California Broker Magazine November 2023

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S E RV I N G C A L I FO R N I A’ S A N N U I T Y, L I F E A N D H E A LT H I N S U R A N C E P R O F E S S I O N A L S • N OV E M B E R 2 0 2 3

November is

[&] Effect

Elements [Passion. Authenticity. Collaboration. Trust.] The [&] Effect is a feeling. It’s the confidence you have working with authentic people who thrive on collaboration. It’s the security of having your business handled by a team passionate about your success. It’s the gift of time you’re granted because you have a partner you can trust.

It’s a phenomenon only experienced with Word & Brown by your side. Experience Word & Brown | NOVEMBER 2023 48 | CALIFORNIA BROKER Word & Brown General Agency | 701 South Parker Street, Suite 8000, Orange, California 92868 | 800.869.6989


Earn even more for offering your clients California’s most comprehensive access to doctors and hospitals:

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11 - 25

$ 2,000 / $3,000

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HMO offerings from • Blue Shield • Kaiser Permanente • Sharp Health Plan CCSB offers 4-tier selection Single bill NEW! CCSB offers more Blue Shield Plans

Contact your local Covered California for Small Business sales representative to learn why we’re growing and how we can help build your business! An increasing number of agents and their clients are glad they did. 844.332.8384

Some Key Rules:

1. Applies to new to Covered California for Small Business (CCSB) groups with initial effective dates of 07/1/23, 08/1/23, 09/1/23, 10/1/23, 11/1/23, 12/1/23 and 1/1/24 2. Agency must submit minimum of three groups to qualify for bonus program 3. Bonuses will be calculated on number of subscribers (employees) in effect for the first effective month of the policy as determined by CCSB. 4. No pro-ration of target values will take place. 5. Business written through partnering General Agencies qualifies. 6. Covered California will issue the second bonus (6+ groups) incentive payment forty-five (45) days following the conclusion of the incentive program so long as qualifying groups satisfy the ninety (90) day requirement outlined in Section (E)(2)(c) of Exhibit F of the Agency Agreement. For a complete list of the program rules go to:

http://w w w.coveredc a .com/agent s/PDFs/Agent- commis sion - schedule.pdf


*Insurance companies vary by region and are subject to change. CCSB_12675_23_calbroker-ad_agent-bonus-program.indd 1


4/4/2023 4:23:45 PM

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Marketing Resources We strive to provide you with innovative programs and resources to help you better utilize your time, so you can capitalize on new business opportunities. Co-op Marketing Support Get 50% of your marketing costs paid for with AGA’s co-op support.

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Client Retention Programs Yearly retention mailings, a monthly birthday card program, and digital retention resources are just a few ways we can help you retain clients or keep them informed of important changes.

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LONG-TERM CARE Addressing the Growing LongTerm Care Crisis with LTC and Legal Insurance BY TIM WEBER

To me, the caregiving story is a personal one. My parents struggled with a protection problem…


2022-2023 SHRM STATE OF THE WORKPLACE REPORT Tamar Arouchian, Dickerson EVP of Sales Responds to Findings The SHRM findings show that demand is high for benefit packages that attract and retain talent, enhance morale, and also manage costs.


VISION Eyecare and Holistic Health is Top of Mind for Employees BY JONATHAN ORMSBY

Savvy employers offer premium vision benefit options, knowing eyecare is an essential element to whole-body wellness.


EDUCATION The History of Prescription Drugs and Health Insurance BY EMMA PETERS

70% of voters across the political spectrum are worried about drug prices and a third have trouble affording their medications. 6 | CALIFORNIA BROKER

Cal Broker’s commitment is to be the leading source of news and information for California brokers and agents operating in the health, life, and annuity industry. We are committed to connecting Life and Health insurance professionals to valuable resources and solutions they can provide to their insurance clients.


LIFE SETTLEMENTS More Seniors Should Be Selling Their Life Insurance Policies Serve Your Clients and Build Your Business Many people don’t need their policies any longer, or the policies become too expensive to maintain.


GROUP A Guide for Health Insurance Brokers: Tips for Open Enrollment Season BY MICHAEL MALHAME

As a health insurance broker, one of the busiest and most critical periods in your calendar is undoubtedly the open enrollment season. Here are several essential steps that health insurance brokers can take to effectively prepare for this amazingly busy and productive season.


BUDDY INSURANCE ANNOUNCEMENT The State of LTCi Claims and the Power of Claims Advocacy Gretchen Barry of Buddy Insurance interviews Jon Thomas of Amada Senior Care With November being National LongTerm Care Awareness Month, this is a great time to consider the conversations you might be having with clients about their plans for funding a long-term care event.


PROFESSIONAL DEVELOPMENT Four Strategies to Become Irreplaceable Real connections can translate to referrals BY BILL CATES

Research tells us that satisfied clients tend to be loyal clients.


MEDICARE The Art of Closing the Deal: Strategies for Independent Insurance Agents


If you’ve ever found yourself scratching your head over how to seal the deal and close those Medicare plans, you’re not alone. In this fast-paced world of insurance, it’s crucial to master the art of deal closure.




Plans must ensure that all agents and brokers (employed, captive, and independent) discuss the following CMS developed list of items during the marketing and sale of an MA or Part D plan, prior to the beginning of the enrollment process:

Inland Empire residents looking for health insurance through Covered California will see a trusted name on the list — Inland Empire Health Plan (IEHP).



MEDICARE CMS Checklist for Enrollment of Medicare Part C MA Plans and Medicare Part D PDPs

FINANCE Americans Need Financial Guidance – And Are Looking for Help Good news! Survey shows majority trust advisors It’s no surprise that uncertainty in the financial market continues to weigh on the minds of many Americans.

IEHP ANNOUNCEMENT Inland Empire Health Plan to join Covered California health care exchange PUBLISHER

Phil Calhoun

Health Broker Publishing, LLC EDITOR

Linda Hubbard Lalande ART DIRECTOR

RSSA ANNOUNCEMENT Win More Clients: Learn How to be a Registered Social Security Analyst (RSSA) Get the California Broker Discount NOW Available for the RSSA program



Carmen Ponce CIRCULATION 130,000 subscribers 12,000 monthly website visits


PUBLISHER’S PICK: BOOK REVIEW “The Art of Significance: Achieving the Level Beyond Success”


Health Broker Publishing

14771 Plaza Drive Suite C Tustin, CA 92780 (714) 664-0311


Dan Clark asked readers: “What would you rather have — conventional success or a high level beyond success?”

Subscriptions: U.S. one year: $18. Send change of address notification at least 20 days prior to effective date; include old/new address to: Health Broker Publishing 14771 Plaza Drive Suite C • Tustin, CA 92780

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California Broker (ISSN #0883-6159) is published monthly. Periodicals Postage Rates Paid at Burbank, CA and additional entry offices (USPS #744-450). POSTMASTER: Send address changes to California Broker, 14771 Plaza Drive Suite C • Tustin, CA 92780

HUMANA GROUP MEDICARE ANNOUNCEMENT Members Give HUMANA Thumbs Up Positive member experience drives industry-leading Group Medicare Net Promotor scores For Group Medicare Advantage, Humana achieved industry-leading NPS of +78 for 2023, which makes six years in a row in the 70s for Humana Group Medicare.

©2023 by Health Broker Publishing. All rights reserved. No part of this publication should be reproduced without consent of the publisher.

IN EVERY ISSUE Industry News 9 Ad Index


No responsibility will be assumed for unsolicited editorial contributions. Manuscripts or other material to be returned should be accompanied by a selfaddressed stamped envelope adequate to return the material. The publishers of this magazine do not assume responsibility for statements made by their advertisers or contributors.





CRQS Search & Add Plans: An exponentially quicker way to quote Scan to watch video. ©2023 BenefitMall. All Rights Reserved.

COLLABORATE WITH SUBJECT MATTER EXPERTS(SMEs) Find Client Solutions and Earn Additional Income

Contact Health Broker Collaborators to gain insights and a no obligation review of your client’s tax, financial, and legal issues. SME's can help in planning and closing insurances cases.

Speak with broker friendly Subject Matter Experts Collaborative to find solutions that cause insurance to be sold and you share in the success Enjoy working with professionals who collaborate with you to resolve client planning needs

REASONS TO CALL our SMEs: When your client needs help outside of your area of expertise:

Tax and retirement income concerns about running run out of money in retirement; Legal concerns such as estate planning, so their tax concerns are addressed; and Business Owner succession planning needs are professionally managed.



WHY NATIONAL November 2023 LONG-TERM CARE National Long-term Care Awareness Month AWARENESS MONTH Only 2.2% of the entire U.S. population has long-term care insurance National Long-Term Care Awareness Month is observed in November every year. This month-long observance highlights the long-term care needs of men and women over the age of 65, and how they should be assisted in their daily lives.

• • • •

• •

The long-term care industry is expanding: By 2050, it is expected that at least 27 million Americans would need long-term care. Alzheimer’s disease is the biggest contributor to the elderlies needing long-term care. Life expectancy: The elderly have a 20-year life expectancy after they reach the age of 65. Few Americans have long-term care insurance: Only 7.5 million Americans have long-term care insurance, which is only 2.2% of the entire U.S. population Elder abuse is rampant: Approximately one out of 10 elderly in the U.S. has experienced elderly abuse. There are about 53 million unpaid family caregivers in the U.S.


A. We love the elderly: Compassion and empathy for the elderly should be the priority of National Long-Term Care Awareness. We should honor the long lives they lived and make their last stage in life as comfortable as possible. B. We love our grandparents: Every elder is somebody’s grandparent. Reach out and give a helping hand. You would want others to do the same thing for your grandfather or grandmother. C. Elders deserve quality care: Elder care is a right that men and women over 65 should exercise. Access to nursing care and longterm assistance should be readily available to them.

California Facts & Statistics From 2020 Genworth Cost of Care Survey •

There are approximately 1,230 licensed long-term care nursing facilities in California. These include free-standing nursing homes and 'distinct part' nursing homes which are attached to hospitals.

More than 400,000 Californians are cared for annually in licensed long-term care facilities.

In 2020, the reported average cost per patient day for a skilled nursing facility was approximately $304 ($110,960 annually). Medicare and private pay costs are usually higher.


From California Office of Statewide Health Planning and Development (OSHPD) utilization file, 2020 • • • • • •

Nursing facility occupancy rates in California are approximately 87%. In 2020, 88% of nursing home residents were discharged after a stay of three months or less. Only 6% of all residents remain in the facility for one year or more. 88% of facilities are proprietary and 12% are nonprofit, Women make up 58% of nursing home residents — 42% are male. More younger people are being admitted for short term rehab. Approximately 43% of skilled nursing residents are age 45-74. 58% are 75 or older.


The Case for Long-Term Care Insurance and Disability Insurance BY MARC GLICKMAN More employers are considering a long-term care insurance benefit for their employees. This additional benefit can help attract and retain great talent and also help employees better plan for their own futures. Since many employers already offer disability insurance (DI), there may be some confusion around the need for long-term care insurance (LTCi) and the differences between disability insurance and LTCi. Read full story here:



CONNECT to Buddy Insurance LTCi PORTAL HERE:

Work with

1.4 million

residents in U.S. nursing homes •

There are about 26,514 nursing homes in the U.S.

70% of people who reach

PUBLISHER’S NOTE California Broker is pleased to have a collaborative relationship with Marc Glickman and his specialists at Buddy Insurance. If you would like to collaborate on LTCi, you can find help through the online portal listed below. Get LTCi case design help, make referrals to LTCi specialists who will collaborate with you and help you help your client. Learn how to write LTCi coverage yourself. You will share in the success of a LTCi sale from your referrals.

