building that is pending the neighborhood to "BOOM"?? Either way you must have this location insured properly, with any and all RISK MANAGEMENT conditions taken care of. That means proper smoke detectors, Fire Extinguishers placed properly, and any other small things that will make the insurance company feel "warm and fuzzy".

This is all very simple stuff to do, just having a well informed agent is the best choice.

Jack Mann 630-546-9303

High Deductible Health Plan (IRS HDHP Section 502 Narrative in LAYMANS TERMS)

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Mon, 17 Dec 2007 01:39:07 -0600

The only constant in life is change. We are seeing that in the medical insurance industry more than ever due to rising costs of health care. One factor is that insurance is cyclical to the degree that our industry re packages old products with new names and enhancements.

This is exactly what is going on with the H S A and the H R A products. In the eighies there was a new product that was to replace the indemnity medical plan. The old indemnity plan was a deductible, coinsurance, then the insurer paid at 100%. The new plans were HMO/PPO type products. The newest "repackaged" product is the Health Savings Account/Health Reimbursement Arrangement. This is the new way of insuring groups using the old "Indemnity Plan" financial model.

The IRS tax code states that an H S A may receive contributions from an eligible individual or any other person, including employer or a family member, on behalf of an eligible individual. Contributions, other than employer contributions, are deductible on the eligible individual's return whether or not the individual itemizes deductions. Employer contributions are not included in income. Distributions from an H S A that are not used to pay qualified medical expenses are not taxed.

A health savings account (H S A) is a tax exempt trust or custodial account that you set up with a qualified H S A trustee to pay or reimburse certain medical expenses you incur. You must be an eligible individual to qualify for an H S A.

To qualify for H S A you must meet the following requirements according to the IRS:

You have a high deductible health plan (HDHP), described by IRS definition, on the first day of the month.
You have no other health coverage except what is permitted under Other health coverage, under IRS code.
You are not enrolled in Medicare.
You cannot be claimed as a dependent on someone else's 2005 tax return.

If you meet these requirements you are an eligible individual even if your spouse has non HDHP family coverage, provided your spouse's coverage does not cover you.

High Deductible Health Plan (HDHP)

An HDHP has:

Higher Deductible that traditional plans.
A maximum limit on the sum of annual deductible and out of pocket medical expenses that you must pay for covered expenses. Out of pocket expenses include co-payments and other amounts, but do not include premiums.
$2650 max contribution per individual
$5250 max contribution per family

Health Reimbursement Arrangements (HRAs)

HRA must be funded solely by the employer.
Contribution cannot be paid through a voluntary salary reduction.
Employees are reimbursed tax free for qualified medical expenses up to a maximum dollar amount for a coverage period. An HRA may be offered with other health plans, including FSAs.

For information on the interaction between HRA and H S A products see Other employee health plans under Qualifying for an H S A.

Benefits of an HRA:

Contributions made by employer can be excluded from your gross income.
Reimbursements may be tax free if you pay qualified medical expenses.
Any unused amounts in the HRA can be carried forward for reimbursements in later years.

Qualifying for HRA:

HRA's are employer-established benefit plans. These may be offered in conjunction with other employer-provided health benefits. Employers have complete flexibility to offer various combinations of benefits in designing their plan. You do not have to be covered under any other health care coverage to participate.

Self employed persons are not eligible for an HRA.

Contributions to a HRA

HRA's are funded solely through employer contributions and may not be funded through employer contributions and may not be funded through employee salary deferrals under a cafeteria plan.

Contribution Amount

There is no limit on the amount of money your employer can contribute to the accounts. Additionally the maximum reimbursement amount credited under the HRA in the future may be increased or decreased by amounts not previously used.

Distributions From an HRA, reimbursements under an HRA can be made to the following persons:

Current and former employees.
Spouses and dependents of those employees.
Any person you could have claimed as a dependent on your return if that person had not received $3,200 or more of gross adjusted income or had not filed a joint return.
Any person you could have claimed as a dependent except that you, or your spouse if filing jointly, were claimed as a dependent on someone else's 2005 return.