As of 2023, there are

the age of 65 will need long-term care at some point in life. •


By 2050, up to million people is the U.S. will require long-term care services.

CalCPA Health this Open Enrollment

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THE THREE STAGES OF LIFE Nov. 2 @ 11:30 am -12:30 pm PST WIFS-LA & NAIFA-LA present “What’s Going On With Long Term Care Insurance Around The Country?” Register: Nov. 07 @ 9:00 am -11:00 am PST CAHIP Golden Gate (GGHAU) Meeting: “Is Parity Working? Mental Health and Substance Use Disorder Claim Advocacy for Brokers Register:


Nov. 8 @ 9 am PST Q4 State of NAIFA Register: Nov. 9 @ 11:30 am - 12:30 pm PST Dickerson Insurance “What Advisors Should Know About Broker Compensation: The Past, Present and Future.” Register: NOTE: Dickerson offers variety of ongoing CE credit courses, found @

Nov. 14, 12:00 - 2:00 pm PST CAHIP OC “CAA Gag Clause Prohibition & Attestation Requirements” Register: Nov. 15, 10:00-11:00 am PST CAHIP LA Medicare Agents Quarterly: Coffee Chats Register: 2024 Jan. 22 @ 10 am – 5pm PST CAHIP Innovation Expo, Sheraton Universal, LA. Register: March 25-27, Ellevate Women’s Leadership Summit 2024 @ JW Marriott Las Vegas. Register: May 6-8, CAHIP Capital Summit @ Kimpton Sawyer Hotel, Sacramento. Register: June 23-26, Society for Human Resources Management SHRM24 Annual Conference and Expo @ Chicago. Register:


Long-term care statistics in the U.S. •

In 2016, roughly 8.3 million people received long-term care services in a regulated facility. (National Center for Health Statistics, 2019)

In the United States, there are nearly 1 million licensed beds with an average of 33 licensed beds per assisted living facility. (AHCA/NCAL, 2015)

Long-term care statistics by facility type

National Center for Health Statistics, 2019 In 2016, there were approximately 65,600 regulated long-term care facilities in the United States. Long-term care services were provided by: •

28,900 assisted living and similar residential care facilities

The Western region of the U.S. has the most assisted living communities (41%) followed by the South (28%), Midwest (23%), and the Northeast (8%). (AHCA/ NCAL, 2015)

15,600 nursing home facilities

12,200 home health agencies

4,600 adult day care centers

There are more than 800,000 people in assisted living throughout the United States. (AHCA/NCAL, 2015)

4,300 hospice agencies

Of 3.9 million Americans receiving care in a skilled nursing facility, 78% received long-term care for 100 days or more. (American Health Care Association, 2015)

There are only 1.7 million assisted living employees in the U.S. to care for the 3.9 million residents. (American Health Care Association, 2015)

Medicare Tools You Can Use Vaccines and Medicare – What’s Covered Medicare drug coverage (Part D) generally covers all recommended adult immunizations like shingles, tetanus, diphtheria, and pertussis vaccines to prevent illness. You can now get MORE vaccines under Part D at no cost to you. FREE items include flu shots, Hepatitis B, Pneumococcal shots and COVID vaccines.

Help Your Clients with Medicare Cost and Coverage Tools Use this tool to get cost estimates for ambulatory surgical center outpatient procedure cost look up. Link:

Most assisted living communities offer 24-hour supervision and assistance, wellness programs, housekeeping, meals, medication management, transportation, and personal care services. The following are examples of personal care services: • • • • • •

The following statistics are the percentage of assisted living communities that provide other healthcare services than those listed above: •

84% provide pharmacy

83% provide dietary and nutritional services

71% provide therapy (including physical therapy, occupational therapy, or speech therapy)

68% provide hospice

66% provide skilled nursing

55% provide mental health or counseling services

51% provide social work services

14% have a dementia care unit, wing, or designated floor

9% only serve adults with dementia

New Medicare “What’s Covered” App Cost and Coverage: Find out what’s covered using your mobile device. Download Medicare’s FREE “What’s covered” mobile app on your smartphone or tablet. This App is available in both the APP Store and on Google Play.


64% of assisted living residents need help bathing 57% need help walking 48% need help dressing 40% need help with going to the bathroom 29% need help with bed transfer 19% need help eating



Addressing the Growing Long-Term Care Crisis with LTC and Legal Insurance By Tim Weber To me, the caregiving story is a personal one. My parents struggled with a protection problem — not knowing how best to protect their estate and future security should they face a serious illness — issues that carry big financial, health and emotional impact. When my dad died, he only had a will, not a trust — which meant that we spent an immense amount of time finding and reconciling his financial accounts and navigating the probate process. Shortly after, I served as a caregiver for my mom when she faced some serious medical challenges. Circumstances like these underscore the importance of planning ahead and having key healthcare documents in place for peace of mind. My family’s situation isn’t unique. Sharing stories like this is usually met with nodding heads from those dealing with similar issues. In my experience, the conversation around the burgeoning care crisis typically follows two paths: the growing need for caregiving and the need to understand long-term care options. These are two sides of the same coin to me. Many times, a caregiving situation for a loved one, like a parent or grandparent, evolves into long-term care — something employees usually aren’t prepared for as they navigate their busy daily lives. Caregiving in the United States In the past several years, we’ve seen just how important caregivers are — and the struggles they face. According to a study by AARP and the National Alliance for Caregiving: • •

21% of Americans are caregivers who have provided care to an adult or child with special needs at some point in the last 12 months And among this group, 61% of family caregivers are also employed

Research from the Roselyn Carter Institute for Caregivers 14 | CALIFORNIA BROKER

shows that most employees who are providing caregiving services feel that their work, careers and productivity have been disrupted — and close to one-third of these employees have voluntarily left their jobs because of their caregiving responsibilities. And these responsibilities disproportionately affect women. Sixty-one percent of caregivers are women and, according to the AARP Caregiving in the U.S. report, women are more often caring for two or more adults. Jennifer Morris-Pugliese, Care Support team manager at, tells us that there are several factors affecting caregiving in the United States. “The number of older adults who need care is on the rise, but the number of available caregivers, like home care and clinical nurses, is decreasing. This lack of staff has led to a crisis in some places, particularly rural areas.” As those who are currently serving as caregivers continue to age, there will be a whole new generation of individuals with long-term care needs. As of September 2021, there were around 12 million Americans who required long-term care services, according to the U.S. Department of Health and Human Services. By 2050, it’s estimated that this number could reach an overwhelming 27 to 30 million. Morris-Pugliese continued, “The sandwich generation is stressed beyond belief. They’re not exercising, sleeping, or eating well because they’re caring for everyone around them and not themselves. That might mean that they’re postponing their own routine medical care, like screenings or follow-up visits. And this lack of focus on their own health, coupled with the long-term effects of the stress they’re under, is worrisome. “It’s critically important for caregivers to seek out at least one hour a day for themselves, for things like appointments, exercise, sleep, therapy –– any kind of self-care,”she says. “It might seem small, but these tiny actions can really help over time. Burnout is very much a real thing.”


The caregiving crisis for employers All these forces are combining to create a caregiving crisis for employers. They need to support employees who provide care for a loved one, while also helping employees plan for their own long-term care needs. The reality is, most employees aren’t prepared for their own long-term care needs, which creates a vicious cycle of generations that are ill-prepared for the future. As employers continuously assess their benefits offering to remain competitive, a major focus is how they can provide a financial hedge to help employees plan for their own long-term care needs. This is all coming at a time where long-term care insurance is being mandated in a growing number of states. In this case, employers who are in non-compliance are facing payroll tax deductions. In California specifically, lawmakers are spending much of this year discussing and researching the pros and cons of mandating long-term care insurance. For those who live in a state where long-term care insurance isn’t mandated, finding a policy is often expensive, especially for those who are nearing retirement. And depending on the carrier, those who are 65 or older might not even qualify due to their age. As an alternative, some employers have started offering benefits that combine life insurance with long-term care riders. In that case, an employee could potentially use an accelerated death benefit rider on a life insurance policy so they can access funds to cover long-term care needs. In the past, stand-alone long-term care insurance plans that provide good coverage were common. However, in recent years, they have become less accessible due to the high cost of premiums. Addressing present caregiving issues Long-term care insurance for employers is often addressing a problem that is looming for the future. But what about employees’ more immediate caregiving issues? Many employers are working hard to find solutions that enable their employees to care for their loved ones while still working. This would include offerings like flexible working arrangements, including work from home arrangements or flexible hours, access to daycare and back-up care for kids and adults. Morris-Pugliese adds that employers offering training and services around the importance of financial planning for the future and general education around benefits can also be a huge help. “Offering basic education can help employees save money and stress,” she said. “For example, a lot of people don’t understand the limits of Medicare, when it comes to their future needs. Something like a tutorial on how to plan for long-term care or the potential impact of not having a will or durable power of attorney would be hugely effective in getting employees thinking ahead — before it becomes an issue.” Complementary offerings — long-term care benefits and legal plans Morris-Pugliese pointed out the synergies between legal insurance and long-term care, particularly in the planning stages. “Legal insurance can ensure that caregivers have the legal documents and financial structures that that they need so they can

make decisions on their loved ones’ behalf, while also helping employees plan for their own future care needs.” Many legal plans include coverage for wills, trusts and other essential estate planning documents, helping employees think about, and legally record, their wishes for their future. Using these instruments to plan for the future can help employees’ loved ones avoid costly legal processes, like probate or Medicare appeals and inheritance disputes. Certain legal insurance plans also extend coverage to employees’ parents and grandparents. Morris-Pugliese reminds us that while it’s easy for employers to say that family comes first, it’s another thing to create policies and benefits that really achieve a family-first mindset. It’s safe to say that the caregiving need is here to stay— and without the proper support, the long-term care crisis will continue to plague employers. But with the addition of benefits, like flexible work arrangements, caregiving assistance and long-term care insurance, combined with legal benefits, employers can feel confident that they’re supporting employees in their current caregiving endeavors and future long-term care planning. Tim Weber, a long-time voluntary benefit veteran, serves as VP, Group Sales and Client Management at ARAG, overseeing ARAG’s core sales business: group sales, sales operations, client management, product development and client support services. To learn more:

PUBLISHER’S NOTE: California Broker is pleased to have a collaborative relationship with Buddy Insurance, a leading long-term care insurance education, marketing and technology company. CEO Marc Glickman and his specialists will collaborate with health and life insurance professionals to help design LTCi options. Learn more about LTCi and refer clients — or learn how to write your own LTCi policies using his process. CONNECT to Buddy Insurance LTCi PORTAL HERE:


2022-2023 SHRM State of the Workplace Report Dickerson EVP of Sales Tamar Arouchian Responds to Findings

According to a 2023 Society for Human Resource Management (SHRM) State of the Workplace Report, both HR professionals, employers and employees ranked “providing good health care coverage” in the top five priorities for 2023. When it comes to finding talent, lack of good applicants and uncompetitive compensation were the most important challenges. The SHRM findings show that demand is high for benefit packages that attract and retain talent, enhance morale, and also manage costs. 16 | CALIFORNIA BROKER


SHRM FINDINGS Looking Ahead to 2023 U.S. employees report recruiting and retaining talent as among the five areas where their organization has been least effective in 2022. For 2023, employees, HR professionals and HR executives alike rank recruiting and retaining talent among their top five priorities. • • • •

Keeping employees engaged with and working for the organization are key priorities. Lack of budget and time are expected to be the key barriers to success. Inflation is an issue that employees and organizations recognize and are planning for. HR professionals and executives agree that training people managers and hiring are important HR plans.

SHRM PRIORITIES Health care coverage Both employees and HR professionals agree their organizations provide effective health care coverage (among the top five areas for both groups). Looking ahead, providing good health care coverage is ranked as a higher priority for employers than in previous years. Mental health coverage Mental health concerns have been a major challenge for employers in 2022. U.S. employees give their organizations higher marks for effectiveness in this area than HR professionals do, suggesting they have noticed employers’ efforts to support mental health. For 2023, both supporting employees with mental health issues and increasing mental health benefits are HR priorities. Link to the full study: shrm-state-of-the-workplace-2023-report. aspx

Tamar Arouchian, EVP of Sales at Dickerson Insurance Services responds First of all, do you agree with the SHRM findings shared here?

How can brokers differentiate themselves?

Yes, we at Dickerson agree with the SHRM findings. Employees feel the most important requirements when accepting a new position are Benefits and Salary. Employees want to make sure their benefits meet their needs. They want to know if their doctors are in network. How much do they pay out of pocket when seeking services? And, how much of their premium is paid by my employer? Salary has always been a crucial consideration for someone when deciding to accept a new position. The cost of living here in California has skyrocketed, and so has the expectation of higher wages. At the same time, employers are seeing higher costs for the benefits they provide. Employers want to maintain high level benefits, but they need to contain costs so they can afford to pay higher wages. We are faced with this dilemma daily. Our brokers come to us to help bridge that gap and offer cost-effective solutions for their clients and prospects.

Brokers can differentiate themselves by not only quoting the fully insured benefit programs but also showing alternative funding strategies and benchmarking reports that show companies what their competition is doing. This allows them to recruit and retain top talent in their specific industry. Our brokers have all these resources available to them through Dickerson and Alera.

What advice, resources or strategies do you as a General Agency offer brokers to help design benefit programs and services for employers to address this reality? At Dickerson Insurance Services, an Alera Group Company, we not only specialize in individual, small group and large group medical, ancillary, and alternative funding benefits, but we also offer many resources to our broker partners. We have Compliance solutions, HR services, online enrollment tools, true account management, and top-notch customer service.

What other messages do you want to convey to brokers? Share any insights about trends or effective strategies that you recommend. By trusting Dickerson as your partner, we feel confident that our team can provide the high level of expertise and support an agent needs to gain, retain, and be an effective resource to their clients and prospects.

Tamar Arouchian is the EVP of Sales at Dickerson Insurance Services and has 27 years of experience in employee benefits. Tamar is committed to building a strong sales team, and her leadership drives group benefits sales within the company. Together with her team, they are committed to strengthening broker relationships with dedication, trust, and mutual understanding. 800-457-6116



Eyecare and Tech Holistic Health Tools is Every Agency Top of Mind for Should Have Employees Eyecare is an essential element to whole-body wellness Savvy employers offer premium vision benefit options By Jonathan Ormsby


s employees are striving to live more holistically healthy lives, they are keeping on top of their health – and that includes their eye health. With issues like blurry vision, eyestrain and headaches negatively impacting workers’ performance and productivity, it’s important for employers to offer health benefits that can positively impact overall health. (According to: Transitions, 2023 Workplace Wellness Survey, Wakefield Research, N=500 U.S. adults, ages 18+, employed full-time or part-time, whose employers offer vision benefits, and 500 U.S. adults, ages 18+, self-employed and enrolled in individual health plans or utilizing private pay.) With 78% of employees reporting that they are more likely to stay with an employer because of their benefits program, employers should be offering holistic benefit programs, including premium vision benefits to their employees to address these health and productivity issues. (Willis Tower Watson, 2018., As we know, health is not just physical, but also mental and emotional, and employees are taking care of themselves holistically as nearly all (96%) of those surveyed by Transitions say they are likely to visit a healthcare provider in the next 12 months, most likely including a primary care provider, dentist, or eyecare professional. These findings coincide with a CVS Health® study that found more than three out of four people report the COVID-19 pandemic has led them to pay more attention to their health in


general. (CVS Health®, 2021 Health Care Insights Study.) We also found that employees (89%) are partaking in other healthy activities quite regularly, including eating healthy foods, exercising, meditating and yoga, and/or visiting a mental health professional. With these findings, we are seeing that employees have taken a greater interest in their own health, and are actively engaging in healthy habits, from taking yoga to visiting their eyecare professional for an eye exam.

Employee focus on holistic health transfers to the workplace Employees are continuing to report issues with their eyes. According to the 2023 Transitions Workplace Wellness Survey, nearly half (49%) of employees cite eyestrain/eye fatigue as negatively impacting their productivity and performance. As the COVID-19 pandemic has impacted the amount of time spent in front of computer screens and phones, 45% of employees cite digital eyestrain symptoms like headaches and 38% cite blurry vision as negative impacts on their productivity. Offering breaks can be an effective workplace erk What are easy but effective ways that employers can help alleviate these negative issues that plague employees? Surveyed employees would like their employers to encourage


them to take breaks, even more than other “perks” such as financial assistance for fitness (39%), catered lunches with healthy food options (33%), meditation breaks (32%) and standing desks (23%). ] This can be as simple as encouraging the 20-20-20 rule, which is taking a 20 second break every 20 minutes to look at something 20 feet away. (American Optometric Association, Not only can employers focus on promoting breaks in their organizations, but offering premium vision benefits to their employees is another way to positively impact employee health. The eyes can offer a solid view into a person’s wholebody health – which influences employees to get their eyes examined, as 95% of them say they are likely to schedule a comprehensive eye exam in the next year if they knew overall health conditions like diabetes, heart disease or brain tumors can be pre-diagnosed. And further, when using their vision benefits, 60% of employees report concerns about their eye health as a motivator to visit an eyecare provider, while 58% report prescription updates as a motivator and 43% say upgrading their lenses and frames motivates them. We also found that employees are attending to the health of their children’s eyes – with whole body health maintenance as a driving factor. The survey found 62% of employees with children are very likely to take them to get a comprehensive eye exam within the next 12 months. The top reasons that influence employee desire to seek care from an eyecare provider for their children include: • 63% say the early diagnosis of eye disease or health conditions • 58% say dry, irritated eyes • 55% say light sensitivity • 54% say eyestrain from digital device usage Facts for brokers Interest in Premium Eyewear Options is on the Rise As employees continue to focus on holistic health and strive to attend their comprehensive eye exams, 95% of employees who wear eyeglasses and have vision benefits are willing to pay above what their insurance covers for premium lens benefits, including scratch-resistant lenses, anti-reflective or no glare coatings, photochromic lenses, UV blocking, and premium lens

design including a sharper, wider field of view. According to the 2023 Transitions Optical Workplace Wellness Survey, nearly half of employees are willing to pay above what their insurance covers for photochromic lenses, like Transitions lenses. Not only are photochromic lenses important for employees, 60% of employees say it is extremely important to have Transitions lenses covered by their company’s vision plan versus other photochromic lens brands. With seven out of 10 employees indicating that protecting their eye health is more important today than it was before the global pandemic—employers who offer premium vision benefits that cover both annual eye exams and eyewear options that employees both want and need can help catch the eye of employees. The increase in employee likeliness to receive a comprehensive eye exam and their interest in seeking care for light sensitivity emphasizes the need for employers to offer premium vision benefits with premium lens options. Employees continue to hold concern for their holistic health, and their children’s holistic health, and this includes their vision. The Transitions Optical Workplace Wellness Survey shows that employees are willing to invest in premium lens options, like Transitions lenses, which offer always-on protection (Transitions lenses block 100% UV & filter at least 26% of blueviolet light indoors & at least 86% outdoors. Tests performed on grey lenses with premium anti reflective coating. Blue violet light is between 400 and 455nm (ISO TR 20772:2018) and can be key in achieving holistic health and improve their productivity.

Jonathan Ormsby is a senior manager – U.S. Managed Care for Transitions Optical.





According to a recent poll conducted by the Campaign for Sustainable Rx Pricing, 70% of voters across the political spectrum are worried about drug prices and a third of them have trouble affording their medications. To understand how this concern has become somewhat universal to the U.S. population, the history of prescription drugs and its correlation with health insurance is needed.

Learning this history will benefit health insurance professionals looking to better understand how health plans have evolved in the drug coverages offered. Illustrated in the first graph, the cost of

retail prescription drugs has steadily increased since the early 1960s. Coincidentally, it was during the 1960s that insurance companies began offering prescription drugs as a health plan benefit, which created a new job role of pharmacy benefit 20 | CALIFORNIA BROKER

managers (PBMs) who were meant to help insurers contain drug spending. Marty Mackary argues in his book “The Price We Pay” that PBMs have been one of the largest contributors to spending on retail prescription drugs because of their lack of transparency in what’s known as “the spread.” According to Mackary, “the PBM is the middleman, so if that pharmacy charges $10 for the medication, the PBM might bill the employer $50 and pocket the extra $40 — that’s the spread.” In addition to the creation of PBMs, in the 1970s and 1980s there was also a scientific explosion which led to further transformation of the pharmaceutical industry. Scientists were able to isolate the genetic basis of certain diseases, opening a lot of therapeutic areas for new drugs. With the influx of new drugs, pharmaceutical manufacturers were eager to patent these products and create higher demand through some brand name products such as Valium and Tagamet. The 1980s also saw the rise of managed care organizations (MCOs), such as Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). These entities introduced a new approach to health insurance, emphasizing cost containment and preventive care. Many managed care plans included prescription drug coverage as part of their benefits package, making medications more accessible. Yet, studies have found that when the potential market for a type of drug grows, there is an increase in the number of new drugs developed in response


to the demand. Insurance expansion has been shown to drive health spending upwards, despite its goals in increasing accessibility. In the 1980s and 1990s, there was a growing emphasis on generic drugs as a cost-saving measure to combat the growing prices. The Hatch-Waxman Act of 1984 streamlined the approval process for generic medications, leading to increased competition and lower drug prices. Health insurance plans increasingly encouraged the use of generics through lower copayments, making prescription drugs more affordable for patients. However, by 1992, three events impacted the number of new drugs released into the market: 1) Regulations on drug ads were relaxed 2) More rapid FDA approvals were made 3) New fees were collected from pharmaceutical manufacturers. All of these developments caused a push of new drugs to enter to the market. These changes impacted the period from 1995 up until the mid 2000s, as spending grew rapidly and numerous “blockbuster” drugs were introduced instead of generic medications, such as Viagra, Lipitor and Celebrex. NOVEMBER 2023

One of the most significant milestones in the history of prescription drug coverage came in 2003 with the passage of the Medicare Modernization Act. This legislation established Medicare Part D, a program that provides prescription drug coverage to Medicare beneficiaries. Part D offered a range of private insurance plans, giving seniors and eligible individuals access to a wide array of medications. The Medicare Part D program expanded drug accessibility and introduced a benefit structure which incentivized enrollees to choose less expensive generic drugs. Although this universal prescription drug benefit was meant to lower costs, statistics show that prices went up as more drugs were available to participants in this program. By 2010, the Affordable Care Act (ACA) was enacted, which provided consumers with subsidies that lower costs of health insurance and expands the Medicaid program in some states. During the first 1.5 years of ACA, the number of prescriptions filled by adults using Medicaid coverage increased by 19% in states that expanded Medicaid compared to states that did not. In the years following the ACA’s implementation, concerns about the affordability and accessibility of

prescription drugs persisted. Once the new Hepatitis C drug was introduced in 2014 there was a significant spike in drug prices that mirrored that of the 1990s. A productlevel approach for measuring inflation estimated a 10% gross drug price increase from 2013 to 2020 for HCV drugs, whereas a class-level approach including the higher prices of the new drugs showed a 31% gross price increase. Policymakers and advocacy groups pushed for measures to increase transparency and competition in the pharmaceutical industry. In 2022, the Inflation Reduction Act was enacted to make improvements to Medicare which is expected to expand benefits, lower drug costs, keep prescription drug premiums stable and improve the strength of the Medicare program. Drug costs have been significantly affected by policies and developments within the health insurance industry. The expansion of programs such as Medicaid and Medicare Part D, development of generic drugs over the years, and the influence of PBM’s are all factors that have contributed to the increase in drug costs in the United States.