BASICALLY H S A PLANS ARE FOR WHITE COLLAR CORPORATIONS THAT UNDERSTAND THE BENEFIT OF A HIGH DEDUCTIBLE, USAGE OF A TAX DEFERRED ACCOUNT (LIKE A IRA FOR MEDICAL INSURANCE) THAT WILL USE THOSE TAX FREE DOLLARS FOR: OVER THE COUNTER MEDS, ANY OTHER IRS APPROVED ITEM NOT COVERED ON THE GROUP MEDICAL PLAN. WOW THAT IS A LOT. THE 502 IS GOING TO BE PUT UP AFTER THIS. THAT IS IRS INFORMATION WHICH ARE ALLOWABLE EXPENSES UNDER THAT TAX CODE. THE INDIVIDUAL TAX DEFERRED ACCOUNTS WILL BE FUNDED WITH THE PRE TAX DOLLARS FROM THEIR PAYROLL. THAT IS GOING TO REDUCE THEIR TAKE HOME PAY, AND REDUCE THEIR TAXABLE INCOME.

NOW THE DIFFERENCE IS THE HRA PLAN. HRA'S ARE SPECIFICALLY GEARED TOWARD THE BUSINESS OWNER THAT HAS A PREDOMINANTLY BLUE COLLAR STAFF. IN THIS CASE A BUSINESS OWNER WILL FUND ALL OF THE MONEY THAT GOES INTO THE INDIVIDUAL "HEALTH SAVINGS ACCOUNTS"!! THAT IS TO SAY THE BUSINESS OWNER WILL BE ABLE TO TAKE THE MONEY AT THE END OF THE PLAN YEAR AND USE IT FOR HIS ONGOING PREMIUMS, CONTINUE FUNDING THE "HEALTH SAVINGS ACCOUNTS", OR SWALLOW IT UP INTERNALLY AND USE IT FOR "ADMINISTRATIVE EXPENSES". AT THAT POINT THE CORPORATION WILL DO WHATEVER THEIR TAX PROFESSIONAL SAYS IS BEST.

PERSONALLY I BELIEVE UTILIZING A HIGH DEDUCTIBLE HEALTH PLAN IS A WONDERFUL WAY TO REDUCE PREMIUMS BY UP TO 25% ANNUALLY. ALSO THERE IS A BIG DIFFERENCE WITH THE HSA/HRA VERSUS A TRADITIONAL PPO: THE HSA / HRA IS GOING TO HAVE A MAXIMUM OF 2 X'S DEDUCTIBLE. THE PPO PLANS ARE UTILIZING 3 X'S DEDUCTIBLE. USUALLY THE MAXIMUM OUT OF POCKET IS GOING TO BE LESS THAN THE PPO OUT OF POCKET, ESPECIALLY IF THE INSURED REMAINS IN NETWORK. IN NETWORK VERSUS OUT OF NETWORK WILL ALWAYS HIT PEOPLE HARDER THAN ANYONE THINKS.

AS AN INSURANCE PROFESSIONAL, A TRUE BLUE "TRUSTED INSURANCE ADVISOR" MY JOB IS TO TELL PEOPLE EXACTLY WHAT THEY ARE GETTING INTO. EVEN IF IT MEANS THAT MY INFORMATION IS NOT THE MOST POPULAR ANSWER. THAT IS MY JOB, HONESTY, INTEGRITY, INFORMATIVE.

International Medical Coverage (Expatriate Overseas Insurance)

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Tue, 04 Dec 2007 02:43:02 -0600

Five categories of focused questions every prospective expatriate medical insurer should be asked

I. Integration of medical assistance services

Can our members call your company 24/7 with a medical question in any language and speak directly with a knowledgeable physician?