Emma Peters is a media intern at California Broker Magazine. She recently graduated from Point Loma Nazarene University summa cum laude, with a Bachelor of Arts in Literature and a minor in Humanities.



More Seniors Should Be Selling Their Life Insurance Policies Serve Your Clients – Build Your Business BY LISA REH BURGR Please know that I am not here to talk anyone out of their life insurance policy. If your client wants and needs their policy, they should keep it. That said, so many people don’t need their policies any longer, or the policies become too expensive to maintain. FACT: 2.5 million seniors lapse or surrender their policies annually. Only a few thousand sold their policies last year. It should have been a lot more. According to the Life Insurance Settlements Association (LISA), more than $100 billion of face value are lapsed by seniors over age 65 each year. This figure does not even include policy surrenders – this is just lapses. This begs the question – why? 22 | CALIFORNIA BROKER

Clients simply do not know that there is another option. They don’t know they can sell their life insurance policy, and receive cash for it. Starting several years ago, LISA began collecting data on the life insurance settlements market. Their members, representing 95% of the market, submit data regarding the number of transactions, face amount of policies purchased, etc. Here is a synopsis of the data for 2022: ~ 3100 life settlement transactions completed ~ $770 million paid to consumers for the sale of their unwanted life insurance policies ~ $610 million more than the amount

consumers would have received if their life insurance policies had been lapsed or surrendered ~ 5 times higher than the cash surrender values offered by the life insurance carrier $250,500 more in American’s pockets, on average, for the completion of their life settlement Obviously, there are 2.5 million reasons a year why clients may wish to get rid of their policies, but ultimately, the policies are unwanted, unneeded or unaffordable. Over time, life changes, and the reason a client purchased a life insurance policy may no longer be a concern. Perhaps a spouse has passed away, the kids have moved out of the house, the house is paid off, etc. A term NOVEMBER 2023

policy may be ending or the policy may not fit into their budget any longer. Clients feel as if they have no other option but to lapse or surrender. They are unaware that an alternative may be available, including the sale of the policy. Clients also may not consult their advisors before lapsing or surrendering. Or, advisors may also not fully understand life insurance settlements, or have misperceptions about how the market operates. Think about the differential in the numbers — that is a very large gap between 2.5 million and 3,100. Clients are missing out on a lot of value for their policies, and advisors are missing out on another opportunity to serve a client and build revenue for their business. To be clear, not all 2.5 million policies could be sold. Some of these policies are too small to be sold (final expense policies), clients too young and healthy, cash values very high relative to the face, or policy loans are high — to name a few reasons. But many more than 3,100 should have been sold. Case study Consider the 72 year old client with a $1,000,000 universal life policy. There is $6,000 in cash left in it. The premium to continue the policy is $2,500 per month. He did not want to afford those premiums. The options? Restructuring the policy did not make sense. Surrendering the policy would bring $6,000. Instead, his financial advisor advised considering a life insurance settlement. The result? The doctor received $150,000. Besides helping benefit a client, selling a policy benefits the referring insurance or financial advisor. There are commissions on the sale itself, but also additional product sale opportunities. What about the scenario just described? If he was your client, and now has $150,000, would he need other products (such as annuities, or long term care insurance) that you offer? Perhaps. You do not need to be a life insurance expert or the writing agent on the life insurance policy, to help your client. These clients could be your Medicare clients, small group business owners, next door neighbors, family members, parents of your individual clients, etc. And you can help give them “found money” from a NOVEMBER 2023

“hidden asset.” Policies do not need to be million dollar policies either. Buyers will consider face values of around $100,000, so this opportunity is available for many clients. No one is trying to talk anyone out of their life insurance policy. Clearly, there are many options available for clients: restructuring the policy, beneficiaries paying the premium, reducing the death benefit, just to name a few. If a client wants to keep their policy, they should. However, if a client has decided that lapsing or surrendering the policy makes the most sense for them, please consider one more option — selling it. 90% of seniors surveyed said had they known about a life insurance settlement, they would have considered it. That is what this is about — giving clients all of their options — so you and they, can make the best decision for them and their family. Remember, the life insurance settlements market is legal and highly regulated by Departments of Insurance across the country. And, if offers are made on a policy, clients are under no obligation to sell. Life settlements can make good sense for your client – and you, too.

Lisa Rehburg is president of Rehburg Life Insurance Settlements, a life insurance settlements broker. Lisa is passionate about assisting financial, insurance, legal and non-profit professionals to help their clients benefit from their unwanted or unneeded life insurance policies. She has been in the health and life insurance industries for over 30 years. Lisa has presented to hundreds of organizations, including various Financial Planning Associations, Fiduciary Associations, Estate Planning Councils, Planned Giving Roundtables, NAPFA, NAIFA and Health Underwriters Associations, to raise the visibility of life insurance settlements as an option for clients, when appropriate. She has held executive roles at carriers, general agencies and TPAs. Lisa earned a Bachelor of Arts degree in Finance and a Master of Arts degree in Organizational Development. 714-349-7981

Questions health insurance professionals can ask their Medicare clients: •

Now that we have you on the Medicare plan that best meets your needs, I wanted to ask you about other issues you may want help with.

Do you have a life insurance policy that is unwanted, unneeded or unaffordable?

Did you know that your life insurance policy (any life insurance policy, including a term policy) is an asset that can be sold?

Were you aware that life insurance policies can be worth tens of thousands or hundreds of thousands of dollars by selling the policy?

I work with experts in this area. Would it be helpful for you to reach out and we can speak with them? To explore your client’s need and find the right SME to help you, contact: The Collaboration Center @ 657-229-2849



A Guide for Health Insurance Brokers:

for Open Enrollment Season Remind employers and employees how to best use their benefits all year long


By Michael Malhame

s a health insurance broker, one of the busiest and most critical periods in your calendar is undoubtedly the open enrollment season, end of the year, or the fourth quarter — whichever you like to call it. This season offers individuals, employers and employees the opportunity to select or modify their health insurance coverage for the upcoming year. Brokers who manage group benefits often find this period requires meticulous preparation and organization to ensure a smooth and successful enrollment process for their clients. We are going to review and discuss some essential steps that health insurance brokers can take to effectively prepare for this amazingly busy and productive season. 24 | CALIFORNIA BROKER


Understand the Group’s Needs Before diving into open enrollment preparations, it is crucial to gain a thorough understanding of each group’s unique needs. Review the group’s demographics, previous enrollment patterns, and any feedback received from members. Conduct meetings or a quick survey to identify potential pain points or desired plan improvements from the previous enrollment period. This understanding will help you tailor an approach to each of your clients and provide better guidance. Stay Updated with Regulatory Changes Healthcare regulations are constantly evolving, and it is vital for brokers to stay up to date with any changes that may impact open enrollment. Familiarize yourself with any new laws, rules, or guidelines that could affect the group’s coverage options or eligibility requirements. This includes changes made by carriers. Carriers are constantly changing their offerings, updating plans and adding options, be sure you review changes and options prior to meeting with a client. By staying informed, you can guide your clients through any potential compliance challenges and ensure their plans meet the necessary standards. Communicate Early and Clearly Clear communication is the key to a successful open enrollment process. Start engaging with your groups well in advance to establish open lines of communication, this is a great time to offer a quick survey to learn if they have any changes they might want to make in their coverage. Share information about the upcoming open enrollment period, key dates, and any changes in policies or procedures. Consider hosting webinars, sending out newsletters, or creating dedicated web pages to educate group members about the available coverage options, benefits, and any important updates. Review Existing Plans and Options Evaluate the existing plans offered to clients and assess their suitability for the next enrollment period. Analyze the benefits, costs, and coverage limitations of each plan, and compare them to the current market offerings. Identify any gaps in coverage or potential cost-saving opportunities that could benefit the groups and their members. This evaluation will enable you to recommend appropriate plan options during open enrollment and provide valuable insights to help clients make informed decisions. This is also a great opportunity to expand a client’s coverage with ancillary options. When a client is able to offer more well-rounded coverage to their employees, everyone wins. You ensure clients have everything their team needs, while growing your business.

proposal ready for your clients prior to a meeting. This type of personalized support ensures clients are able to make choices based not only on the healthcare needs of their team, but also on the best interest and financial requirements of their business. Streamline Administrative Processes Managing open enrollment for multiple groups can be complex, involving numerous administrative tasks. To streamline the process, leverage technology solutions that automate routine tasks such as data collection, enrollment forms, and plan comparisons. Utilize online portals or software tools that simplify the enrollment process, facilitate efficient data exchange, and ensure accurate record-keeping. Platforms like MyHealthily make management, enrollment, quoting, and renewals elegantly simple. Follow Up and Provide Post-Enrollment Support Your busy season does not end once individuals have made their health insurance selections for the next enrollment period. A follow-up service for your clients ensures they have successfully enrolled and are able to address any outstanding issues. A best practice is to provide ongoing support and be readily available to assist with claims, plan changes, provider access, or any other concerns that may arise after enrollment. This post-enrollment support helps build trust and strengthens your relationships with both the groups and their members. Preparing for open enrollment for groups requires careful planning, effective communication, and personalized assistance. By understanding the group’s needs, staying updated with regulatory changes, and providing clear guidance, health insurance brokers can navigate the open enrollment period successfully. Finally, by embracing technology brokers are able to serve their clients more efficiently. Michael Malhame, founder & CEO of MyHealthily formed the company to let insurance brokers and agents leverage technology to write small group health insurance with valuable added enhancements and doing it more efficiently with online quoting, plan selection, enrollment and administrator all from one site. Contact:

Provide Personalized Guidance During open enrollment, group members may feel overwhelmed by the numerous coverage options and choices available to them. As a broker, your expertise and guidance can make a significant difference. Schedule one-on-one consultations or group presentations to assist members in understanding the available plans, clarifying terms, and answering their questions. You could even have a personalized NOVEMBER 2023


The State of LTCi Claims and the Power of Claims Advocacy B U D DY I N S U R A N C E A DVE R TO R I A L

By Gretchen Barry of Buddy Insurance interviews Jon Thomas of Amada Senior Care With November being National Long-Term Care Awareness Month, this is a great time to consider the conversations you might be having with clients about their plans for funding a long-term care event. Part of that conversation often involves misperceptions about long-term care insurance, specifically the claims process. The long-term care insurance (LTCi) claims process and care coordination can be a mystery to policyholders and their financial advisors. There might also be an objection to purchasing LTCi if a client has a negative impression or believes the carrier won’t meet its claims obligation. Even some of the best long-term care insurance specialists have questions about the claims and care coordination process. Recently, I had the pleasure of speaking with Jon Thomas, director of national accounts and strategic partnerships at Amada Senior Care, to answer some of the tough questions around the current claims process and what the future holds as this wave of seniors seeks extended care. Gretchen Barry: Let’s start by unpacking the current situation that retirees and seniors are finding themselves in as they enter retirement and begin to age in place. We’ve all heard about the wave of baby boomers entering retirement, and the potential 26 | CALIFORNIA BROKER

challenges this large aging demographic may impose on our society. As a top national senior care agency, what do you recognize about the situation seniors are facing today? Jon Thomas: The senior care continuum is incredibly complex. Every administration has been working to address the issue since Roosevelt signed the Social Security act into law and President Johnson signed the Medicare and Medicaid Act. Our aging population presents a public health crisis that affects families, wealth dynamics, economic productivity, hospitals, healthcare systems, and ultimately social and government efficacy. This large generation of baby boomers aging in place presents several challenges, the largest of which might be the cost to social programs. The government, through Medicare and Medicaid, is the largest payer of healthcare costs, specifically for seniors as they need increased health resources. Senior care and long-term care (LTC) additionally represent exorbitant costs that our government programs aren’t ready to handle. There is increased attention and concern on this issue demonstrated by moves such as Washington’s creation of a public LTC program to shift costs away from their state Medicaid budget, and the dozen other states soon to follow suit. Or the federal


government’s attempt to include LTC benefits in the ACA (Affordable Care Act) and multiple proposed federal initiatives being evaluated currently. There is a substantial need for our society to get its arms around what to do with our senior population. In addition to societal pressure, families are experiencing tremendous challenges to care for their loved ones physically and financially. The reality is that most seniors want to stay at home for as long as possible, and family members end up becoming primary caregivers. It’s estimated that there is a loss in income of nearly $522 billion annually by the nearly 53 million people in the U.S. who care for someone close to them. As a long-time provider of home care services, Amada Senior Care understands how important it is for families to preserve their loved ones’ health, independence, and dignity. Senior care advisors from Amada offices around the country frequently meet with families who have become weighed down by both the physical and emotional exhaustion that occurs when caring for a loved one. At Amada, we provide support not just for the senior loved one but also the entire family. Gretchen: This immense societal pressure has certainly been growing for some time. Has COVID-19 made a significant impact on the situation? If so, in what ways? Jon: COVID-19 has absolutely made an impact. It was a collective gut check globally that forced us all to take inventory of what is important. Families lost loved ones, people learned to work from home, many senior care facilities lost 20-40% of their residents either to COVID-19 or as they transitioned to care at home. COVID-19 changed how healthcare is being delivered, with far more healthcare services being delivered at home. Ultimately, families were forced to consider other options and many families have chosen to make plans for care at home as their loved one’s age. A long-lasting impact of COVID-19 will be that there will be more and more care services delivered at home and because there is now a sea change in thinking about what kinds of health care can be accomplished in the home. Gretchen: I understand that Amada takes an active role in assisting families during their time of need. Can you explain your process? Jon: We take a holistic approach to care as a care advocate for our seniors and their families. We start by conducting a comprehensive assessment of our client’s needs, evaluating the medical, financial, and social needs present for our family. This assessment by our team of senior care advisors identifies support needs with activities of daily living (ADLs) and other needs identified in the client’s plan of care with their health professional, such as cognitive issues, ambulatory issues, etc. This comprehensive needs assessment is necessary to then create a personal care plan for our senior clients that is suitable based on their needs and preferences. The plan of care for many families includes some level of home care. It might be part- time home care in partnership with the family or full-time, round-the-clock care by our trained caregivers. Most seniors desire to stay in their homes for as long as possible. If care at home isn’t possible because of the NOVEMBER 2023

level of medical needs present, we have partnerships with thousands of senior housing and elder care communities across the country. An Amada senior care advisor has the knowledge and experience to help the family find the right assisted living or continuous care community or nursing community for their loved one. Of equal importance in this process is helping our clients afford the type of care that they desire. We are experts in helping our clients financially plan to cover the costs of in-home care. This might include identifying veteran’s VA benefits, retirement benefits or long-term care insurance benefits that will completely or partially pay for care. Amada Senior Care began franchising in 2012, thus we have locations across the country with a large network of caregivers providing care to thousands of seniors. Gretchen: Wow, care advocacy sounds like so much more than just care coordination or care advice. For those of us looking for help, what should we look for when choosing the right care advocate? Jon: A senior care advisor should certainly address all physical, health, and emotional needs as well as financial needs. Additionally, does the advisor ask the right questions about the senior’s unique situation? Does the home care agency employ its own workforce of trained caregivers? What is their process for vetting caregivers or the assisted living communities they recommend? What is their experience working with LTC insurance claims management and advocating with brokers on behalf of senior clients and their families? Can the senior care advisor show a proven process for filing LTC insurance claims or successfully working with the VA to acquire funding to pay for in-home care services? These are a few of the many questions that should be asked when choosing the right care advocate and partner to provide care services for your loved one. Amada has earned critical acclaim for our home care services, primarily because we employ our caregivers and have established a culture of compassion and gratitude for the work of our caregiving team that extends to the value and dignity of the seniors they care for. Home care agencies that contract independent caregivers don’t have the same influence or control over the quality of care provided by their network. We have also worked with clients who have LTC insurance for over a decade and have become leading experts in working with insurance carriers to file, process and get approvals from every LTC carrier in the market. We have found this to be pivotal in ensuring that senior policyholders receive all the LTC benefits they are due. Gretchen: This comprehensive approach to care is certainly valuable to the families you serve. Tell us more about how you provide support for families with LTC insurance. Jon: The process begins with re-educating clients on the benefits available in their LTC insurance policy. We’ll contact the insurance company on the family’s behalf, collect information, complete and file the claim forms, and even continue to manage the payments if the client wants us to. A critical component of the claim process is providing a registered nurse (RN) or medical professional to meet the client in their


home and complete a medical assessment as well as a plan of care that is submitted upon filing the claim. Once the claim is approved, our team will automatically collect and file all paperwork as well as maintain the client’s eligibility status by managing recertifications. As client advocates, Amada senior care advisors have worked with most insurance carriers and have filed tens of thousands of LTC insurance claims on behalf of clients. That gives us a unique perspective that is based on real-world cases. We work hard to share our experience with others, like Buddy Insurance, to help educate financial advisors and consumers about the LTC claims process. Gretchen: How do you foresee the LTC insurance claim’s process changing as more and more seniors age and become benefit eligible? Jon: There was a little more than $12 billion in LTC insurance benefits paid in 2022, and that number is expected to grow considerably over the next decade. Additionally, there is an estimated 73 million baby boomers that will all be over age 65 by 2030. This block of aging baby boomers has represented a majority of LTC insurance policyholders over the last several decades. As many carriers are transitioning from not just collecting insurance premiums to now paying significant claims benefits, it’s foreseeable that there will be additional scrutiny on the claims process. Applying even more pressure to the situation is the predicted shortage of geriatric specialists, care managers and caregivers. Seniors will desperately need advocates to not only help them navigate their LTC insurance claims but also to navigate the complexities of the senior care environment. It’s expected that home care services, quality caregiving, and senior advocacy will all be in short supply and incredibly valuable. This demand is already being felt by non-medical, in-home care providers as they struggle to hire enough caregivers to meet the growing need. Gretchen: Is home care right for everyone? Jon: Home care isn’t right for everyone, but it is ideal for many. Data from AARP’s Home and Community Preferences Survey shows that 77% of adults 50 and older want to remain in their homes for the long-term — a number that has been consistent for more than a decade. Most seniors intend to stay home and age in place. The challenge for many is that without a plan to make staying at home possible, their desire isn’t possible. For seniors who can’t afford to stay home or have complicated medical needs that make aging at home untenable, there are a range of options for them to consider. Gretchen: You’ve highlighted how complex our health care system is and the challenges that seniors face. Whose job is it ultimately to make sure our seniors are cared for? Jon: It’s our job to serve seniors, it’s the job of family members, and it’s the job of our communities. The complex needs of many seniors and families require an all-hands-on-deck approach. That being said, we have recognized how valuable and critical the impact of LTC insurance is for families that 28 | CALIFORNIA BROKER

have prepared ahead. We are huge proponents of LTC insurance and the higher quality of life and superior care that it delivers to many seniors who without it wouldn’t be able to afford the personalized care they need to stay healthy and happy at home. Organizations that advocate for and educate consumers about the need for long-term care planning are an invaluable resource. The movement to ensure consumers are educated and have all the information they need to make the best senior care decisions for their families will continue to grow and serve more people. And that’s a positive development no matter how you look at it. Gretchen Barry is chief marketing officer, Buddy Insurance. With over 20 years of marketing leadership experience, Gretchen has built an extensive marketing portfolio. As chief marketing officer for BuddyIns, Gretchen works closely with the BuddyIns team and partners to identify ways to advance the company’s brand, partnerships, and mission. With first-hand experience as a caregiver, Gretchen understands the inherent challenges and unlimited opportunities facing the company and the LTCi industry. Contact: Website:

Jon Thomas is director of National Accounts, Amada Senior Care Agency. Jon recently joined Amada Senior Care Agency as their director of national accounts and strategic partnerships. He spent the last 15+ years working as a financial and insurance professional with Nationwide Insurance and most recently Securian Financial. He’s dedicated to helping grow market awareness of the importance of long-term care (LTC) preparation. Jon has family experience caring for aging loved ones and is passionate about the dignity and freedom quality LTC solutions can provide. Contact: Website:

PUBLISHER’S NOTE: California Broker is pleased to have a collaborative relationship with Buddy Insurance, a leading long-term care insurance education, marketing and technology company. CEO Marc Glickman and his specialists will collaborate with health and life insurance professionals to help design LTCi options. Learn more about LTCi and refer clients — or learn how to write your own LTCi policies using his process. CONNECT to Buddy Insurance LTCi PORTAL HERE:



Four Strategies to Become Irreplaceable Real connections can translate to referrals


esearch tells us that satisfied clients tend to be loyal clients. In one study conducted by Julie Littlechild, CEO of Absolute Engagement out of Toronto, Canada, “satisfied” clients had a high loyalty rating. That’s good. You want to retain all of our clients — right? Well… at least most of them. You probably have a couple you wouldn’t mind offloading to someone… anyone. HOWEVER — and it’s a big however — there’s a low correlation between satisfied clients and the giving of referrals or making introductions. Engaged Clients In Julie’s study, engaged clients not only gave more referrals, they were 100% loyal. Engaged clients stay with you and become advocates. “So, Bill, what’s an engaged client?” I’m glad you asked. An engaged client is one who feels connected to your value and connected to you as a person. There’s a value connection and a personal connection. This is why I’m such an advocate for client appreciation events and the like. They are opportunities to build these allimportant business friendships. Four Strategies to Enhance Client Engagement Some of these items enhance the value connection, some of them enhance the personal connection, and some of them help with both. 1. Serve the Entire Family Most clients don’t fully understand how the decisions (or non-decisions) they make affect many other people in their lives. Nor do they understand how the decisions (or non-decisions) that other people make might impact them. For example. Let’s say the grandparents have been designated to take over the upbringing of the grandchildren, should something happen to their parents. Have the parents planned for that NOVEMBER 2023