Immediate access to a knowledgeable medical professional is key to quickly assessing the condition and needs of the expatriate with medical concerns. It also gives confidence and reassurance to the member that they aren't facing a serious situation alone. While a nurse may also be able to provide similar results, a physician may be more inclined to provide self-treatment advice and will have an easier peer-to-peer communication if a conversation with the member's local treating doctor or referral doctor is required.

Which assistance company do you use and what is their experience with providing assistance services?

The assistance industry has its share of the very good, the very poor and the untested. Additional probing may be appropriate to understand the vendor's true capability and experience, such as: what percentage (and number) of its cases occur outside of North America (e.g., is most of its international case activity composed of Canadian snowbirds?); describe the size, location and background of the medical staff employed by the assistance company; and, is medical assistance focused on expatriates a core, long-term offering or is this a recent diversification from seemingly related services (e.g., the international equivalent of AAA or in-flight medical advice)?

It takes a substantial amount of repetitive medical case activity to build up worldwide resources and a knowledge base.

Describe the degree to which the assistance company is integrated into your service, provider network, utilization and healthcare processes.

Typically the more integrated, the better. This avoids silos and workflow that can result in misrouted or overlooked requests for help, eliminating opportunities for error. On the other hand, you don't want an operation that totally delegates core services to a vendor without adequate oversight.

What medical assistance services are included in your basic service offering?

Some carriers bundle certain medical assistance services in their core offering while others make this a fee-for-service option. Indemnified evacuation and repatriation services are often an option.

If we have evacuation coverage through another vendor, will you carve evacuation out of our coverage and provide a corresponding reduction in rates?

Your company may have separate evacuation coverage through a medical assistance provider for your travelers and expatriates, Business Travel Accident policy, etc. Some carriers may not be willing to unbundle evacuation from their core offering, meaning you're effectively paying for double-coverage.

II. International provider network

That types of providers are in your international provider network and are they all visible in a directory accessible by the member?

Does the carrier provide a directory of their international network providers to their members? If so, do they provide some guidelines to the member on how to most appropriately use the network? For instance, the appearance of specialists on a directory accessible by the member may imply the carrier is happy for members who believe they require specialty care to simply self-refer to a specialist without any assistance or guidance by a medical professional. While this isn't necessarily a concern in developed countries, it is a considerable concern in under-developed countries. A member with current symptoms is best served by receiving a real-time medical assessment so that the most appropriate provider/specialist can be determined.

Describe the selection criteria and process employed for providers to be listed on your international provider directory.

This may be the most important question you can ask of a carrier that provides such a directory. Around the globe there is no single, commonly used qualification or accreditation standard or process. Within the industry there is a range of responses to such a question. On the low end of the scale is a directory that utilizes no specific selection criteria and is simply a directory of known providers, similar to the phone book. A mid-range response would be a process involving simple recommendations from various external parties with subjective/anecdotal qualifiers. Examples would include: embassy recommendation, airline /hotel recommendation, or American board certification/Royal College of Medicine certification. The higher end range involves a number of objective criteria regarding the provider's training, experience, and documented history with the carrier or carrier's assistance company. On-site evaluations by medical professionals represent the "gold standard

Do all of the providers with whom you have contracts or formal arrangements meet your provider selection criteria?

This will demonstrate how seriously the carrier takes their own selection criteria.

Do you use brokers or other independent intermediaries to negotiate discounts with international providers?

It's not uncommon in the industry for a carrier to use an independent intermediary to negotiate discounts. The intermediary brokers arrangements whereby a number of purchasers may consolidate their purchasing power; however, there are risks to this approach. The carrier may lack controls and data necessary to ensure discounts represent actual savings, which can create an opportunity for providers engaged in such relationships to inflate charges to offset the discounts. When the intermediary's fee (e.g., percent of savings, etc.) is added, the result may be a net increase in charges for the carrier. All the while the carrier believes they are enjoying discounted pricing.

What is the basis for your international provider discounts (e.g., discount off billed, fee schedule, DRG, etc.) and what is the resulting effective range of discounts with international providers? Are all of the savings generated from these discount arrangements passed along to your ASO clients?