By Bill Cates possibility? Is there enough life insurance in place so that the grandparents are not burdened financially? Many advisors I coach like to go deep and wide with their families. Not only is it the right thing to do in terms of proper financial planning, it also makes you irreplaceable 2. Help with Essential Document Organization Nobody wants to leave a mess behind when they leave this earth. Yet very few people —including your clients — have taken the time and discipline to organize their documents and other important aspects of their life — so that burdensome process closing down someone’s life is made just a little bit easier. BTW — If you and your team provide this service to some of your clients, don’t forget about their digital lives. Make sure passwords are saved and other digital footprints are documents. I use a great tool called LastPass. It saves every password I use and auto-fills, if I wish. The only password I need to remember is the password for LastPass. When you and your team provide the process and create the discipline to help someone do this work, not only are you rendering an incredible service, you’re learning quite a bit about your clients. When your client passes, the family sees you aa an essential family advisor. Again, they see you as irreplaceable. 3. Become the Quarterback of Client’s Advisory Team My financial advisor, Larry, as part of creating my financial plan, assembled my CPA and bookkeeper in a conference room. With my input from time to time, I watched these professionals go to work for me. By doing this, Larry established himself as the financial quarterback of my advisory team. With some clients — especially small business owners — you can often become the quarterback quickly — because they don’t have anyone like that. In other cases,

it may take some time for you to rise to that level. My advisor established a working relationship with my other advisors. Since I don’t make any significant financial decisions without Larry, Larry has become irreplaceable. 4. Build Business Friendships Pssst! Come closer. Do you want to know the secret ingredient that turns loyal and happy clients into advocates for your business? Connection — typically born from your business friendships. Now, by business friendship, I’m not talking about staying out late, sipping an adult beverage, and telling each other deep dark secrets. I’m talking about a relationship that has evolved beyond just the advisor-client all-business relationship. One sign that you have created a business friendship is when your clients invite you to their personal social events — like a backyard barbecue, a child’s wedding or confirmation, etc. By creating business friendships with your clients that are open to it, you are on your way to creating an army of advocates and you’ve succeeded in becoming irreplaceable. Bill Cates, CSP, CPAE, is president of Referral Coach International. He is the author of Get More Referrals Now, Beyond Referrals, and Radical Relevance, and is a highly sought-after coach, consultant, international speaker, and virtual presenter. 301-497-2200

CalBroker readers can get valuable free tools here:



The Art of Closing the Deal: for Independent Insurance Agents What you need to know By Joanne Nelson

If you’ve ever found yourself scratching your head over how to seal the deal and close those Medicare plans, you’re not alone. In this fast-paced world of insurance, it’s crucial to master the art of deal closure. That’s where we come in – as a seasoned Field Marketing Organization (FMO) and National Marketing Organization (NMO), AGA is here to spill the beans on some killer strategies that have worked wonders for many of our agents. So, grab a coffee, sit back, and let’s dive into the world of successful deal closure. 30 | CALIFORNIA BROKER


Understanding Your Audience: Building Trust One Chat at a Time Navigating the world of health coverage options can be overwhelming, especially for seniors who are considering their insurance needs, even if they’re working past the age of 65. At times, discussing health coverage can feel like trying to translate a foreign language. However, there’s a key ingredient that can make all the difference: tailoring your approach to meet the specific needs and concerns of your audience. Seniors seeking health coverage aren’t just numbers on a spreadsheet — they’re real people with unique stories, experiences, and worries. To connect with them effectively, start by building a foundation of trust and rapport. Let them know that you understand their situation and are genuinely invested in helping them find the best solution.

clients into making hasty decisions. Instead, educate them about enrollment deadlines, potential price hikes and changing regulations. Highlight the benefits of acting sooner rather than later. Especially if they are in a current enrollment period. No one wants to miss out, and your clients will appreciate the headsup without feeling pressured.

“Sales is not about selling anymore, but about building trust and educating.” — Sevia Devaki

“If this is the right plan for you, let’s enroll you, today.” — Juan Valdovinos, Presley General Insurance Agency (PGIA)

Thorough Product Knowledge: Be the Medicare Guru To close those deals, you need to be the go-to source of knowledge on all things Medicare. Clients appreciate agents who know their stuff. This involves going beyond the basics. To truly stand out, agents should proactively stay ahead of the game, anticipating clients’ needs before they even realize them. By adopting a forward-thinking approach, agents can establish themselves as reliable advisors who consistently offer tailored solutions. There are numerous strategies that agents can employ to stay ahead of the curve. These include active participation in Medicare training sessions and webinars, as well as staying up to date on breaking industry news and trends. Effective Communication Techniques: The Power of Listening Communication is a two-way street, and in our business, listening is golden. Active listening helps you tailor your pitch to suit your client’s unique needs. Ask open-ended questions, let them talk, and take notes. Craft your responses based on their concerns. Avoid jargon — remember, you’re the expert, not them. And hey, storytelling is your secret weapon. Share success stories from previous clients to show the positive impact of your plans. Overcoming Objections: Turning “No” into “Let’s Do This!” Objections are like speed bumps on the road to closing deals. Common ones include cost worries and doubts about coverage. But don’t worry — objections are opportunities in disguise. Address concerns empathetically. For instance, if they’re concerned about costs, explain the value they’ll receive for their investment. Show them you’ve got their back and are genuinely invested in their well-being.

Follow-Up and Persistence: Keep the Ball Rolling The fortune is in the follow-up! Don’t be disheartened if a deal doesn’t close on the first try. Persistence pays off. Send personalized follow-up emails, make friendly check-in calls, and provide additional information they might find useful. But remember, there’s a fine line between being persistent and coming across as pushy. Respect their space and timing.

You’ve Got This! Remember, it’s all about understanding your audience, being the Medicare guru, communicating effectively, personalizing solutions, creating a sense of urgency, and persistent follow-up. Keep honing your skills, stay updated on industry trends, and keep providing value to your clients. With these strategies in your pocket, you’re well on your way to becoming a deal-closing superstar. Good luck out there!

Joanne Nelson, AGA’s VP of Sales, is known for her ability to drive revenue growth and foster enduring client relationships. With unparalleled strategic vision and innovative approaches, she consistently elevates AGA’s performance, ensuring exceptional customer experiences and positioning the company as a leader in the industry. Prior to AGA, Joanne was a sales executive with Cenetene and HealthNet insurers as well as retail consumer companies. Committed to her community, she’s volunteered for Food Finders Food Bank and spent time building homes for the needy in Mexico. 800-498-6880

Creating a Sense of Urgency: FOMO Done Right FOMO = Fear of Missing Out. Use this natural inclination to your advantage. However, creating urgency doesn’t mean scaring NOVEMBER 2023


CMS Checklist for Enrollment of Medicare Part C MA Plans and Medicare Part D PDPs Consistent with 422.2274(c)(12) and 423.2274(c)(12), plans must ensure that all agents and brokers (employed, captive, and independent) discuss the following CMS developed list of items during the marketing and sale of an MA or Part D plan, prior to the beginning of the enrollment process:  Review the beneficiary specific information: What

PCP copay, Specialist copay, inpatient hospital

kind of health plan does the beneficiary wish to

copay, and any other copays for services/items

enroll in (such as low premium and higher copay (or

beneficiary needs.

vice versa)?

 Discuss the costs/limitations on dental, vision, and

 Check to see if beneficiary’s PCP and Specialists are in network. If not, explain that they will need to

hearing.  Review coverage for out-of-network providers

choose new ones or pay out of pocket.

and services (e.g., except in emergency or urgent

 Check to see if the beneficiary’s prescriptions are

situations, plan does not cover services by out-of-

on the formulary and their pharmacy is in network.

network providers (i.e., doctors who are not listed in

If not, explain that they will need to choose a new

the provider directory)).

pharmacy or may have to pay the full price of the

 Review coverage outside the United States.


 Explain the potential effect that enrolling in this plan

 Does beneficiary require hearing, dental, and/or

will have on other, current coverage, which may in

vision coverage?

some cases mean that the individual is disenrolled

 Does the beneficiary have any other health care

from the beneficiary’s current health coverage (e.g.,

needs, such as needing durable medical equipment, physical therapy?

another MA plan, Medigap).  Explain that this is not a hearing/dental/vision

 Check to see if the beneficiary’s preferred hospital is in-network. If it is not, explain that they will need to

“rider” but a full plan.  Explain that plan operates on a calendar year

pick a new one.

basis, so benefits may change on January 1 of the

 Are there other preferred facilities that need to be in-network?

following year.  Explain that Evidence of Coverage provides all the

 Does the beneficiary have any other specific health care needs?

costs, benefits, and rules for the plan.  Review how to file a complaint.

 The right to cancel this enrollment as well as the

 Items only applicable to certain plan types: Review

specific date through which cancellation may occur.  Go over premiums, including Part B premium,

PPO or PFFS out-of-network coverage.  Review need to qualify for chronic/disabling

{insert dollar amount} per month/quarter/year.

condition requirement for C-SNPs

[This one only applies if there is a premium >$0.] If

 Review need to have Medicaid to qualify for D-SNP.

applicable, review current premium vs. another plan

 Review need to remain in institutional skilled


nursing facility in order to qualify for I-SNP.

 Review beneficiary cost-sharing such as deductibles,

 Review need to maintain trust/custodial account in

copays, and coinsurances. Go over deductible cost,


order to remain enrolled in MSA.



Americans Need Financial Guidance – And Are Looking for Help Good news! Survey shows majority trust advisors Courtesy of Million Dollar Round Table (MDRT)


t’s no surprise that uncertainty in the financial market continues to weigh on the minds of many Americans. To better understand the extent of its impact on consumers, MDRT conducted a survey on Americans’ views on financial advising, investments and their financial health. The results from the MDRT survey revealed insights into consumers’ mindsets, giving advisors a deeper understanding of some of their clients’ behaviors and how they can develop financial plans that address concerns about the current market.



EXPECTATIONS Americans continue to grapple with financial concerns and most have a negative outlook on the economy in the coming year. Many of them also lack recommended savings for a financial emergency.

of Americans feel very or somewhat negative about the economy in the coming year.

With robo-advisors Without an advisor



With human advisors

of Americans only have enough savings for three months or less.

37% 60%

Can support themselves for less than one month

Can support themselves for longer than a year

31% of women 18% of men

17% of women 26% of men

TRUSTING THE PROFESSIONALS Whether or not they work with financial advisors, Americans recognize the value of their expertise, but a lingering gender gap shows advisors have work to do when it comes to gaining women’s trust.

of growth clearly aligns with the 48% of Americans who reported that they only have enough savings to support themselves for three months or less, with women being less likely to support themselves without income for longer periods of time. Thirty-one percent of women stated they only have enough savings to support themselves for less than one month, compared to 26% of men who can support themselves for longer than a year. To help consumers get back on an upwards trajectory in this financial climate, they need expert guidance on the market. Advisors should consider providing consumers with a weekly overview of current market trends and sharing their recommendations for navigating an unstable market. Having a consistent explanation of the ins and outs of the changes in the market will allow consumers to be ahead of the game and boost their financial standing.

1: Majority of Americans Trust Advisors 15% 69% Sixty-nine percent of of Americans have at least some trust in Americans reported they have financial advisors, with 27% of Americans reporting they have a lot of trust in advisors. at least some trust in financial of Americans said they have not that much or no trust services professionals, and 27% at all in financial advisors. Have some or a lot of said they have a lot of trust in trust in advisors With human advisors 93% them. While this financial climate With robo-advisors 95% continues to be a pain point for Without an advisor 55% 66% of women many consumers, they are willing 74% of men to put their faith in an advisor 3: Many Americans Need when it comes to receiving Investment Guidance financial guidance. While the majority of challenges and provide them with This indicates that current market consumers are aware of their need for services and solutions that are tailored to conditions are creating an opportunity health and income protection policies, their unique financial situations. for advisors to forge genuine connections they aren’t as confident in other financial with clients and prospects, creating investment products. Only 32% of 2: Americans Witnessing more long-term, mutually beneficial Americans consider corporate bonds Stagnant Financial Standings relationships. Advisors should invest to be worthwhile investments and only Only 24% of Americans say their time in having more in-depth discussions 44% consider annuities worthwhile — in financial situation improved since last with clients about how they are feeling comparison to 75% for life insurance and year, while 41% say they’re in the same currently and their real financial place as they were one year ago. This lack 80% for health insurance. 34 | CALIFORNIA BROKER


This is an opportunity for advisors to go beyond the more common investment opportunities and explain how other investments could contribute to a wellbalanced portfolio. Providing a proactive and simple explanation of potential investments will help ease anxiety during clients’ decision-making process both now and in years ahead. 4: Americans’ Financial Priorities for the Year are Divided Forty-three percent of Americans reported that their main financial focus for the year will be saving for future goals, with 55% of 18-39 yearolds prioritizing saving for the future, compared to 42% of 40-59-year-olds. On the other hand, 41% of consumers reported that their main financial focus will be spending on essential needs, such as gas, bills, groceries, childcare, etc., with 30% of 18-39-year-olds, compared to 52% of Americans 60 and older. Though the responses were varied, there was an overarching message: consumers are struggling and need advisors to help them build guardrails around their finances. The fluctuations in the economy have led many consumers to make hard decisions around their finances, creating an urgent need for advisors to work with clients on their budgets and overall financial plans. It can be overwhelming for consumers to try to account for all aspects of their finances and to know all of their options, so having an advisor’s support will help them be more confident about financial decisions now than ever before. Article provided by MDRT, the Premier Association of Financial Professionals®. For more information, visit and follow them on Twitter at @MDRtweet. Survey Link:

Publisher’s Note:

To find a financial subject matter professional to partner with, reach out to The Collaboration Center @ 657-229-2849 info@



THE ART OF SIGNIFICANCE Achieving The Level Beyond Success

In his book “The Art of Significance,” Dan Clark asked readers: “What would you rather have — conventional success or a high level beyond success?” Dan, one of the world’s leading inspirational speakers and leadership trainers, vehemently opposes the conventional wisdom about success. He believes it is tragic and superficial to build our careers and personal lives around getting more money, bigger houses, cooler toys and fancier job titles. For health insurance professionals — those who fight to retain their clients and win new ones — the difference between success and significance can define you in your client’s eyes and create higher retention and more referrals from clients. Dan asks all of us, “What’s it all worth in the end? How many outwardly successful people still feel empty inside?” His answer is to push people, to challenge our thinking, to do the work to move toward significance. It is hard to put in a review all the points Dan makes on significance. You will need to read the book to get all of them, but I will share some thoughts that relate to health insurance professionals. Dan’s Extraordinary History Some background on a truly remarkable person is needed here. Dan has spent decades traveling around the world, interviewing famous and powerful people; consulting with presidents and generals, sheikhs and corporate leaders. He’s created a multimillion-dollar business; and — before any of the above — overcame a paralyzing injury with years of rehab and numerous hurdles. From his youth and into early adulthood, Dan was an accomplished athlete. He also had intelligence to match his physical skills. At age 12, Dan starred in a weekly CBS television series and was the voice of a cartoon character. As 36 | CALIFORNIA BROKER

a teenager, he was a four sport, 9-Time Varsity Letterman and was voted Outstanding High School Athlete three years in a row. Then he became a Golden Gloves Boxing champion, Alpine Ski Racing champion, Intermountain Moto Cross champion, Sunkist All-American Football Player and All-Star Baseball Pitcher, earning a full athletic scholarship to play both sports at the University of Utah. In 1982, Dan was named Outstanding Young Man of America and was sponsored into the National Speaker Association by world-renowned motivational speaker Zig Ziglar who personally mentored Dan for 25 years in the art and science of speaking, writing and storytelling! Dan Clark is a success by anyone’s definition, but he strives to be significant. His book provides a guide for all to use to move to Significance.

Dan quickly became one of the most sought-after speakers in North America and was honored by U.S. President Ronald Reagan with the Presidential Service Award as the primary speaker for Mrs. Nancy Reagan’s ‘Just Say No’ program. Dan has earned the highest ‘Certified Speaking Professional’ designation in the National Speakers Association; was inducted into the Professional Speakers Hall of Fame and has been named one of the Top Ten Motivational Speakers in the World. Having raised four extraordinary, talented, significant children, Dan was named 2012 Utah Father of the Year! Dan teaches “self is not discovered – self is created – and the only person you need to be better than is the person you were yesterday! This intention leads to significance.

Dan is an alumnus of the University of Utah (psychology); a university professor; podcast host; New York Times bestselling author of 35 books and a primary contributing author to the Chicken Soup for the Soul series. One of Dan’s famous


stories ‘Puppies For Sale’ was made into a film at Paramount Studios, starring Jack Lemmon. As a master storyteller Dan has been published in over 50 million books in 40 languages worldwide; has appeared on over 500 TV and radio programs including Oprah, Glenn Beck, NPR and Voices of America/Radio Free Europe. Dan’s key lessons focus on what matters most — how we can make an impact that lasts the longest. Dan outlines the laws of success to significance. He pushes one to think more deeply about what they want to leave behind — how they will be remembered. The KEY point Dan strives to implant is “Do what you can to leave this life with lives touched and experiences shared with others and avoid trying to do things to make more money and chase more fame.”

“We all know that a baby must crawl before he walks, and a math student must become proficient in addition and subtraction before she can use algebra and calculus,” he says. “The same holds true in leadership development and the pursuit of self-mastery.” This book can be compared and contrasted to the popular principles of success and how they prepare us to live the advanced laws of significance. Dan proposes the following: Successful people think wealth flows to them, but significant individuals know wealth flows through them.

Successful people say patience is a virtual while significant individuals realize any virtue taken to the extreme could become a vice. Perseverance is the highest law of endurance for significant people. A successful person believes it is all about the team.

“We are trying to force a work-life balance upon employees in order for them to be successful in work,” Dan observes. “The significant are exercising passion, creativity, and imagination so that they may experience harmony in their lives.” Dan wants readers to discover a whole new world, a higher way of thinking, leading, loving, and living. He encourages those with passion to accept a journey that will help them achieve the level beyond success, the level that leads to lifelong significance.

another sale — while focusing on what is best for the person is significance. The decision to be significant will lead to greater trust and respect. What do you think the person would say should you then ask if there is anyone who would need the type of help you provide? Or what would they say if you asked another question centered on other products you might offer them such as dental, vision, life, long term care or annuities? Would they accept your offer to review some of their other issues? (Of course at another time — thank you, CMS.) In the case where you do what is best for your prospect, you know the path moves from success to significance as you look for issues where you can show your concern and as their trusted advisor, assist with. When you do this style of work, according to Dan, you will become a health insurance professional who strives for significance. REVIEWS “Dan Clark’s “The Art of Significance” is a magnificent read! His Twelve Laws urge us to chart a course beyond the fleeting success found in money, popularity and fame to enjoy the enduring rewards found in service, obedience, harmony and love. Leaving a legacy is our true gift to the world.” ~ STEPHEN M. R. COVEY, author of The Speed of Trust “Dan Clark shows how success is but a stepping-stone to the real prize — making a difference that benefits others. Mr. Clark’s work affirms my belief that ‘the best exercise for the human heart is reaching down and lifting another up.” ~ JON M. HUNTSMAN, Sr., founder and executive chairman “I recommend The Art of Significance as a must-read to all officers, enlisted, and civilian personnel enrolled in our professional military educa¬tion courses. In this extraordinary read Clark articulates the highest laws of life-changing leadership while illustrating the practical application of our core values: integrity first, service before self, and excellence in all we do.” ~ LIEUTENANT GENERAL AL PECK (USAF, retired), former commander of Air University, leadership center of the U.S. Air Force

He offers commonsense tools for character building and focusing on the greater purpose. Dan’s supporters agree that his work affirms the belief that ‘the best exercise for the human heart is reaching down and lifting another up.’ Applying Dan’s Significance versus Success concepts, I see his teaching clarifying the difference between a health insurance professional, or about any salesperson, who is all about the sale, the enrollment, getting the application and then moving on to find the next prospect. An example of significance is the broker who listens carefully, applies a blend of expertise and compassion to provide solutions for clients even when the solution does not result in a sale but does result in the best solution for the person seeking your expertise. Think about the person on Medicare who has a solid plan. If you let them know they are in the right plan, this leads to enhancing your significance according to Dan. Significance is when, as a trusted advisor, you reinforce that your client has a great plan and should stay on that plan. Success on its own is


Success is but a stepping-stone to the real prize —making a difference that benefits others.

Dan was keynote speaker at the August 2002 IEAHU, OCAHU & SDAHU Medicare Senior Summit in Temecula, Calif. Contact:

Reviewed by Phil Calhoun owner and publisher of California Broker Magazine. He is an active member of several insurance associations including the California Association of Health Insurance Professionals (CAHIP) and local chapters in Orange County, Los Angeles, San Diego and Inland Empire Health Insurance Professionals. Phil’s book,“The Health Broker’s Guide: To Protect Grow and Sell Commissions” is available free. or 714-664-0311



Members Give

HUMANA Thumbs Up

Positive member experience drives industry-leading Group Medicare Net Promotor scores

What is a Net Promoter Score® (NPS)? NPS helps organizations put human experience first More than two decades ago, Net Promoter Score® (NPS) was created by Bain & Company to measure the way people feel about the organizations they interact with. While the NPS methodology has expanded and improved over the years, it still starts with one simple question: “How likely are you to recommend this company to a friend or colleague?” The answers to this question and the resulting NPS have led countless organizations to transform their focus on their audiences’ experience. Because NPS shows how much people would recommend their experience, it represents their true perception of an organization, whether they’ve had a recent interaction or not. Insights about experience set NPS apart from other customer satisfaction metrics, which measure recent interactions. Because NPS measures real human experiences, it’s a primary metric used to understand the drivers of loyalty, advocacy and satisfaction at many organizations. NPS is equally useful for measuring the experiences of customers and employees alike. How NPS works In an NPS survey, all responders are filtered into one of three groups: detractors, passives and promoters. NPS is calculated by taking the total percentage of promoter scores and 38 | CALIFORNIA BROKER

subtracting them from the total percentage of detractor scores. While NPS can range from -100 to +100, Bain & Company notes that any score above 0 is good, above 20 is favorable and above 50 is excellent. Many industry-leading organizations have high NPS scores due to their dedicated focus on customer experience. As of 2021, Starbucks had an NPS score of 77, the United Services Automobile Association had an NPS score of 75 and Apple had an NPS score of 47. Humana achieved industry-leading NPS of +78 for 2023 for Group Medicare Advantage, which makes six years in a row in the 70s for Humana Group Medicare. Humana NPS driven by positive member experiences Today, people have many options for Group Medicare insurance and it’s easy to learn what different insurers provide before making a choice. While member experience has always been a differentiating factor among insurers, it is now considered more important than ever. In 2022, the Centers for Medicare and Medicaid Services doubled the weight of member experience, complaints and access within their Star Rating Progam, which positioned Humana Group Medicare to stand out for its commitment to outstanding care and support that contributes to the satisfaction and well-being of retirees.