The most common form of discount, where discounts exist, are percent off billed charges. While having less predictability than other forms, the carrier can add controls such as having data on the provider's normal schedule of fees. Clearly, passing the carrier's savings to ASO and dividend eligible clients is preferable. You should also confirm whether the member enjoys any discounts on their coinsurance.

III. Making payments directly to international providers

Do you provide guarantees of payments to international physicians, dentists and clinics?

Some carriers will only provide guarantees of payment to international hospitals for inpatient care. Others will honor assignment of benefits to non-institutional providers but will not actually provide a guarantee of payment in advance of services. Some of the carriers will only make guarantees of payment to a limited number of facilities with whom they have existing contractual relationships. Finally, some carriers will administer guarantee of payments to any international provider.

How many different claim forms do you maintain?

Some carriers have claim forms for each and every line of coverage, while others have a single form. What languages are the forms available in?

Is a completed claim form required with every international claim submission?

Some carriers insist that a claim form be sent with every claim submission. Others will insist on at least one completed claim form for each member annually. The most liberal approach is to not require a claim form as long as the submitted documents contain all of the necessary data elements required to resolve the claim.

What is the process and timeframe for a member to request a guarantee of payment to an international physician and hospital?

Lead times range from no required advance notice to at least 10 days advance notice. Requiring any advance notice limits the use of guarantees of payment in emergency situations. Adding financial concerns on top of a medical emergency is not conducive to a beneficial outcome.

What percentage of your international benefits are paid directly to providers?

This is a good question to ask in order to differentiate the approaches and success carriers have with paying benefits directly to international providers and alleviating members from the pain of "pay and claim."

What tools or approaches do you employ if a provider does not accept a guarantee of payment from your company?

Does the carrier simply give up or do they have other mechanisms for meeting the financial requirements of an uncooperative provider? International providers have a long history of being burned by insurance companies, so it isn't unusual for them to be skeptical.

IV. Composition and experience of the medical staff performing international care monitoring and case management

Who are the staff who perform international medical monitoring and care management? Where are they located? What is their international clinical experience?

Beware of a US-centric set-up. While the value of US nurses is clearly understood within North America and many European countries, a US-based nurse may not have the professional stature in the eyes of providers in the rest of the world required to get the cooperation of the treating doctor. The most effective care managers not only receive information, but provide information and professional suasion to steer treatment plans to optimal outcomes. Has the staff ever practiced medicine abroad? Do they understand the nuances of medicine as delivered in all of the locations you have staff?

If you outsource this function, what process do you employ to oversee their work? What is the international clinical experience of the person(s) within your organization who perform this oversight?

It's not unusual or undesirable for a carrier to outsource international medical monitoring and care management. This may enable the carrier a greater footprint, local knowledge and service capabilities; however, it is key for the carrier to have an effective program to manage the vendor. A medical professional with actual international clinical experience is preferable.

Do you employ a full-time international medical director? What is his/her international clinical experience?

Few carriers have a full-time international medical director, much less one with international clinical experience. The presence of such a position may indicate a the carrier's commitment to the quality medical care its members receive.

Describe the international clinical experience of any nurses you employ.

Nurses who have first-hand experience with delivering care internationally will have greater success with obtaining information and providing appropriate advice to treating doctors.

V. Innovative health programs for the global population

What innovative health management programs are you developing to serve our population? Are such programs part of your basic service offering or do they require additional fees?

The carrier should describe their vision of where the industry is currently headed, and what programs they're creating to ensure they are among the leaders. Are these programs simply opportunities for additional fees or do they strengthen the value proposition of the carrier's entire portfolio?

Call Jack Mann if you have questions.

Benefits Consulting Provided By Jack T. Mann

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Wed, 21 Nov 2007 00:42:49 -0600

Benefits Consulting

Health Benefits Consulting Services

Jack T. Mann offers a full range of consulting services for health plan sponsors, including:

• Health Plan Design Jack T. Mann's health consultants have extensive experience in the design and redesign of all health benefit plans for employees and retirees, such as medical, dental, prescription drug, vision, behavioral health, short- and long-term disability, life, accidental death and dismemberment and flexible benefits.

• Vendor Selection Jack T. Mann creates custom requests for proposals (RFPs) for fully insured and/or self-funded plans. We create and analyze vendor/bidder responses from the full array of managed care organizations (MCOs): health maintenance organizations (HMOs), preferred provider organization (PPOs) and point-of-service (POS) plans. Our analysis covers vendors' fee projections. Jack T. Mann also negotiates with vendors and helps clients coordinate vendor management.

• Projection and Forecasting of Benefit Plan Costs Jack T. Mann's consulting services include projecting claims, setting contribution and COBRA rates, determining reserve requirements, performing incurred-but-not-reported (IBNR) calculations required for retiree health accounting, analyzing the impact of proposed plan design changes, underwriting and funding methodology, creating budget and renewal projections, preparing annual health benefits reports, determining pricing for flexible benefits, conducting merger studies and analyzing the development of health care purchasing coalitions.

• Evaluation and Formulation of Provider Reimbursement Methodology Evaluation and formulation of provider reimbursement methodology includes per diems, diagnostic-related groups (DRGs), outliers, discounts, capitation and physician services and procedures.

• Health Care Quality Assessment (Q-ValSM) For more information on this unique service, click here.

• Collection and Analysis of Cost Utilization Data Collection and analysis of cost utilization data includes monthly claim experience, health care trends and cost savings.

• Medical Claims Auditing Jack T. Mann's claims auditors review medical, dental and/or prescription drug plans for fully insured and self-funded administrative-service-only claims administrators to assure financial and procedural accuracy in claims processing. We can benchmark results for clients to industry norms.

• Reviews of Pharmacy Benefit Managers (PBMs) Rapidly rising prescription drug costs are driving overall increases in the cost of health coverage. Jack T. Mann's health consultants conduct PBM reviews that yield information that can be used to manage the cost of prescription drug coverage.

• Design and Implementation of Prevention and Medical Management Features Jack T. Mann designs and implements health promotion/wellness programs, employee assistance programs (EAPs), managed disability programs, disease management programs, centers of excellence programs, 24-hour, telephone-based nurse "triage" programs, executive physical exam benefits and long-term care coverage.

• Health Compliance Updates and Research Jack T. Mann keeps clients informed about health compliance news through publications, including the Web-based Capital Checkup, a periodic electronic newsletter summarizing activity in Washington with respect to health care and related subjects. Jack T. Mann's health compliance consultants can be retained to research plan sponsors' specific questions about compliance issues, update or create plan documents, create amendments and investigate vendor compliance with state and federal laws (e.g., ERISA, HIPAA and COBRA).

• Participant Communications Jack T. Mann's communications consultants write and design general or personalized participant communications, including summary plan descriptions (SPD), participant communications required by state and federal laws, announcements about plan amendments, brochures highlighting plan features. In addition, Jack T. Mann publishes Health Report, a quarterly subscription newsletter for plan participants that is devoted to wellness and promotion of a healthy lifestyle.

• Design and Tabulation of Participant Surveys Participant satisfaction with their benefits contributes to a content workforce, and content workers are less likely to seek alternative employment. Jack T. Mann can draft, conduct and tabulate custom surveys to assess participant satisfaction annually or periodically. Our communications consultants can draft and design summaries of survey results for distribution to participants.

• Complete Analysis of Claims Based on Carrier Discounts By utilizing proprietary software we can research, develop, and implement the analysis of claims. We can show the client how much the discounts would have been with various carriers on various lines of coverage.

• Corporate Benefit Surveys As clients wish to know where they stand when compared to other employers we can provide surveys and reports which grade other employers based on the benefits package offered.

5 Categoris of Focused Questions For International Medical Insurers

Mann Insurance & Mann Consulting (MANN INSURANCE & MANN CONSULTING) — Sat, 17 Nov 2007 02:46:46 -0600