This commitment comes to life through Humana Group Medicare Custom Connect, our member experience model for all retirees and plan sponsors. In this unique customer service model, Customer Care specialist act proactively to assist members while advocating for their needs. Customer Care specialists get to know each member’s unique situation in order to deliver ideal solutions, and it’s easy for members to connect with these Customer Care specialists anytime. No question is too complex or too trivial for Humana Group Medicare representatives. Their service-driven dedication to resolving every issue is rated very highly by members, who are always helped by a single Customer Care specialist who is trained in all areas and focuses on resolving issues on the first call, so members are never passed to different departments. Awards tell the story The results of Humana Group Medicare’s commitment to member experience can be seen in its industryleading NPS and customer service awards.

In 2023, Humana was ranked ~ #1 among health insurers for Customer Experience by Forrester ~ #1 in Mail Order Pharmacy customer satisfaction for four consecutive years by J.D. Power. Contact: 888-666-0710 (TTY: 711)

Humana members talk about their service experiences “A member expressed that she could not have anything more valuable than Humana insurance. She exclaimed that she and her husband really do appreciate Humana and especially our rep Deanna. She stated that Deanna was so wonderful going over the plan and policies with them and they appreciate her very much.” “I could never thank anybody any more than I can thank you for helping me.” “Not only have you answered all of my questions; you’ve really been a kind person and I appreciate it.” “A woman called Humana on behalf of her father, who is a member. He had just gotten out of rehab and she wanted to get information on personal home care. Calay at Humana gave her advice and promoted the 2022 personal home care benefit. She wanted to give Calay the highest commendation; Calay helped her incredibly with her father.”



Inland Empire Health Plan (IEHP) to join Covered California health care exchange Inland Empire residents looking for health insurance through Covered California will see a trusted name on the list — Inland Empire Health Plan (IEHP). The Rancho Cucamonga-based not-for-profit health organization will be among the list of options on the exchange for those seeking coverage in 2024. IEHP will offer four levels of coverage to consumers — including the lowest-cost silver plan option in Region 17 — when open enrollment begins Nov. 1 and continues through Jan. 31, 2024. To help spread this exciting news, the IEHP sales and outreach team will work with external broker and navigator partners across the state to introduce IEHP and its new IEHP Covered plans. With over 27 years of expertise and care in serving the residents of Riverside and San Bernardino counties, and currently serving more than 1.6 million members, IEHP hopes to bring quality health care services to residents of the IE. “Joining the Covered California exchange allows

us to expand our services to ensure that even more Inland Empire residents can enjoy optimal care and vibrant health at a more affordable price,” said Wayne Guzman, director of sales and outreach strategy for IEHP. “We are excited about our new partnership with Covered California and the dedicated certified agents and navigators who are vital to fulfilling our IEHP mission by serving our communities throughout the region.” Known as the plan with a heart, IEHP is one of the top 10 largest Medicaid health plans and the largest not-for-profit Medicare-Medicaid public health plan in the country. To learn more, go to iehp. org. IEHP’s sales and outreach team will be hosting webinars about IEHP’s transition into the Covered California market periodically throughout the rest of the year. If you are interested in attending or learning more about becoming an IEHP broker, send an email to or call 844-264-IEHP (4347).

Add Expert Social Security Advisory To Your Business

About IEHP With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans, the largest not-for-profit Medicare-Medicaid public health plan in the country, and for the third year in a row, certified as A Great Place To Work®. In its 27th year, IEHP supports more than 1.6 million Riverside and San Bernardino County residents enrolled in Medicaid or IEHP DualChoice (those with both MediCal and Medicare). Today, IEHP has a growing network of nearly 6,800 providers and more than 3,000 team members who are fully committed to the vision: We will not rest until our communities enjoy optimal care and vibrant health. To learn more, go to 40 | CALIFORNIA BROKER



IEHP enters Covered CA. Lowest cost Silver Plan in Region 17 | Extensive quality-focused provider network IEHP is entering Covered CA, offering the lowest cost Silver Plan in Region 17, Southern California’s rapidly growing Inland Empire – and we want to partner with you! A trusted name in Medi-Cal and Medicare coverage for 27 years, IEHP is known as “the Health Plan with a Heart” in San Bernardino and Riverside counties, where it serves nearly 1.7 million members. Join our growing network of Covered California broker partners today!

Email or call 844-264-IEHP (4347) ©2023 Inland Empire Health Plan. A Public Entity. All Rights Reserved. CCA-23-4363664





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Win More Clients: Learn How to be a Registered Social Security Analyst (RSSA)

Get the California Broker Discount NOW Available for the RSSA program


ocial Security represents a significant portion of most people’s future retirement income. Individuals who seek assistance in determining the optimal time for filing Social Security benefits are often the same individuals who need guidance in making Medicare plan decisions. The RSSA® program will transform Medicare insurance agents into the go-to Social Security experts. As a Registered Social Security Analyst®, Medicare agents will receive referrals from baby boomer’s friends and family, CPAs, and other centers of influence. Get trained to host Social Security optimization events, workshops and seminars using RSSA Roadmap® software, scripts, and PowerPoints. The RSSA® program is an all-in-one turn-key platform designed specifically for Medicare and Insurance agents and provides a comprehensive solution to help agents build a pipeline of sales opportunities through education, technology, marketing, and support. The RSSA® program fills that gap in the Social Security system and provides insurance agents with an educational and technology platform to identify current and future Medicare and insurance opportunities. Medicare agents with expertise in Social Security will also be able to offer an employer a valuable complimentary HR benefit for their employees — free Social Security advisory and optimization services, seminars, and webinars — which will fill seats with employees at Social Security events and ultimately result in new client relationships for the sale of Medicare, life insurance, annuities or other retirement planning products or services. 44 | CALIFORNIA BROKER

The RSSA® Mission is to provide financial professionals, advisors, and agents with the education and technology platform to acquire the Social Security knowledge to obtain the RSSA® credential that demonstrates their competency and provide professionals with the resources and software they need to better serve clients that seek advice on issues related to Social Security and Medicare. The RSSA® program is a turn-key Social Security education, technology, marketing, and support program to help build a sales funnel, fill seats at events, and open the door to organic Medicare, Insurance, and Wealth Management sales opportunities. What’s Included in the RSSA® Program for Medicare & Insurance Professionals? Agent Onboarding The RSSA® team will host onboarding agent webinars and/or attend live training events to explain the advantages of the RSSA® program and communicate the value proposition of providing Social Security advisory services to prospects and clients in detail. The National Exam and Credential includes a five-module self-study program. The RSSA Course is a five-module eLearning course and is the required prerequisite for agents that wish to earn the RSSA® credential as a Registered Social Security Analyst®. The eLearning course covers basic to advanced concepts of Social Security. The self-study course consists of five modules and is easy to navigate with the help of images and videos. It provides approximately 15 to 25 hours of learning, equipping agents with everything they need to become experts in Social Security. When ready, advisors must pass an independently proctored national exam given twice a month to earn their RSSA® credential. This proctored online exam is held on the 2nd and 4th Tuesday of each month. It consists of two parts, with multiple-choice questions and case studies. Agents can use the software to generate cases for their responses. Passing the exam grants use of the RSSA® credential, which demonstrates their foundation of education, understanding of Social Security issues, mastery of the software, and expertise in the field. The Agent Training Webinar is hosted by the RSSA® team monthly for those agents that are enrolled in the RSSA® program to ensure that they understand all Social Security concepts and strategies and understand how to use the RSSA Roadmap® software to successfully complete the eLearning. The Exam Prep Webinar will provide pre-exam bootcamp webinars for the agents that have completed Module five of the program and are scheduled to sit for the exam to ensure that they will pass the National RSSA® Competency exam. To receive the CalBroker discount, go to this webpage:


GET MORE LEADS California Broker has partnered with Registered Social Security Analyst (RSSA) to bring a lead generating program to you

Social Security education works to attract new prospects Medicare is a competitive field; Social Security is a hot topic and education and more solutions is the NEW answer

With the Registered Social Security Analysts (RSSA) program certificate, Learn more about how you can meet more; Medicare prospects, more annuity prospects, more long-term care prospects, more life insurance prospects.

YOU Can Be the Expert on both Social Security and Medicare planning. Scan QR or visit our page link for more information

2 United Healthcare


Covered California forsmallbusiness 844-332-8384


AGA Applied General Agency 800-498-6880


Benefitmall 800-350-0500

Collaboration Center 657-229-2849

Regal Medical Group



CalCPA Health 866-954-7406


Petersen International Underwriters 800-345-8816




Commission Solutions 800-500-9799

Registered Social Security Analysts (RSSA)


Cahip (800) 322-5934


Inland Empire Health Plan (IEHP) 844-264-IEHP (4347)


Commission Solutions David Ethington 714-664-0605


Word & Brown (Northern CA) 800-255-9673 (Los Angeles) 800-560-5614 (Inland Empire) 877-225-0988 (Orange) 800-869-6989 (San Diego) 800-397-3381


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Discover how a Commission Protection Plan can help you protect your hard-earned income. This book has three significant values: PROTECT:The important message is to identify a Successor to may achieve

100% commission protection and avoid losing all your hard-earned commissions.

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SELL:The time it takes to sell a book of business can range from one to five years, and when a broker takes the time to prepare, the average increase in value is 20% to 33%.



Scan this QR code to register and/or become a sponsor

Level Funded health plans are catching on Don’t miss out on up to 17% potential savings for your California small business1 In 2019, only 7% of small businesses offered a level funded health plan. Today, more than a third of them do.2 Get in on UnitedHealthcare Level Funded and the advantages that come with it — like exemption from many ACA regulations and surplus refund potential,3 too.

Get the details at


Average savings for UnitedHealthcare Fully Insured groups 2–50 nationwide migrated to UnitedHealthcare Level Funded, Jan. 1, 2021 – Dec. 31, 2022. Savings are not guaranteed.


Kaiser Family Foundation Employer Health Benefits Surveys, 2019 and 2022. For the purposes of the surveys, a “small business” was defined as groups with 3–199 employees. 2019 survey available: 2022 survey available: Accessed: Feb. 17, 2023.


Please consult a tax and/or legal advisor to determine if, by receiving this refund, there are any restrictions or obligations. Surplus refund available only where allowed by law.

Administrative services provided by United HealthCare Services, Inc. or their affiliates, and UnitedHealthcare Service LLC in NY. Stop-loss insurance is underwritten by UnitedHealthcare Insurance Company or their affiliates, including UnitedHealthcare Life Insurance Company in NJ, and UnitedHealthcare Insurance Company of New York in NY. B2B EI232373327.0 7/23 © 2023 United HealthCare Services, Inc. All Rights Reserved. 23-2365811-K

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Inland Empire Health Plan (IEHP) to join Covered California health care exchange

pages 40-41


pages 36-37

Americans Need Financial Guidance – And Are Looking for Help

pages 34-35

The Art of Closing the Deal: for Independent Insurance Agents

pages 30-31

The History of Prescription Drugs and Health Insurance

pages 20-21

CMS Checklist for Enrollment of Medicare

page 32

Four Strategies to Become Irreplaceable

page 29

The State of LTCi Claims and the Power of Claims Advocacy

pages 26-28

Win More Clients: Learn How to be a Registered Social Security Analyst (RSSA)

page 44

Members Give HUMANA Thumbs Up

pages 38-39

A Guide for Health Insurance Brokers: Tips for Open Enrollment Season

pages 24-25

More Seniors Should Be Selling Their Life Insurance Policies

pages 22-23

Eyecare and Holistic Health is Top of Mind for Employees

pages 18-19

2022-2023 SHRM State of the Workplace Report

pages 16-17

Addressing the Growing Long-Term Care Crisis with LTC and Legal Insurance

pages 14-15
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